Yu Lei, Wu Meng, Hou Ping, Zhang Hong
Renal Division, Inner Mongolia People's Hospital, Hohhot, Inner Mongolia, 010017, People's Republic of China.
Department of Nephrology, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, Fujian, 364000, People's Republic of China.
BMC Nephrol. 2020 Feb 28;21(1):69. doi: 10.1186/s12882-020-01725-9.
Familial renal glucosuria (FRG) is characterized by persistent glucosuria without other impairments of tubular function in the presence of normal serum glucose. SGLT2, which is almost exclusively expressed in the kidney, accounts for most of the glucose reabsorption. Recently, some studies have confirmed that SLC5A2 mutations are responsible for the pathogenesis of familial renal glucosuria, but FRG cases are still rare. Furthermore, there are a few reports about splice-site mutations in previous studies, but the effect of these variants at the mRNA level has hardly been verified.
Ten patients were recruited in our renal division because of persistent glucosuria, and clinical data of the patients and their family members were recorded as much as possible. The entire coding region and adjacent intronic segments of SLC5A2 were sequenced in FRG patients and their relatives. Permanent growing lymphoblastoid cell lines from FRG patients were established to better preserve genetic information.
A total of nine different mutations were identified: IVS1-16C > A, c.305C > T/p.(A102V), c.395G > A/p.(R132H), c.736C > T/p.(P246S), c.886(-10_-31)delGCAAGCGGGCAGCTGAACGCCC, c.1152_1163delGGTCATGCTGGC/p.(Val385_Ala388del), c.1222G > T/p.(D408Y), c.1496G > A/p.(R499H) and c.1540C > T/p.(P514S); two novel mutations in SLC5A2, c.1222G > T/p.(D408Y) and c.1496G > A/p.(R499H), were identified in the Chinese FRG pedigrees. Ten individuals with heterozygous or compound heterozygous variants had glucosuria in the range of 3.1 to 37.6 g/d.
We screened ten additional Chinese FRG pedigrees for mutations in the SLC5A2 gene and found nine mutations, including two novel mutations. Most variants were private, but IVS1-16C > A and c.886(-10_-31) del may be high frequency splice-site mutations that could be preferentially screened when variants cannot be found in the SLC5A2 exon. Furthermore, we successfully established a permanent growing lymphoblastoid cell line from patients with FRG, which could facilitate further studies of the SLC5A2 gene. The current study provides a valuable clue for further research on the molecular mechanism of SGLT2.
家族性肾性糖尿(FRG)的特征是在血清葡萄糖正常的情况下持续出现糖尿,而肾小管功能无其他损害。几乎仅在肾脏中表达的SGLT2负责大部分葡萄糖重吸收。最近,一些研究证实SLC5A2突变是家族性肾性糖尿发病机制的原因,但FRG病例仍然很少见。此外,先前的研究中有一些关于剪接位点突变的报道,但这些变异在mRNA水平上的作用几乎未得到验证。
我们肾科招募了10例因持续性糖尿就诊的患者,并尽可能记录患者及其家庭成员的临床资料。对FRG患者及其亲属的SLC5A2整个编码区和相邻内含子片段进行测序。建立了来自FRG患者的永久性生长淋巴细胞系,以更好地保存遗传信息。
共鉴定出9种不同的突变:IVS1-16C>A、c.305C>T/p.(A102V)、c.395G>A/p.(R132H)、c.736C>T/p.(P246S)、c.886(-10_-31)delGCAAGCGGGCAGCTGAACGCCC、c.1152_1163delGGTCATGCTGGC/p.(Val385_Ala388del)、c.1222G>T/p.(D408Y)、c.1496G>A/p.(R499H)和c.1540C>T/p.(P514S);在中国FRG家系中鉴定出SLC5A2的两个新突变,即c.1222G>T/p.(D408Y)和c.1496G>A/p.(R499H)。10名携带杂合或复合杂合变异的个体的尿糖范围为3.1至37.6g/d。
我们对另外10个中国FRG家系进行了SLC5A2基因突变筛查,发现了9种突变,包括2种新突变。大多数变异是个体特有的,但IVS1-16C>A和c.886(-10_-31)del可能是高频剪接位点突变,当在SLC5A2外显子中未发现变异时可优先进行筛查。此外,我们成功地从FRG患者中建立了永久性生长淋巴细胞系,这有助于对SLC5A2基因进行进一步研究。本研究为进一步研究SGLT2的分子机制提供了有价值的线索。