A novel homozygous UMOD mutation reveals gene dosage effects on uromodulin processing and urinary excretion.

A novel homozygous UMOD mutation reveals gene dosage effects on uromodulin processing and urinary excretion.
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DOI:
10.1093/ndt/gfx066
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发表时间:
2017-12-01
期刊:
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
影响因子:
--
通讯作者:
Sayer JA
Sayer JA
中科院分区:
其他
文献类型:
--
作者:
Edwards N;Olinger E;Adam J;Kelly M;Schiano G;Ramsbottom SA;Sandford R;Devuyst O;Sayer JA

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尿蛋白尿调蛋白UMOD杂合性突变是常染色体显性遗传性肾小管间质肾病(ADTKD)最常见的遗传原因。我们描述了一例来自血缘关系家族的患者携带一种新的纯合子UMOD突变(p.C120Y),该突变影响尿调蛋白的EGF样区III内保守的半胱氨酸残基。比较纯合子突变携带者和纯合子突变携带者,发现了一种基因剂量效应,纯合子先证者尿液中的尿调蛋白水平和异常尿调蛋白片段水平前所未有地低。尽管纯合子突变的生物学效应被放大,但先证者并没有表现出明显更严重的临床演变,也没有出现与尿路感染或肾结石相关的几乎不存在尿调蛋白的情况。
Heterozygous mutations in UMOD encoding the urinary protein uromodulin are the most common genetic cause of autosomal dominant tubulointerstitial kidney disease (ADTKD). We describe the exceptional case of a patient from a consanguineous family carrying a novel homozygous UMOD mutation (p.C120Y) affecting a conserved cysteine residue within the EGF-like domain III of uromodulin. Comparison of heterozygote and homozygote mutation carriers revealed a gene dosage effect with unprecedented low levels of uromodulin and aberrant uromodulin fragments in the urine of the homozygote proband. Despite an amplified biological effect of the homozygote mutation, the proband did not show a strikingly more severe clinical evolution nor was the near absence of urinary uromodulin associated with urinary tract infections or kidney stones.
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