A systematic approach to mapping recessive disease genes in individuals from outbred populations

The identification of recessive disease-causing genes by homozygosity mapping is often restricted by lack of suitable consanguineous families. To overcome these limitations, we apply homozygosity mapping to single affected individuals from outbred populations. In 72 individuals of 54 kindred ascertained worldwide with known homozygous mutations in 13 different recessive disease genes, we performed total genome homozygosity mapping using 250,000 SNP arrays. Likelihood ratio Z-scores (ZLR) were plotted across the genome to detect ZLR peaks that reflect segments of homozygosity by descent, which may harbor the mutated gene. In 93% of cases, the causative gene was positioned within a consistent ZLR peak of homozygosity. The number of peaks reflected the degree of inbreeding. We demonstrate that disease-causing homozygous mutations can be detected in single cases from outbred populations within a single ZLR peak of homozygosity as short as 2 Mb, containing an average of only 16 candidate genes. As many specialty clinics have access to cohorts of individuals from outbred populations, and as our approach will result in smaller genetic candidate regions, the new strategy of homozygosity mapping in single outbred individuals will strongly accelerate the discovery of novel recessive disease genes

Influence of the Ca2+-sensitive potassium channel hIK1 on human neutrophil granulocytes` movement on fibronectin

Die Migration neutrophiler Granulozyten aus dem Gefäßsystem in das umgebende Gewebe stellt einen zentralen Schritt bei der Entstehung von akuten Entzündungsherden dar. Es ist bislang vergleichsweise wenig über die Rolle von Ionenkanälen und Carriermolekülen wie dem Ca2+-empfindlichen K+-Kanal hIK1 oder den Na+/H+- und Cl-/HCO3 --Austauschern bei der Wanderung von Neutrophilen bekannt. Nach heutigem Wissen ist die Funktion dieser Transportmoleküle neben zytoskelettalen Umbauvorgängen aber unter anderem in metastasierenden Melanomzellen, Fibroblasten oder auch sogenannten MDCK-F-Zellen für die Migration wichtig. Große Übereinstimmungen bekannter Migrationsmechanismen zwischen diesen Zelltypen und Neutrophilen, wie auch erste Versuche an Granulozyten legen eine Kanalfunktion auch bei ihnen nahe. In meiner Arbeit untersuchte ich, inwieweit ein Einfluss Ca2+-empfindlicher K+-Kanäle auf die Migration von humanen neutrophilen Granulozyten bei einer Migration auf dem Matrixprotein Fibronektin nachweisbar ist. Dazu wurden humane neutrophile Granulozyten mit dem Chemotaxin fMLP stimuliert und auf verschieden starken Fibronektinbeschichtungen zur Migration gebracht. Die Neutrophilen wurden dabei mit erwärmter Ringerlösung überströmt, und ihre Migrationsgeschwindigkeit mittels Zeitraffer-Videomikroskopie und computergestützter Auswertung der Migrationstrajektorien bestimmt. Den Einfluss der hIK1-Kanäle auf die Migration beobachtete ich durch Kanalinhibition mittels Clotrimazol bzw. Kanalaktivierung mittels 1-EBIO. Es stellte sich heraus, dass die Migrationsgeschwindigkeit der neutrophilen Granulozyten stark von der Fibronektinbeschichtung abhing. Die Migrationsgeschwindigkeit hing biphasisch von der Fibronektinkonzentration ab und wies ein Maximum von 6 µm/min bei einer mittleren Beschichtungsstärke von 100 µg/ml Fibronektin auf. Unter diesen Bedingungen wanderten die Neutrophilen in einer amöboiden Weise. Bei Hemmung der Kaliumkanäle mit Clotrimazol oder Aktivierung mit 1-EBIO zeigten alle Zellen unabhängig von ihrer Morphologie und Geschwindigkeit keine Veränderung der Migrationsgeschwindigkeit. Dies war angesichts vergleichbarer Versuche auf Polylysinbeschichtungen überraschend, da diese eine dosisabhängige Verlangsamung der Neutrophilen nach Blockade der Kaliumkanäle mit Clotrimazol und Charybdotoxin ergebenhatten. Nachdem ausgeschlossen wurde, dass Zellmorphologie oder –geschwindigkeit diesen Unterschied bedingten, spricht dies für einen matrixspezifischen „Crosstalk“ zwischen Adhäsionsmolekülen der Zelle und Untergrund. Die dabei aktivierten verschiedenartigen Signalkaskaden bzw. alternative in die Zellmembran eingebrachte Kaliumkanaltypen könnten zur Kompensation der hIK1-Blockade auf Fibronektin geführt haben. Vor dem Hintergrund der sich durch meine Arbeit abzeichnenden hohen Modulationsfähigkeit kanalvermittelter Migrationsschritte dürfte sich die Entwicklung neuer antimigratorisch-antiinflammatorisch wirkender Kaliumkanalhemmstoffe für Neutrophile deutlich schwieriger gestalten, als bislang vermutet.Migration of human neutrophil granulocytes on fibronektin in superfusion technique is hIK potassium channel. The influence of the channel on cellmigration was excluded in superfusion technique with channel specific stimulation (1-EBIO) or inhibition (clotrimazol). The study showed that the movement pattern of this cell type depends on the form of chemotactic stimulation an cell-matrix-interaction

Specific Podocin Mutations Correlate with Age of Onset in Steroid-Resistant Nephrotic Syndrome

Mutations in the gene encoding podocin (NPHS2) cause autosomal recessive steroid-resistant nephrotic syndrome (SRNS). For addressing the possibility of a genotype–phenotype correlation between podocin mutations and age of onset, a worldwide cohort of 430 patients from 404 different families with SRNS were screened by direct sequencing. Recessive podocin mutations were present in 18.1% (73 of 404) of families with SRNS, and 69.9% of these mutations were nonsense, frameshift, or homozygous R138Q. Patients with these mutations manifested symptoms at a significantly earlier age (mean onset <1.75 years) than any other patient group, with or without podocin mutations, in this study (mean onset >4.17 yr). All but one patient affected by truncating or homozygous R138Q mutations developed SRNS before 6 yr of age. Patient groups with other recessive podocin mutations, with single heterozygous podocin mutations, with sequence variants, and with no podocin changes could not be distinguished from each other on the basis of age of onset. In conclusion, nephrotic syndrome in children with truncating or homozygous R138Q mutations manifests predominantly before 6 yr of life, and the onset of disease is significantly earlier than for any other podocin mutations. Because the age of onset can vary by several years among those with identical mutations, additional factors may modify the phenotype

A novel TRPC6 mutation that causes childhood FSGS.

TRPC6, encoding a member of the transient receptor potential (TRP) superfamily of ion channels, is a calcium-permeable cation channel, which mediates capacitive calcium entry into the cell. Until today, seven different mutations in TRPC6 have been identified as a cause of autosomal-dominant focal segmental glomerulosclerosis (FSGS) in adults.Here we report a novel TRPC6 mutation that leads to early onset FSGS. We identified one family in whom disease segregated with a novel TRPC6 mutation (M132T), that also affected pediatric individuals as early as nine years of age. Twenty-one pedigrees compatible with an autosomal-dominant mode of inheritance and biopsy-proven FSGS were selected from a worldwide cohort of 550 families with steroid resistant nephrotic syndrome (SRNS). Whole cell current recordings of the mutant TRPC6 channel, compared to the wild-type channel, showed a 3 to 5-fold increase in the average out- and inward TRPC6 current amplitude. The mean inward calcium current of M132T was 10-fold larger than that of wild-type TRPC6. Interestingly, M132T mutants also lacked time-dependent inactivation. Generation of a novel double mutant M132T/N143S did not further augment TRPC6 channel activity.In summary, our data shows that TRPC6 mediated FSGS can also be found in children. The large increase in channel currents and impaired channel inactivation caused by the M132T mutant leads to an aggressive phenotype that underlines the importance of calcium dose channeled through TRPC6

Mutations In Plce1 Are A Major Cause Of Isolated Diffuse Mesangial Sclerosis (Idms)

Background and objectives. Diffuse mesangial sclerosis (DMS) is a histologically distinct variant of nephrotic syndrome (NS) that is characterized by early onset and by progression to end-stage kidney disease (ESKD). Besides syndromic DMS, isolated (non-syndromic) DMS (IDMS) has been described. The etiology and pathogenesis of DMS is not understood. We recently identified by positional cloning recessive mutations in the gene PLCE1/NPHS3 as a novel cause of IDMS. We demonstrated a role of PLCE1 in glomerulogenesis. Mutations in two other genes WT1 and LAMB2 may also cause IDMS. We therefore determine in this study the relative frequency of mutations in PLCE1, WT1 or LAMB2 as the cause of IDMS in a worldwide cohort. Methods. We identified 40 children from 35 families with IDMS from a worldwide cohort of 1368 children with NS. All the subjects were analyzed for mutations in all exons of PLCE1 by multiplex capillary heteroduplex analysis and direct sequencing, by direct sequencing of exons 8 and 9 of WT1, and all the exons of LAMB2. Results. The median ( range) age at onset of NS was 11 (1-72) months. We detected truncating mutations in PLCE1 in 10/35 (28.6%) families and WT1 mutations in 3/35 (8.5%) families. We found no mutations in LAMB2. Conclusions. PLCE1 mutation is the most common cause of IDMS in this cohort. We previously reported that one child with truncating mutation in PLCE1 responded to cyclosporine therapy. If this observation is confirmed in a larger study, mutations in PLCE1 may serve as a biomarker for selecting patients with IDMS who may benefit from treatment.WoSScopu

A complex microdeletion 17q12 phenotype in a patient with recurrent <it>de novo</it> membranous nephropathy

<p>Abstract</p> <p>Background</p> <p>Microdeletions on chromosome 17q12 cause of diverse spectrum of disorders and have only recently been identified as a rare cause of Mayer-Rokitansky-Kuester-Hauser-Syndrome (MRKH), which is characterized by uterus aplasia ± partial/complete vaginal aplasia in females with a regular karyotype. For the first time we report about a patient with a 17q12 microdeletion who is affected by MRKH in combination with a vascular and soft tissue disorder. Repeatedly she suffered from kidney transplant failure caused by consuming membranous nephropathy.</p> <p>Case presentation</p> <p>A 38-year-old female patient had been diagnosed with right kidney aplasia, left kidney dysplasia and significantly impaired renal function during infancy. Aged 16 she had to start hemodialysis. Three years later she received her first kidney transplant. Only then she was diagnosed with MRKH. The kidney transplant was lost due to consuming nephrotic syndrome caused by <it>de novo</it> membranous nephropathy, as was a second kidney transplant years later<it>.</it> In addition, a hyperelasticity syndrome affects the patient with congenital joint laxity, kyphoscoliosis, bilateral hip dysplasia, persistent hypermobility of both elbows, knees and hips. Her clinical picture resembles a combination of traits of a hypermobile and a vascular form of Ehlers-Danlos-Syndrome, but no mutations in the <it>COL3A1</it> gene was underlying. Instead, array-based comparative genomic hybridisation (CGH) detected a heterozygous 1.43 Mb deletion on chromosome 17q12 encompassing the two renal developmental genes <it>HNF1</it>β and <it>LHX1.</it></p> <p>Conclusions</p> <p>Deletions of <it>HNF1</it>β have recently drawn significant attention in pediatric nephrology as an important cause of prenatally hyperechogenic kidneys, renal aplasia and renal hypodysplasia. In contrast, membranous nephropathy represents an often-unaccounted cause of nephrotic syndrome in the adult population. A causative connection between theses two conditions has never been postulated, but is suggestive enough in this case to hypothesize it.</p