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Sorani MD, Manley GT, Giacomini KM. Genetic variation in human aquaporins and effects on phenotypes of water homeostasis. Hum Mutat 2008; 29:1108-17. [DOI: 10.1002/humu.20762] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Knops NBB, Bos KK, Kerstjens M, van Dael K, Vos YJ. Nephrogenic diabetes insipidus in a patient with L1 syndrome: a new report of a contiguous gene deletion syndrome including L1CAM and AVPR2. Am J Med Genet A 2008; 146A:1853-8. [PMID: 18553546 DOI: 10.1002/ajmg.a.32386] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We report on an infant boy with congenital hydrocephalus due to L1 syndrome and polyuria due to diabetes insipidus. We initially believed his excessive urine loss was from central diabetes insipidus and that the cerebral malformation caused a secondary insufficient pituitary vasopressin release. However, he failed to respond to treatment with a vasopressin analogue, which pointed to nephrogenic diabetes insipidus (NDI). L1 syndrome and X-linked NDI are distinct clinical disorders caused by mutations in the L1CAM and AVPR2 genes, respectively, located in adjacent positions in Xq28. In this boy we found a deletion of 61,577 basepairs encompassing the entire L1CAM and AVPR2 genes and extending into intron 7 of the ARHGAP4 gene. To our knowledge this is the first description of a patient with a deletion of these three genes. He is the second patient to be described with L1 syndrome and NDI. During follow-up he manifested complications from the hydrocephalus and NDI including global developmental delay and growth failure with low IGF-1 and hypothyroidism.
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Affiliation(s)
- Noël B B Knops
- Department of Pediatric Nephrology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
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Sahakitrungruang T, Wacharasindhu S, Sinthuwiwat T, Supornsilchai V, Suphapeetiporn K, Shotelersuk V. Identification of two novel aquaporin-2 mutations in a Thai girl with congenital nephrogenic diabetes insipidus. Endocrine 2008; 33:210-4. [PMID: 18473191 DOI: 10.1007/s12020-008-9074-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2008] [Revised: 04/30/2008] [Accepted: 05/01/2008] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To describe a Thai girl with congenital nephrogenic diabetes insipidus (NDI) and perform mutation analysis of the AQP2 gene. DESIGN Case report. PATIENT A 6-year old girl with a history of failure to thrive, polydipsia and polyuria was studied. Polyuria and polydipsia were observed within the first few months of life. Despite normal serum osmolality and electrolyte, the result of water deprivation test was compatible with a diagnosis of NDI. METHODS The entire coding regions of the AQP2 gene were assessed by polymerase chain reaction and sequencing analysis. The presence of mutations was also confirmed by restriction enzyme digestion analysis. RESULTS Two heterozygous novel missense mutations were identified. Both were located in exon 1; a guanine-to-thymine substitution at nucleotide position 3 (c.3G-->T) inherited from her mother and a guanine-to-adenine at position 85 (c.85G-->A) inherited from her father, resulting in a methionine to isoleucine at codon 1 (p.M1I) and glycine to serine at codon 29 (p.G29S), respectively. These mutations have never been previously described and were not detected in 100 ethnic-matched unaffected control chromosomes. CONCLUSION We report two novel mutations of the AQP2 gene, p.M1I and p.G29S, associated with autosomal recessive congenital NDI. This study expands the genotypic spectrum of AQP2 mutations and emphasizes an important role of genetic testing for definite diagnosis and genetic counseling.
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Affiliation(s)
- Taninee Sahakitrungruang
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
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Boson WL, Della Manna T, Damiani D, Miranda DM, Gadelha MR, Liberman B, Correa H, Romano-Silva MA, Friedman E, Silva FF, Ribeiro PA, De Marco L. Novel vasopressin type 2 (AVPR2) gene mutations in Brazilian nephrogenic diabetes insipidus patients. ACTA ACUST UNITED AC 2007; 10:157-62. [PMID: 17020465 DOI: 10.1089/gte.2006.10.157] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Nephrogenic diabetes insipidus (NDI) is an inherited disorder characterized by renal resistance to the antidiuretic effect of arginine vasopressin (AVP), resulting in polyuria, polydipsia, and hypoosmolar urine. In the vast majority of cases, NDI is associated with germ-line mutations in the vasopressin receptor type 2 gene (AVPR2) and in about 8% of the cases with the water channel aquaporin-2 gene (AQP-2) mutations. To date, approximately 277 families with 185 germ-line mutations in the AVPR2 gene have been described worldwide. In the present study, the AVPR2 gene was genotyped in eight unrelated Brazilian kindred with NDI. In five of these NDI families, novel mutations were noted (S54R, I130L, S187R, 219delT, and R230P), whereas three seemingly unrelated probands were found to harbor previously described AVPR2 gene mutations (R106C, R137H, R337X). Additionally a novel polymorphism (V281V) was detected. In conclusion, although NDI is a rare disease, the findings of mutations scattered over the entire coding region of the AVPR2 gene are a valuable model to determine structure function relationship in G-protein-coupled receptor related diseases. Furthermore, our data indicate that in Brazil the spectrum of AVPR2 gene mutations is "family specific".
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Affiliation(s)
- W L Boson
- Department of Pharmacology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Sasaki G, Ishii T, Amano N, Hachiya R, Narumi S, Hasegawa T. Growth Failure in an Infant with Congenital Nephrogenic Diabetes Insipidus During Sodium Restriction. Clin Pediatr Endocrinol 2007; 16:95-8. [PMID: 24790353 PMCID: PMC4004888 DOI: 10.1297/cpe.16.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2007] [Accepted: 09/21/2007] [Indexed: 11/13/2022] Open
Abstract
Congenital nephrogenic diabetes insipidus (CNDI) is an inherited disorder characterized
by renal tubular insensitivity to antidiuretic hormone, resulting in an inability to
concentrate urine. We report on an infant boy with CNDI who showed growth failure during
treatment with sodium restriction. At the age of 4 mo, he was diagnosed as having CNDI,
judging from fever with hypernatremia (serum Na 153 mEq/L), diluted urine (urine
osmolarity 193 mOsm/kg), high antidiuretic hormone (plasma antidiuretic hormone 53 pg/mL),
and normal renal function (serum creatinine 0.3 mg/dL). His length and weight were mean
+0.4 and –1.1 SD, respectively, at that time. He was treated with sodium restriction
(sodium intake; 0.53 mEq/kg/day) using low sodium formula in addition to
trichlormethiazide, spironolactone, and mefenamic acid. Growth failure developed: his
length and weight were mean –2.4 and –3.3 SD, respectively, at the age of 10 mo. After
withdrawal of sodium restriction to 1.5 mEq/kg/day of sodium intake without any change of
caloric intake and medication, catch-up growth was observed. At the age of 39 mo, the
patient’s height and weight were mean –0.8 and –0.6 SD, respectively. We conclude that
excessive sodium restriction can cause growth failure in infants with CNDI.
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Affiliation(s)
- Goro Sasaki
- Department of Pediatrics, Keio University School of Medicine
| | - Tomohiro Ishii
- Department of Pediatrics, Keio University School of Medicine
| | - Naoko Amano
- Department of Pediatrics, Keio University School of Medicine
| | - Rumi Hachiya
- Department of Pediatrics, Keio University School of Medicine
| | - Satoshi Narumi
- Department of Pediatrics, Keio University School of Medicine
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Hora M, Reischig T, Hes O, Ferda J, Klecka J. Urological complications of congenital nephrogenic diabetes insipidus--long-term follow-up of one patient. Int Urol Nephrol 2006; 38:531-2. [PMID: 17111080 DOI: 10.1007/s11255-006-0093-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2006] [Accepted: 03/08/2006] [Indexed: 11/24/2022]
Abstract
A male with a severe form of congenital nephrogenic diabetes insipidus (diuresis 10 l per day) had megaureters, megavesica, large residuum and a history of three traumatic ruptures of the megavesica and a recurrent urinary tract infection (RUTI). Hemodialysis was introduced at 41 years of age. At age of 42, he underwent a bilateral retroperitoneoscopic nephrectomy to prevent further RUTI and 8 months later transplantation of a cadaver kidney. Intermittent catheterization is necessary due to residual urine in the urinary bladder.
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Affiliation(s)
- M Hora
- Department of Urology, Charles University Hospital, E. Benese 13, 305 99, Plzen, Czech Republic.
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Schulz A, Römpler H, Mitschke D, Thor D, Schliebe N, Hermsdorf T, Strotmann R, Sangkuhl K, Schöneberg T. Molecular basis and clinical features of nephrogenic diabetes insipidus. Expert Rev Endocrinol Metab 2006; 1:727-741. [PMID: 30754158 DOI: 10.1586/17446651.1.6.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Maintenance of water and electrolyte homeostasis is central to mammalian survival and, therefore, under stringent hormonal control. Water homeostasis is achieved by balancing fluid intake with water excretion, governed by the antidiuretic action of arginine vasopressin. Arginine vasopressin stimulation of renal V2 vasopressin receptors in the basolateral membrane of principal cells induces aquaporin-2-mediated water reabsorption in the kidney. The importance of this system is apparent when mutations inactivate V2 vasopressin receptors and aquaporin-2 and cause the clinical phenotype of nephrogenic diabetes insipidus. To date, over 190 mutations in the V2 vasopressin receptors gene (AVPR2) and approximately 38 mutations in the aquaporin-2 gene have been identified in patients with inherited nephrogenic diabetes insipidus. Extensive in vitro expression and mutagenesis studies of V2 vasopressin receptors and aquaporin-2 have provided detailed insights into the molecular mechanisms of G-protein-coupled receptor and water channel dysfunction per se. Targeted deletions of AVPR2 and AQP2 in mice have extended the knowledge of nephrogenic diabetes insipidus pathophysiology and have stimulated testing of old and new ideas to therapeutically restore normal kidney function in animal models and patients with this disease. In this review, we summarize the current knowledge relevant to understand the molecular basis of inherited nephrogenic diabetes insipidus forms and the rationales for the current pharmacological treatment of patients with this illness.
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Affiliation(s)
- Angela Schulz
- a University of Leipzig, Institute of Biochemistry, Molecular Biochemistry, Medical Faculty, Johannisallee 30, 04103, Leipzig, Germany.
| | - Holger Römpler
- b University of Leipzig, Institute of Biochemistry, Molecular Biochemistry, Medical Faculty, Johannisallee 30, 04103, Leipzig, Germany.
| | - Doreen Mitschke
- c University of Leipzig, Institute of Biochemistry, Molecular Biochemistry, Medical Faculty, Johannisallee 30, 04103, Leipzig, Germany.
| | - Doreen Thor
- d University of Leipzig, Institute of Biochemistry, Molecular Biochemistry, Medical Faculty, Johannisallee 30, 04103, Leipzig, Germany.
| | - Nicole Schliebe
- e University of Leipzig, Institute of Biochemistry, Molecular Biochemistry, Medical Faculty, Johannisallee 30, 04103, Leipzig, Germany.
| | - Thomas Hermsdorf
- f University of Leipzig, Institute of Biochemistry, Molecular Biochemistry, Medical Faculty, Johannisallee 30, 04103, Leipzig, Germany.
| | - Rainer Strotmann
- g University of Leipzig, Institute of Biochemistry, Molecular Biochemistry, Medical Faculty, Johannisallee 30, 04103, Leipzig, Germany.
| | - Katrin Sangkuhl
- h Division of Reproductive Biology, Department of Obstetrics and Gynecology, Stanford University Medical Center, California, USA.
| | - Torsten Schöneberg
- i University of Leipzig, Molecular Biochemistry, Medical Faculty, Johannisallee 30, 04103 Leipzig, Germany.
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Robben JH, Knoers NVAM, Deen PMT. Cell biological aspects of the vasopressin type-2 receptor and aquaporin 2 water channel in nephrogenic diabetes insipidus. Am J Physiol Renal Physiol 2006; 291:F257-70. [PMID: 16825342 DOI: 10.1152/ajprenal.00491.2005] [Citation(s) in RCA: 146] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
In the renal collecting duct, water reabsorption is regulated by the antidiuretic hormone vasopressin (AVP). Binding of this hormone to the vasopressin V2 receptor (V2R) leads to insertion of aquaporin-2 (AQP2) water channels in the apical membrane, thereby allowing water reabsorption from the pro-urine to the interstitium. The disorder nephrogenic diabetes insipidus (NDI) is characterized by the kidney's inability to concentrate pro-urine in response to AVP, which is mostly acquired due to electrolyte disturbances or lithium therapy. Alternatively, NDI is inherited in an X-linked or autosomal fashion due to mutations in the genes encoding V2R or AQP2, respectively. This review describes the current knowledge of the cell biological causes of NDI and how these defects may explain the patients' phenotypes. Also, the increased understanding of these cellular defects in NDI has opened exciting initiatives in the development of novel therapies for NDI, which are extensively discussed in this review.
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MESH Headings
- Amino Acid Sequence
- Aquaporin 2/genetics
- Aquaporin 2/physiology
- DNA/genetics
- Diabetes Insipidus, Nephrogenic/etiology
- Diabetes Insipidus, Nephrogenic/genetics
- Diabetes Insipidus, Nephrogenic/physiopathology
- Diabetes Insipidus, Nephrogenic/therapy
- Gene Expression Regulation/physiology
- Genetic Diseases, X-Linked/etiology
- Genetic Diseases, X-Linked/genetics
- Genetic Diseases, X-Linked/physiopathology
- Genetic Diseases, X-Linked/therapy
- Humans
- Molecular Sequence Data
- Mutation/genetics
- Mutation/physiology
- Receptors, Vasopressin/genetics
- Receptors, Vasopressin/physiology
- Vasopressins/physiology
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Affiliation(s)
- Joris H Robben
- Department of Physiology, Nijmegen Centre for Molecular Life Sciences and Human Genetics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Nishimura N, Yonemoto J, Nishimura H, Tohyama C. Localization of cytochrome P450 1A1 in a specific region of hydronephrotic kidney of rat neonates lactationally exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin. Toxicology 2006; 227:117-26. [PMID: 16959395 DOI: 10.1016/j.tox.2006.07.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2006] [Revised: 07/24/2006] [Accepted: 07/25/2006] [Indexed: 10/24/2022]
Abstract
Hydronephrosis is typically observed in terata caused by in utero and lactational exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), via the arylhydrocarbon receptor, but the molecular mechanism underlying its pathogenesis is largely unknown. In the present study, pregnant Holtzman rats were treated once by gavage with TCDD (1.0 microg/kg bw) or corn oil on gestation day 15. All dams were allowed to litter, and standardized litters in terms of litter size were then reciprocally cross-fostered on postnatal day (PND) 1. On PND1, pups were divided into four experimental groups: pups exposed only in utero, pups exposed only lactationally, pups not exposed via either route (vehicle control), and pups exposed via both routes. Pups were euthanized on PND21 for further analyses. The TCDD dose used was not overtly toxic to the dams or neonates. The incidence and severity of hydronephrosis were markedly high in pups exposed to TCDD lactationally, but not those exposed in utero. On PND21, cytochrome P450 (CYP) 1A1 was detected predominantly in the outer zone of the medulla of the kidney from all the pups lactationally exposed to TCDD, regardless of the occurrence of hydronephrosis. Interestingly, TCDD concentrations in the cortex, the outer zone of the medulla and the inner zone of the medulla were similar. When adult Holtzman rats were administered TCDD, the induction of CYP1A1 was immunohistochemically detected in the liver but not in the kidney 7 days postadministration. The present findings suggest that TCDD-inducible genes via an AhR-dependent mechanism may be associated with the etiology of hydronephrosis in a particular region of the kidney.
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Affiliation(s)
- Noriko Nishimura
- Endocrine Disruptors and Dioxin Research Project, National Institute for Environmental Studies, Tsukuba 305-8506, Japan
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60
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Yoo TH, Ryu DR, Song YS, Lee SC, Kim HJ, Kim JS, Choi HY, Kang SW. Congenital nephrogenic diabetes insipidus presented with bilateral hydronephrosis: genetic analysis of V2R gene mutations. Yonsei Med J 2006; 47:126-30. [PMID: 16502494 PMCID: PMC2687569 DOI: 10.3349/ymj.2006.47.1.126] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Most cases of hydronephrosis are caused by urinary tract obstruction. However, excessive polyuric syndrome rarely gives rise to non-obstructive hydronephrosis, megaureter, and a distended bladder. The authors report here on two cases of congenital nephrogenic diabetes insipidus (NDI) with severe bilateral hydronephrosis and megaureter. It is Interesting that the patients were symptomless except for their polyuria, and they both presented with bilateral hydronephrosis. Fluid deprivation testing revealed the presence of AVP resistant NDI. Gene analysis for these patients showed the AVP receptor 2 (V2R) missense mutations (Q225X and S126F), which have previously been reported on in other studies. We made the diagnosis of NDI by using a physiologic test, and we confirmed it by mutation analysis of the V2R gene.
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Affiliation(s)
- Tae-Hyun Yoo
- Department of Internal Medicine, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea
| | - Dong-Ryeol Ryu
- Department of Internal Medicine, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea
| | - Young Soo Song
- Department of Internal Medicine, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Chul Lee
- Department of Internal Medicine, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea
| | - Hyung Jong Kim
- Department of Internal Medicine, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea
| | - Joo Seong Kim
- Department of Internal Medicine, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea
| | - Hoon Young Choi
- Department of Internal Medicine, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea
| | - Shin-Wook Kang
- Department of Internal Medicine, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea
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61
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Affiliation(s)
- Jeff M Sands
- Renal Division, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
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Bernier V, Morello JP, Zarruk A, Debrand N, Salahpour A, Lonergan M, Arthus MF, Laperrière A, Brouard R, Bouvier M, Bichet DG. Pharmacologic chaperones as a potential treatment for X-linked nephrogenic diabetes insipidus. J Am Soc Nephrol 2005; 17:232-43. [PMID: 16319185 DOI: 10.1681/asn.2005080854] [Citation(s) in RCA: 188] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
In many mendelian diseases, some mutations result in the synthesis of misfolded proteins that cannot reach a transport-competent conformation. In X-linked nephrogenic diabetes insipidus, most of the mutant vasopressin 2 (V2) receptors are trapped in the endoplasmic reticulum and degraded. They are unable to reach the plasma membrane and promote water reabsorption through the principal cells of the collecting ducts. Herein is reported two types of experiments: In vivo studies to assess clinically a short-term treatment with a nonpeptide V1a receptor antagonist (SR49059) and in vitro studies in cultured cell systems. In patients, SR49059 decreased 24- h urine volume (11.9 +/- 2.3 to 8.2 +/- 2.0 L; P = 0.005) and water intake (10.7 +/- 1.9 to 7.2 +/- 1.6 L; P < 0.05). Maximum increase in urine osmolality was observed on day 3 (98 +/- 22 to 170 +/- 52 mOsm/kg; P = 0.05). Sodium, potassium, and creatinine excretions and plasma sodium were constant throughout the study. In vitro studies indicate that the nonpeptide V1a receptor antagonist SR49059 and the V1a/V2 receptor antagonist YM087 (Conivaptan) rescued cell surface expression and function of mutant V2 receptors. Mutant V2 receptors with nonsense mutations were not affected by the treatment. Misfolded V2 receptor mutants were rescued in vitro and also in vivo by nonpeptide antagonists. This therapeutic approach could be applied to the treatment of several hereditary diseases that result from errors in protein folding and kinesis.
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Affiliation(s)
- Virginie Bernier
- Department of Biochemistry, Groupe de recherche universitaire sur le médicament, Hôpital du Sacré-Coeur de Montréal, 5400 boulevard Gouin Ouest, Montréal, Québec, H4J 1C5 Canada
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63
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Bajpai A, Kabra M, Thapliyal R, Gulati S, Kalra V. Nephrogenic diabetes insipidus presenting with developmental delay and intracranial calcification. Indian J Pediatr 2005; 72:527-8. [PMID: 15985744 DOI: 10.1007/bf02724433] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A one-year-boy presented with constipation, fever, failure to thrive and developmental delay from the neonatal period. Investigations revealed persistent hypernatremia and deranged renal functions. Diagnostic work-up was suggestive of nephrogenic diabetes insipidus (NDI). Computerized tomography of head revealed calcification in the frontal, thalamic and basal ganglia region. The rare association of NDI and intracranial calcification is discussed.
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Affiliation(s)
- Anurag Bajpai
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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Shalev H, Romanovsky I, Knoers NV, Lupa S, Landau D. Bladder function impairment in aquaporin-2 defective nephrogenic diabetes insipidus. Nephrol Dial Transplant 2004; 19:608-13. [PMID: 14767016 DOI: 10.1093/ndt/gfg574] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The aim of this study was to describe the urological complications associated with nephrogenic diabetes insipidus (NDI) due to a mutation in aquaporin-2 (AQP2), a collecting-duct protein activated by ADH signalling. METHODS We provide a case series description of a group of seven patients with autosomal recessive NDI due to AQP2 gene mutation, receiving routine medical management since diagnosis in the first months of life. RESULTS Mean urine osmolarity at diagnosis and last follow-up was 89+/-25 and 83+/-18 mosm/l, respectively. Hydroureteronephrosis was observed in all children, beginning at age 3 years. Two children have daytime enuresis at ages 7 and 10 years and all children older than 6 years continue to have nocturnal enuresis. Markedly enlarged bladders were observed as early as age 4 years in all patients. Trabeculated bladder walls were found in three children. Urodynamic studies performed in two daytime incontinent children revealed a hypotonic-large-capacity type of neurogenic bladder. No impairment in kidney function is currently observed. CONCLUSIONS The severe renal concentrating defect in this type of NDI is associated with the development of hydroureteronephrosis followed by bladder enlargement and dysfunction. Careful follow-up is needed in order to assure that no bladder outlet obstruction and/or renal insufficiency develop.
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Affiliation(s)
- Hanna Shalev
- Department of Pediatrics, Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel
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65
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Sasaki S. Nephrogenic diabetes insipidus: update of genetic and clinical aspects. Nephrol Dial Transplant 2004; 19:1351-3. [PMID: 15004257 DOI: 10.1093/ndt/gfh172] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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Hirano K, Zuber C, Roth J, Ziak M. The proteasome is involved in the degradation of different aquaporin-2 mutants causing nephrogenic diabetes insipidus. THE AMERICAN JOURNAL OF PATHOLOGY 2003; 163:111-20. [PMID: 12819016 PMCID: PMC1868181 DOI: 10.1016/s0002-9440(10)63635-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/01/2003] [Indexed: 11/30/2022]
Abstract
Mutations in the water channel aquaporin-2 (AQP2) can cause congenital nephrogenic diabetes insipidus. To reveal the possible involvement of the protein quality control system in processing AQP2 mutants, we created an in vitro system of clone 9 hepatocytes stably expressing endoplasmic reticulum-retained T126M AQP2 and misrouted E258K AQP2 as well as wild-type AQP2 and studied their biosynthesis, degradation, and intracellular distribution. Mutant and wild-type AQP2 were synthesized as 29-kd nonglycosylated and 32-kd core-glycosylated forms in the endoplasmic reticulum. The wild-type AQP2 had a t(1/2) of 4.6 hours. Remarkable differences in the degradation kinetics were observed for the glycosylated and nonglycosylated T126M AQP2 (t(1/2) = 2.0 hours versus 0.9 hours). Moreover, their degradation was depending on proteasomal activity as demonstrated in inhibition studies. Degradation of E258K AQP2 also occurred rapidly (t(1/2) = 1.8 hours) but in a proteasome- and lysosome-dependent manner. By triple confocal immunofluorescence microscopy misrouting of E258K to lysosomes via the Golgi apparatus could be demonstrated. Notwithstanding the differences in degradation kinetics and subcellular distribution such as endoplasmic reticulum-retention and misrouting to lysosomes, both T126M and E258K AQP2 were efficiently degraded. This implies the involvement of different protein quality control processes in the processing of these AQP2 mutants.
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Affiliation(s)
- Kiyoko Hirano
- Department of Pathology, Division of Cell and Molecular Pathology, University of Zürich, Zürich, Switzerland
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Higuchi A, Kawamura T, Nakai H, Hasegawa Y. Infrequent voiding in nephrogenic diabetes insipidus as a cause of renal failure. Pediatr Int 2002; 44:540-2. [PMID: 12225559 DOI: 10.1046/j.1442-200x.2002.01599.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Asako Higuchi
- Endocrinology, Metabolism, and Genetics Unit, Tokyo Metropolitan Kiyose Children's Hospital, Tokyo, Japan
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Affiliation(s)
- P M Deen
- Department of Cell Physiology, University of Nijmegen, The Netherlands.
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Arthus MF, Lonergan M, Crumley MJ, Naumova AK, Morin D, DE Marco LA, Kaplan BS, Robertson GL, Sasaki S, Morgan K, Bichet DG, Fujiwara TM. Report of 33 novel AVPR2 mutations and analysis of 117 families with X-linked nephrogenic diabetes insipidus. J Am Soc Nephrol 2000; 11:1044-1054. [PMID: 10820168 DOI: 10.1681/asn.v1161044] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
X-linked nephrogenic diabetes insipidus (NDI) is a rare disease caused by mutations in the arginine vasopressin receptor 2 gene (AVPR2). Thirty-three novel AVPR2 mutations were identified in 62 families that were not included in our previous studies. This study describes the diversity of mutations observed in a total of 117 families, the number of affected people at the time of diagnosis, skewed X chromosome inactivation in severely affected females, the inferred parental origin of de novo mutations, and it provides estimates of incidence. Among 117 families, there were 82 different putative disease-causing mutations. Based on haplotype analysis, it can be inferred that when the same AVPR2 mutation is identified in different families that were not known to be related, the mutations most likely arose independently. More than half of the families had only one affected male; two families presented with a severely affected female and no family history of NDI. A de novo mutation arose during oogenesis in the mother in 20% of isolated cases. The estimate of about 8.8 per million male live births of the incidence of X-linked NDI in the province of Quebec, Canada may be representative of the general population except in Nova Scotia and New Brunswick, where the incidence is more than six times higher. Documentation of the diversity of mutations will assist in revealing the full spectrum of clinical variation. Discussion of genetic and population genetic aspects of X-linked NDI may contribute to early diagnosis and treatment.
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Affiliation(s)
- Marie-Françoise Arthus
- Department of Medicine, Université de Montréal and Research Centre, Hôpital du Sacré-Coeur de Montréal, Montreal, Canada
| | - Michèle Lonergan
- Department of Medicine, Université de Montréal and Research Centre, Hôpital du Sacré-Coeur de Montréal, Montreal, Canada
| | - M Joyce Crumley
- Montreal General Hospital Research Institute, Montreal, Canada
| | - Anna K Naumova
- Department of Medicine, McGill University, Montreal, Canada
- Department of Obstetrics and Gynecology, McGill University, Montreal, Canada
| | - Denis Morin
- Unité 469, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique-INSERM de Pharmacologie-Endocrinologie, Montpellier, France
| | - Luiz A DE Marco
- Department of Pharmacology, University Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Bernard S Kaplan
- Division of Nephrology, The Children's Hospital of Philadelphia and Department of Pediatrics, The University of Pennsylvania, Philadelphia, Pennsylvania
| | - Gary L Robertson
- Clinical Research Center and Northwestern University Medical School, Chicago, Illinois
| | - Sei Sasaki
- Second Department of Internal Medicine, School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenneth Morgan
- Department of Human Genetics, McGill University, Montreal, Canada
- Department of Medicine, McGill University, Montreal, Canada
- Montreal General Hospital Research Institute, Montreal, Canada
| | - Daniel G Bichet
- Department of Medicine, Université de Montréal and Research Centre, Hôpital du Sacré-Coeur de Montréal, Montreal, Canada
| | - T Mary Fujiwara
- Department of Human Genetics, McGill University, Montreal, Canada
- Department of Medicine, McGill University, Montreal, Canada
- Montreal General Hospital Research Institute, Montreal, Canada
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