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Tokhmafshan F, El Andalousi J, Murugapoopathy V, Fillion ML, Campillo S, Capolicchio JP, Jednak R, El Sherbiny M, Turpin S, Schalkwijk J, Matsumoto KI, Brophy PD, Gbadegesin RA, Gupta IR. Children with vesicoureteric reflux have joint hypermobility and occasional tenascin XB sequence variants. Can Urol Assoc J 2019; 14:E128-E136. [PMID: 31702543 DOI: 10.5489/cuaj.6068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION To consider alternative mechanisms that give rise to a refluxing ureterovesical junction (UVJ), we hypothesized that children with a common heritable urinary tract defect, vesicoureteric reflux (VUR), may have a defect in the extracellular matrix composition of the UVJ and other tissues that would be revealed by assessment of the peripheral joints. Hypermobile joints can arise from defects in the extracellular matrix within the joint capsule that affect proteins, including tenascin XB (TNXB). METHODS We performed an observational study of children with familial and non-familial VUR to determine the prevalence of joint hypermobility, renal scarring, and DNA sequence variants in TNXB. RESULTS Most children (27/44) exhibited joint hypermobility using the Beighton scoring system. This included 15/26 girls (57.7%) and 12/18 boys (66.7%), which is a significantly higher prevalence for both sexes when compared to population controls (p<0.005). We found no association between joint hypermobility and renal scarring. Seven of 49 children harbored rare pathogenic sequence variants in TNXB, and two also exhibited joint hypermobility. No sequence variants in TNXB were identified in 25/27 children with VUR and joint hypermobility. Due to the observational design of the study, there was missing data for joint hypermobility scores in six children and for dimercaptosuccinic acid (DMSA) scans in 17 children. CONCLUSIONS We observed a high prevalence of VUR and joint hypermobility in children followed within a tertiary care pediatric urology clinic. While mutations in TNXB have been reported in families with VUR and joint hypermobility, we identified only two children with these phenotypes and pathogenic variants in TNXB. We, therefore, speculate that VUR and joint hypermobility may be due to mutations in other extracellular matrix genes.
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Affiliation(s)
| | - Jasmine El Andalousi
- Research Institute of McGill University Health Centre, Montreal Children's Hospital, Montreal, QC, Canada
| | | | | | - Sarah Campillo
- Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, QC, Canada
| | - John-Paul Capolicchio
- Department of Pediatric Surgery, Division of Pediatric Urology, Montreal Children's Hospital and McGill University, Montreal, QC, Canada
| | - Roman Jednak
- Department of Pediatric Surgery, Division of Pediatric Urology, Montreal Children's Hospital and McGill University, Montreal, QC, Canada
| | - Mohamed El Sherbiny
- Department of Pediatric Surgery, Division of Pediatric Urology, Montreal Children's Hospital and McGill University, Montreal, QC, Canada
| | - Sophie Turpin
- Department of Medical Imaging, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, QC, Canada
| | - Joost Schalkwijk
- Department of Dermatology, Nijmegen Centre for Molecular Life Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Ken-Ichi Matsumoto
- Department of Biosignaling and Radioisotope Experiment, Interdisciplinary Center for Science Research, Organization for Research and Academic Information, Shimane University, Izumo, Shimane, Japan
| | - Patrick D Brophy
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY, United States
| | - Rasheed A Gbadegesin
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, NC, United States
| | - Indra R Gupta
- Department of Human Genetics, McGill University, Montreal, QC, Canada.,Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, QC, Canada
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Fillion ML, El Andalousi J, Tokhmafshan F, Murugapoopathy V, Watt CL, Murawski IJ, Capolicchio JP, El-Sherbiny M, Jednak R, Gupta IR. Heterozygous loss-of-function mutation in Odd-skipped related 1 ( Osr1) is associated with vesicoureteric reflux, duplex systems, and hydronephrosis. Am J Physiol Renal Physiol 2017; 313:F1106-F1115. [PMID: 28724605 DOI: 10.1152/ajprenal.00107.2017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 07/17/2017] [Accepted: 07/18/2017] [Indexed: 01/09/2023] Open
Abstract
Odd-skipped related 1 (Osr1) is a transcriptional repressor that plays critical roles in maintaining the mesenchymal stem cell population within the developing kidney. Here, we report that newborn pups with a heterozygous null mutation in Osr1 exhibit a 21% incidence of vesicoureteric reflux and have hydronephrosis and urinary tract duplications. Newborn pups have a short intravesical ureter, resulting in a less competent ureterovesical junction which arises from a delay in urinary tract development. We describe a new domain of Osr1 expression in the ureteral mesenchyme and within the developing bladder in the mouse. OSR1 was sequenced in 186 children with primary vesicoureteric reflux, and 17 have single nucleotide polymorphisms. Fifteen children have a common synonymous variant, rs12329305, one child has a rare nonsynonymous variant, rs3440471, and one child has a rare 5'-UTR variant, rs45535040 The impact of these SNPs is not clear; therefore, the role of OSR1 in human disease remains to be elucidated. Osr1 is a candidate gene implicated in the pathogenesis of vesicoureteric reflux and congenital abnormalities of the kidney and urinary tract in mice.
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Affiliation(s)
- Marie-Lyne Fillion
- Department of Human Genetics, McGill University, Montréal, Québec, Canada
| | - Jasmine El Andalousi
- Research Institute of McGill University Health Centre, Montreal Children's Hospital, Montréal, Québec, Canada
| | - Fatima Tokhmafshan
- Department of Human Genetics, McGill University, Montréal, Québec, Canada
| | - Vasikar Murugapoopathy
- Research Institute of McGill University Health Centre, Montreal Children's Hospital, Montréal, Québec, Canada
| | - Christine L Watt
- Department of Human Genetics, McGill University, Montréal, Québec, Canada
| | - Inga J Murawski
- Department of Human Genetics, McGill University, Montréal, Québec, Canada
| | - John-Paul Capolicchio
- Division of Urology, Montreal Children's Hospital and McGill University, Montréal, Québec, Canada; and
| | - Mohamed El-Sherbiny
- Division of Urology, Montreal Children's Hospital and McGill University, Montréal, Québec, Canada; and
| | - Roman Jednak
- Division of Urology, Montreal Children's Hospital and McGill University, Montréal, Québec, Canada; and
| | - Indra R Gupta
- Department of Human Genetics, McGill University, Montréal, Québec, Canada; .,Research Institute of McGill University Health Centre, Montreal Children's Hospital, Montréal, Québec, Canada.,Department of Pediatrics, Montreal Children's Hospital, McGill University, Montréal, Québec, Canada
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Uy N, Reidy K. Developmental Genetics and Congenital Anomalies of the Kidney and Urinary Tract. J Pediatr Genet 2015; 5:51-60. [PMID: 27617142 DOI: 10.1055/s-0035-1558423] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 02/10/2015] [Indexed: 02/06/2023]
Abstract
Congenital anomalies of the kidney and urinary tract (CAKUT) are common birth defects and the leading cause of end-stage renal disease in children. There is a wide spectrum of renal abnormalities, from mild hydronephrosis to more severe cases, such as bilateral renal dysplasia. The etiology of the majority of cases of CAKUT remains unknown, but there is increasing evidence that genomic imbalance contributes to the pathogenesis of CAKUT. Advances in human and mouse genetics have contributed to increased understanding of the pathophysiology of CAKUT. Mutations in genes involved in both transcription factors and signal transduction pathways involved in renal development are associated with CAKUT. Large cohort studies suggest that copy number variants, genomic, or de novo mutations may explain up to one-third of all cases of CAKUT. One of the major challenges to the use of genetic information in the clinical setting remains the lack of strict genotype-phenotype correlation. However, identifying genetic causes of CAKUT may lead to improved diagnosis of extrarenal complications. With the advent of decreasing costs for whole genome and exome sequencing, future studies focused on genotype-phenotype correlations, gene modifiers, and animal models of gene mutations will be needed to translate genetic advances into improved clinical care.
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Affiliation(s)
- Natalie Uy
- Department of Pediatrics/Nephrology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York, United States
| | - Kimberly Reidy
- Department of Pediatrics/Nephrology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York, United States
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