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Zhu X, Cheung WW, Zhang A, Ding G. Mutation Characteristics of Primary Hyperoxaluria in the Chinese Population and Current International Diagnosis and Treatment Status. KIDNEY DISEASES (BASEL, SWITZERLAND) 2024; 10:313-326. [PMID: 39131880 PMCID: PMC11309763 DOI: 10.1159/000539516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/16/2024] [Indexed: 08/13/2024]
Abstract
Background Primary hyperoxaluria (PH) is a rare autosomal recessive disorder, mainly due to the increase in endogenous oxalate production, causing a series of clinical features such as kidney stones, nephrocalcinosis, progressive impairment of renal function, and systemic oxalosis. There are three common genetic causes of glycolate metabolism anomalies. Among them, PH type 1 is the most prevalent and severe type, and early end-stage renal failure often occurs. Summary This review summarizes PH through pathophysiology, genotype, clinical manifestation, diagnosis, and treatment options. And explore the characteristics of Chinese PH patients. Key Messages Diagnosis of this rare disease is based on clinical symptoms, urinary or blood oxalate concentrations, liver biopsy, and genetic testing. Currently, the main treatment is massive hydration, citrate inhibition of crystallization, dialysis, liver and kidney transplantation, and pyridoxine. Recently, RNA interference drugs have also been used. In addition, technologies such as gene editing and autologous liver cell transplantation are also being developed. C.815_816insGA and c.33_34insC mutation in the AGXT gene could be a common variant in Chinese PH1 population. Mutations at the end of exon 6 account for approximately 50% of all Chinese HOGA1 mutations. Currently, the treatment of PH in China still relies mainly on symptomatic and high-throughput dialysis, with poor prognosis (especially for PH1 patients).
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Affiliation(s)
- Xingying Zhu
- Department of Nephrology, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Wai W. Cheung
- Division of Pediatric Nephrology, Rady Children’s Hospital, University of California, San Diego, CA, USA
| | - Aihua Zhang
- Department of Nephrology, Children’s Hospital of Nanjing Medical University, Nanjing, China
- State Key Laboratory of Reproductive Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Guixia Ding
- Department of Nephrology, Children’s Hospital of Nanjing Medical University, Nanjing, China
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2
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Xin Q, Dong Y, Guo W, Zhao X, Liu Z, Shi X, Lang Y, Shao L. Four novel variants identified in primary hyperoxaluria and genotypic and phenotypic analysis in 21 Chinese patients. Front Genet 2023; 14:1124745. [PMID: 37139236 PMCID: PMC10150119 DOI: 10.3389/fgene.2023.1124745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/04/2023] [Indexed: 05/05/2023] Open
Abstract
Background: Primary hyperoxaluria (PH) is a rare genetic disorder characterized by excessive accumulation of oxalate in plasma and urine, resulting in various phenotypes due to allelic and clinical heterogeneity. This study aimed to analyze the genotype of 21 Chinese patients with primary hyperoxaluria (PH) and explore their correlations between genotype and phenotype. Methods: Combined with clinical phenotypic and genetic analysis, we identified 21 PH patients from highly suspected Chinese patients. The clinical, biochemical, and genetic data of the 21 patients were subsequently reviewed. Results: We reported 21 cases of PH in China, including 12 cases of PH1, 3 cases of PH2 and 6 cases of PH3, and identified 2 novel variants (c.632T > G and c.823_824del) in AGXT gene and 2 novel variants (c.258_272del and c.866-34_866-8del) in GRHPR gene, respectively. A possible PH3 hotspot variant c.769T > G was identified for the first time. In addition, patients with PH1 showed higher levels of creatinine and lower eGFR than those with PH2 and PH3. In PH1, patients with severe variants in both alleles had significantly higher creatinine and lower eGFR than other patients. Delayed diagnosis still existed in some late-onset patients. Of all cases, 6 had reached to end-stage kidney disease (ESKD) at diagnosis with systemic oxalosis. Five patients were on dialysis and three had undergone kidney or liver transplants. Notably, four patients showed a favorable therapeutic response to vitamin B6, and c.823_824dup and c.145A > C may be identified as potentially vitamin B6-sensitive genotypes. Conclusion: In brief, our study identified 4 novel variants and extended the variant spectrum of PH in the Chinese population. The clinical phenotype was characterized by large heterogeneity, which may be determined by genotype and a variety of other factors. We first reported two variants that may be sensitive to vitamin B6 therapy in Chinese population, providing valuable references for clinical treatment. In addition, early screening and prognosis of PH should be given more attention. We propose to establish a large-scale registration system for rare genetic diseases in China and call for more attention on rare kidney genetic diseases.
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Affiliation(s)
- Qing Xin
- Department of Nephrology, Qingdao Municipal Hospital, Qingdao, China
| | - Yameng Dong
- Department of Nephrology, Qingdao Municipal Hospital, Qingdao, China
| | - Wencong Guo
- Department of Nephrology, Qingdao Municipal Hospital, Qingdao, China
| | - Xiangzhong Zhao
- Medical Research Center, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhiying Liu
- Renal Division, Peking University First Hospital, Beijing, China
| | - Xiaomeng Shi
- Department of Nephrology, Qingdao Municipal Hospital, Qingdao, China
| | - Yanhua Lang
- Department of Nursing, Qingdao Municipal Hospital, Qingdao, China
- *Correspondence: Yanhua Lang, ; Leping Shao,
| | - Leping Shao
- Department of Nephrology, Qingdao Municipal Hospital, Qingdao, China
- *Correspondence: Yanhua Lang, ; Leping Shao,
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3
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Moochhala SH, Worcester EM. Primary hyperoxaluria: the adult nephrologist's point of view. Clin Kidney J 2022; 15:i29-i32. [PMID: 35711295 PMCID: PMC9194796 DOI: 10.1093/ckj/sfac068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Indexed: 11/22/2022] Open
Abstract
In adults, primary hyperoxaluria (PH) does not always present as obviously as in children, leading to delayed or even missed diagnosis. When diagnosed in adulthood, PH usually progresses at a slower rate and the focus is on the prevention of recurrent kidney stones as much as it is on the preservation of renal function. The most tragic presentation is when the diagnosis is made after primary non-function of a renal graft for treating previously unknown renal disease. Recurrent stones, nephrocalcinosis and features of systemic oxalosis can all be presenting features. For these reasons, consideration should be given to screening for this rare condition, using biochemical and/or genetic means, but being careful to exclude common differential diagnoses. Such efforts should be synchronized with diagnostic methods for other rare kidney diseases.
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Affiliation(s)
- Shabbir H Moochhala
- Royal Free and University College Medical School, UCL
Department of Renal Medicine,
London, UK
| | - Elaine M Worcester
- University of Chicago, Nephrology Section, South
Maryland, Chicago, IL, USA
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4
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Xu CB, Zhou XD, Xu HE, Zhao YL, Zhao XH, Liu DH, Tian YA, Hu XX, Guan JY, Guo JC, Tang WX, Xue X. A novel nonsense variant of the AGXT identified in a Chinese family: special variant research in the Chinese reference genome. BMC Nephrol 2021; 22:83. [PMID: 33691640 PMCID: PMC7945658 DOI: 10.1186/s12882-021-02276-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 02/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary hyperoxaluria(PH)is a rare autosomal recessive genetic disease that contains three subtypes (PH1, PH2 and PH3). Approximately 80% of PH patients has been reported as subtype PH1, this subtype of PH has been related to a higher risk of renal failure at any age. Several genetic studies indicate that the variants in gene AGXT are responsible for the occurrence of PH1. However, the population heterogeneity of the variants in AGXT makes the genetic diagnosis of PH1 more challenging as it is hard to locate each specific variant. It is valuable to have a complete spectrum of AGXT variants from different population for early diagnosis and clinical treatments of PH1. CASE PRESENTATION In this study, We performed high-throughput sequencing and genetic analysis of a 6-year-old male PH1 patient from a Chinese family. Two variants (c.346G > A: p.Gly116Arg; c.864G > A: p.Trp288X) of the gene AGXT were identified. We found a nonsense variant (c.864G > A: p.Trp288X) that comes from the proband's mother and has never been reported previously. The other missense variant (c.346G > A: p.Gly116Arg) was inherited from his father and has been found previously in a domain of aminotransferase, which plays an important role in the function of AGT protein. Furthermore, we searched 110 pathogenic variants of AGXT that have been reported worldwide in healthy local Chinese population, none of these pathogenic variants was detected in the local genomes. CONCLUSIONS Our research provides an important diagnosis basis for PH1 on the genetic level by updating the genotype of PH1 and also develops a better understanding of the variants in AGXT by broadening the variation database of AGXT according to the Chinese reference genome.
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Affiliation(s)
- Chang Bao Xu
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Xu Dong Zhou
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Hong En Xu
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China.,Academy of Medical Sciences, ZhengZhou University, Zhengzhou, China.,Precision Medicine Center of ZhengZhou University, Zhengzhou, China
| | - Yong Li Zhao
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Xing Hua Zhao
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Dan Hua Liu
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Yong An Tian
- BGI College, ZhengZhou University, Zhengzhou, China
| | - Xin Xin Hu
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China.,Precision Medicine Center of ZhengZhou University, Zhengzhou, China
| | - Jing Yuan Guan
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China.,Precision Medicine Center of ZhengZhou University, Zhengzhou, China
| | - Jian Cheng Guo
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China.,Academy of Medical Sciences, ZhengZhou University, Zhengzhou, China.,Precision Medicine Center of ZhengZhou University, Zhengzhou, China.,Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
| | - Wen Xue Tang
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China.,Academy of Medical Sciences, ZhengZhou University, Zhengzhou, China.,Precision Medicine Center of ZhengZhou University, Zhengzhou, China.,Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
| | - Xia Xue
- Academy of Medical Sciences, ZhengZhou University, Zhengzhou, China. .,Precision Medicine Center of ZhengZhou University, Zhengzhou, China.
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5
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Pan K, Wang Y, Pan P, Xu G, Mo L, Cao L, Wu C, Shen X. The regulatory role of microRNA-mRNA co-expression in hepatitis B virus-associated acute liver failure. Ann Hepatol 2020; 18:883-892. [PMID: 31521462 DOI: 10.1016/j.aohep.2019.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 07/16/2019] [Accepted: 06/25/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES Acute liver failure (ALF) is a dramatic disorder requiring intensive care. MicroRNAs (miRNAs) have been identified to play important roles in ALF. This study was performed to identify miRNA-mRNA co-expression network after ALF to investigate the molecule mechanism underlying the pathogenesis of ALF. MATERIALS AND METHODS The microarray dataset GSE62030 and GSE62029 were downloaded from Gene Expression Omnibus database. Overlapping differentially expressed miRNAs (DEmiRNAs) and genes (DEGs) were identified in liver tissues from patients with hepatitis B virus (HBV)-associated ALF in comparison with normal tissues from donors. Gene enrichment analysis was performed. Key pathways associated with the DEGs were identified. The miRNA-mRNA regulatory network was constructed. RESULTS Total 42 DEmiRNAs and 523 DEGs were identified in liver tissues from patients with HBV-associated ALF. Gene ontology and pathways enrichment analysis showed upregulated DEGs were related to immune responses, inflammation, and infection, and downregulated DEGs were associated with amino acids, secondary metabolites and xenobiotics metabolism. In miRNA-mRNA co-expression network, DEGs were regulated by at least one DEmiRNA and transcription factor. Further analysis showed DEmiRNAs, including has-miR-55-5p, has-miR-193b-5p, has-miR-200b-3p, and has-miR-3175 were associated with amino acid metabolism, drug metabolism and detoxication, and signaling pathways including mitogen-activated protein kinase (MAPK), phosphatidylinositol 3-kinase (PI3K)/AKT, Ras, and Rap1. CONCLUSIONS These miRNA-mRNA pairs and changed profiles were associated with and might be responsible for the impairment of detoxification and metabolism induced by HBV-associated ALF.
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Affiliation(s)
- Kanda Pan
- Department of Intensive Care Unit (ICU), The First People's Hospital of Xiaoshan District, Hangzhou, Xiaoshan District, Hangzhou, China
| | - Yunchao Wang
- Department of Intensive Care Unit (ICU), The First People's Hospital of Xiaoshan District, Hangzhou, Xiaoshan District, Hangzhou, China
| | - Ping Pan
- Department of General Medicine, The First People's Hospital of Xiaoshan District, Hangzhou, Xiaoshan District, Hangzhou, China
| | - Guanhua Xu
- Department of Intensive Care Unit (ICU), The First People's Hospital of Xiaoshan District, Hangzhou, Xiaoshan District, Hangzhou, China
| | - Lujiao Mo
- Department of Intensive Care Unit (ICU), The First People's Hospital of Xiaoshan District, Hangzhou, Xiaoshan District, Hangzhou, China
| | - Lijia Cao
- Department of Intensive Care Unit (ICU), The First People's Hospital of Xiaoshan District, Hangzhou, Xiaoshan District, Hangzhou, China
| | - Channi Wu
- Department of Gastroenterology, Zhejiang Xiaoshan Hospital, Xiaoshan District, Hangzhou, China.
| | - Xiaoyuan Shen
- Department of Intensive Care Unit (ICU), The First People's Hospital of Xiaoshan District, Hangzhou, Xiaoshan District, Hangzhou, China
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6
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Zhao F, Li J, Tang L, Li C, Wang W, Ning C. Characteristics of the genotype and phenotype in Chinese primary hyperoxaluria type 1 populations. Urolithiasis 2020; 49:17-25. [PMID: 32556641 DOI: 10.1007/s00240-020-01201-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 05/29/2020] [Indexed: 11/30/2022]
Abstract
The aim of our study is to explore the relationship between genotype and phenotype in Chinese PH1 patients and determine the putative mutation hotspot regions. This was a retrospective study regarding 13 Chinese PH1 patients. And all sporadic published researches of Chinese PH1 populations were searched and enrolled based on the inclusive standard. All patients presented with multiple urolithiasis or nephrolithiasis. Urinary oxalate values demonstrated an obvious and extensive variability, ranging from 1.01 to 3.85 mmol/1.73 m2. Molecular diagnosis showed that 13 mutant types were detected. Infantile form patient (pt.) 10 and five patients (pts. 5, 7, 8, 9, 12) carrying c.815_816insGA or c.33_34insC demonstrated a worse prognosis, of whom pt. 5 progressed into ESRD 4 years later and died of chronic kidney failure. Based on the integrated Chinese mutation data, two variants (c.815_816insGA and c.33_34insC) were determined as the most common mutations. Besides, c.1049G>A was initially identified in a Chinese patient. Conclusions: heterogeneity between genotype and phenotype was observed and described in Chinese PH1 patients. c.815_816insGA and c.33_34insC which were recognized as AGXT mutation hotspot regions in China implied a poor prognosis. And c.1049G>A was not determined as the race-specific mutation of Pakistani.
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Affiliation(s)
- Fangzhou Zhao
- Department of Urology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, 100050, China
| | - Jun Li
- Department of Urology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, 100050, China.
| | - Lei Tang
- Department of Urology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, 100050, China
| | - Chunming Li
- Department of Urology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, 100050, China
| | - Wenying Wang
- Department of Urology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, 100050, China
| | - Chen Ning
- Department of Urology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, 100050, China
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7
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Lu X, Chen W, Li L, Zhu X, Huang C, Liu S, Yang Y, Zhao Y. Two Novel AGXT Mutations Cause the Infantile Form of Primary Hyperoxaluria Type I in a Chinese Family: Research on Missed Mutation. Front Pharmacol 2019; 10:85. [PMID: 30787879 PMCID: PMC6372570 DOI: 10.3389/fphar.2019.00085] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 01/21/2019] [Indexed: 11/13/2022] Open
Abstract
Primary hyperoxaluria type 1 (PH1) is a rare metabolic disorder characterized by a defect in the liver-specific peroxisomal enzyme alanine-glyoxylate and serine-pyruvate aminotransferase (AGT). This disorder results in hyperoxaluria, recurrent urolithiasis, and nephrocalcinosis. Three forms of PH1 have been reported. Data on the infantile form of PH1 are currently limited in literature. Despite the fact that China is the most populated country in the world, only a few AGXT mutations have been reported in several Chinese PH1 patients. In the present study, we investigated a Chinese family in which two siblings are affected by the infantile form of PH1. Sanger sequencing was carried out on the proband, but the results were misleading. Two novel missense mutations (c.517T > C/p.Cys173Arg and c.667A > C/p.Ser223Arg) of the AGXT gene were successfully detected through whole-exome sequencing. These two mutations occurred in the highly conserved residues of the AGT. Four software programs predicted both mutations as the cause of the disease. A postmortem examination was performed and revealed the occurrence of global nephrocalcinosis on both kidneys. The crystals were collected and analyzed as calcium oxalate monohydrate. This study extends the knowledge on the clinical phenotype-genotype correlation of the AGXT mutation. That is, (i) two novel missense mutations were identified for the infantile form of PH1 and (ii) the same AGXT genotype caused the same infantile form of PH1 within the family.
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Affiliation(s)
- Xiulan Lu
- The Laboratory of Genetics and Metabolism, Hunan Children’s Research Institute (HCRI), Hunan Children’s Hospital, University of South China, Changsha, China
- Pediatric Intensive Care Unit, Hunan Children’s Hospital, University of South China, Changsha, China
| | - Weijian Chen
- The Laboratory of Genetics and Metabolism, Hunan Children’s Research Institute (HCRI), Hunan Children’s Hospital, University of South China, Changsha, China
- Department of Pathology, Hunan Children’s Hospital, University of South China, Changsha, China
| | - Liping Li
- The Laboratory of Genetics and Metabolism, Hunan Children’s Research Institute (HCRI), Hunan Children’s Hospital, University of South China, Changsha, China
| | - Xinyuan Zhu
- The Laboratory of Genetics and Metabolism, Hunan Children’s Research Institute (HCRI), Hunan Children’s Hospital, University of South China, Changsha, China
| | - Caizhi Huang
- The Laboratory of Genetics and Metabolism, Hunan Children’s Research Institute (HCRI), Hunan Children’s Hospital, University of South China, Changsha, China
| | | | - Yongjia Yang
- The Laboratory of Genetics and Metabolism, Hunan Children’s Research Institute (HCRI), Hunan Children’s Hospital, University of South China, Changsha, China
| | - Yaowang Zhao
- The Laboratory of Genetics and Metabolism, Hunan Children’s Research Institute (HCRI), Hunan Children’s Hospital, University of South China, Changsha, China
- Department of Urinary Surgery, Hunan Children’s Hospital, University of South China, Changsha, China
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Mikhaylenko DS, Prosyannikov MY, Baranova A, Nemtsova MV. [Genetic and biochemical features of the monogenic hereditary urolithiasis]. BIOMEDIT︠S︡INSKAI︠A︡ KHIMII︠A︡ 2018; 64:315-325. [PMID: 30135278 DOI: 10.18097/pbmc20186404315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Urolithiasis is a common urological problem. In most cases, this multifactorial pathology develops due to the combination of inherited low-penetrance gene variants and environment factors such as urinary tract infections and unbalanced diet. However, some cases are monogenic. These hereditary forms of urolithiasis manifest in childhood, and are characterized by multiple, bilateral and recurrent kidney stones and progress to chronic renal failure relatively early. Due to widening acceptance of exome and gene panel sequencing, substantially larger percentages of urolithiasis cases are now attributed to hereditary causes, up to 20% among patients of 18 years old or younger. Here we review genetic and biochemical mechanisms of urolithiasis, with an emphasis on its hereditary forms, including fermentopathies (primary hyperoxaluria, adenine phosphorobosyltransferase deficiency, phosphoribosyl-pyrophosphate-synthetase deficiency, xanthinuria, Lesch-Nihan syndrome) and these caused by membrane transport alterations (Dent's disease, familial hypomagnesia with hypercalciuria and nephrocalcinosis, hypophosphatemic urolithiasis, distal tubular acidosis, cystinuria, Bartter's syndrome). We suggest a comprehensive gene panel for NGS diagnostics of the hereditary urolithiasis. It is expected that accurate and timely diagnosis of hereditary forms of urolithiasis would enable the counselling of the carriers in affected families, and ensure personalized management of the patients with these conditions.
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Affiliation(s)
- D S Mikhaylenko
- Institute of Molecular Medicine of the Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; Lopatkin Research Institute of Urology and Interventional Radiology - branch of the National Medical Research Center of Radiology, Moscow, Russia; Research Centre for Medical Genetics, Moscow, Russia
| | - M Y Prosyannikov
- Lopatkin Research Institute of Urology and Interventional Radiology - branch of the National Medical Research Center of Radiology, Moscow, Russia
| | - A Baranova
- Center for the Study of Chronic Metabolic and Rare Diseases, George Mason University, Fairfax, Virginia, USA
| | - M V Nemtsova
- Institute of Molecular Medicine of the Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; Research Centre for Medical Genetics, Moscow, Russia
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9
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Lu J, Zhao X, Paiardini A, Lang Y, Bottillo I, Shao L. Familial hypomagnesaemia, Hypercalciuria and Nephrocalcinosis associated with a novel mutation of the highly conserved leucine residue 116 of Claudin 16 in a Chinese patient with a delayed diagnosis: a case report. BMC Nephrol 2018; 19:181. [PMID: 30005619 PMCID: PMC6045852 DOI: 10.1186/s12882-018-0979-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 06/28/2018] [Indexed: 01/23/2023] Open
Abstract
Background Sixty mutations of claudin 16 coding gene have been reported in familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) patients. Recent investigations revealed that a highly conserved glycine-leucine-tryptophan (115G-L-W117) motif in the first extracellular segment (ESC1) of claudin 16 might be essential for stabilization of the appropriately folded ECS1 structure and conservation of normal claudin 16 function. However, neither missense nor nonsense mutation has ever been described in this motif. Our study aimed at identifying mutations in a Chinese patient with FHHNC and exploring the association between genotype and phenotype. Case presentation A 33-year-old female presented with 4 years history of recurrent acute pyelonephritis without other notable past medical history. Her healthy parents, who aged 56 and 53 respectively, were second cousins, and her only sibling died from renal failure without definite cause at age 25. Renal ultrasound imaging demonstrated atrophic kidneys and bilateral nephrocalcinosis. The laboratory workup revealed impaired renal function (Stage CKD IV), hypocalcemia and mild hypomagnesemia, accompanied with marked renal loss of magnesium and hypercalciuria. During the follow-up, treatment with calcitriol and calcium but not with magnesium was difficult to achieve normal serum calcium levels, whereas her serum magnesium concentration fluctuated within normal ranges. In the end, the patient unavoidably reached ESRD at 36 years old. The clinical features and family history suggested the diagnosis of FHHNC. To make a definite diagnosis, we use whole-exome sequencing to identify the disease-causing mutations and Sanger sequencing to confirm the mutation co-segregation in the family. As a result, a novel homozygous mutation (c.346C > G, p.Leu116Val) in 115G-L-W117 motif of claudin 16 was identified. Her parents, grandmother and one of her cousins carried heterozygous p.Leu116Val, whereas 200 unrelated controls did not carry this mutation. Conclusions We described a delayed diagnosis patient with FHHNC in the Chinese population and identified a novel missense mutation in the highly conserved 115G-L-W117 motif of claudin 16 for the first time. According to the reported data and the information deduced from 3D modeling, we speculate that this mutation probably reserve partial residual function which might be related to the slight phenotype of the patient. Electronic supplementary material The online version of this article (10.1186/s12882-018-0979-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jingru Lu
- Department of Nephrology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, China.,Central Laboratory, The Affiliated Hospital of Qingdao University, 1677 Wutaishan Road, Qingdao, 266555, China
| | - Xiangzhong Zhao
- Central Laboratory, The Affiliated Hospital of Qingdao University, 1677 Wutaishan Road, Qingdao, 266555, China
| | - Alessandro Paiardini
- Dipartimento di Scienze Biochimiche "A. Rossi Fanelli", Sapienza - Università di Roma, 00185, Rome, Italy
| | - Yanhua Lang
- Department of Nephrology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, China
| | - Irene Bottillo
- Division of Medical Genetics, Department of Molecular Medicine, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | - Leping Shao
- Department of Nephrology, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266003, China. .,Central Laboratory, The Affiliated Hospital of Qingdao University, 1677 Wutaishan Road, Qingdao, 266555, China.
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10
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Li X, Gu J, Yang Y, Li J, Li Y. A Putative Mutation Hotspot of the AGXT Gene Associated with Primary Hyperoxaluria Type 1 in the Chinese Population. TOHOKU J EXP MED 2018; 246:233-241. [DOI: 10.1620/tjem.246.233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Xiyuan Li
- Precision Medicine Center, General Hospital of Tianjin Medical University
| | - Jie Gu
- Department of Laboratory Animal Center, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Yanling Yang
- Department of Pediatrics, Peking University First Hospital
| | - Jun Li
- Department of Urology, Beijing Friendship Hospital, Capital Medical University
| | - Yanhan Li
- Department of Laboratory Animal Center, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
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