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Chen M, Lv X, Li J, Guo M, Ma S. Clinical and genetic characteristics of the patients with hypertension and hypokalemia carrying a novel SCNN1A mutation. Scand J Clin Lab Invest 2022; 82:576-580. [PMID: 36336351 DOI: 10.1080/00365513.2022.2140454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The objective of this study was to clinically and genetically characterize a pedigree with Liddle syndrome (LS). A LS pedigree comprising with one proband and seven family members was enrolled. The subjects' symptoms, laboratory results and genotypes were analyzed. Peripheral venous samples were collected from the subjects, and genomic DNA was extracted. DNA library construction and exome capture were performed on an Illumina HiSeq 4000 platform. The selected variant sites were validated using Sanger sequencing. The mutation effects were investigated using prediction tools. The proband and her paternal male family members had mild hypertension, hypokalemia and muscle weakness, including the absence of low renin and low aldosterone. Genetic analysis revealed that the proband carried a compound heterozygous mutation in SCNN1A, a novel heterozygous mutation, c.1130T > G (p.Ile377Ser) and a previously characterized polymorphism, c.1987A > G (p.Thr633Ala). The novel mutation site was inherited in an autosomal dominant manner and was predicted by in silico tools to exert a damaging effect. Alterations in the SCNN1A domain were also predicted by protein structure modeling. After six months of follow-up, treatment had significantly improved the patient's limb weakness and electrolyte levels. The novel mutation c.1130T > G of the SCNN1A gene was detected in the pedigree with LS. The clinical manifestations of the pedigree were described, which expand the phenotypic spectrum of LS. This result of this study also emphasizes the value of genetic testing for diagnosing LS.
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Affiliation(s)
- Mengzi Chen
- Graduate School, Guangxi University of Chinese Medicine, Nanning, China
| | - Xi Lv
- Graduate School, Guangxi University of Chinese Medicine, Nanning, China
| | - Jiwu Li
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Manli Guo
- Department of Endocrinology and Metabolism, The Affiliated Suqian Hospital of Xuzhou Medical University, and Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, China
| | - Shaogang Ma
- Department of Endocrinology and Metabolism, Laibin People's Hospital, Laibin, China
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Habeeb E, Aldosari S, Saghir SA, Cheema M, Momenah T, Husain K, Omidi Y, Rizvi SA, Akram M, Ansari RA. Role of Environmental Toxicants in the Development of Hypertensive and Cardiovascular Diseases. Toxicol Rep 2022; 9:521-533. [PMID: 35371924 PMCID: PMC8971584 DOI: 10.1016/j.toxrep.2022.03.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 03/17/2022] [Indexed: 12/12/2022] Open
Abstract
The incidence of hypertension with diabetes mellitus (DM) as a co-morbid condition is on the rise worldwide. In 2000, an estimated 972 million adults had hypertension, which is predicted to grow to 1.56 billion by 2025. Hypertension often leads to diabetes mellitus that strongly puts the patients at an increased risk of cardiovascular, kidney, and/or atherosclerotic diseases. Hypertension has been identified as a major risk factor for the development of diabetes; patients with hypertension are at two-to-three-fold higher risk of developing diabetes than patients with normal blood pressure (BP). Causes for the increase in hypertension and diabetes are not well understood, environmental factors (e.g., exposure to environmental toxicants like heavy metals, organic solvents, pesticides, alcohol, and urban lifestyle) have been postulated as one of the reasons contributing to hypertension and cardiovascular diseases (CVD). The mechanism of action(s) of these toxicants in developing hypertension and CVDs is not well defined. Research studies have linked hypertension with the chronic consumption of alcohol and exposure to metals like lead, mercury, and arsenic have also been linked to hypertension and CVD. Workers chronically exposed to styrene have a higher incidence of CVD. Recent studies have demonstrated that exposure to particulate matter (PM) in diesel exhaust and urban air contributes to increased CVD and mortality. In this review, we have imparted the role of environmental toxicants such as heavy metals, organic pollutants, PM, alcohol, and some drugs in hypertension and CVD along with possible mechanisms and limitations in extrapolating animal data to humans. Rising incidence of hypertension may be linked to chronic exposure with environmental toxicants. Urban lifestyle and alcohol intake may be responsible for increased incidence of hypertension among urbanites. Exposure with organic solvent, heavy metals and pesticides could also be contributing to the rise in blood pressure.
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Affiliation(s)
- Ehsan Habeeb
- Department of Pharmaceutical Sciences, College of Pharmacy, Health Professions Division, Nova Southeastern University, 3200S University Drive, Fort Lauderdale, FL 33200, USA
| | - Saad Aldosari
- Department of Pharmaceutical Sciences, College of Pharmacy, Health Professions Division, Nova Southeastern University, 3200S University Drive, Fort Lauderdale, FL 33200, USA
| | - Shakil A. Saghir
- The Scotts Company LLC, Marysville, OH 43041, USA
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
| | - Mariam Cheema
- Department of Pharmaceutical Sciences, College of Pharmacy, Health Professions Division, Nova Southeastern University, 3200S University Drive, Fort Lauderdale, FL 33200, USA
| | - Tahani Momenah
- Department of Pharmaceutical Sciences, College of Pharmacy, Health Professions Division, Nova Southeastern University, 3200S University Drive, Fort Lauderdale, FL 33200, USA
| | - Kazim Husain
- Department of Gastrointestinal Oncology (FOB-2), Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Yadollah Omidi
- Department of Pharmaceutical Sciences, College of Pharmacy, Health Professions Division, Nova Southeastern University, 3200S University Drive, Fort Lauderdale, FL 33200, USA
| | - Syed A.A. Rizvi
- Department of Pharmaceutical Sciences, School of Pharmacy, Hampton University, VA 23668, USA
| | - Muhammad Akram
- Department of Eastern Medicine and Surgery, Government College University Faisalabad, Faisalabad, Pakistan
| | - Rais A. Ansari
- Department of Pharmaceutical Sciences, College of Pharmacy, Health Professions Division, Nova Southeastern University, 3200S University Drive, Fort Lauderdale, FL 33200, USA
- Corresponding author.
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Hypokalemia and hypertensive urgency in a 10-year-old boy: Answers. Pediatr Nephrol 2021; 36:3629-3631. [PMID: 33825041 DOI: 10.1007/s00467-021-05072-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/10/2021] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
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Abstract
The Epithelial Na+ Channel, ENaC, comprised of 3 subunits (αβγ, or sometimes δβγENaC), plays a critical role in regulating salt and fluid homeostasis in the body. It regulates fluid reabsorption into the blood stream from the kidney to control blood volume and pressure, fluid absorption in the lung to control alveolar fluid clearance at birth and maintenance of normal airway surface liquid throughout life, and fluid absorption in the distal colon and other epithelial tissues. Moreover, recent studies have also revealed a role for sodium movement via ENaC in nonepithelial cells/tissues, such as endothelial cells in blood vessels and neurons. Over the past 25 years, major advances have been made in our understanding of ENaC structure, function, regulation, and role in human disease. These include the recently solved three-dimensional structure of ENaC, ENaC function in various tissues, and mutations in ENaC that cause a hereditary form of hypertension (Liddle syndrome), salt-wasting hypotension (PHA1), or polymorphism in ENaC that contributes to other diseases (such as cystic fibrosis). Moreover, great strides have been made in deciphering the regulation of ENaC by hormones (e.g., the mineralocorticoid aldosterone, glucocorticoids, vasopressin), ions (e.g., Na+ ), proteins (e.g., the ubiquitin-protein ligase NEDD4-2, the kinases SGK1, AKT, AMPK, WNKs & mTORC2, and proteases), and posttranslational modifications [e.g., (de)ubiquitylation, glycosylation, phosphorylation, acetylation, palmitoylation]. Characterization of ENaC structure, function, regulation, and role in human disease, including using animal models, are described in this article, with a special emphasis on recent advances in the field. © 2021 American Physiological Society. Compr Physiol 11:1-29, 2021.
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Affiliation(s)
- Daniela Rotin
- The Hospital for Sick Children, and The University of Toronto, Toronto, Canada
| | - Olivier Staub
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
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Kozina AA, Okuneva EG, Baryshnikova NV, Fedonyuk ID, Kholin AA, Il'ina ES, Krasnenko AY, Stetsenko IF, Plotnikov NA, Klimchuk OI, Surkova EI, Ilinsky VV. Two novel PCDH19 mutations in Russian patients with epilepsy with intellectual disability limited to females: a case report. BMC MEDICAL GENETICS 2020; 21:209. [PMID: 33087045 PMCID: PMC7579871 DOI: 10.1186/s12881-020-01119-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 09/03/2020] [Indexed: 11/16/2022]
Abstract
Background Epilepsy with intellectual disability limited to females (Epileptic encephalopathy, early infantile, 9; EIEE9) is a rare early infantile epileptic encephalopathy characterized by an unusual X-linked inheritance: females with heterozygous mutations are affected, while hemizygous males are not. Case presentation We describe the clinical and molecular characteristics of 2 Russian patients with EIEE9 (females, ages 3 years and 7 years). In these patients seizures developed at the age of 3 years. Additionally, for our patients and for cases described in the literature we searched for a possible relationship between the type and localization of the mutation and the EIEE9 clinical phenotype. Conclusions We identified two novel PCDH19 mutations in EIEE9 patients: a missense mutation in exon 1 (c.1236C > A, p.Asp412Glu) and a frameshift in exon 3 (c.2386_2387insGTCT, p.Thr796fs). We conclude that the age of seizure onset and the presence of intellectual disability may depend not on the type and localization of PCDH19 mutations, but on the X-inactivation status. The study also highlights the need to screen for EIEE9 among young female epilepsy patients.
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Affiliation(s)
- Anastasiya Aleksandrovna Kozina
- Institute of Biomedical Chemistry, Pogodinskaya street 10/8, 119121, Moscow, Russia.,Pirogov Russian National Research Medical University, Ostrovitianova street 1, 117997, Moscow, Russia
| | | | - Natalia Vladimirovna Baryshnikova
- Pirogov Russian National Research Medical University, Ostrovitianova street 1, 117997, Moscow, Russia.,Genotek Ltd., Nastavnicheskii pereulok 17/1, 105120, Moscow, Russia
| | - Inessa Dmitrievna Fedonyuk
- Russian Children's Clinical Hospital of Pirogov Russian National Research Medical University, Leniskiy prospekt 117, 117513, Moscow, Russia
| | - Alexey Aleksandrovich Kholin
- Pirogov Russian National Research Medical University, Ostrovitianova street 1, 117997, Moscow, Russia.,Russian Children's Clinical Hospital of Pirogov Russian National Research Medical University, Leniskiy prospekt 117, 117513, Moscow, Russia
| | - Elena Stepanovna Il'ina
- Russian Children's Clinical Hospital of Pirogov Russian National Research Medical University, Leniskiy prospekt 117, 117513, Moscow, Russia
| | | | | | | | | | | | - Valery Vladimirovich Ilinsky
- Institute of Biomedical Chemistry, Pogodinskaya street 10/8, 119121, Moscow, Russia.,Pirogov Russian National Research Medical University, Ostrovitianova street 1, 117997, Moscow, Russia.,Genotek Ltd., Nastavnicheskii pereulok 17/1, 105120, Moscow, Russia.,Vavilov Institute of General Genetics, Gubkina street 3, 119333, Moscow, Russia
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Lu YT, Fan P, Zhang D, Zhang Y, Meng X, Zhang QY, Zhao L, Yang KQ, Zhou XL. Overview of Monogenic Forms of Hypertension Combined With Hypokalemia. Front Pediatr 2020; 8:543309. [PMID: 33569358 PMCID: PMC7868374 DOI: 10.3389/fped.2020.543309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 12/29/2020] [Indexed: 12/26/2022] Open
Abstract
Hypertension is an important risk factor in many conditions and creates a heavy burden of disease and mortality globally. Polygenic hypertension is the most common form; however, it is increasingly recognized that monogenic hypertension is not rare, especially in patients with electrolyte disorders. Single genetic alterations are associated with plasma volume expansion and catecholamines/sympathetic excess with simultaneously increased potassium excretion in the urine and potassium intracellular shift. Early-onset refractory hypertension and profound hypokalemia are characteristics of monogenic hypertension. However, accumulated evidence shows the existence of phenotypic heterogeneity in monogenic hypertension meaning that, even for mild symptoms, clinicians cannot easily exclude the possibility of monogenic hypertension. Genetic, epigenetic and non-genetic factors are all possible mechanisms influencing phenotypic diversity. Genetic sequencing is a precise and efficient method that can broaden the mutant gene spectrum of the disease and is very helpful for understanding the pathophysiology of monogenic hypertension. Genetic sequencing, along with biochemical tests and imaging modalities, is essential for the early diagnosis and targeted management of monogenic hypertension to avoid long-term catastrophic complications.
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Affiliation(s)
- Yi-Ting Lu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Peng Fan
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Di Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xu Meng
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiong-Yu Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lin Zhao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kun-Qi Yang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xian-Liang Zhou
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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