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Mutations in kelch-like 3 and cullin 3 cause hypertension and electrolyte abnormalities 总被引:2,自引:0,他引:2
Boyden LM Choi M Choate KA Nelson-Williams CJ Farhi A Toka HR Tikhonova IR Bjornson R Mane SM Colussi G Lebel M Gordon RD Semmekrot BA Poujol A Välimäki MJ De Ferrari ME Sanjad SA Gutkin M Karet FE Tucci JR Stockigt JR Keppler-Noreuil KM Porter CC Anand SK Whiteford ML Davis ID Dewar SB Bettinelli A Fadrowski JJ Belsha CW Hunley TE Nelson RD Trachtman H Cole TR Pinsk M Bockenhauer D Shenoy M Vaidyanathan P Foreman JW Rasoulpour M Thameem F Al-Shahrouri HZ Radhakrishnan J Gharavi AG Goilav B 《Nature》2012,482(7383):98-102
Hypertension affects one billion people and is a principal reversible risk factor for cardiovascular disease. Pseudohypoaldosteronism type II (PHAII), a rare Mendelian syndrome featuring hypertension, hyperkalaemia and metabolic acidosis, has revealed previously unrecognized physiology orchestrating the balance between renal salt reabsorption and K(+) and H(+) excretion. Here we used exome sequencing to identify mutations in kelch-like 3 (KLHL3) or cullin 3 (CUL3) in PHAII patients from 41 unrelated families. KLHL3 mutations are either recessive or dominant, whereas CUL3 mutations are dominant and predominantly de novo. CUL3 and BTB-domain-containing kelch proteins such as KLHL3 are components of cullin-RING E3 ligase complexes that ubiquitinate substrates bound to kelch propeller domains. Dominant KLHL3 mutations are clustered in short segments within the kelch propeller and BTB domains implicated in substrate and cullin binding, respectively. Diverse CUL3 mutations all result in skipping of exon 9, producing an in-frame deletion. Because dominant KLHL3 and CUL3 mutations both phenocopy recessive loss-of-function KLHL3 mutations, they may abrogate ubiquitination of KLHL3 substrates. Disease features are reversed by thiazide diuretics, which inhibit the Na-Cl cotransporter in the distal nephron of the kidney; KLHL3 and CUL3 are expressed in this location, suggesting a mechanistic link between KLHL3 and CUL3 mutations, increased Na-Cl reabsorption, and disease pathogenesis. These findings demonstrate the utility of exome sequencing in disease gene identification despite the combined complexities of locus heterogeneity, mixed models of transmission and frequent de novo mutation, and establish a fundamental role for KLHL3 and CUL3 in blood pressure, K(+) and pH homeostasis. 相似文献
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Wnk4 controls blood pressure and potassium homeostasis via regulation of mass and activity of the distal convoluted tubule 总被引:10,自引:0,他引:10
Lalioti MD Zhang J Volkman HM Kahle KT Hoffmann KE Toka HR Nelson-Williams C Ellison DH Flavell R Booth CJ Lu Y Geller DS Lifton RP 《Nature genetics》2006,38(10):1124-1132
The mechanisms that govern homeostasis of complex systems have been elusive but can be illuminated by mutations that disrupt system behavior. Mutations in the gene encoding the kinase WNK4 cause pseudohypoaldosteronism type II (PHAII), a syndrome featuring hypertension and hyperkalemia. We show that physiology in mice transgenic for genomic segments harboring wild-type (TgWnk4(WT)) or PHAII mutant (TgWnk4(PHAII)) Wnk4 is changed in opposite directions: TgWnk4(PHAII) mice have higher blood pressure, hyperkalemia, hypercalciuria and marked hyperplasia of the distal convoluted tubule (DCT), whereas the opposite is true in TgWnk4(WT) mice. Genetic deficiency for the Na-Cl cotransporter of the DCT (NCC) reverses phenotypes seen in TgWnk4(PHAII) mice, demonstrating that the effects of the PHAII mutation are due to altered NCC activity. These findings establish that Wnk4 is a molecular switch that regulates the balance between NaCl reabsorption and K+ secretion by altering the mass and function of the DCT through its effect on NCC. 相似文献
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