; Feather, Sally ; Stanescu, Horia C. ; Bandulik, Sascha ; Zdebik, Anselm A. ; Reichold, Markus ; Tobin, Jonathan ; Lieberer, Evelyn ; Sterner, Christina ; Landoure, Guida ; Arora, Ruchi ; Sirimanna, Tony ; Thompson, Dorothy
; Cross, J. Helen ; van't Hoff, William ; Al Masri, Omar ; Tullus, Kjell ; Yeung, Stella ; Anikster, Yair ; Klootwijk, Enriko ; Hubank, Mike
; Dillon, Michael J. ; Heitzmann, Dirk ; Arcos-Burgos, Mauricio
; Knepper, Mark A. ; Dobbie, Angus ; Gahl, William A. ; Warth, Richard
; Sheridan, Eamonn ; Kleta, Robert | Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | New England Journal of Medicine | ||||
| Publisher: | MASSACHUSETTS MEDICAL SOC | ||||
| Place of Publication: | WALTHAM | ||||
| Volume: | 360 | ||||
| Number of Issue or Book Chapter: | 19 | ||||
| Page Range: | pp. 1960-1970 | ||||
| Date: | 2009 | ||||
| Institutions: | Biology, Preclinical Medicine > Institut für Physiologie | ||||
| Identification Number: |
| ||||
| Keywords: | DISTAL CONVOLUTED TUBULE; WIDE LINKAGE ANALYSIS; NA-CL COTRANSPORTER; BARTTERS-SYNDROME; K+ CHANNEL; POTASSIUM CHANNEL; BLOOD-PRESSURE; HYPOKALEMIC ALKALOSIS; BASOLATERAL MEMBRANE; KNOCK-OUT; | ||||
| Dewey Decimal Classification: | 500 Science > 570 Life sciences | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 67169 |
Abstract
Background: Five children from two consanguineous families presented with epilepsy beginning in infancy and severe ataxia, moderate sensorineural deafness, and a renal salt-losing tubulopathy with normotensive hypokalemic metabolic alkalosis. We investigated the genetic basis of this autosomal recessive disease, which we call the EAST syndrome (the presence of epilepsy, ataxia, sensorineural ...

Abstract
Background: Five children from two consanguineous families presented with epilepsy beginning in infancy and severe ataxia, moderate sensorineural deafness, and a renal salt-losing tubulopathy with normotensive hypokalemic metabolic alkalosis. We investigated the genetic basis of this autosomal recessive disease, which we call the EAST syndrome (the presence of epilepsy, ataxia, sensorineural deafness, and tubulopathy). Methods: Whole-genome linkage analysis was performed in the four affected children in one of the families. Newly identified mutations in a potassium-channel gene were evaluated with the use of a heterologous expression system. Protein expression and function were further investigated in genetically modified mice. Results: Linkage analysis identified a single significant locus on chromosome 1q23.2 with a lod score of 4.98. This region contained the KCNJ10 gene, which encodes a potassium channel expressed in the brain, inner ear, and kidney. Sequencing of this candidate gene revealed homozygous missense mutations in affected persons in both families. These mutations, when expressed heterologously in xenopus oocytes, caused significant and specific decreases in potassium currents. Mice with Kcnj10 deletions became dehydrated, with definitive evidence of renal salt wasting. Conclusions: Mutations in KCNJ10 cause a specific disorder, consisting of epilepsy, ataxia, sensorineural deafness, and tubulopathy. Our findings indicate that KCNJ10 plays a major role in renal salt handling and, hence, possibly also in blood-pressure maintenance and its regulation. N Engl J Med 2009;360:1960-70.
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