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Mutations in transcription factor CP2-like 1 may cause a novel syndrome with distal renal tubulopathy in humans

Item Type:Article
Title:Mutations in transcription factor CP2-like 1 may cause a novel syndrome with distal renal tubulopathy in humans
Creators Name:Klämbt, V. and Werth, M. and Onuchic-Whitford, A.C. and Getwan, M. and Kitzler, T.M. and Buerger, F. and Mao, Y. and Deutsch, K. and Mann, N. and Majmundar, A.J. and Kaminski, M.M. and Shen, Tian and Schmidt-Ott, K.M. and Shalaby, M. and El Desoky, S. and Kari, J.A. and Shril, S. and Lienkamp, S.S. and Barasch, J. and Hildebrandt, F.
Abstract:BACKGROUND: An underlying monogenic cause of early-onset chronic kidney disease (CKD) can be detected in ∼20% of individuals. For many etiologies of CKD manifesting before 25 years of age, >200 monogenic causative genes have been identified to date, leading to the elucidation of mechanisms of renal pathogenesis. METHODS: In 51 families with echogenic kidneys and CKD, we performed whole-exome sequencing to identify novel monogenic causes of CKD. RESULTS: We discovered a homozygous truncating mutation in the transcription factor gene transcription factor CP2-like 1 (TFCP2L1) in an Arabic patient of consanguineous descent. The patient developed CKD by the age of 2 months and had episodes of severe hypochloremic, hyponatremic and hypokalemic alkalosis, seizures, developmental delay and hypotonia together with cataracts. We found that TFCP2L1 was localized throughout kidney development particularly in the distal nephron. Interestingly, TFCP2L1 induced the growth and development of renal tubules from rat mesenchymal cells. Conversely, the deletion of TFCP2L1 in mice was previously shown to lead to reduced expression of renal cell markers including ion transporters and cell identity proteins expressed in different segments of the distal nephron. TFCP2L1 localized to the nucleus in HEK293T cells only upon coexpression with its paralog upstream-binding protein 1 (UBP1). A TFCP2L1 mutant complementary DNA (cDNA) clone that represented the patient's mutation failed to form homo- and heterodimers with UBP1, an essential step for its transcriptional activity. CONCLUSION: Here, we identified a loss-of-function TFCP2L1 mutation as a potential novel cause of CKD in childhood accompanied by a salt-losing tubulopathy.
Keywords:Chronic Kidney Disease, Genetic, Metabolic Alkalosis, Monogenic, Whole-Exome Sequencing, Animals, Mice, Rats
Source:Nephrology Dialysis Transplantation
ISSN:0931-0509
Publisher:Oxford University Press
Volume:36
Number:2
Page Range:237-246
Date:February 2021
Official Publication:https://doi.org/10.1093/ndt/gfaa215
PubMed:View item in PubMed

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