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Publication : Pathogenicity of a Human Laminin <i>β</i>2 Mutation Revealed in Models of Alport Syndrome.

First Author  Funk SD Year  2018
Journal  J Am Soc Nephrol Volume  29
Issue  3 Pages  949-960
PubMed ID  29263159 Mgi Jnum  J:280129
Mgi Id  MGI:6369306 Doi  10.1681/ASN.2017090997
Citation  Funk SD, et al. (2018) Pathogenicity of a Human Laminin beta2 Mutation Revealed in Models of Alport Syndrome. J Am Soc Nephrol 29(3):949-960
abstractText  Pierson syndrome is a congenital nephrotic syndrome with eye and neurologic defects caused by mutations in laminin beta2 (LAMB2), a major component of the glomerular basement membrane (GBM). Pathogenic missense mutations in human LAMB2 cluster in or near the laminin amino-terminal (LN) domain, a domain required for extracellular polymerization of laminin trimers and basement membrane scaffolding. Here, we investigated an LN domain missense mutation, LAMB2-S80R, which was discovered in a patient with Pierson syndrome and unusually late onset of proteinuria. Biochemical data indicated that this mutation impairs laminin polymerization, which we hypothesized to be the cause of the patient's nephrotic syndrome. Testing this hypothesis in genetically altered mice showed that the corresponding amino acid change (LAMB2-S83R) alone is not pathogenic. However, expression of LAMB2-S83R significantly increased the rate of progression to kidney failure in a Col4a3(-/-) mouse model of autosomal recessive Alport syndrome and increased proteinuria in Col4a5(+/-) females that exhibit a mild form of X-linked Alport syndrome due to mosaic deposition of collagen alpha3alpha4alpha5(IV) in the GBM. Collectively, these data show the pathogenicity of LAMB2-S80R and provide the first evidence of genetic modification of Alport phenotypes by variation in another GBM component. This finding could help explain the wide range of Alport syndrome onset and severity observed in patients with Alport syndrome, even for family members who share the same COL4 mutation. Our results also show the complexities of using model organisms to investigate genetic variants suspected of being pathogenic in humans.
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