Glycine amidinotransferase (GATM), renal Fanconi syndrome, and kidney failure

Background For many patients with kidney failure, the cause and underlying defect remain unknown. Here, we describe a novel mechanism of a genetic order characterized by renal Fanconi syndrome and kidney failure.Methods We clinically and genetically characterized members of five families with autoso...

Full description

Bibliographic Details
Main Authors: Reichold, M, Klootwijk, ED, Reinders, J, Otto, EA, Milani, M, Broeker, C, Laing, C, Wiesner, J, Devi, S, Zhou, W, Schmitt, R, Tegtmeier, I, Sterner, C, Doellerer, H, Renner, K, Oefner, PJ, Dettmer, K, Simbuerger, JM, Witzgall, R, Stanescu, HC, Dumitriu, S, Iancu, D, Patel, V, Mozere, M, Tekman, M, Jaureguiberry, G, Issler, N, Kesselheim, A, Walsh, SB, Gale, DP, Howie, AJ, Martins, JR, Hall, AM, Kasgharian, M, O'Brien, K, Ferreira, CR, Atwal, PS, Jain, M, Hammers, A, Charles-Edwards, G, Choe, C-U, Isbrandt, D, Cebrian-Serrano, A, Davies, B, Sandford, RN, Pugh, C, Konecki, DS, Povey, S, Bockenhauer, D, Lichter-Konecki, U, Gahl, WA, Unwin, RJ, Warth, R, Kleta, R
Format: Journal article
Language:English
Published: American Society of Nephrology 2018
_version_ 1797069793391542272
author Reichold, M
Klootwijk, ED
Reinders, J
Otto, EA
Milani, M
Broeker, C
Laing, C
Wiesner, J
Devi, S
Zhou, W
Schmitt, R
Tegtmeier, I
Sterner, C
Doellerer, H
Renner, K
Oefner, PJ
Dettmer, K
Simbuerger, JM
Witzgall, R
Stanescu, HC
Dumitriu, S
Iancu, D
Patel, V
Mozere, M
Tekman, M
Jaureguiberry, G
Issler, N
Kesselheim, A
Walsh, SB
Gale, DP
Howie, AJ
Martins, JR
Hall, AM
Kasgharian, M
O'Brien, K
Ferreira, CR
Atwal, PS
Jain, M
Hammers, A
Charles-Edwards, G
Choe, C-U
Isbrandt, D
Cebrian-Serrano, A
Davies, B
Sandford, RN
Pugh, C
Konecki, DS
Povey, S
Bockenhauer, D
Lichter-Konecki, U
Gahl, WA
Unwin, RJ
Warth, R
Kleta, R
author_facet Reichold, M
Klootwijk, ED
Reinders, J
Otto, EA
Milani, M
Broeker, C
Laing, C
Wiesner, J
Devi, S
Zhou, W
Schmitt, R
Tegtmeier, I
Sterner, C
Doellerer, H
Renner, K
Oefner, PJ
Dettmer, K
Simbuerger, JM
Witzgall, R
Stanescu, HC
Dumitriu, S
Iancu, D
Patel, V
Mozere, M
Tekman, M
Jaureguiberry, G
Issler, N
Kesselheim, A
Walsh, SB
Gale, DP
Howie, AJ
Martins, JR
Hall, AM
Kasgharian, M
O'Brien, K
Ferreira, CR
Atwal, PS
Jain, M
Hammers, A
Charles-Edwards, G
Choe, C-U
Isbrandt, D
Cebrian-Serrano, A
Davies, B
Sandford, RN
Pugh, C
Konecki, DS
Povey, S
Bockenhauer, D
Lichter-Konecki, U
Gahl, WA
Unwin, RJ
Warth, R
Kleta, R
author_sort Reichold, M
collection OXFORD
description Background For many patients with kidney failure, the cause and underlying defect remain unknown. Here, we describe a novel mechanism of a genetic order characterized by renal Fanconi syndrome and kidney failure.Methods We clinically and genetically characterized members of five families with autosomal dominant renal Fanconi syndrome and kidney failure. We performed genome-wide linkage analysis, sequencing, and expression studies in kidney biopsy specimens and renal cells along with knockout mouse studies and evaluations of mitochondrial morphology and function. Structural studies examined the effects of recognized mutations.Results The renal disease in these patients resulted from monoallelic mutations in the gene encoding glycine amidinotransferase (GATM), a renal proximal tubular enzyme in the creatine biosynthetic pathway that is otherwise associated with a recessive disorder of creatine deficiency. In silico analysis showed that the particular GATM mutations, identified in 28 members of the five families, create an additional interaction interface within the GATM protein and likely cause the linear aggregation of GATM observed in patient biopsy specimens and cultured proximal tubule cells. GATM aggregates-containing mitochondria were elongated and associated with increased ROS production, activation of the NLRP3 inflammasome, enhanced expression of the profibrotic cytokine IL-18, and increased cell death.Conclusions In this novel genetic disorder, fully penetrant heterozygous missense mutations in GATM trigger intramitochondrial fibrillary deposition of GATM and lead to elongated and abnormal mitochondria. We speculate that this renal proximal tubular mitochondrial pathology initiates a response from the inflammasome, with subsequent development of kidney fibrosis.
first_indexed 2024-03-06T22:29:42Z
format Journal article
id oxford-uuid:57e146d1-bfee-48e7-b94e-be3c50aaad2d
institution University of Oxford
language English
last_indexed 2024-03-06T22:29:42Z
publishDate 2018
publisher American Society of Nephrology
record_format dspace
spelling oxford-uuid:57e146d1-bfee-48e7-b94e-be3c50aaad2d2022-03-26T16:59:41ZGlycine amidinotransferase (GATM), renal Fanconi syndrome, and kidney failureJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:57e146d1-bfee-48e7-b94e-be3c50aaad2dEnglishSymplectic Elements at OxfordAmerican Society of Nephrology2018Reichold, MKlootwijk, EDReinders, JOtto, EAMilani, MBroeker, CLaing, CWiesner, JDevi, SZhou, WSchmitt, RTegtmeier, ISterner, CDoellerer, HRenner, KOefner, PJDettmer, KSimbuerger, JMWitzgall, RStanescu, HCDumitriu, SIancu, DPatel, VMozere, MTekman, MJaureguiberry, GIssler, NKesselheim, AWalsh, SBGale, DPHowie, AJMartins, JRHall, AMKasgharian, MO'Brien, KFerreira, CRAtwal, PSJain, MHammers, ACharles-Edwards, GChoe, C-UIsbrandt, DCebrian-Serrano, ADavies, BSandford, RNPugh, CKonecki, DSPovey, SBockenhauer, DLichter-Konecki, UGahl, WAUnwin, RJWarth, RKleta, RBackground For many patients with kidney failure, the cause and underlying defect remain unknown. Here, we describe a novel mechanism of a genetic order characterized by renal Fanconi syndrome and kidney failure.Methods We clinically and genetically characterized members of five families with autosomal dominant renal Fanconi syndrome and kidney failure. We performed genome-wide linkage analysis, sequencing, and expression studies in kidney biopsy specimens and renal cells along with knockout mouse studies and evaluations of mitochondrial morphology and function. Structural studies examined the effects of recognized mutations.Results The renal disease in these patients resulted from monoallelic mutations in the gene encoding glycine amidinotransferase (GATM), a renal proximal tubular enzyme in the creatine biosynthetic pathway that is otherwise associated with a recessive disorder of creatine deficiency. In silico analysis showed that the particular GATM mutations, identified in 28 members of the five families, create an additional interaction interface within the GATM protein and likely cause the linear aggregation of GATM observed in patient biopsy specimens and cultured proximal tubule cells. GATM aggregates-containing mitochondria were elongated and associated with increased ROS production, activation of the NLRP3 inflammasome, enhanced expression of the profibrotic cytokine IL-18, and increased cell death.Conclusions In this novel genetic disorder, fully penetrant heterozygous missense mutations in GATM trigger intramitochondrial fibrillary deposition of GATM and lead to elongated and abnormal mitochondria. We speculate that this renal proximal tubular mitochondrial pathology initiates a response from the inflammasome, with subsequent development of kidney fibrosis.
spellingShingle Reichold, M
Klootwijk, ED
Reinders, J
Otto, EA
Milani, M
Broeker, C
Laing, C
Wiesner, J
Devi, S
Zhou, W
Schmitt, R
Tegtmeier, I
Sterner, C
Doellerer, H
Renner, K
Oefner, PJ
Dettmer, K
Simbuerger, JM
Witzgall, R
Stanescu, HC
Dumitriu, S
Iancu, D
Patel, V
Mozere, M
Tekman, M
Jaureguiberry, G
Issler, N
Kesselheim, A
Walsh, SB
Gale, DP
Howie, AJ
Martins, JR
Hall, AM
Kasgharian, M
O'Brien, K
Ferreira, CR
Atwal, PS
Jain, M
Hammers, A
Charles-Edwards, G
Choe, C-U
Isbrandt, D
Cebrian-Serrano, A
Davies, B
Sandford, RN
Pugh, C
Konecki, DS
Povey, S
Bockenhauer, D
Lichter-Konecki, U
Gahl, WA
Unwin, RJ
Warth, R
Kleta, R
Glycine amidinotransferase (GATM), renal Fanconi syndrome, and kidney failure
title Glycine amidinotransferase (GATM), renal Fanconi syndrome, and kidney failure
title_full Glycine amidinotransferase (GATM), renal Fanconi syndrome, and kidney failure
title_fullStr Glycine amidinotransferase (GATM), renal Fanconi syndrome, and kidney failure
title_full_unstemmed Glycine amidinotransferase (GATM), renal Fanconi syndrome, and kidney failure
title_short Glycine amidinotransferase (GATM), renal Fanconi syndrome, and kidney failure
title_sort glycine amidinotransferase gatm renal fanconi syndrome and kidney failure
work_keys_str_mv AT reicholdm glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT klootwijked glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT reindersj glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT ottoea glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT milanim glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT broekerc glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT laingc glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT wiesnerj glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT devis glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT zhouw glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT schmittr glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT tegtmeieri glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT sternerc glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT doellererh glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT rennerk glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT oefnerpj glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT dettmerk glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT simbuergerjm glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT witzgallr glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT stanescuhc glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT dumitrius glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT iancud glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT patelv glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT mozerem glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT tekmanm glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT jaureguiberryg glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT isslern glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT kesselheima glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT walshsb glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT galedp glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT howieaj glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT martinsjr glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT hallam glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT kasgharianm glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT obrienk glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT ferreiracr glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT atwalps glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT jainm glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT hammersa glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT charlesedwardsg glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT choecu glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT isbrandtd glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT cebrianserranoa glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT daviesb glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT sandfordrn glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT pughc glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT koneckids glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT poveys glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT bockenhauerd glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT lichterkoneckiu glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT gahlwa glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT unwinrj glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT warthr glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure
AT kletar glycineamidinotransferasegatmrenalfanconisyndromeandkidneyfailure