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J Am Soc Nephrol 10:2342-2351, 1999
© 1999 American Society of Nephrology

Aberrant Splicing in the PKD2 Gene as a Cause of Polycystic Kidney Disease

DAVID M. REYNOLDS*, TOMOHITO HAYASHI*, YIQIANG CAI*, BARBERA VELDHUISEN{dagger}, TERRY J. WATNICK{ddagger}, XOSE M. LENS§, TOSHIO MOCHIZUKI*, FENG QIAN{ddagger}, YOSHIKO MAEDA*, LI LI*, RAGNHEIDUR FOSSDAL||, ELIECER COTO, GUANQING WU*, MARTIJN H. BREUNING{dagger}, GREGORY G. GERMINO{ddagger}, DORIEN J. M. PETERS{dagger} and STEFAN SOMLO*

* Departments of Medicine and Molecular Genetics, Albert Einstein College of Medicine, Bronx, New York
{dagger} Department of Human Genetics, Sylvius Laboratory, Leiden University, Leiden, Netherlands
{ddagger} Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
§ Complexo Hospitalario, Universitario de Santiago, Santiago de Compostela, Spain
|| Department of Medical Genetics, National University Hospital, Reykjavik, Iceland
Servicio de Immunologia, Hospital Central de Asturias, Oviedo, Spain.

Correspondence to Dr. Stefan Somlo, Section of Nephrology, Yale University School of Medicine, LMP 2073, 333 Cedar Street, New Haven, CT 06520-8029. Phone: 203-785-7595; Fax: 203-624-8213; E-mail: stefan.somlo{at}yale.edu

Abstract. It is estimated that approximately 15% of families with autosomal dominant polycystic kidney disease (ADPKD) have mutations in PKD2. Identification of these mutations is central to identifying functionally important regions of gene and to understanding the mechanisms underlying the pathogenesis of the disorder. The current study describes mutations in six type 2 ADPKD families. Two single base substitution mutations discovered in the ORF in exon 14 constitute the most COOH-terminal pathogenic variants described to date. One of these mutations is a nonsense change and the other encodes an apparent missense variant. Reverse transcription-PCR from patient lymphoblast RNA showed that, in addition, both mutations resulted in out-of-frame splice variants by activating cryptic splice sites via different mechanisms. The apparent missense variant produced such a strong splicing signal that the processed transcript from the mutant chromosome did not contain any of the normally spliced, missense product. A third mutation, a nonconservative missense change effecting a negatively charged residue in the third transmembrane span, is likely pathogenic and defines a highly conserved residue consistent with a potential channel subunit function for polycystin-2. The remaining three mutations included two frame shifts resulting from deletion of one or two bases in exons 6 and 10, respectively, and a nonsense mutation due to a single base substitution in exon 4. The study also defined a novel intragenic polymorphism in exon 1 that will be useful in analyzing "second hits" in PKD2. Finally, the study demonstrates that there are reduced levels of normal polycystin-2 protein in lymphoblast lines from PKD2-affected individuals and that truncated mutant polycystin-2 cannot be detected in patient lymphoblasts, suggesting that the latter may be unstable in at least some tissues. The mutations described will serve as critical reagents for future functional studies in PKD2.




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