TY - JOUR
T1 - Mutation affecting the conserved acidic WNK1 motif causes inherited hyperkalemic hyperchloremic acidosis
AU - Louis-Dit-Picard, Hélène
AU - Kouranti, Ilektra
AU - Rafael, Chloé
AU - Loisel-Ferreira, Irmine
AU - Chavez-Canales, Maria
AU - Abdel-Khalek, Waed
AU - Argaiz, Eduardo R.
AU - Baron, Stéphanie
AU - Vacle, Sarah
AU - Migeon, Tiffany
AU - Coleman, Richard
AU - Cruzeiro, Marcio Do
AU - Hureaux, Marguerite
AU - Thurairajasingam, Nirubiah
AU - Decramer, Stéphane
AU - Girerd, Xavier
AU - O’Shaugnessy, Kevin
AU - Mulatero, Paolo
AU - Roussey, Gwenaëlle
AU - Tack, Ivan
AU - Unwin, Robert
AU - Vargas-Poussou, Rosa
AU - Staub, Olivier
AU - Grimm, Richard
AU - Welling, Paul A.
AU - Gamba, Gerardo
AU - Clauser, Eric
AU - Hadchouel, Juliette
AU - Jeunemaitre, Xavier
N1 - Funding Information:
We thank all patients and families for their participation in the study. We acknowledge the contributions of additional clinicians for the clinical and biochemical characterization of FHHt patients, especially Béatrice Fiquet and Geneviève Beaurain (Paris, France), Patrick Giraud (Montauban, France), and Silvia Monticone (Torino, Italy). We also thank Valérie Boccio for her contribution to the genetic analysis of the WNK1 gene. This work was supported by the Institut National de la Santé et de la Recherche Médicale (INSERM); the Fondation pour la Recherche pour l’Hypertension Artérielle (to XJ and JH); the Transatlantic Network on Hypertension funded by the Fondation Leducq (to XJ, GG, JH, and OS); the Transatlantic Network on Potassium and Hypertension funded by the Fondation Leducq (to PAW and OS); and the Agence Nationale pour la Recherche (ANR) (grant to JH and GG). This study also received funding from the European Union’s Seventh Framework Programme (FP7/2007-2013) under grant agreement no. 305608 (EURenOmics). IK was supported by a grant from Institut de Recherche Servier, and PM is supported by a grant from MIUR (ex-60% 2016 and 2017). This study was also supported by grants no. A1-S-8290 from the Mexican Council of Science and Technology (CONACYT) and no. IN201519 from PAPIIT-DGAPA (to GG) and collaborative funding from CONACYT–Agence Nationale pour la Recherche (Conacyt 188712-ANR-12-ISVS1-0001-01 to GG and JH). OS and SV were supported by Swiss National Science Foundation grant 310030-141013 and the NCCR-Kidney. ch (Swiss National Science Foundation). PAW was supported by grants from the NIH (DK054231 and DK093501).
Funding Information:
We thank all patients and families for their participation in the study. We acknowledge the contributions of additional clinicians for the clinical and biochemical characterization of FHHt patients, especially Béatrice Fiquet and Geneviève Beaurain (Paris, France), Patrick Giraud (Montauban, France), and Silvia Monticone (Torino, Italy). We also thank Valérie Boccio for her contribution to the genetic analysis of the WNK1 gene. This work was supported by the Institut National de la Santé et de la Recherche Médicale (INSERM); the Fondation pour la Recherche pour l’Hypertension Artérielle (to XJ and JH); the Transatlantic Network on Hypertension funded by the Fondation Leducq (to XJ, GG, JH, and OS); the Transatlantic Network on Potassium and Hypertension funded by the Fondation Leducq (to PAW and OS); and the Agence Natio-nale pour la Recherche (ANR) (grant to JH and GG). This study also received funding from the European Union’s Seventh Frame-work Programme (FP7/2007-2013) under grant agreement no. 305608 (EURenOmics). IK was supported by a grant from Institut de Recherche Servier, and PM is supported by a grant from MIUR (ex-60% 2016 and 2017). This study was also supported by grants no. A1-S-8290 from the Mexican Council of Science and Technology (CONACYT) and no. IN201519 from PAPIIT-DGAPA (to GG) and collaborative funding from CONACYT–Agence Natio-nale pour la Recherche (Conacyt 188712-ANR-12-ISVS1-0001-01 to GG and JH). OS and SV were supported by Swiss National Science Foundation grant 310030-141013 and the NCCR-Kidney. ch (Swiss National Science Foundation). PAW was supported by grants from the NIH (DK054231 and DK093501).
Publisher Copyright:
© 2020, American Society for Clinical Investigation.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Gain-of-function mutations in with no lysine (K) 1 (WNK1) and WNK4 genes are responsible for familial hyperkalemic hypertension (FHHt), a rare, inherited disorder characterized by arterial hypertension and hyperkalemia with metabolic acidosis. More recently, FHHt-causing mutations in the Kelch-like 3–Cullin 3 (KLHL3-CUL3) E3 ubiquitin ligase complex have shed light on the importance of WNK’s cellular degradation on renal ion transport. Using full exome sequencing for a 4-generation family and then targeted sequencing in other suspected cases, we have identified new missense variants in the WNK1 gene clustering in the short conserved acidic motif known to interact with the KLHL3-CUL3 ubiquitin complex. Affected subjects had an early onset of a hyperkalemic hyperchloremic phenotype, but normal blood pressure values”Functional experiments in Xenopus laevis oocytes and HEK293T cells demonstrated that these mutations strongly decrease the ubiquitination of the kidney-specific isoform KS-WNK1 by the KLHL3-CUL3 complex rather than the long ubiquitous catalytically active L-WNK1 isoform. A corresponding CRISPR/Cas9 engineered mouse model recapitulated both the clinical and biological phenotypes. Renal investigations showed increased activation of the Ste20 proline alanine–rich kinase–Na+-Cl– cotransporter (SPAK-NCC) phosphorylation cascade, associated with impaired ROMK apical expression in the distal part of the renal tubule. Together, these new WNK1 genetic variants highlight the importance of the KS-WNK1 isoform abundance on potassium homeostasis.
AB - Gain-of-function mutations in with no lysine (K) 1 (WNK1) and WNK4 genes are responsible for familial hyperkalemic hypertension (FHHt), a rare, inherited disorder characterized by arterial hypertension and hyperkalemia with metabolic acidosis. More recently, FHHt-causing mutations in the Kelch-like 3–Cullin 3 (KLHL3-CUL3) E3 ubiquitin ligase complex have shed light on the importance of WNK’s cellular degradation on renal ion transport. Using full exome sequencing for a 4-generation family and then targeted sequencing in other suspected cases, we have identified new missense variants in the WNK1 gene clustering in the short conserved acidic motif known to interact with the KLHL3-CUL3 ubiquitin complex. Affected subjects had an early onset of a hyperkalemic hyperchloremic phenotype, but normal blood pressure values”Functional experiments in Xenopus laevis oocytes and HEK293T cells demonstrated that these mutations strongly decrease the ubiquitination of the kidney-specific isoform KS-WNK1 by the KLHL3-CUL3 complex rather than the long ubiquitous catalytically active L-WNK1 isoform. A corresponding CRISPR/Cas9 engineered mouse model recapitulated both the clinical and biological phenotypes. Renal investigations showed increased activation of the Ste20 proline alanine–rich kinase–Na+-Cl– cotransporter (SPAK-NCC) phosphorylation cascade, associated with impaired ROMK apical expression in the distal part of the renal tubule. Together, these new WNK1 genetic variants highlight the importance of the KS-WNK1 isoform abundance on potassium homeostasis.
UR - http://www.scopus.com/inward/record.url?scp=85097112367&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85097112367&partnerID=8YFLogxK
U2 - 10.1172/JCI94171
DO - 10.1172/JCI94171
M3 - Article
C2 - 32790646
AN - SCOPUS:85097112367
SN - 0021-9738
VL - 130
SP - 6379
EP - 6394
JO - Journal of Clinical Investigation
JF - Journal of Clinical Investigation
IS - 12
ER -