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XB-ART-39645
N Engl J Med May 7, 2009; 360 (19): 1960-70.

Epilepsy, ataxia, sensorineural deafness, tubulopathy, and KCNJ10 mutations.

Bockenhauer D , Feather S , Stanescu HC , Bandulik S , Zdebik AA , Reichold M , Tobin J , Lieberer E , Sterner C , Landoure G , Arora R , Sirimanna T , Thompson D , Cross JH , van't Hoff W , Al Masri O , Tullus K , Yeung S , Anikster Y , Klootwijk E , Hubank M , Dillon MJ , Heitzmann D , Arcos-Burgos M , Knepper MA , Dobbie A , Gahl WA , Warth R , Sheridan E , Kleta R .


Abstract
BACKGROUND: Five children from two consanguineous families presented with epilepsy beginning in infancy and severe ataxia, moderate sensorineural deafness, and a renal salt-losing tubulopathy with normotensive hypokalemic metabolic alkalosis. We investigated the genetic basis of this autosomal recessive disease, which we call the EAST syndrome (the presence of epilepsy, ataxia, sensorineural deafness, and tubulopathy). METHODS: Whole-genome linkage analysis was performed in the four affected children in one of the families. Newly identified mutations in a potassium-channel gene were evaluated with the use of a heterologous expression system. Protein expression and function were further investigated in genetically modified mice. RESULTS: Linkage analysis identified a single significant locus on chromosome 1q23.2 with a lod score of 4.98. This region contained the KCNJ10 gene, which encodes a potassium channel expressed in the brain, inner ear, and kidney. Sequencing of this candidate gene revealed homozygous missense mutations in affected persons in both families. These mutations, when expressed heterologously in xenopus oocytes, caused significant and specific decreases in potassium currents. Mice with Kcnj10 deletions became dehydrated, with definitive evidence of renal salt wasting. CONCLUSIONS: Mutations in KCNJ10 cause a specific disorder, consisting of epilepsy, ataxia, sensorineural deafness, and tubulopathy. Our findings indicate that KCNJ10 plays a major role in renal salt handling and, hence, possibly also in blood-pressure maintenance and its regulation.

PubMed ID: 19420365
PMC ID: PMC3398803
Article link: N Engl J Med
Grant support: [+]
Genes referenced: kcnj10
GO keywords: potassium channel activity [+]

Disease Ontology terms: EAST syndrome [+]
OMIMs: PENDRED SYNDROME; PDS [+]
References [+] :
Abecasis, Merlin--rapid analysis of dense genetic maps using sparse gene flow trees. 2001, Pubmed


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