Atypical haemolytic uraemic syndrome associated with a hybrid complement gene.
| Autor: | Julian P Venables, Lisa Strain, Danny Routledge, David Bourn, Helen M Powell, Paul Warwicker, Martha L Diaz-Torres, Anne Sampson, Paul Mead, Michelle Webb, Yves Pirson, Michael S Jackson, Anne Hughes, Katrina M Wood, Judith A Goodship, Timothy H J Goodship |
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| Jazyk: | angličtina |
| Rok vydání: | 2006 |
| Předmět: | |
| Zdroj: | PLoS Medicine, Vol 3, Iss 10, p e431 (2006) |
| Druh dokumentu: | article |
| ISSN: | 1549-1277 1549-1676 |
| DOI: | 10.1371/journal.pmed.0030431 |
| Popis: | BACKGROUND: Sequence analysis of the regulators of complement activation (RCA) cluster of genes at chromosome position 1q32 shows evidence of several large genomic duplications. These duplications have resulted in a high degree of sequence identity between the gene for factor H (CFH) and the genes for the five factor H-related proteins (CFHL1-5; aliases CFHR1-5). CFH mutations have been described in association with atypical haemolytic uraemic syndrome (aHUS). The majority of the mutations are missense changes that cluster in the C-terminal region and impair the ability of factor H to regulate surface-bound C3b. Some have arisen as a result of gene conversion between CFH and CFHL1. In this study we tested the hypothesis that nonallelic homologous recombination between low-copy repeats in the RCA cluster could result in the formation of a hybrid CFH/CFHL1 gene that predisposes to the development of aHUS. METHODS AND FINDINGS: In a family with many cases of aHUS that segregate with the RCA cluster we used cDNA analysis, gene sequencing, and Southern blotting to show that affected individuals carry a heterozygous CFH/CFHL1 hybrid gene in which exons 1-21 are derived from CFH and exons 22/23 from CFHL1. This hybrid encodes a protein product identical to a functionally significant CFH mutant (c.3572C>T, S1191L and c.3590T>C, V1197A) that has been previously described in association with aHUS. CONCLUSIONS: CFH mutation screening is recommended in all aHUS patients prior to renal transplantation because of the high risk of disease recurrence post-transplant in those known to have a CFH mutation. Because of our finding it will be necessary to implement additional screening strategies that will detect a hybrid CFH/CFHL1 gene. |
| Databáze: | Directory of Open Access Journals |
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