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Article Dans Une Revue Nature Genetics Année : 2013

Recessive mutations in DGKE cause atypical hemolytic-uremic syndrome

Mathieu Lemaire
  • Fonction : Auteur
Murim Choi
  • Fonction : Auteur
Wai Ho Tang
  • Fonction : Auteur
Moglie Le Quintrec
  • Fonction : Auteur
Weizhen Ji
  • Fonction : Auteur
John D. Overton
  • Fonction : Auteur
Shrikant M. Mane
  • Fonction : Auteur
Brigitte Llanas
  • Fonction : Auteur
Laure Collard
  • Fonction : Auteur
Mohammed A. Majid
  • Fonction : Auteur
Eva Simkova
  • Fonction : Auteur
Gilbert W. Moeckel
  • Fonction : Auteur
Marie Claire Gubler
  • Fonction : Auteur
John Hwa
  • Fonction : Auteur

Résumé

Pathologic thrombosis is a major cause of mortality. Hemolytic-uremic syndrome (HUS) features episodes of small-vessel thrombosis resulting in microangiopathic hemolytic anemia, thrombocytopenia and renal failure. Atypical HUS (aHUS) can result from genetic or autoimmune factors that lead to pathologic complement cascade activation. Using exome sequencing, we identified recessive mutations in DGKE (encoding diacylglycerol kinase ɛ) that co-segregated with aHUS in nine unrelated kindreds, defining a distinctive Mendelian disease. Affected individuals present with aHUS before age 1 year, have persistent hypertension, hematuria and proteinuria (sometimes in the nephrotic range), and develop chronic kidney disease with age. DGKE is found in endothelium, platelets and podocytes. Arachidonic acid-containing diacylglycerols (DAG) activate protein kinase C (PKC), which promotes thrombosis, and DGKE normally inactivates DAG signaling. We infer that loss of DGKE function results in a prothrombotic state. These findings identify a new mechanism of pathologic thrombosis and kidney failure and have immediate implications for treating individuals with aHUS.

Dates et versions

hal-01064383 , version 1 (16-09-2014)

Identifiants

Citer

Mathieu Lemaire, Véronique Frémeaux-Bacchi, Franz Schaefer, Murim Choi, Wai Ho Tang, et al.. Recessive mutations in DGKE cause atypical hemolytic-uremic syndrome. Nature Genetics, 2013, 45 (5), pp.531--536. ⟨10.1038/ng.2590⟩. ⟨hal-01064383⟩
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