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Am J Hum Genet
2009 May 01;845:651-7. doi: 10.1016/j.ajhg.2009.04.014.
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Mutations of KCNJ10 together with mutations of SLC26A4 cause digenic nonsyndromic hearing loss associated with enlarged vestibular aqueduct syndrome.
Yang T
,
Gurrola JG
,
Wu H
,
Chiu SM
,
Wangemann P
,
Snyder PM
,
Smith RJ
.
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Mutations in SLC26A4 cause nonsyndromic hearing loss associated with an enlarged vestibular aqueduct (EVA, also known as DFNB4) and Pendred syndrome (PS), the most common type of autosomal-recessive syndromic deafness. In many patients with an EVA/PS phenotype, mutation screening of SLC26A4 fails to identify two disease-causing allele variants. That a sizable fraction of patients carry only one SLC26A4 mutation suggests that EVA/PS is a complex disease involving other genetic factors. Here, we show that mutations in the inwardly rectifying K(+) channel gene KCNJ10 are associated with nonsyndromic hearing loss in carriers of SLC26A4 mutations with an EVA/PS phenotype. In probands from two families, we identified double heterozygosity in affected individuals. These persons carried single mutations in both SLC26A4 and KCNJ10. The identified SLC26A4 mutations have been previously implicated in EVA/PS, and the KCNJ10 mutations reduce K(+) conductance activity, which is critical for generating and maintaining the endocochlear potential. In addition, we show that haploinsufficiency of Slc26a4 in the Slc26a4(+/-) mouse mutant results in reduced protein expression of Kcnj10 in the stria vascularis of the inner ear. Our results link KCNJ10 mutations with EVA/PS and provide further support for the model of EVA/PS as a multigenic complex disease.
Figure 1
Double Heterozygosity for Mutations in KCNJ10 and SLC26A4 in Family 82120 with EVA/PS
(A) Pedigree and genotypes of the family, showing that the parents and their unaffected child carry a single mutation in either SLC26A4 or KCNJ10 and that the affected child carries both mutations.
(B) Representative chromatograms of the SLC26A4 c.919-2AâG and KCNJ10 p.R348C mutations identified in this family.
Figure 2
Voltage-Clamp Analysis of K+ Conductance of WT and Mutant KCNJ10
(A) Representative trace of current (top) and voltage commands (bottom) versus time in Xenopus oocyte expressing WT KCNJ10. A 1 mM final concentration of channel blocker BaCl2 was added into the extracellular bath at the time point near 20 s, as indicated (black bar).
(B) Steady-state current-voltage relationship for WT and mutant KCNJ10 (mean ± SE, n = 6). For clarity, error bars are shown only for WT and R348C mutant KCNJ10. The differences between the currents of WT and mutant KCNJ10 are statistically significant at voltages between â120 mV and â20 mV (p < 0.05), as indicated by asterisks. The slopes of the current-voltage relationship in the linear range between â120 mV and 0 mV were calculated by linear regression analysis and are shown at the right of each curve (from top: WT, R348C, and P194H; R2 values are shown in parentheses).
Figure 3
Quantitative Immunoblot Analysis of Kcnj10 Expression in Mouse Stria Vascularis
(A) Representative immunoblot showing protein expression of Kcnj10 and β-tubulin in equal sample volumes from Slc26a4+/+, Slc26a4+/â, and Slc26a4â/â mice. Molecular weights (kDa) of protein standards are marked on the right side. The two major bands of 120 kDa and 50 kDa and the minor smears of Kcnj10 reflect variable protein glycosylation, stoichiometry, and ubiquitination, as previously reported,9 and all are included in the quantitative analysis.
(B) Quantification of Kcnj10 expression normalized against β-tubulin control expression. Reduced expression of Kcnj10 in the stria vascularis of Slc26a4+/â and Slc26a4â/â mice as compared to WT mice (mean percentage ± SE, n = 3) is shown as scaled bars. The differences in Kcnj10 expression between Slc26a4+/â and Slc26a4+/+ mice and between Slc26a4â/â and Slc26a4+/+ mice are statistically significant (p < 0.05), as indicated by asterisks.
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