Mutations of the SLIT2–ROBO2 pathway genes SLIT2 and SRGAP1 confer risk for congenital anomalies of the kidney and urinary tract

Daw Yang Hwang, Stefan Kohl, Xueping Fan, Asaf Vivante, Stefanie Chan, Gabriel C. Dworschak, Julian Schulz, Albertien M. van Eerde, Alina C. Hilger, Heon Yung Gee, Tracie Pennimpede, Bernhard G. Herrmann, Glenn van de Hoek, Kirsten Y. Renkema, Christoph Schell, Tobias B. Huber, Heiko M. Reutter, Neveen A. Soliman, Natasa Stajic, Radovan BogdanovicElijah O. Kehinde, Richard P. Lifton, Velibor Tasic, Weining Lu, Friedhelm Hildebrandt*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Congenital anomalies of the kidney and urinary tract (CAKUT) account for 40–50 % of chronic kidney disease that manifests in the first two decades of life. Thus far, 31 monogenic causes of isolated CAKUT have been described, explaining ~12 % of cases. To identify additional CAKUT-causing genes, we performed whole-exome sequencing followed by a genetic burden analysis in 26 genetically unsolved families with CAKUT. We identified two heterozygous mutations in SRGAP1 in 2 unrelated families. SRGAP1 is a small GTPase-activating protein in the SLIT2–ROBO2 signaling pathway, which is essential for development of the metanephric kidney. We then examined the pathway-derived candidate gene SLIT2 for mutations in cohort of 749 individuals with CAKUT and we identified 3 unrelated individuals with heterozygous mutations. The clinical phenotypes of individuals with mutations in SLIT2 or SRGAP1 were cystic dysplastic kidneys, unilateral renal agenesis, and duplicated collecting system. We show that SRGAP1 is expressed in early mouse nephrogenic mesenchyme and that it is coexpressed with ROBO2 in SIX2-positive nephron progenitor cells of the cap mesenchyme in developing rat kidney. We demonstrate that the newly identified mutations in SRGAP1 lead to an augmented inhibition of RAC1 in cultured human embryonic kidney cells and that the SLIT2 mutations compromise the ability of the SLIT2 ligand to inhibit cell migration. Thus, we report on two novel candidate genes for causing monogenic isolated CAKUT in humans.

Original languageEnglish
Pages (from-to)905-916
Number of pages12
JournalHuman Genetics
Volume134
Issue number8
DOIs
Publication statusPublished - Aug 2015

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