Functional analysis of heterozygous variants in the SALL1 gene in 2 children with Townes-Brocks syndrome with FSGS

Abstract Background To investigate the functional characteristics of heterozygous variants in the SALL1 gene in two children with Townes-Brocks syndrome (TBS), as well as the underlying mechanisms leading to chronic kidney disease. Methods We retrospectively analyzed the clinical manifestations, lab...

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Main Authors: Rong Liang, Bixia Zheng, Chunli Wang, Sanlong Zhao, Wei Zhou, Ying Chen, Ruochen Che
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Pediatrics
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Online Access:https://doi.org/10.1186/s12887-024-05326-5
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author Rong Liang
Bixia Zheng
Chunli Wang
Sanlong Zhao
Wei Zhou
Ying Chen
Ruochen Che
author_facet Rong Liang
Bixia Zheng
Chunli Wang
Sanlong Zhao
Wei Zhou
Ying Chen
Ruochen Che
author_sort Rong Liang
collection DOAJ
description Abstract Background To investigate the functional characteristics of heterozygous variants in the SALL1 gene in two children with Townes-Brocks syndrome (TBS), as well as the underlying mechanisms leading to chronic kidney disease. Methods We retrospectively analyzed the clinical manifestations, laboratory findings, and genetic backgrounds of two TBS patients admitted to our hospital presenting with chronic kidney disease stage 2 and focal segmental glomerulosclerosis (FSGS). The genetic function was investigated through cultured cells transfected with variants. The Sall1 protein expression level was detected by western blotting. Immunofluorescence was also employed to detect the subcellular localization of SALL1. Results Novel heterozygous genetic variations (c.3175 C > T and c.694 C > T) were detected in two respective probands with distinct clinical presentations: Proband 1 presented with polydactyly, nephrotic syndrome, and stage 2 chronic kidney disease; while Proband 2 manifested renal dysplasia, progressive proteinuria, and also stage 2 chronic kidney disease. FSGS was confirmed by kidney biopsies from both probands. To assess the functional impact of these variations, we introduced mutant plasmids carrying the c.3175 C > T and c.694 C > T variants into podocytes. The expression level of variant c.3175 C > T(p.Q1059X) in podocytes showed a significant decrease compared to that of the wild-type (P < 0.05), whereas variant c.694 C > T(p.Q232X) was markedly upregulated (P < 0.01). Immunofluorescence analysis revealed aberrant localization patterns for both SALL1 variants within podocytes. Conclusions Two patients with Townes-Brocks syndrome (TBS) harboring novel variants presented atypical phenotypes, characterized primarily by significant and rapidly progressing renal involvement. Rare renal biopsy pathology revealed the presence of focal segmental glomerulosclerosis (FSGS) in both cases. Experimental validation demonstrated that both variants led to alterations in the molecular size, expression level, and localization of the Sall1 protein, suggesting that these SALL1 gene variants might contribute to FSGS by impacting podocyte function.
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spelling doaj-art-910491bdb8694510bb77674696138c2a2025-02-09T12:54:38ZengBMCBMC Pediatrics1471-24312025-02-012511910.1186/s12887-024-05326-5Functional analysis of heterozygous variants in the SALL1 gene in 2 children with Townes-Brocks syndrome with FSGSRong Liang0Bixia Zheng1Chunli Wang2Sanlong Zhao3Wei Zhou4Ying Chen5Ruochen Che6Department of Nephrology, Children’s Hospital of Nanjing Medical UniversityNanjing Key Laboratory of Pediatrics, Children’s Hospital of Nanjing Medical UniversityNanjing Key Laboratory of Pediatrics, Children’s Hospital of Nanjing Medical UniversityDepartment of Nephrology, Children’s Hospital of Nanjing Medical UniversityNanjing Key Laboratory of Pediatrics, Children’s Hospital of Nanjing Medical UniversityDepartment of Nephrology, Children’s Hospital of Nanjing Medical UniversityDepartment of Nephrology, Children’s Hospital of Nanjing Medical UniversityAbstract Background To investigate the functional characteristics of heterozygous variants in the SALL1 gene in two children with Townes-Brocks syndrome (TBS), as well as the underlying mechanisms leading to chronic kidney disease. Methods We retrospectively analyzed the clinical manifestations, laboratory findings, and genetic backgrounds of two TBS patients admitted to our hospital presenting with chronic kidney disease stage 2 and focal segmental glomerulosclerosis (FSGS). The genetic function was investigated through cultured cells transfected with variants. The Sall1 protein expression level was detected by western blotting. Immunofluorescence was also employed to detect the subcellular localization of SALL1. Results Novel heterozygous genetic variations (c.3175 C > T and c.694 C > T) were detected in two respective probands with distinct clinical presentations: Proband 1 presented with polydactyly, nephrotic syndrome, and stage 2 chronic kidney disease; while Proband 2 manifested renal dysplasia, progressive proteinuria, and also stage 2 chronic kidney disease. FSGS was confirmed by kidney biopsies from both probands. To assess the functional impact of these variations, we introduced mutant plasmids carrying the c.3175 C > T and c.694 C > T variants into podocytes. The expression level of variant c.3175 C > T(p.Q1059X) in podocytes showed a significant decrease compared to that of the wild-type (P < 0.05), whereas variant c.694 C > T(p.Q232X) was markedly upregulated (P < 0.01). Immunofluorescence analysis revealed aberrant localization patterns for both SALL1 variants within podocytes. Conclusions Two patients with Townes-Brocks syndrome (TBS) harboring novel variants presented atypical phenotypes, characterized primarily by significant and rapidly progressing renal involvement. Rare renal biopsy pathology revealed the presence of focal segmental glomerulosclerosis (FSGS) in both cases. Experimental validation demonstrated that both variants led to alterations in the molecular size, expression level, and localization of the Sall1 protein, suggesting that these SALL1 gene variants might contribute to FSGS by impacting podocyte function.https://doi.org/10.1186/s12887-024-05326-5Townes-Brocks syndromeSALL1 geneFSGSPodocyte
spellingShingle Rong Liang
Bixia Zheng
Chunli Wang
Sanlong Zhao
Wei Zhou
Ying Chen
Ruochen Che
Functional analysis of heterozygous variants in the SALL1 gene in 2 children with Townes-Brocks syndrome with FSGS
BMC Pediatrics
Townes-Brocks syndrome
SALL1 gene
FSGS
Podocyte
title Functional analysis of heterozygous variants in the SALL1 gene in 2 children with Townes-Brocks syndrome with FSGS
title_full Functional analysis of heterozygous variants in the SALL1 gene in 2 children with Townes-Brocks syndrome with FSGS
title_fullStr Functional analysis of heterozygous variants in the SALL1 gene in 2 children with Townes-Brocks syndrome with FSGS
title_full_unstemmed Functional analysis of heterozygous variants in the SALL1 gene in 2 children with Townes-Brocks syndrome with FSGS
title_short Functional analysis of heterozygous variants in the SALL1 gene in 2 children with Townes-Brocks syndrome with FSGS
title_sort functional analysis of heterozygous variants in the sall1 gene in 2 children with townes brocks syndrome with fsgs
topic Townes-Brocks syndrome
SALL1 gene
FSGS
Podocyte
url https://doi.org/10.1186/s12887-024-05326-5
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