Sulfonylurea-Insensitive Permanent Neonatal Diabetes Caused by a Severe Gain-of-Function Tyr330His Substitution in Kir6.2.


Journal

Hormone research in paediatrics
ISSN: 1663-2826
Titre abrégé: Horm Res Paediatr
Pays: Switzerland
ID NLM: 101525157

Informations de publication

Date de publication:
2022
Historique:
received: 27 08 2021
accepted: 02 12 2021
pubmed: 10 1 2022
medline: 9 8 2022
entrez: 9 1 2022
Statut: ppublish

Résumé

Mutations in KCNJ11, the gene encoding the Kir6.2 subunit of pancreatic and neuronal KATP channels, are associated with a spectrum of neonatal diabetes diseases. Variant screening was used to identify the cause of neonatal diabetes, and continuous glucose monitoring was used to assess effectiveness of sulfonylurea treatment. Electrophysiological analysis of variant KATP channel function was used to determine molecular basis. We identified a previously uncharacterized KCNJ11 mutation, c.988T>C [p.Tyr330His], in an Italian child diagnosed with sulfonylurea-resistant permanent neonatal diabetes and developmental delay (intermediate DEND). Functional analysis of recombinant KATP channels reveals that this mutation causes a drastic gain-of-function, due to a reduction in ATP inhibition. Further, we demonstrate that the Tyr330His substitution causes a significant decrease in sensitivity to the sulfonylurea, glibenclamide. In this subject, the KCNJ11 (c.988T>C) mutation provoked neonatal diabetes, with mild developmental delay, which was insensitive to correction by sulfonylurea therapy. This is explained by the molecular loss of sulfonylurea sensitivity conferred by the Tyr330His substitution and highlights the need for molecular analysis of such mutations.

Sections du résumé

BACKGROUND/AIMS OBJECTIVE
Mutations in KCNJ11, the gene encoding the Kir6.2 subunit of pancreatic and neuronal KATP channels, are associated with a spectrum of neonatal diabetes diseases.
METHODS METHODS
Variant screening was used to identify the cause of neonatal diabetes, and continuous glucose monitoring was used to assess effectiveness of sulfonylurea treatment. Electrophysiological analysis of variant KATP channel function was used to determine molecular basis.
RESULTS RESULTS
We identified a previously uncharacterized KCNJ11 mutation, c.988T>C [p.Tyr330His], in an Italian child diagnosed with sulfonylurea-resistant permanent neonatal diabetes and developmental delay (intermediate DEND). Functional analysis of recombinant KATP channels reveals that this mutation causes a drastic gain-of-function, due to a reduction in ATP inhibition. Further, we demonstrate that the Tyr330His substitution causes a significant decrease in sensitivity to the sulfonylurea, glibenclamide.
CONCLUSIONS CONCLUSIONS
In this subject, the KCNJ11 (c.988T>C) mutation provoked neonatal diabetes, with mild developmental delay, which was insensitive to correction by sulfonylurea therapy. This is explained by the molecular loss of sulfonylurea sensitivity conferred by the Tyr330His substitution and highlights the need for molecular analysis of such mutations.

Identifiants

pubmed: 34999583
pii: 000521858
doi: 10.1159/000521858
pmc: PMC9259755
mid: NIHMS1779390
doi:

Substances chimiques

Blood Glucose 0
KATP Channels 0
Kir6.2 channel 0
Potassium Channels, Inwardly Rectifying 0
Sulfonylurea Compounds 0
Sulfonylurea Receptors 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

215-223

Subventions

Organisme : NHLBI NIH HHS
ID : K99 HL150277
Pays : United States
Organisme : NHLBI NIH HHS
ID : R00 HL150277
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK109407
Pays : United States
Organisme : NHLBI NIH HHS
ID : R35 HL140024
Pays : United States

Informations de copyright

© 2022 S. Karger AG, Basel.

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Auteurs

Conor McClenaghan (C)

Center for the Investigation of Membrane Excitability Diseases, Washington University School of Medicine, St. Louis, Missouri, USA.
Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri, USA.

Novella Rapini (N)

Dipartimento Pediatrico Universitario Ospedaliero, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy.

Domenico Umberto De Rose (DU)

Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus - Newborn - Infant, "Bambino Gesù" Children's Hospital IRCCS, Rome, Italy.
Neonatal Intensive Care Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.

Jian Gao (J)

Center for the Investigation of Membrane Excitability Diseases, Washington University School of Medicine, St. Louis, Missouri, USA.
Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri, USA.

Jacob Roeglin (J)

Center for the Investigation of Membrane Excitability Diseases, Washington University School of Medicine, St. Louis, Missouri, USA.
Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri, USA.

Carla Bizzarri (C)

Dipartimento Pediatrico Universitario Ospedaliero, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy.

Riccardo Schiaffini (R)

Dipartimento Pediatrico Universitario Ospedaliero, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy.

Eloisa Tiberi (E)

Neonatal Intensive Care Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.

Mafalda Mucciolo (M)

Genetics and Rare Disease Research Division, Bambino Gesù Pediatric Hospital, Rome, Italy.

Annalisa Deodati (A)

Dipartimento Pediatrico Universitario Ospedaliero, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy.

Alessandro Perri (A)

Neonatal Intensive Care Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.

Giovanni Vento (G)

Neonatal Intensive Care Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy.

Fabrizio Barbetti (F)

Dipartimento Pediatrico Universitario Ospedaliero, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy.
Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.

Colin G Nichols (CG)

Center for the Investigation of Membrane Excitability Diseases, Washington University School of Medicine, St. Louis, Missouri, USA.
Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri, USA.

Stefano Cianfarani (S)

Dipartimento Pediatrico Universitario Ospedaliero, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy.
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden.

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