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1.
Biochem Biophys Res Commun ; 602: 21-26, 2022 04 30.
Article in English | MEDLINE | ID: mdl-35247700

ABSTRACT

SKD3, also known as human CLPB, belongs to the AAA+ family of ATPases associated with various activities. Mutations in the SKD3/CLPB gene cause 3-methylglutaconic aciduria type VII and congenital neutropenia. SKD3 is upregulated in acute myeloid leukemia, where it contributes to anti-cancer drug resistance. SKD3 resides in the mitochondrial intermembrane space, where it forms ATP-dependent high-molecular weight complexes, but its biological function and mechanistic links to the clinical phenotypes are currently unknown. Using sedimentation equilibrium and dynamic light scattering, we show that SKD3 is monomeric at low protein concentration in the absence of nucleotides, but it forms oligomers at higher protein concentration or in the presence of adenine nucleotides. The apparent molecular weight of the nucleotide-bound SKD3 is consistent with self-association of 12 monomers. Image-class analysis and averaging from negative-stain electron microscopy (EM) of SKD3 in the ATP-bound state visualized cylinder-shaped particles with an open central channel along the cylinder axis. The dimensions of the EM-visualized particle suggest that the SKD3 dodecamer is formed by association of two hexameric rings. While hexameric structure has been often observed among AAA+ ATPases, a double-hexamer sandwich found for SKD3 appears uncommon within this protein family. A functional significance of the non-canonical structure of SKD3 remains to be determined.


Subject(s)
Endopeptidase Clp , Nucleotides , ATPases Associated with Diverse Cellular Activities/metabolism , Adenosine Triphosphate/metabolism , Endopeptidase Clp/genetics , Humans , Mitochondria/metabolism , Nucleotides/metabolism
2.
Br J Pharmacol ; 179(14): 3542-3559, 2022 07.
Article in English | MEDLINE | ID: mdl-33155670

ABSTRACT

Temperature-sensitive transient receptor potential vanilloid ion channel subtypes 1-4 (thermoTRPV1-thermoTRPV4) play important roles in a wide range of physiological processes, including temperature sensing and body temperature regulation, inflammation, pain, itch, maintenance of skin, bone and hair, along with osmotic regulation. ThermoTRPV function is modulated by numerous natural product compounds, such as capsaicin, camphor and cannabinoids. Because of their physiological importance and their druggability, these channels have made attractive potential targets for drug development. Since the beginning of the cryo-electron miscroscopy (cryo-EM) "resolution revolution," a lot of progress has been made towards dissecting the activation mechanisms of thermoTRPVs and mapping the binding sites for modulatory compounds. Here, we review the thermoTRPV physiology and pharmacology and summarize the current knowledge of their mechanisms of gating and ligand binding sites. LINKED ARTICLES: This article is part of a themed issue on Structure Guided Pharmacology of Membrane Proteins (BJP 75th Anniversary). To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.14/issuetoc.


Subject(s)
Transient Receptor Potential Channels , Capsaicin , Humans , Ligands , Pain , Temperature , Transient Receptor Potential Channels/metabolism
3.
Methods Enzymol ; 653: 21-48, 2021.
Article in English | MEDLINE | ID: mdl-34099173

ABSTRACT

Transient Receptor Potential (TRP) channels play numerous important physiological roles in humans. Notably, they are involved in temperature sensing and regulation, in the proper functioning of immune and cardiac systems, in skin, hair, and bone physiology and in many types of cancer. Because of their physiological significance there has been much interest in elucidating their molecular mechanisms of action. Recent improvements in eukaryotic protein expression and purification techniques and in cryo-electron microscopy (cryo-EM) have greatly facilitated TRP channel studies. The TRP Vanilloid 2 (TRPV2) channel has emerged as particularly amenable to structural studies and its structure has been solved by both X-ray crystallography and by cryo-EM. Here, we provide an overview of demands posed by X-ray crystallography and cryo-EM on protein sample preparation and outline a step-by-step protocol for preparing the TRPV2 protein for structure determination by both of these techniques.


Subject(s)
TRPV Cation Channels , Cryoelectron Microscopy , Crystallography, X-Ray , Humans , TRPV Cation Channels/genetics
5.
Neuron ; 105(5): 882-894.e5, 2020 03 04.
Article in English | MEDLINE | ID: mdl-31866091

ABSTRACT

Transient receptor potential channel subfamily A member 1 (TRPA1) is a Ca2+-permeable cation channel that serves as one of the primary sensors of environmental irritants and noxious substances. Many TRPA1 agonists are electrophiles that are recognized by TRPA1 via covalent bond modifications of specific cysteine residues located in the cytoplasmic domains. However, a mechanistic understanding of electrophile sensing by TRPA1 has been limited due to a lack of high-resolution structural information. Here, we present the cryoelectron microscopy (cryo-EM) structures of nanodisc-reconstituted ligand-free TRPA1 and TRPA1 in complex with the covalent agonists JT010 and BITC at 2.8, 2.9, and 3.1 Å, respectively. Our structural and functional studies provide the molecular basis for electrophile recognition by the extraordinarily reactive C621 in TRPA1 and mechanistic insights into electrophile-dependent conformational changes in TRPA1. This work also provides a platform for future drug development targeting TRPA1.


Subject(s)
Acetamides/metabolism , Irritants/metabolism , Isothiocyanates/metabolism , TRPA1 Cation Channel/ultrastructure , Thiazoles/metabolism , Acetamides/pharmacology , Cryoelectron Microscopy , Cysteine/metabolism , HEK293 Cells , Humans , Irritants/pharmacology , Isothiocyanates/pharmacology , Models, Molecular , Nociceptors , Pain/metabolism , Patch-Clamp Techniques , Phospholipids/metabolism , Protein Domains , Protein Structure, Tertiary , Pruritus/metabolism , TRPA1 Cation Channel/drug effects , TRPA1 Cation Channel/metabolism , Thiazoles/pharmacology
6.
Curr Opin Struct Biol ; 58: 314-323, 2019 10.
Article in English | MEDLINE | ID: mdl-31378426

ABSTRACT

Transient Receptor Potential (TRP) channels are a large superfamily of polymodal ion channels, which perform important roles in numerous physiological processes. The architecture of their transmembrane (TM) domains closely resembles that of voltage-gated potassium channels (KV). However, recent cryoEM and crystallographic studies of TRP channels have identified π-helices in functionally important regions, and it is increasingly recognized that they utilize a distinct mechanism of gating that relies on α-to-π secondary structure transitions. Here we review our current understanding of the role of π-helices in TRP channel function and their broader impact on different classes of ion channels.


Subject(s)
Ion Channel Gating , TRPC Cation Channels/chemistry , TRPC Cation Channels/metabolism , Animals , Conserved Sequence , Humans , Protein Conformation, alpha-Helical
7.
Elife ; 82019 05 15.
Article in English | MEDLINE | ID: mdl-31090543

ABSTRACT

The Transient Receptor Potential Vanilloid 2 (TRPV2) channel is a member of the temperature-sensing thermoTRPV family. Recent advances in cryo-electronmicroscopy (cryo-EM) and X-ray crystallography have provided many important insights into the gating mechanisms of thermoTRPV channels. Interestingly, crystallographic studies of ligand-dependent TRPV2 gating have shown that the TRPV2 channel adopts two-fold symmetric arrangements during the gating cycle. However, it was unclear if crystal packing forces played a role in stabilizing the two-fold symmetric arrangement of the channel. Here, we employ cryo-EM to elucidate the structure of full-length rabbit TRPV2 in complex with the agonist resiniferatoxin (RTx) in nanodiscs and amphipol. We show that RTx induces two-fold symmetric conformations of TRPV2 in both environments. However, the two-fold symmetry is more pronounced in the native-like lipid environment of the nanodiscs. Our data offers insights into a gating pathway in TRPV2 involving symmetry transitions.


Subject(s)
Membranes/enzymology , TRPV Cation Channels/metabolism , TRPV Cation Channels/ultrastructure , Animals , Cryoelectron Microscopy , Diterpenes/metabolism , Protein Binding , Protein Conformation , Rabbits
8.
Elife ; 82019 05 09.
Article in English | MEDLINE | ID: mdl-31070581

ABSTRACT

Temperature-sensitive transient receptor potential vanilloid (thermoTRPV) channels are activated by ligands and heat, and are involved in various physiological processes. ThermoTRPV channels possess a large cytoplasmic ring consisting of N-terminal ankyrin repeat domains (ARD) and C-terminal domains (CTD). The cytoplasmic inter-protomer interface is unique and consists of a CTD coiled around a ß-sheet which makes contacts with the neighboring ARD. Despite much existing evidence that the cytoplasmic ring is important for thermoTRPV function, the mechanism by which this unique structure is involved in thermoTRPV gating has not been clear. Here, we present cryo-EM and electrophysiological studies which demonstrate that TRPV3 gating involves large rearrangements at the cytoplasmic inter-protomer interface and that this motion triggers coupling between cytoplasmic and transmembrane domains, priming the channel for opening. Furthermore, our studies unveil the role of this interface in the distinct biophysical and physiological properties of individual thermoTRPV subtypes.


Subject(s)
Cytoplasm/metabolism , Ion Channel Gating , TRPV Cation Channels/metabolism , HEK293 Cells , Humans , Models, Molecular , Mutant Proteins/chemistry , Mutant Proteins/metabolism , Protein Domains , Protein Subunits/chemistry , Protein Subunits/metabolism , TRPV Cation Channels/chemistry , Temperature
9.
Nat Commun ; 9(1): 4773, 2018 11 14.
Article in English | MEDLINE | ID: mdl-30429472

ABSTRACT

Transient receptor potential vanilloid channel 3 (TRPV3), a member of the thermosensitive TRP (thermoTRPV) channels, is activated by warm temperatures and serves as a key regulator of normal skin physiology through the release of pro-inflammatory messengers. Mutations in trpv3 have been identified as the cause of the congenital skin disorder, Olmsted syndrome. Unlike other members of the thermoTRPV channel family, TRPV3 sensitizes upon repeated stimulation, yet a lack of structural information about the channel precludes a molecular-level understanding of TRPV3 sensitization and gating. Here, we present the cryo-electron microscopy structures of apo and sensitized human TRPV3, as well as several structures of TRPV3 in the presence of the common thermoTRPV agonist 2-aminoethoxydiphenyl borate (2-APB). Our results show α-to-π-helix transitions in the S6 during sensitization, and suggest a critical role for the S4-S5 linker π-helix during ligand-dependent gating.


Subject(s)
TRPV Cation Channels/ultrastructure , Boron Compounds/metabolism , Cryoelectron Microscopy , Hot Temperature , Humans , Protein Conformation, alpha-Helical , TRPV Cation Channels/agonists , TRPV Cation Channels/metabolism
10.
Nat Struct Mol Biol ; 25(5): 405-415, 2018 05.
Article in English | MEDLINE | ID: mdl-29728656

ABSTRACT

Transient receptor potential vanilloid (TRPV) channels are activated by ligands and heat and are involved in various physiological processes. In contrast to the architecturally related voltage-gated cation channels, TRPV1 and TRPV2 subtypes possess another activation gate at the selectivity filter that can open widely enough to permeate large organic cations. Despite recent structural advances, the mechanism of selectivity filter gating and permeation for both metal ions and large molecules by TRPV1 or TRPV2 is not well known. Here, we determined two crystal structures of rabbit TRPV2 in its Ca2+-bound and resiniferatoxin (RTx)- and Ca2+-bound forms, to 3.9 Å and 3.1 Å, respectively. Notably, our structures show that RTx binding leads to two-fold symmetric opening of the selectivity filter of TRPV2 that is wide enough for large organic cation permeation. Combined with functional characterizations, our studies reveal a structural basis for permeation of Ca2+ and large organic cations in TRPV2.


Subject(s)
Calcium/metabolism , Diterpenes/metabolism , TRPV Cation Channels/metabolism , Animals , Binding Sites , Cell Line , Crystallography, X-Ray , Enzyme Activation/physiology , HEK293 Cells , Humans , Models, Molecular , Patch-Clamp Techniques , Protein Conformation , Rabbits , Sf9 Cells , TRPV Cation Channels/genetics
11.
Science ; 359(6372): 237-241, 2018 01 12.
Article in English | MEDLINE | ID: mdl-29217583

ABSTRACT

Transient receptor potential melastatin (TRPM) cation channels are polymodal sensors that are involved in a variety of physiological processes. Within the TRPM family, member 8 (TRPM8) is the primary cold and menthol sensor in humans. We determined the cryo-electron microscopy structure of the full-length TRPM8 from the collared flycatcher at an overall resolution of ~4.1 ångstroms. Our TRPM8 structure reveals a three-layered architecture. The amino-terminal domain with a fold distinct among known TRP structures, together with the carboxyl-terminal region, forms a large two-layered cytosolic ring that extensively interacts with the transmembrane channel layer. The structure suggests that the menthol-binding site is located within the voltage-sensor-like domain and thus provides a structural glimpse of the design principle of the molecular transducer for cold and menthol sensation.


Subject(s)
Avian Proteins/chemistry , Menthol/metabolism , Passeriformes/metabolism , TRPM Cation Channels/chemistry , Animals , Avian Proteins/metabolism , Avian Proteins/ultrastructure , Binding Sites , Cold Temperature , Cryoelectron Microscopy , Image Processing, Computer-Assisted , Models, Molecular , Protein Domains , Protein Folding , Protein Structure, Secondary , Protein Subunits , TRPM Cation Channels/metabolism , TRPM Cation Channels/ultrastructure
12.
Nat Struct Mol Biol ; 23(2): 180-186, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26779611

ABSTRACT

Transient receptor potential vanilloid (TRPV) cation channels are polymodal sensors involved in a variety of physiological processes. TRPV2, a member of the TRPV family, is regulated by temperature, by ligands, such as probenecid and cannabinoids, and by lipids. TRPV2 has been implicated in many biological functions, including somatosensation, osmosensation and innate immunity. Here we present the atomic model of rabbit TRPV2 in its putative desensitized state, as determined by cryo-EM at a nominal resolution of ∼4 Å. In the TRPV2 structure, the transmembrane segment 6 (S6), which is involved in gate opening, adopts a conformation different from the one observed in TRPV1. Structural comparisons of TRPV1 and TRPV2 indicate that a rotation of the ankyrin-repeat domain is coupled to pore opening via the TRP domain, and this pore opening can be modulated by rearrangements in the secondary structure of S6.


Subject(s)
TRPV Cation Channels/chemistry , TRPV Cation Channels/ultrastructure , Animals , Ankyrin Repeat , Cryoelectron Microscopy , Models, Molecular , Protein Conformation , Rabbits , TRPV Cation Channels/metabolism
13.
Sci Rep ; 5: 15305, 2015 Oct 16.
Article in English | MEDLINE | ID: mdl-26470642

ABSTRACT

Potassium channels exhibit a modular design with distinct structural and functional domains; in particular, a highly conserved pore-loop sequence that determines their ionic selectivity. We now report the functional characterisation of a novel group of functionally non-selective members of the prokaryotic 'inward rectifier' subfamily of K(+) channels. These channels share all the key structural domains of eukaryotic and prokaryotic Kir/KirBac channels, but instead possess unique pore-loop selectivity filter sequences unrelated to any other known ionic selectivity filter. The strikingly unusual architecture of these 'NirBac' channels defines a new family of functionally non-selective ion channels, and also provides important insights into the modular design of ion channels, as well as the evolution of ionic selectivity within this superfamily of tetrameric cation channels.


Subject(s)
Bacterial Proteins/metabolism , Models, Molecular , Potassium Channels, Inwardly Rectifying/metabolism , Amino Acid Sequence , Bacterial Proteins/classification , Bacterial Proteins/genetics , Evolution, Molecular , Ion Transport , Molecular Sequence Data , Myxococcales/metabolism , Phylogeny , Potassium Channels, Inwardly Rectifying/classification , Potassium Channels, Inwardly Rectifying/genetics , Protein Structure, Tertiary , Recombinant Proteins/biosynthesis , Recombinant Proteins/chemistry , Recombinant Proteins/isolation & purification
14.
J Biol Chem ; 289(1): 143-51, 2014 Jan 03.
Article in English | MEDLINE | ID: mdl-24257749

ABSTRACT

KirBac channels are prokaryotic homologs of mammalian inwardly rectifying potassium (Kir) channels, and recent structures of KirBac3.1 have provided important insights into the structural basis of gating in Kir channels. In this study, we demonstrate that KirBac3.1 channel activity is strongly pH-dependent, and we used x-ray crystallography to determine the structural changes that arise from an activatory mutation (S205L) located in the cytoplasmic domain (CTD). This mutation stabilizes a novel energetically favorable open conformation in which changes at the intersubunit interface in the CTD also alter the electrostatic potential of the inner cytoplasmic cavity. These results provide a structural explanation for the activatory effect of this mutation and provide a greater insight into the role of the CTD in Kir channel gating.


Subject(s)
Bacterial Proteins/chemistry , Magnetospirillum/chemistry , Potassium Channels, Inwardly Rectifying/chemistry , Amino Acid Substitution , Bacterial Proteins/genetics , Bacterial Proteins/metabolism , Ion Channel Gating/physiology , Magnetospirillum/genetics , Magnetospirillum/metabolism , Mutation, Missense , Potassium Channels, Inwardly Rectifying/genetics , Potassium Channels, Inwardly Rectifying/metabolism , Protein Structure, Tertiary
15.
Nat Struct Mol Biol ; 19(2): 158-63, 2012 Jan 08.
Article in English | MEDLINE | ID: mdl-22231399

ABSTRACT

KirBac channels are prokaryotic homologs of mammalian inwardly rectifying (Kir) potassium channels, and recent crystal structures of both Kir and KirBac channels have provided major insight into their unique structural architecture. However, all of the available structures are closed at the helix bundle crossing, and therefore the structural mechanisms that control opening of their primary activation gate remain unknown. In this study, we engineered the inner pore-lining helix (TM2) of KirBac3.1 to trap the bundle crossing in an apparently open conformation and determined the crystal structure of this mutant channel to 3.05 Å resolution. Contrary to previous speculation, this new structure suggests a mechanistic model in which rotational 'twist' of the cytoplasmic domain is coupled to opening of the bundle-crossing gate through a network of inter- and intrasubunit interactions that involve the TM2 C-linker, slide helix, G-loop and the CD loop.


Subject(s)
Bacterial Proteins/chemistry , Bacterial Proteins/metabolism , Magnetospirillum/enzymology , Potassium Channels/chemistry , Potassium Channels/metabolism , Amino Acid Substitution , Bacterial Proteins/genetics , Crystallography, X-Ray , Models, Biological , Models, Molecular , Mutant Proteins/chemistry , Mutant Proteins/genetics , Mutant Proteins/metabolism , Mutation, Missense , Potassium Channels/genetics , Protein Binding , Protein Conformation , Protein Structure, Tertiary , Protein Subunits/chemistry , Protein Subunits/metabolism
17.
EMBO Mol Med ; 1(3): 166-77, 2009 Jun.
Article in English | MEDLINE | ID: mdl-20049716

ABSTRACT

K(ATP) channels regulate insulin secretion from pancreatic beta-cells. Loss- and gain-of-function mutations in the genes encoding the Kir6.2 and SUR1 subunits of this channel cause hyperinsulinism of infancy and neonatal diabetes, respectively. We report two novel mutations in the gating loop of Kir6.2 which cause neonatal diabetes with developmental delay (T293N) and hyperinsulinism (T294M). These mutations increase (T293N) or decrease (T294M) whole-cell K(ATP) currents, accounting for the different clinical phenotypes. The T293N mutation increases the intrinsic channel open probability (Po((0))), thereby indirectly decreasing channel inhibition by ATP and increasing whole-cell currents. T294M channels exhibit a dramatically reduced Po((0)) in the homozygous but not in the pseudo-heterozygous state. Unlike wild-type channels, hetT294M channels were activated by MgADP in the absence but not in the presence of MgATP; however, they are activated by MgGDP in both the absence and presence of MgGTP. These mutations demonstrate the importance of the gating loop of Kir channels in regulating Po((0)) and further suggest that Mg-nucleotide interaction with SUR1 may reduce ATP inhibition at Kir6.2.


Subject(s)
Congenital Hyperinsulinism/genetics , Diabetes Mellitus/genetics , Potassium Channels, Inwardly Rectifying/genetics , Adenosine Triphosphate/metabolism , Female , Humans , Infant, Newborn , Male , Pedigree , Potassium/metabolism , Potassium Channels, Inwardly Rectifying/chemistry , Protein Structure, Tertiary
18.
J Clin Invest ; 119(1): 80-90, 2009 Jan.
Article in English | MEDLINE | ID: mdl-19065048

ABSTRACT

Neonatal diabetes is a rare monogenic form of diabetes that usually presents within the first six months of life. It is commonly caused by gain-of-function mutations in the genes encoding the Kir6.2 and SUR1 subunits of the plasmalemmal ATP-sensitive K+ (KATP) channel. To better understand this disease, we generated a mouse expressing a Kir6.2 mutation (V59M) that causes neonatal diabetes in humans and we used Cre-lox technology to express the mutation specifically in pancreatic beta cells. These beta-V59M mice developed severe diabetes soon after birth, and by 5 weeks of age, blood glucose levels were markedly increased and insulin was undetectable. Islets isolated from beta-V59M mice secreted substantially less insulin and showed a smaller increase in intracellular calcium in response to glucose. This was due to a reduced sensitivity of KATP channels in pancreatic beta cells to inhibition by ATP or glucose. In contrast, the sulfonylurea tolbutamide, a specific blocker of KATP channels, closed KATP channels, elevated intracellular calcium levels, and stimulated insulin release in beta-V59M beta cells, indicating that events downstream of KATP channel closure remained intact. Expression of the V59M Kir6.2 mutation in pancreatic beta cells alone is thus sufficient to recapitulate the neonatal diabetes observed in humans. beta-V59M islets also displayed a reduced percentage of beta cells, abnormal morphology, lower insulin content, and decreased expression of Kir6.2, SUR1, and insulin mRNA. All these changes are expected to contribute to the diabetes of beta-V59M mice. Their cause requires further investigation.


Subject(s)
Diabetes Mellitus/genetics , Disease Models, Animal , Insulin-Secreting Cells/metabolism , Mutation , Potassium Channels, Inwardly Rectifying/genetics , Protein Subunits/genetics , Adenosine Triphosphate/metabolism , Animals , Calcium/metabolism , Diabetes Mellitus/metabolism , Female , Humans , Hypoglycemic Agents/pharmacology , Infant, Newborn , Insulin-Secreting Cells/cytology , Insulin-Secreting Cells/drug effects , Male , Mice , Mice, Transgenic , Patch-Clamp Techniques , Potassium Channels, Inwardly Rectifying/metabolism , Protein Subunits/metabolism , Tolbutamide/pharmacology
19.
Proc Natl Acad Sci U S A ; 105(28): 9811-6, 2008 Jul 15.
Article in English | MEDLINE | ID: mdl-18599453

ABSTRACT

Leptin is believed to exert its potent appetite-suppressing effects via stimulation of hypothalamic anorexigenic proopiomelanocortin (POMC)-containing neurons and inhibition of orexigenic agouti-related protein (AgRP) neurons. We show here that at 11 mM glucose leptin excites POMC cells. At 5 mM glucose, however, leptin hyperpolarizes POMC neurons and suppresses action potential firing, by producing a greater decrease in excitatory synaptic tone than inhibitory tone. These results argue that when glucose is low (5 mM or less) AgRP neurons will be more important for mediating the anorectic effects of leptin than POMC cells. However, at high glucose concentrations (11 mM), activation of POMC cells may contribute to the appetite-suppressing effects of leptin. Our data also suggest the regulation of neuropeptide efficacy as a novel function of hypothalamic glucose sensing.


Subject(s)
Glucose/pharmacology , Hypothalamus/cytology , Leptin/physiology , Neurons/drug effects , Pro-Opiomelanocortin , Animals , Appetite Regulation , Brain Chemistry , Cells, Cultured , Dose-Response Relationship, Drug , Mice
20.
Diabetes Care ; 31(9): 1736-7, 2008 Sep.
Article in English | MEDLINE | ID: mdl-18556340

ABSTRACT

OBJECTIVE: Neonatal diabetes is a heterogeneous group of disorders with diabetes manifestation in the first 6 months of life. The most common etiology in permanent neonatal diabetes is mutations of the ATP-sensitive K(+) channel subunits; in transient neonatal diabetes, chromosome 6q24 abnormalities are the most common cause. RESEARCH DESIGN AND METHODS: We report a sporadic case of diabetes without ketoacidosis diagnosed on the fourth day of life. RESULTS: Analysis of the KCNJ11 gene found a novel R365H mutation in the proband and her unaffected father. The functional analysis did not support pathogenicity of this variant. When the patient's diabetes remitted in the seventh month of life, the 6q24 region was analyzed and a paternally inherited duplication was identified. CONCLUSIONS: Our case reports a coincidental novel KCNJ11 variant in a patient with transient neonatal diabetes due to a 6q24 duplication, illustrating the difficulty in testing neonates before the clinical course of neonatal diabetes is known.


Subject(s)
Chromosomes, Human, Pair 6 , Diabetes Mellitus/genetics , Gene Duplication , Genetic Variation , Mutation, Missense , Potassium Channels, Inwardly Rectifying/genetics , Birth Weight , C-Peptide/blood , Diabetes Mellitus/drug therapy , Female , Humans , Infant, Low Birth Weight , Infant, Newborn , Insulin/blood , Insulin/therapeutic use , Male
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