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American Journal of Human Genetics logoLink to American Journal of Human Genetics
. 1998 Jun;62(6):1332–1340. doi: 10.1086/301872

Novel molecular variants of the Na-K-2Cl cotransporter gene are responsible for antenatal Bartter syndrome.

R Vargas-Poussou 1, D Feldmann 1, M Vollmer 1, M Konrad 1, L Kelly 1, L P van den Heuvel 1, L Tebourbi 1, M Brandis 1, L Karolyi 1, S C Hebert 1, H H Lemmink 1, G Deschênes 1, F Hildebrandt 1, H W Seyberth 1, L M Guay-Woodford 1, N V Knoers 1, C Antignac 1
PMCID: PMC1377151  PMID: 9585600

Abstract

Antenatal Bartter syndrome is a variant of inherited renal-tubular disorders associated with hypokalemic alkalosis. This disorder typically presents as a life-threatening condition beginning in utero, with marked fetal polyuria that leads to polyhydramnios and premature delivery. Another hallmark of this variant is a marked hypercalciuria and, as a secondary consequence, the development of nephrocalcinosis and osteopenia. We have analyzed 15 probands belonging to 13 families and have performed SSCP analysis of the coding sequence and the exon-intron boundaries of the NKCC2 gene; and we report 14 novel mutations in patients with antenatal Bartter syndrome, as well as the identification of three isoforms of human NKCC2 that arise from alternative splicing.

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Selected References

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  1. BARTTER F. C., PRONOVE P., GILL J. R., Jr, MACCARDLE R. C. Hyperplasia of the juxtaglomerular complex with hyperaldosteronism and hypokalemic alkalosis. A new syndrome. Am J Med. 1962 Dec;33:811–828. doi: 10.1016/0002-9343(62)90214-0. [DOI] [PubMed] [Google Scholar]
  2. Deschenes G., Burguet A., Guyot C., Hubert P., Garabedian M., Dechaux M., Loirat C., Broyer M. Forme anténatale du syndrome de Bartter. Ann Pediatr (Paris) 1993 Feb;40(2):95–101. [PubMed] [Google Scholar]
  3. Fanconi A., Schachenmann G., Nüssli R., Prader A. Chronic hypokalaemia with growth retardation, normotensive hyperrenin-hyperaldosteronism ("Bartter's syndrome"), and hypercalciuria. Report of two cases with emphasis on natural history and on catch-up growth during treatment. Helv Paediatr Acta. 1971 Jun;26(2):144–163. [PubMed] [Google Scholar]
  4. Gitelman H. J., Graham J. B., Welt L. G. A new familial disorder characterized by hypokalemia and hypomagnesemia. Trans Assoc Am Physicians. 1966;79:221–235. [PubMed] [Google Scholar]
  5. Good D. W., Knepper M. A., Burg M. B. Ammonia and bicarbonate transport by thick ascending limb of rat kidney. Am J Physiol. 1984 Jul;247(1 Pt 2):F35–F44. doi: 10.1152/ajprenal.1984.247.1.F35. [DOI] [PubMed] [Google Scholar]
  6. Greger R. Ion transport mechanisms in thick ascending limb of Henle's loop of mammalian nephron. Physiol Rev. 1985 Jul;65(3):760–797. doi: 10.1152/physrev.1985.65.3.760. [DOI] [PubMed] [Google Scholar]
  7. Hiort O., Wodtke A., Struve D., Zöllner A., Sinnecker G. H. Detection of point mutations in the androgen receptor gene using non-isotopic single strand conformation polymorphism analysis. German Collaborative Intersex Study Group. Hum Mol Genet. 1994 Jul;3(7):1163–1166. doi: 10.1093/hmg/3.7.1163. [DOI] [PubMed] [Google Scholar]
  8. Hogewind B. L., van Brummelen P., Veltkamp J. J. Bartter's syndrome: an autosomal recessive disorder? Study of four patients in one generation of the same pedigree and their relatives. Acta Med Scand. 1981;209(6):463–467. [PubMed] [Google Scholar]
  9. Igarashi P., Vanden Heuvel G. B., Payne J. A., Forbush B., 3rd Cloning, embryonic expression, and alternative splicing of a murine kidney-specific Na-K-Cl cotransporter. Am J Physiol. 1995 Sep;269(3 Pt 2):F405–F418. doi: 10.1152/ajprenal.1995.269.3.F405. [DOI] [PubMed] [Google Scholar]
  10. Knebelmann B., Breillat C., Forestier L., Arrondel C., Jacassier D., Giatras I., Drouot L., Deschênes G., Grünfeld J. P., Broyer M. Spectrum of mutations in the COL4A5 collagen gene in X-linked Alport syndrome. Am J Hum Genet. 1996 Dec;59(6):1221–1232. [PMC free article] [PubMed] [Google Scholar]
  11. Knebelmann B., Deschenes G., Gros F., Hors M. C., Grünfeld J. P., Zhou J., Tryggvason K., Gubler M. C., Antignac C. Substitution of arginine for glycine 325 in the collagen alpha 5 (IV) chain associated with X-linked Alport syndrome: characterization of the mutation by direct sequencing of PCR-amplified lymphoblast cDNA fragments. Am J Hum Genet. 1992 Jul;51(1):135–142. [PMC free article] [PubMed] [Google Scholar]
  12. Köckerling A., Reinalter S. C., Seyberth H. W. Impaired response to furosemide in hyperprostaglandin E syndrome: evidence for a tubular defect in the loop of Henle. J Pediatr. 1996 Oct;129(4):519–528. doi: 10.1016/s0022-3476(96)70116-6. [DOI] [PubMed] [Google Scholar]
  13. Leonhardt A., Timmermanns G., Roth B., Seyberth H. W. Calcium homeostasis and hypercalciuria in hyperprostaglandin E syndrome. J Pediatr. 1992 Apr;120(4 Pt 1):546–554. doi: 10.1016/s0022-3476(05)82480-1. [DOI] [PubMed] [Google Scholar]
  14. McCredie D. A., Rotenberg E., Williams A. L. Hypercalciuria in potassium-losing nephropathy: a variant of Bartter's syndrome. Aust Paediatr J. 1974 Oct;10(5):286–295. doi: 10.1111/j.1440-1754.1974.tb02786.x. [DOI] [PubMed] [Google Scholar]
  15. Ohlsson A., Sieck U., Cumming W., Akhtar M., Serenius F. A variant of Bartter's syndrome. Bartter's syndrome associated with hydramnios, prematurity, hypercalciuria and nephrocalcinosis. Acta Paediatr Scand. 1984 Nov;73(6):868–874. doi: 10.1111/j.1651-2227.1984.tb17793.x. [DOI] [PubMed] [Google Scholar]
  16. Orita M., Suzuki Y., Sekiya T., Hayashi K. Rapid and sensitive detection of point mutations and DNA polymorphisms using the polymerase chain reaction. Genomics. 1989 Nov;5(4):874–879. doi: 10.1016/0888-7543(89)90129-8. [DOI] [PubMed] [Google Scholar]
  17. Payne J. A., Forbush B., 3rd Alternatively spliced isoforms of the putative renal Na-K-Cl cotransporter are differentially distributed within the rabbit kidney. Proc Natl Acad Sci U S A. 1994 May 10;91(10):4544–4548. doi: 10.1073/pnas.91.10.4544. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Proesmans W., Devlieger H., Van Assche A., Eggermont E., Vandenberghe K., Lemmens F., Sieprath P., Lijnen P. Bartter syndrome in two siblings--antenatal and neonatal observations. Int J Pediatr Nephrol. 1985 Jan-Mar;6(1):63–70. [PubMed] [Google Scholar]
  19. Péault B., Weissman I. L., Buckle A. M., Tsukamoto A., Baum C. Thy-1-expressing CD34+ human cells express multiple hematopoietic potentialities in vitro and in SCID-hu mice. Nouv Rev Fr Hematol. 1993 Feb;35(1):91–93. [PubMed] [Google Scholar]
  20. Reed P. W., Davies J. L., Copeman J. B., Bennett S. T., Palmer S. M., Pritchard L. E., Gough S. C., Kawaguchi Y., Cordell H. J., Balfour K. M. Chromosome-specific microsatellite sets for fluorescence-based, semi-automated genome mapping. Nat Genet. 1994 Jul;7(3):390–395. doi: 10.1038/ng0794-390. [DOI] [PubMed] [Google Scholar]
  21. Rozet J. M., Gerber S., Perrault I., Camuzat A., Calvas P., Viegas-Pequignot E., Molina-Gomes D., Le Paslier D., Chumakov I., Munnich A. Structure and physical mapping of DR1, a TATA-binding protein-associated phosphoprotein gene, to chromosome 1p22.1 and its exclusion in Stargardt disease (STGD). Genomics. 1996 Sep 15;36(3):554–556. doi: 10.1006/geno.1996.0508. [DOI] [PubMed] [Google Scholar]
  22. Seyberth H. W., Königer S. J., Rascher W., Kühl P. G., Schweer H. Role of prostaglandins in hyperprostaglandin E syndrome and in selected renal tubular disorders. Pediatr Nephrol. 1987 Jul;1(3):491–497. doi: 10.1007/BF00849259. [DOI] [PubMed] [Google Scholar]
  23. Seyberth H. W., Rascher W., Schweer H., Kühl P. G., Mehls O., Schärer K. Congenital hypokalemia with hypercalciuria in preterm infants: a hyperprostaglandinuric tubular syndrome different from Bartter syndrome. J Pediatr. 1985 Nov;107(5):694–701. doi: 10.1016/s0022-3476(85)80395-4. [DOI] [PubMed] [Google Scholar]
  24. Shizuya H., Birren B., Kim U. J., Mancino V., Slepak T., Tachiiri Y., Simon M. Cloning and stable maintenance of 300-kilobase-pair fragments of human DNA in Escherichia coli using an F-factor-based vector. Proc Natl Acad Sci U S A. 1992 Sep 15;89(18):8794–8797. doi: 10.1073/pnas.89.18.8794. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Shoemaker L., Welch T. R., Bergstrom W., Abrams S. A., Yergey A. L., Vieira N. Calcium kinetics in the hyperprostaglandin E syndrome. Pediatr Res. 1993 Jan;33(1):92–96. doi: 10.1203/00006450-199301000-00019. [DOI] [PubMed] [Google Scholar]
  26. Simon D. B., Bindra R. S., Mansfield T. A., Nelson-Williams C., Mendonca E., Stone R., Schurman S., Nayir A., Alpay H., Bakkaloglu A. Mutations in the chloride channel gene, CLCNKB, cause Bartter's syndrome type III. Nat Genet. 1997 Oct;17(2):171–178. doi: 10.1038/ng1097-171. [DOI] [PubMed] [Google Scholar]
  27. Simon D. B., Karet F. E., Hamdan J. M., DiPietro A., Sanjad S. A., Lifton R. P. Bartter's syndrome, hypokalaemic alkalosis with hypercalciuria, is caused by mutations in the Na-K-2Cl cotransporter NKCC2. Nat Genet. 1996 Jun;13(2):183–188. doi: 10.1038/ng0696-183. [DOI] [PubMed] [Google Scholar]
  28. Simon D. B., Karet F. E., Rodriguez-Soriano J., Hamdan J. H., DiPietro A., Trachtman H., Sanjad S. A., Lifton R. P. Genetic heterogeneity of Bartter's syndrome revealed by mutations in the K+ channel, ROMK. Nat Genet. 1996 Oct;14(2):152–156. doi: 10.1038/ng1096-152. [DOI] [PubMed] [Google Scholar]
  29. Winters C. J., Reeves W. B., Andreoli T. E. A survey of transport properties of the thick ascending limb. Semin Nephrol. 1991 Mar;11(2):236–247. [PubMed] [Google Scholar]
  30. Yang T., Huang Y. G., Singh I., Schnermann J., Briggs J. P. Localization of bumetanide- and thiazide-sensitive Na-K-Cl cotransporters along the rat nephron. Am J Physiol. 1996 Oct;271(4 Pt 2):F931–F939. doi: 10.1152/ajprenal.1996.271.4.F931. [DOI] [PubMed] [Google Scholar]
  31. Zusman R. M., Keiser H. R. Prostaglandin biosynthesis by rabbit renomedullary interstitial cells in tissue culture. Stimulation by angiotensin II, bradykinin, and arginine vasopressin. J Clin Invest. 1977 Jul;60(1):215–223. doi: 10.1172/JCI108758. [DOI] [PMC free article] [PubMed] [Google Scholar]

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