Bi‐allelic mutations of CCDC88C are a rare cause of severe congenital hydrocephalus

Congenital or infantile hydrocephalus is caused by genetic and non‐genetic factors and is highly heterogeneous in etiology. In recent studies, a limited number of genetic causes of hydrocephalus have been identified. To date, recessive mutations in the CCDC88C gene have been identified as a cause of non‐syndromic congenital hydrocephalus in three reported families. Here, we report the fourth known family with two affected individuals with congenital hydrocephalus due to a homozygous mutation in the CCDC88C gene identified by whole exome sequencing. Our two newly described children, as well as the previously published ones, all shared several features including severe infantile‐onset hydrocephalus, mild to severe intellectual delay, varying degrees of motor delay, and infantile onset seizures. All identified homozygous mutations in CCDC88C abolish the PDZ binding site necessary for proper CCDC88C protein function in the Wnt signaling pathway. Our report further establishes CCDC88C as one of the few known recessive causes of severe prenatal‐onset hydrocephalus. Recognition of this syndrome has important diagnostic and genetic implications for families identified in the future.

     

Ultrastructural features resembling those of harlequin ichthyosis in patients with severe congenital ichthyosiform erythroderma

Congenital ichthyoses are a group of heterogeneous disorders of cornification. Autosomal recessive congenital ichthyosis (ARCI) can be clinically subdivided into congenital ichthyosiform erythroderma and lamellar ichthyosis. Ultrastructurally, ARCI is classified into four groups: ichthyosis congenita (IC) types I-IV. The genetic background of the ARCI disorders is heterogeneous, but only one disease gene, transglutaminase 1, has been detected so far. We describe six patients with severe congenital ichthyosis from six different Scandinavian families. They could not be classified ultrastructurally into the four IC groups because of atypical findings of electron microscopy. These included abnormal lamellar bodies, alterations in keratohyalin, remnant organelles and lipid inclusions in the upper epidermal cells, which resembled the ultrastructural findings of harlequin ichthyosis (HI), although the HI phenotype was not present at birth. Some clinical features, such as thick scales, erythroderma, alopecia and ectropion were common to all patients. Ichthyosis was usually accentuated in the scalp and four patients had clumped fingers and toes. None of the patients carried the transglutaminase 1 mutation. We conclude that ultrastructural findings resembling those detected in previous HI cases (type 1 and 2) can also be found in patients who do not have classic clinical features of that rare ichthyosis. This may be due to lack of specificity of ultrastructural markers for HI or to its clinical heterogeneity.     

水通道蛋白在多囊肾病小鼠肾囊泡上皮细胞的表达与调控

目的 探讨水通道蛋白(AQP)在多囊肾病囊泡上皮细胞的表达和调控。 方法 采用免疫荧光染色和Western印迹法分别检测不同亚型的水通道蛋白AQP1、AQP2、AQP3和AQP4在小鼠常染色体隐性遗传病jck多囊肾小鼠肾脏的表达定位和表达调控。 结果 8周龄jck纯合子小鼠的肾脏占体质量的百分率约是同窝野生型小鼠肾脏的4倍,肾脏组织出现多发、大小不一囊泡,囊泡上皮细胞呈扁平状,肾脏间质可见纤维化。jck小鼠血尿素水平为（42.6±6.7） mmol/L,约是野生型小鼠血尿素水平[（8.4±1.9） mmol/L]的5倍（P < 0.01）。免疫荧光定位分析结果表明AQP1 在近曲小管上皮细胞顶膜和基底膜表达,也表达于髓袢降支细段和直小血管降支,肾囊泡上皮细胞未见AQP1表达。AQP2在集合管和肾囊泡上皮细胞顶膜表达,AQP3和AQP4在集合管和囊泡上皮细胞基底膜表达。Western印迹分析结果表明,jck肾脏AQP2、AQP3和AQP4蛋白表达水平与野生型肾脏相似,但AQP1在jck肾脏的表达水平显著低于其在野生型肾脏的表达水平（P < 0.01）。 结论 jck多囊肾小鼠肾囊泡上皮表达AQP2、AQP3和AQP4,提示肾囊泡来源于肾集合管,水通道蛋白可能在肾囊泡生长过程中起重要作用。