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      Co‐occurrence of neurofibromatosis type 1 and optic nerve gliomas with autosomal dominant polycystic kidney disease type 2

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          Abstract

          Background

          Autosomal dominant polycystic kidney disease (ADPKD) and neurofibromatosis type 1 (NF1) are both autosomal dominant disorders with a high rate of novel mutations. However, the two disorders have distinct and well‐delineated genetic, biochemical, and clinical findings. Only a few cases of coexistence of ADPKD and NF1 in a single individual have been reported, but the possible implications of this association are unknown.

          Methods

          We report an ADPKD male belonging to a family of several affected members in three generations associated with NF1 and optic pathway gliomas. The clinical diagnosis of ADPKD and NF1 was performed by several image techniques.

          Results

          Linkage analysis of ADPKD family was consistent to the PKD2 locus by a nonsense mutation, yielding a truncated polycystin‐2 by means of next‐generation sequencing. The diagnosis of NF1 was confirmed by mutational analysis of this gene showing a 4‐bp deletion, resulting in a truncated neurofibromin, as well. The impact of this association was investigated by analyzing putative genetic interactions and by comparing the evolution of renal size and function in the proband with his older brother with ADPKD without NF1 and with ADPKD cohorts.

          Conclusion

          Despite the presence of both conditions there was not additive effect of NF1 and PKD2 in terms of the severity of tumor development and/or ADPKD progression.

          Abstract

          We report an Autosomal dominant polycystic kidney disease (ADPKD) male belonging to a family of several affected members in three generations associated with neurofibromatosis type 1 (NF1) ) and optic pathway gliomas. Conclusión: this is the first reported case of concurrence of a truncated NF1 mutation with optic pathway gliomas and a nonsense PKD2 mutation. Despite the presence of both conditions there was not additive effect of NF1 and PKD2 in terms of the severity of tumour development and/or ADPKD progression.

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          Most cited references72

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          Autosomal dominant polycystic kidney disease.

          Autosomal dominant polycystic kidney disease is the most prevalent, potentially lethal, monogenic disorder. It is associated with large interfamilial and intrafamilial variability, which can be explained to a large extent by its genetic heterogeneity and modifier genes. An increased understanding of the disorder's underlying genetic, molecular, and cellular mechanisms and a better appreciation of its progression and systemic manifestations have laid out the foundation for the development of clinical trials and potentially effective treatments.
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            The mTOR pathway is regulated by polycystin-1, and its inhibition reverses renal cystogenesis in polycystic kidney disease.

            Autosomal-dominant polycystic kidney disease (ADPKD) is a common genetic disorder that frequently leads to renal failure. Mutations in polycystin-1 (PC1) underlie most cases of ADPKD, but the function of PC1 has remained poorly understood. No preventive treatment for this disease is available. Here, we show that the cytoplasmic tail of PC1 interacts with tuberin, and the mTOR pathway is inappropriately activated in cyst-lining epithelial cells in human ADPKD patients and mouse models. Rapamycin, an inhibitor of mTOR, is highly effective in reducing renal cystogenesis in two independent mouse models of PKD. Treatment of human ADPKD transplant-recipient patients with rapamycin results in a significant reduction in native polycystic kidney size. These results indicate that PC1 has an important function in the regulation of the mTOR pathway and that this pathway provides a target for medical therapy of ADPKD.
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              Unified criteria for ultrasonographic diagnosis of ADPKD.

              Individuals who are at risk for autosomal dominant polycystic kidney disease are often screened by ultrasound using diagnostic criteria derived from individuals with mutations in PKD1. Families with mutations in PKD2 typically have less severe disease, suggesting a potential need for different diagnostic criteria. In this study, 577 and 371 at-risk individuals from 58 PKD1 and 39 PKD2 families, respectively, were assessed by renal ultrasound and molecular genotyping. Using sensitivity data derived from genetically affected individuals and specificity data derived from genetically unaffected individuals, various diagnostic criteria were compared. In addition, data sets were created to simulate the PKD1 and PKD2 case mix expected in practice to evaluate the performance of diagnostic criteria for families of unknown genotype. The diagnostic criteria currently in use performed suboptimally for individuals with mutations in PKD2 as a result of reduced test sensitivity. In families of unknown genotype, the presence of three or more (unilateral or bilateral) renal cysts is sufficient for establishing the diagnosis in individuals aged 15 to 39 y, two or more cysts in each kidney is sufficient for individuals aged 40 to 59 y, and four or more cysts in each kidney is required for individuals > or = 60 yr. Conversely, fewer than two renal cysts in at-risk individuals aged > or = 40 yr is sufficient to exclude the disease. These unified diagnostic criteria will be useful for testing individuals who are at risk for autosomal dominant polycystic kidney disease in the usual clinical setting in which molecular genotyping is seldom performed.
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                Author and article information

                Contributors
                ramon.peces@salud.madrid.org
                Journal
                Mol Genet Genomic Med
                Mol Genet Genomic Med
                10.1002/(ISSN)2324-9269
                MGG3
                Molecular Genetics & Genomic Medicine
                John Wiley and Sons Inc. (Hoboken )
                2324-9269
                13 June 2020
                August 2020
                : 8
                : 8 ( doiID: 10.1002/mgg3.v8.8 )
                : e1321
                Affiliations
                [ 1 ] Servicio de Nefrología Hospital Universitario La Paz IdiPAZ Universidad Autónoma Madrid Spain
                [ 2 ] Instituto de Genética Médica y Molecular (INGEMM)‐IdiPAZ Hospital Universitario La Paz Universidad Autónoma Madrid Spain
                [ 3 ] CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras ISCIII Madrid Spain
                [ 4 ] Servicio de Genética Hospital Universitario Ramón y Cajal Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) Madrid Spain
                [ 5 ] Area de Tecnologías de la Información SESCAM Toledo Spain
                [ 6 ] Servicio de Radiología Hospital Universitario La Paz IdiPAZ Universidad Autónoma Madrid Spain
                Author notes
                [*] [* ] Correspondence

                Ramón Peces, Servicio de Nefrología, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain.

                Email: ramon.peces@ 123456salud.madrid.org

                Author information
                https://orcid.org/0000-0002-9170-8746
                Article
                MGG31321
                10.1002/mgg3.1321
                7434601
                32533764
                e44ce7ca-df2a-4dea-be04-004248f32b16
                © 2020 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals LLC

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 January 2020
                : 25 April 2020
                : 27 April 2020
                Page count
                Figures: 4, Tables: 2, Pages: 13, Words: 9144
                Funding
                Funded by: Ministerio de Ciencia y Innovación
                Award ID: EC08/00236
                Funded by: Fundación Mutua Madrileña de Investigación Biomédica (FMM) and Asociación Española de Afectados de Neurofibromatosis
                Funded by: IdiPAZ and Agencia Lain‐Entralgo
                Funded by: IdiPAZ and FIBHULP
                Funded by: Instituto de Salud Carlos III , open-funder-registry 10.13039/501100004587;
                Award ID: EC08/00236
                Funded by: ISCIII RETIC REDINREN RD16/0009 FEDER Funds
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                August 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.6 mode:remove_FC converted:18.08.2020

                autosomal dominant polycystic kidney disease (adpkd),neurofibromatosis type 1 (nf1),next‐generation sequencing (ngs),nf1 mutation,optic pathway gliomas,pkd2

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