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Autosomal dominant pseudohypoaldosteronism type 1: Mechanisms, evidence for neonatal lethality, and phenotypic expression in adults

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Abstract
Autosomal dominant pseudohypoaldosteronism type 1 (adPHA1) is a rare condition that is characterized by renal resistance to aldosterone, with salt wasting, hyperkalemia, and metabolic acidosis. It is thought of as a mild disorder; affected children's symptoms respond promptly to salt therapy, and treatment is not required after childhood. Mutations in the mineralocorticoid receptor gene (MR) cause adPHA1, but the long-term consequences of MR deficiency in humans are not known. Herein are described six novel adPHA1-causing MR mutations (four de novo) and evidence that haploinsufficiency of MR is sufficient to cause adPHA1. Furthermore, genotype-phenotype correlation is reported in a large adPHA1 kindred. A number of cases of neonatal mortality in infants who were at risk for adPHA1 were identified; coupled with the frequent identification of de novo mutations in affected individuals, this suggests that the seemingly benign adPHA1 may have been a fatal neonatal disorder in previous eras, preventing propagation of disease alleles. In contrast, it is shown that adult patients with adPHA1 are clinically indistinguishable from their wild-type relatives except for, presumably lifelong elevation of renin, angiotensin II, and aldosterone levels. These data highlight the critical role of MR in the maintenance of salt homeostasis early in life and illuminate the sodium dependence of pathologic effects of renin and angiotensin II. They furthermore argue that nongenomic effects of aldosterone play no significant role in the long-term development of cardiovascular disease.
Keywords
EPITHELIAL SODIUM-CHANNEL, MINERALOCORTICOID RECEPTOR GENE, I PSEUDOHYPOALDOSTERONISM, GLUCOCORTICOID RESISTANCE, INACTIVATING MUTATIONS, THYROID-HORMONE, IDENTIFICATION, HETEROGENEITY, FAMILY, ALDOSTERONE

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MLA
Geller, DS, et al. “Autosomal Dominant Pseudohypoaldosteronism Type 1: Mechanisms, Evidence for Neonatal Lethality, and Phenotypic Expression in Adults.” JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, vol. 17, no. 5, LIPPINCOTT WILLIAMS & WILKINS, 2006, pp. 1429–36, doi:10.1681/ASN.2005111188.
APA
Geller, D., Zhang, J., Zennaro, M., Vallo-Boado, A., Rodriguez-Soriano, J., Furu, L., … Lifton, R. (2006). Autosomal dominant pseudohypoaldosteronism type 1: Mechanisms, evidence for neonatal lethality, and phenotypic expression in adults. JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 17(5), 1429–1436. https://doi.org/10.1681/ASN.2005111188
Chicago author-date
Geller, DS, JH Zhang, MC Zennaro, A Vallo-Boado, J Rodriguez-Soriano, L Furu, R Haws, et al. 2006. “Autosomal Dominant Pseudohypoaldosteronism Type 1: Mechanisms, Evidence for Neonatal Lethality, and Phenotypic Expression in Adults.” JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY 17 (5): 1429–36. https://doi.org/10.1681/ASN.2005111188.
Chicago author-date (all authors)
Geller, DS, JH Zhang, MC Zennaro, A Vallo-Boado, J Rodriguez-Soriano, L Furu, R Haws, D Metzger, B Botelho, L Karaviti, AM Haqq, H Corey, Sandra Janssens, P Corvol, and RP Lifton. 2006. “Autosomal Dominant Pseudohypoaldosteronism Type 1: Mechanisms, Evidence for Neonatal Lethality, and Phenotypic Expression in Adults.” JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY 17 (5): 1429–1436. doi:10.1681/ASN.2005111188.
Vancouver
1.
Geller D, Zhang J, Zennaro M, Vallo-Boado A, Rodriguez-Soriano J, Furu L, et al. Autosomal dominant pseudohypoaldosteronism type 1: Mechanisms, evidence for neonatal lethality, and phenotypic expression in adults. JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY. 2006;17(5):1429–36.
IEEE
[1]
D. Geller et al., “Autosomal dominant pseudohypoaldosteronism type 1: Mechanisms, evidence for neonatal lethality, and phenotypic expression in adults,” JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, vol. 17, no. 5, pp. 1429–1436, 2006.
@article{869189,
  abstract     = {{Autosomal dominant pseudohypoaldosteronism type 1 (adPHA1) is a rare condition that is characterized by renal resistance to aldosterone, with salt wasting, hyperkalemia, and metabolic acidosis. It is thought of as a mild disorder; affected children's symptoms respond promptly to salt therapy, and treatment is not required after childhood. Mutations in the mineralocorticoid receptor gene (MR) cause adPHA1, but the long-term consequences of MR deficiency in humans are not known. Herein are described six novel adPHA1-causing MR mutations (four de novo) and evidence that haploinsufficiency of MR is sufficient to cause adPHA1. Furthermore, genotype-phenotype correlation is reported in a large adPHA1 kindred. A number of cases of neonatal mortality in infants who were at risk for adPHA1 were identified; coupled with the frequent identification of de novo mutations in affected individuals, this suggests that the seemingly benign adPHA1 may have been a fatal neonatal disorder in previous eras, preventing propagation of disease alleles. In contrast, it is shown that adult patients with adPHA1 are clinically indistinguishable from their wild-type relatives except for, presumably lifelong elevation of renin, angiotensin II, and aldosterone levels. These data highlight the critical role of MR in the maintenance of salt homeostasis early in life and illuminate the sodium dependence of pathologic effects of renin and angiotensin II. They furthermore argue that nongenomic effects of aldosterone play no significant role in the long-term development of cardiovascular disease.}},
  author       = {{Geller, DS and Zhang, JH and Zennaro, MC and Vallo-Boado, A and Rodriguez-Soriano, J and Furu, L and Haws, R and Metzger, D and Botelho, B and Karaviti, L and Haqq, AM and Corey, H and Janssens, Sandra and Corvol, P and Lifton, RP}},
  issn         = {{1046-6673}},
  journal      = {{JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY}},
  keywords     = {{EPITHELIAL SODIUM-CHANNEL,MINERALOCORTICOID RECEPTOR GENE,I PSEUDOHYPOALDOSTERONISM,GLUCOCORTICOID RESISTANCE,INACTIVATING MUTATIONS,THYROID-HORMONE,IDENTIFICATION,HETEROGENEITY,FAMILY,ALDOSTERONE}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{1429--1436}},
  publisher    = {{LIPPINCOTT WILLIAMS & WILKINS}},
  title        = {{Autosomal dominant pseudohypoaldosteronism type 1: Mechanisms, evidence for neonatal lethality, and phenotypic expression in adults}},
  url          = {{http://doi.org/10.1681/ASN.2005111188}},
  volume       = {{17}},
  year         = {{2006}},
}

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