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자료유형
학술저널
저자정보
Nozu Kandai (Department of Pediatrics Kobe University Graduate School of Medicine Kobe Japan) Takaoka Yutaka (Division of Medical Informatics and Bioinformatics Kobe University Hospital Kobe Japan) Kai Hirofumi (Department of Molecular Medicine Graduate School of Pharmaceutical Sciences Kumamoto University Kum) Takasato Minoru (RIKEN Center for Biosystems Dynamics Research) Yabuuchi Kensuke (Laboratory for Human Organogenesis RIKEN Center for Biosystems Dynamics Research Kobe Japan) Yamamura Tomohiko (Department of Pediatrics Kobe University Graduate School of Medicine Kobe Japan) Horinouchi Tomoko (Department of Pediatrics Kobe University Graduate School of Medicine Kobe Japan) Sakakibara Nana (Department of Pediatrics Kobe University Graduate School of Medicine Kobe Japan) Ninchoji Takeshi (Department of Pediatrics Kobe University Graduate School of Medicine Kobe Japan) Nagano China (Department of Pediatrics Kobe University Graduate School of Medicine Kobe Japan) Iijima Kazumoto (Department of Pediatrics Kobe University Graduate School of Medicine Kobe Japan)
저널정보
대한신장학회 Kidney Research and Clinical Practice Kidney Research and Clinical Practice Vol.39 No.4
발행연도
2020.1
수록면
402 - 413 (12page)

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Alport syndrome (AS) is a progressive inherited kidney disease characterized by hearing loss and ocular abnormalities. There are three forms of AS depending on inheritance mode: X-linked Alport syndrome (XLAS), autosomal recessive AS (ARAS), and autosomal dominant AS (ADAS). XLAS is caused by pathogenic variants in COL4A5, which encodes type IV collagen α5 chain, while ADAS and ARAS are caused by variants in COL4A3 or COL4A4, which encode type IV collagen α3 or α4 chain, respectively. In male XLAS or ARAS cases, end-stage kidney disease (ESKD) develops around a median age of 20 to 30 years old, while female XLAS or ADAS cases develop ESKD around a median age of 60 to 70 years old. The diagnosis of AS is dependent on either genetic or pathological findings. However, determining the pathogenicity of the variants detected by gene tests can be difficult. Recently, we applied the following molecular investigation tools to determine pathogenicity: 1) in silico and in vitro trimer formation assay of α345 chains to assess triple helix formation ability, 2) kidney organoids constructed from patients’ induced pluripotent stem cells to identify α5 chain expression on the glomerular basement membrane, and 3) in vitro splicing assay to detect aberrant splicing to determine the pathogenicity of variants. In this review article, we discuss the genetic background and novel assays for determining the pathogenicity of variants. We also discuss the current treatment approaches and introduce exon skipping therapy as one potential treatment option.

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