Hereditary lysozyme amyloidosis variant p.Leu102Ser associates with unique phenotype

Samih H. Nasr, Surendra Dasari, John R. Mills, Jason D. Theis, Michael T. Zimmermann, Rafael Fonseca, Julie A. Vrana, Steven Jay Lester, Brooke M. McLaughlin, Robert Gillespie, W Edward Jr. Highsmith, John J. Lee, Angela Dispenzieri, Paul J. Kurtin

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Lysozyme amyloidosis (ALys) is a rare form of hereditary amyloidosis that typically manifests with renal impairment, gastrointestinal (GI) symptoms, and sicca syndrome, whereas cardiac involvement is exceedingly rare and neuropathy has not been reported. Here, we describe a 40-year-old man with renal impairment, cardiac and GI symptoms, and peripheral neuropathy. Renal biopsy specimen analysis revealedamyloidosis with extensive involvement of glomeruli, vessels, and medulla. Amyloid was also detected in the GI tract. Echocardiographic and electrocardiographic findings were consistent with cardiac involvement. Proteomic analysis of Congo red-positive renal and GI amyloid deposits detected abundant lysozyme C protein. DNA sequencing of the lysozyme gene in the patient and his mother detected a heterozygous c.305T.>C alteration in exon 3, which causes a leucine to serine substitution at codon 102 (Human Genome Variation Society nomenclature: P.Leu102Ser; legacy designation: L84S).We also detected the mutant peptide in the proband's renal and GI amyloid deposits. PolyPhen analysis predicted that the mutation damages the encoded protein. Molecular dynamics simulations suggested that the pathogenesis of ALys p.Leu102Ser is mediated by shifting the position of the central b-hairpin coordinated with an antiparallel motion of the C-terminal helix, which may alter the native-state structural ensemble of the molecule, leading to aggregation-prone intermediates.

Original languageEnglish (US)
Pages (from-to)431-438
Number of pages8
JournalJournal of the American Society of Nephrology
Volume28
Issue number2
DOIs
StatePublished - Feb 1 2017

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Familial Amyloidosis
Muramidase
Phenotype
Kidney
Amyloid Plaques
Congo Red
Sjogren's Syndrome
Peripheral Nervous System Diseases
Amyloidosis
Human Genome
Molecular Dynamics Simulation
Protein C
DNA Sequence Analysis
Amyloid
Terminology
Codon
Leucine
Proteomics
Serine
Gastrointestinal Tract

ASJC Scopus subject areas

  • Nephrology

Cite this

Hereditary lysozyme amyloidosis variant p.Leu102Ser associates with unique phenotype. / Nasr, Samih H.; Dasari, Surendra; Mills, John R.; Theis, Jason D.; Zimmermann, Michael T.; Fonseca, Rafael; Vrana, Julie A.; Lester, Steven Jay; McLaughlin, Brooke M.; Gillespie, Robert; Highsmith, W Edward Jr.; Lee, John J.; Dispenzieri, Angela; Kurtin, Paul J.

In: Journal of the American Society of Nephrology, Vol. 28, No. 2, 01.02.2017, p. 431-438.

Research output: Contribution to journalArticle

Nasr, SH, Dasari, S, Mills, JR, Theis, JD, Zimmermann, MT, Fonseca, R, Vrana, JA, Lester, SJ, McLaughlin, BM, Gillespie, R, Highsmith, WEJ, Lee, JJ, Dispenzieri, A & Kurtin, PJ 2017, 'Hereditary lysozyme amyloidosis variant p.Leu102Ser associates with unique phenotype', Journal of the American Society of Nephrology, vol. 28, no. 2, pp. 431-438. https://doi.org/10.1681/ASN.2016090951
Nasr, Samih H. ; Dasari, Surendra ; Mills, John R. ; Theis, Jason D. ; Zimmermann, Michael T. ; Fonseca, Rafael ; Vrana, Julie A. ; Lester, Steven Jay ; McLaughlin, Brooke M. ; Gillespie, Robert ; Highsmith, W Edward Jr. ; Lee, John J. ; Dispenzieri, Angela ; Kurtin, Paul J. / Hereditary lysozyme amyloidosis variant p.Leu102Ser associates with unique phenotype. In: Journal of the American Society of Nephrology. 2017 ; Vol. 28, No. 2. pp. 431-438.
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