Lecture VIII Flashcards
What kind of diseases may be affected by protein trafficking?
kidney diseases
What is Autosomal Dominant Tubulointerstitial Kidney Disease (ADTKD)?
it is an autosomal dominant disease that has a phenotype characterized by tubular damage and interstitial fluids
Why is ADTKD undetectable in terms of lab findings?
urine analysis is not very informative (no protein urea, which is a sign that glomerulus is not filtering correctly)
kidneys have a normal or slightly smaller size
What are some functional defects that can be seen in patients with ADTKD?
patient has urinary concentration defects, which leads to polyurea and polydipsia
kidneys lose function
What are the therapies available for ADTKD patients?
none, the only option is to undergo dialysis or have a kidney transplant
What kind of disease is ADTKD?
genetically heterogenous disease
What are the 2 most frequent mutations associated with ADTKD?
UMOD (uromodulin) and MUC1 (Mucin 1)
What is the most common human kidney disease in the world?
ADTKD-UMOD
What is a TF related to ADTKD?
HNF1β
What are some ultra rare ADTKD diseases?
ADTKD-REN and ADTKD-SEC61A1
What can this flowchart be useful for?
help nephrologists correctly diagnose patients with ADTKD
What is another name for Uromodulin?
Tamm-Horsfall protein
What is uromodulin?
protein with immunomodulatory function that is abundant in urine
it has a high MW polymer, which forms large filaments once it is secreted in urine
Where is uromodulin expressed?
ONLY in the kidneys
ONLY in the Thick Ascending Limb (TAL) of Henle’s loop: it is most likely localized on the membrane of TAL cels
Describe uromodulin:
large amount of cysteins involved in SS-bond formation
EGF is involved in protein-protein interactions
D8C is a domain of non-function
ZP domain is involved in the formation of extracellular polymers
internal and external hydrophobic patches are involved in keeping the ZP domain in closed conformation
What happens after uromodulin reaches the membrane?
hepsin cleaves at the end of ZP and seperates the interactions of the 2 domainsand changes the conformation of uromodulin → allows other uromodulins to interact and form filaments
What does uromodulin do in the kidney?
regulates ion transport in the TAL segment
Why is the loop of Henle important?
it is where important molcules are reabsorbed from urine (ex: 20% of Na+)
What happens to the urine as it progresses through the loop of Henle?
it is progressively diluted as it progresses via the tubules
What does the TAL segment do?
implements the mechanism where we have the counter current gradient in kidneys where most of the water gets reabsorbed thanks to the osmotic gradient
If one of the 1st symptoms of ADTKD-UMOD is urine concentration defects, what can be implied?
uromodulin defects cause damage in TAL causing urinalysis
What makes uromoduline a great defense factor?
it is a great antibacterial agent as it is kept in a high mannose conformation (not modified in golgi) and it keeps the original conformation that the glycans acquire in the ER
it is able to sequestrate bacteria from the urinary tract
What can be used instead of antibiotics to treat urinary tract infections?
uromoduline
WHat else can uromodulin function as?
immunoregulatory agent
acts as a DAMP (damage-associated molecular pattern), so when the tubule is damaged, the protein extravates into the interstitium and activated inflammatory cells
*acts as a guardian of the integrity of the tubules once it is secreted within the nephron