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Phenotypic differences in PFIC2 and BRIC2 correlate with protein stability of mutant Bsep and impaired taurocholate secretion in MDCK II cells.
[benign recurrent intrahepatic cholestasis]
Progressive
familial
cholestasis
(
PFIC
)
2
and
benign
recurrent
intrahepatic
cholestasis
(
BRIC
)
2
are
caused
by
mutations
in
the
bile
salt
export
pump
(
BSEP
,
ABCB
11
)
gene
;
however
,
their
prognosis
differs
.
PFIC
2
progresses
to
cirrhosis
and
requires
liver
transplantation
,
whereas
BRIC
2
is
clinically
benign
.
To
identify
the
molecular
mechanism
(
s
)
responsible
for
the
phenotypic
differences
,
eight
PFIC
2
and
two
BRIC
2
mutations
were
introduced
in
rat
Bsep
,
which
was
transfected
in
MDCK
II
cells
.
Taurocholate
transport
activity
,
protein
expression
,
and
subcellular
distribution
of
these
mutant
proteins
were
studied
in
a
polarized
MDCK
II
monolayer
.
The
taurocholate
transport
activity
was
approximately
half
of
the
wild-
type
(
WT
)
in
BRIC
2
mutants
(
A
570
T
and
R
1050
C
)
,
was
substantially
less
in
two
PFIC
2
mutants
(
D
482
G
and
E
297
G
)
,
and
was
almost
abolished
in
six
other
PFIC
2
mutants
(
K
461
E
,
G
982
R
,
R
1153
C
,
R
1268
Q
,
3767
-
3768
insC
,
and
R
1057
X
)
.
Bsep
protein
expression
levels
correlated
closely
with
transport
activity
,
except
for
R
1057
X
.
The
half
-life
of
the
D
482
G
mutant
was
shorter
than
that
of
the
WT
(
1
.
35
h
vs
.
3
.
49
h
in
the
mature
form
)
.
BRIC
2
mutants
and
three
PFIC
mutants
(
D
482
G
,
E
297
G
,
and
R
1057
X
)
were
predominantly
distributed
in
the
apical
membrane
.
The
other
PFIC
2
mutants
remained
intracellular
.
The
R
1057
X
mutant
protein
was
stably
expressed
and
trafficked
to
the
apical
membrane
,
suggesting
that
the
COOH-terminal
tail
is
required
for
transport
activity
but
not
for
correct
targeting
.
In
conclusion
,
taurocholate
transport
function
was
impaired
in
proportion
to
rapid
degradation
of
Bsep
protein
in
the
mutants
,
which
were
aligned
in
the
following
order
:
A
570
T
and
R
1050
C
>
D
482
G
>
E
297
G
>
K
461
E
,
G
982
R
,
R
1153
C
,
R
1268
Q
,
3767
-
3768
insC
,
and
R
1057
X
.
These
results
may
explain
the
phenotypic
difference
between
BRIC
2
and
PFIC
2
.
Diseases
Validation
Diseases presenting
"cirrhosis"
symptom
allergic bronchopulmonary aspergillosis
benign recurrent intrahepatic cholestasis
cholangiocarcinoma
erythropoietic protoporphyria
esophageal adenocarcinoma
heparin-induced thrombocytopenia
hirschsprung disease
locked-in syndrome
neonatal adrenoleukodystrophy
papillon-lefèvre syndrome
primary effusion lymphoma
This symptom has already been validated