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Submitted on January 18, 2005
Accepted on March 14, 2005
Department of Pediatrics, Kyoto University Hospital, Kyoto, Japan; Department of Diabetes and Clinical Nutrition, Kyoto University Hospital, Kyoto Japan; Oishi Clinic, Kyoto, Japan; Diabetes Center, National Hospital Organization Kyoto Medical Center, Kyoto, Japan; Department of Physiology, Akita University School of Medicine, Akita, Japan
* To whom correspondence should be addressed. E-mail: yorif{at}kuhp.kyoto-u.ac.jp.
[Context]: Known MODY genes account for only a fraction of families with dominantly inherited diabetes in Japan. There should be as yet unidentified genes which account for the rest of the patients
[Objective]: To identify and characterize the mutation responsible for a Japanese family with dominantly inherited diabetes mellitus.
[Subjects]: Members of a four-generation family with dominantly inherited diabetes mellitus observed in three generations. None of the patients in this family had permanent neonatal diabetes (PND). One with transient neonatal diabetes, one with childhood diabetes, the others with adult-onset diabetes without autoantibodies or insulin resistance.
[Methods]: Screening of the chromosomal location of the gene by a genome-wide linkage analysis followed by candidate gene sequencing. Confirmation of the functional significance of the identified mutation by the population survey and the physiological analysis
[Results]: We identified a novel mutation (C42R) in the KCNJ11 gene coding for the Kir6.2 subunit of the pancreatic KATP channel. The patch-clamp experiments using the mutated KCNJ11 showed that the mutation causes increased spontaneous open probability (Po) and reduced ATP-sensitivity. The effect, however, was partially compensated by the reduction of functional KATP-channel expression at the cell surface, which could account for the milder phenotype of our patients.
[Conclusions]: These results broaden the spectrum of diabetes phenotypes caused by mutations of KCNJ11, and suggest that mutations in this gene should be taken into consideration not only for PND but also for other forms of diabetes with milder phenotypes and later onset.
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