Molecular genetics of inherited cystic kidney diseases: new diagnostic approaches

Background. Hhereditary cystic kidney diseases are a heterogeneous spectrum of disorders leading to renal failure. Clinical features and family history can help to distinguish the recessive from dominant diseases but the differential diagnosis is difficult due the phenotypic overlap. The molecular diagnosis is often the only way to characterize the different forms. A conventional molecular screening is suitable for small genes but is expensive and time-consuming for large size genes. Next Generation Sequencing (NGS) technologies enables massively parallel sequencing of nucleic acid fragments. Purpose. The first purpose was to validate a diagnostic algorithm useful to drive the genetic screening. The second aim was to validate a NGS protocol of PKHD1 gene. Methods. DNAs from 50 patients were submitted to conventional screening of NPHP1, NPHP5, UMOD, REN and HNF1B genes. 5 patients with known mutations in PKHD1 were submitted to NGS to validate the new method and a not genotyped proband with his parents were analyzed for a diagnostic application. Results. The conventional molecular screening detected 8 mutations: 1) the novel p.E48K of REN in a patient with cystic nephropathy, hyperuricemia, hyperkalemia and anemia; 2) p.R489X of NPHP5 in a patient with Senior Loken Syndrome; 3) pR295C of HNF1B in a patient with renal failure and diabetes.; 4) the NPHP1 deletion in 3 patients with medullar cysts; 5) the HNF1B deletion in a patient with medullar cysts and renal hypoplasia and in a diabetic patient with liver disease. The NGS of PKHD1 detected all known mutations and two additional variants during the validation. The diagnostic NGS analysis identified the patient’s compound heterozygosity with a maternal frameshift mutation and a paternal missense mutation besides a not transmitted paternal missense mutation. Conclusions. The results confirm the validity of our diagnostic algorithm and suggest the possibility to introduce this NGS protocol to clinical practice.

Biomineralization in calcifying marine organisms

The objective of this theses is to contribute to the wide discussion about the biological control level on the biomineralization operated by calcifying organisms. In particular the intra-crystalline organic matrix associated with different coral species was studied and its role in the process was investigated. The main goals obtained from the research on corals included: (i) the discovery of the species specific role of the intra-crystalline organic matrix molecules in the precipitation of calcium carbonate; (ii) the definition of the role of magnesium ions in the control of the macromolecules assembly/aggregation and in the consequent calcium carbonate polymorphic selectivity; (iii) the discovery that in corals the biomineralization process is not affected by the sea water acidity, as consequence corals are able to construct their skeletons independently from the environmental conditions as far they survive. At the same time, investigations on different kind of vaterite, biogenic and synthetic, were also carried out and confirm the importance of the organism control on the biomineralization process and in particular on the co-existence of different crystalline structures of vaterite for enabling optimization of specific functions, through the employment of OM and acidic macromolecules.