Abstract
Mutations in the CLCN5 gene encoding the
2Cl-/1H+ exchanger ClC-5 are
associated with Dent disease 1, an inherited renal disorder
characterized by low molecular weight (LMW) proteinuria and
hypercalciuria. In the kidney, ClC-5 is mostly localized in proximal
tubule cells where it is thought to play a key role in the endocytosis
of LMW proteins. Here, we investigated the consequences of eight
previously reported pathogenic missense mutations of ClC-5 surrounding
the “proton glutamate” that serves as a crucial
H+-binding site for the exchanger. A complete loss of
function was observed for a group of mutants that were either retained
in the endoplasmic reticulum of HEK293T cells or unstainable at plasma
membrane due to proteasomal degradation. In contrast, the currents
measured for a second group of mutations in X. laevis oocytes
were reduced. Molecular Dynamics simulations performed on a ClC-5
homology model demonstrated that such mutations may alter ClC-5
protonation by interfering with the water pathway. Analysis of clinical
data from patients harboring these mutations demonstrated no
phenotype/genotype correlation. This study reveals that mutations
clustered in a crucial region of ClC-5 have diverse molecular
consequences in patients with Dent disease 1, ranging from altered
expression to defects in transport.