Mutations in POGLUT1, Encoding Protein O-Glucosyltransferase 1, Cause Autosomal- Dominant Dowling-Degos Disease  F. Buket Basmanav, Ana-Maria Oprisoreanu,

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Mutations in POGLUT1, Encoding Protein O-Glucosyltransferase 1, Cause Autosomal- Dominant Dowling-Degos Disease F. Buket Basmanav, Ana-Maria Oprisoreanu,
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Mutations in POGLUT1, Encoding Protein O-Glucosyltransferase 1, Cause Autosomal- Dominant Dowling-Degos Disease  F. Buket Basmanav, Ana-Maria Oprisoreanu, Sandra M. Pasternack, Holger Thiele, Günter Fritz, Jörg Wenzel, Leopold Größer, Maria Wehner, Sabrina Wolf, Christina Fagerberg, Anette Bygum, Janine Altmüller, Arno Rütten, Laurent Parmentier, Laila El Shabrawi- Caelen, Christian Hafner, Peter Nürnberg, Roland Kruse, Susanne Schoch, Sandra Hanneken, Regina C. Betz  The American Journal of Human Genetics  Volume 94, Issue 1, Pages 135-143 (January 2014) DOI: 10.1016/j.ajhg.2013.12.003 Copyright © 2014 The American Society of Human Genetics Terms and Conditions

Figure 1 Clinical Appearance and Pedigrees (A–F) Reticulate hyperpigmentation and hyperkeratotic brown papules on the back (A), breast (B), trunk (C), arm (D), and legs (E and F) of affected individuals. (G and H) Pedigrees with two affected individuals. Affected family members are shown in black; circles and squares denote females and males, respectively. Both individuals II:1 (G and H) were used for exome sequencing. The American Journal of Human Genetics 2014 94, 135-143DOI: (10.1016/j.ajhg.2013.12.003) Copyright © 2014 The American Society of Human Genetics Terms and Conditions

Figure 2 Position of Mutations in POGLUT1 and Verification of Mutations Identified by Exome Sequencing (A) Cartoon depicting the exon structure of POGLUT1. All identified mutations are marked by arrow heads. The mutations are defined on nucleotide and protein levels. The number of individuals carrying each mutation is denoted with the number of squares. Red squares indicate mutations identified by exome sequencing. (B) All three mutations identified by exome sequencing were verified by Sanger sequencing. The mutated sequences are given in comparison to WT sequences. The American Journal of Human Genetics 2014 94, 135-143DOI: (10.1016/j.ajhg.2013.12.003) Copyright © 2014 The American Society of Human Genetics Terms and Conditions

Figure 3 Protein Modeling of Wild-Type and Mutant POGLUT1 (A) POGLUT1 is composed of two major domains; the N-terminal domain (residues 1–180; green) and the C-terminal domain (residues 181–349; magenta) together form a binding pocket for the substrate UDP-glucose (stick model; yellow) at the domain interface. A long C-terminal helix (residues 350–384; blue) stabilizes the arrangement of the two domains. (B) Arg279 is critically involved in UDP-glucose binding forming two salt bridges to oxygen atoms of the diphosphate moiety of UDP-glucose. UDP-glucose is shown as stick model with carbon shown in yellow, nitrogen in blue, phosphor in orange, and oxygen in red. Arg279 is shown as stick model with carbon in magenta and nitrogen atoms in blue. The salt bridges are indicated as broken lines. (C) Sequence analysis showing the mutant and WT sequences for the missense mutation leading to substitution of an arginine residue with tryptophan (c.835C>T [p.Arg279Trp]). (D) Partial amino acid sequence of human POGLUT1 in comparison with orthologs from other species. Arginine residue depicted with red is highly conserved across different species. (E) p.Arg279Trp leads to the substitution of this arginine residue with tryptophan. Loss of the interaction between arginine and the phosphate group of UDP-glucose will largely decrease the affinity to the substrate. Moreover, the large side chain of Trp279 in the mutant form of the enzyme might block the access of UDP-glucose. The side chain of Trp279 is shown as stick model and Van-der-Waals spheres in cyan. The American Journal of Human Genetics 2014 94, 135-143DOI: (10.1016/j.ajhg.2013.12.003) Copyright © 2014 The American Society of Human Genetics Terms and Conditions

Figure 4 Immunohistochemistry on Skin Biopsies, Immunoblotting, and Immunofluorescence Analysis of HEK293T cells Transiently Expressing Wild-Type and Mutant POGLUT1 (A) For immunohistochemistry, sections were prepared from formalin-fixed, paraffin-embedded skin biopsies obtained by plastic surgery from individuals with DDD and healthy controls. POGLUT1 localization was analyzed with the polyclonal antibody NBP1-90311 (named KTELC1; Novus Biologicals) at a 1:500 dilution. Visualization was performed with the LSAB2 staining kit (DAKO) with Fast Red Chromogen. POGLUT1 was strongly present in the epidermis of healthy controls, especially in the upper parts (the stratum spinosum and stratum granulosum). POGLUT1 staining was weaker in lesional skin of individuals affected by DDD. (B) For immunoblotting, WT sequence, sequence bearing mutation c.652C>T (p.Arg218∗), and sequence bearing mutation c.835C>T (p.Arg279Trp) were cloned into the eukaryotic expression vector pAAV-CMV-MCS (Stratagene). HEK293T cells (European Collection of Cell Cultures [ECACC]) were transiently transfected with the plasmids by the use of Lipofectamine 2000 (Invitrogen) according to the manufacturer’s instructions. Forty-eight hr after transfection, cells were lysed in ice cold lysis buffer (50 mM HEPES pH 7.5, 150 mM NaCl, 1% Triton X-100) supplemented with proteinase inhibitors (Roche) for 30 min on ice followed by sonication and centrifugation at 14.000 rpm/10 min/4°C. Clear supernatant was boiled with SDS-sample buffer at 95°C for 5 min and the proteins were subjected to gel electrophoresis (SDS-PAGE, 10%) followed by transfer to nitrocellulose membrane (Millipore). Immunoblotting was performed with mouse anti-Flag (1804; Sigma Aldrich, 1:1.000), rabbit anti-POGLUT1 (NBP1-90311; Novus Biologicals, 1:1.000) primary antibodies and IRDye secondary antibodies (IRDye 800 goat anti-mouse and IRDye 680 goat anti-rabbit, 1:10.000). Bands of the expected size were detected for the WT POGLUT1 and the protein with the p.Arg279Trp substitution, whereas the nonsense mutation (c.652C>T [p.Arg218∗]) led to translation of a truncated protein of around 30 kDa. (C) Immunofluorescence analysis was performed with transiently transfected HEK293T cells. Cells were fixed and incubated for 12–14 hr with mouse anti-Flag (1:400, Sigma-Aldrich) and rabbit anti-PDI (1:200, Abcam) antibodies. After several washing steps, cells were incubated for 40 min with Alexa Fluor 488 goat anti-rabbit, Alexa Fluor 568 goat anti-mouse (1:300, Invitrogen), and DAPI (Invitrogen). Images were acquired at room temperature with a laser-scanning confocal microscope (Nikon A1/Ti, Nikon) with a CFI Plan Apochromat infrared 60× water-immersion objective (NA 1.27). For each construct z stack (step: 0.250 um), images were taken with the NIS-Elements 4.0 acquisition software (Nikon). The analysis revealed the colocalization of the WT POGLUT1 with endoplasmic reticulum (ER). No significant difference was observed in localization patterns of the WT protein and the protein with the amino acid substitution. However, a more aggregated pattern was observed for the truncated protein in comparison to the WT protein, which coincided with an impaired colocalization with the ER. Abbreviations are as follows: HC, healthy control; DDD, Dowling-Degos disease, IB, immunoblot. The American Journal of Human Genetics 2014 94, 135-143DOI: (10.1016/j.ajhg.2013.12.003) Copyright © 2014 The American Society of Human Genetics Terms and Conditions