Complement Factor H Gene Mutation Associated with Autosomal Recessive Atypical Hemolytic Uremic Syndrome  Lihua Ying, Yitzhak Katz, Menachem Schlesinger,

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Complement Factor H Gene Mutation Associated with Autosomal Recessive Atypical Hemolytic Uremic Syndrome  Lihua Ying, Yitzhak Katz, Menachem Schlesinger, Rivka Carmi, Hanna Shalev, Neena Haider, Gretel Beck, Val C. Sheffield, Daniel Landau  The American Journal of Human Genetics  Volume 65, Issue 6, Pages 1538-1546 (December 1999) DOI: 10.1086/302673 Copyright © 1999 The American Society of Human Genetics Terms and Conditions

Figure 1 Family pedigree and genotypes. Blackened symbols denote affected individuals; unblackened symbols, unaffected individuals; unblackened diamond, CVS. I–VII denote generation. The ID numbers for each member of generations V–VII are listed below each symbol. Genotypes of both flanking and linked markers are shown below ID numbers. Note that all the affected individuals are homozygous for the markers between flanking markers D1S408 and D1S1647. Only the markers defining the critical region are listed. The American Journal of Human Genetics 1999 65, 1538-1546DOI: (10.1086/302673) Copyright © 1999 The American Society of Human Genetics Terms and Conditions

Figure 2 Representative genotypes with marker D1S1160. Twenty-three DNA samples from the HUS kindred were analyzed by PCR with D1S1660. The ID numbers for each lane are shown. The unaffected parents are individuals V-1 and V-2, V-10 and V-11, and V-4 and V-5. Lanes labeled with an “S” represent the siblings who do not show in the pedigree but were included in the genotyping. Two affected individuals genotyped are VI-4 and VI-24. All affected individuals are homozygous for marker D1S1160. Similar results were obtained with other linked STRPs (data not shown). The American Journal of Human Genetics 1999 65, 1538-1546DOI: (10.1086/302673) Copyright © 1999 The American Society of Human Genetics Terms and Conditions

Figure 3 A, SSCP of exon 20 in family members with HUS. DNA samples were screened for mutations, by use of SSCP with primers from the CFH coding region. The ID numbers for each lane are shown. A CVS was included in lane 16 (VII-4). Note the shifted bands representing a mutation in the CFH gene. B, Partial chromatograms for the exon 20 codon sequence for affected individuals (VI-4) and for unaffected individuals (VI-15). Note the mutation in affected individuals (C→T change). The American Journal of Human Genetics 1999 65, 1538-1546DOI: (10.1086/302673) Copyright © 1999 The American Society of Human Genetics Terms and Conditions

Figure 4 Western blot analysis of serum CFH from affected individuals VII-2 (lanes 1–3), VI-4 (lanes 7–9), and VI-24 (lanes 10–12); from unaffected parents VI-19 (lane 4) and V-7 (lane 5); and from sibling VII-3 (lane 6). P1 and P2 are the pools of unaffected individuals corresponding to VII-2 and VI-4, respectively. The blot was probed with antisera specific for CFH. Size markers are shown. The serum dilutions are indicated below each lane. The American Journal of Human Genetics 1999 65, 1538-1546DOI: (10.1086/302673) Copyright © 1999 The American Society of Human Genetics Terms and Conditions

Figure 5 The correlation between serum CFH and C3. Immunodiffusion assay of serum from peripheral blood of unaffected parents and siblings. CFH and C3 were measured with the use of monospecific goat antibodies to human C complement. The protein counts were expressed as a percentage of pooled normal sera. Correlation: r=0.67, P<.05. The American Journal of Human Genetics 1999 65, 1538-1546DOI: (10.1086/302673) Copyright © 1999 The American Society of Human Genetics Terms and Conditions

Figure 6 CFH mRNA: northern blot analysis of fibroblasts from affected individuals VII-2 (lanes 1 and 2), VI-4 (lanes 3 and 4) and from unaffected control individuals C1 (lanes 5 and 6) and C2 (lanes 7 and 8), in both the basal state (B) and the stimulated state (S). The blot was probe with a CFH cDNA probe. An internal control probe (C1I [complement 1 inhibitor]) was included. Size markers are not shown. The American Journal of Human Genetics 1999 65, 1538-1546DOI: (10.1086/302673) Copyright © 1999 The American Society of Human Genetics Terms and Conditions

Figure 7 CFH and C3 biosynthesis and secretion. Pulse-chase experiments of CFH (A) and C3 (B) from skin fibroblasts from two patients (denoted by “HUS”) (VI-4 and VII-2) and from two healthy controls (denoted by “control”). Intracellular biosynthesis or extracellular secretion rate at 0 h is denoted by gray bars; at 2 h, by unblackened bars; and at 8 h, by blackened bars. IC = inside fibroblasts; EC = in medium. The American Journal of Human Genetics 1999 65, 1538-1546DOI: (10.1086/302673) Copyright © 1999 The American Society of Human Genetics Terms and Conditions