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Volume 145, Issue 1, Pages 138-148 (July 2013) Congenital Proprotein Convertase 1/3 Deficiency Causes Malabsorptive Diarrhea and Other Endocrinopathies in a Pediatric Cohort Martín G. Martín, Iris Lindberg, R. Sergio Solorzano–Vargas, Jiafang Wang, Yaron Avitzur, Robert Bandsma, Christiane Sokollik, Sarah Lawrence, Lindsay A. Pickett, Zijun Chen, Odul Egritas, Buket Dalgic, Valeria Albornoz, Lissy de Ridder, Jessie Hulst, Faysal Gok, Ayşen Aydoğan, Abdulrahman Al–Hussaini, Deniz Engin Gok, Michael Yourshaw, S. Vincent Wu, Galen Cortina, Sara Stanford, Senta Georgia Gastroenterology Volume 145, Issue 1, Pages 138-148 (July 2013) DOI: 10.1053/j.gastro.2013.03.048 Copyright © 2013 AGA Institute Terms and Conditions

Figure 1 Pedigrees and mutations in PCSK1. Pedigrees of families studied, showing genotypes (./., NA; 0/0, WT; 0/1, heterozygous; 1/1, homozygous) and Sanger sequencing results for proband and unaffected control. The proband(s) that were sequenced are indicated by the black square (male) or black circle (female). Homozygote mutations within each family are indicated by MM, heterozygotes are indicated by MN, normal on both alleles is indicated by NN; and not assessed is indicated as NA. A slash through the symbol indicates that the subject is deceased, and a double line between the parents indicates a consanguineous union. Gastroenterology 2013 145, 138-148DOI: (10.1053/j.gastro.2013.03.048) Copyright © 2013 AGA Institute Terms and Conditions

Figure 2 Domain structure and mutation locations within prepro-PC1/3. Overview of PC1/3 protein regions with locations of mutations presented in this study and previously published mutations. Gastroenterology 2013 145, 138-148DOI: (10.1053/j.gastro.2013.03.048) Copyright © 2013 AGA Institute Terms and Conditions

Figure 3 Location of 5 missense mutations in the PC1/3 gene family in conserved domains. Alignment of missense variants to members of the PC1/3 gene family. Gastroenterology 2013 145, 138-148DOI: (10.1053/j.gastro.2013.03.048) Copyright © 2013 AGA Institute Terms and Conditions

Figure 4 Western blot of PC1/3 wild-type and mutant protein expression. HEK293 cells were transfected with empty vector (E), wild-type PC1/3 (WT), or PC1/3s containing novel mutations. Media and cells were subjected to Western blotting using amino-terminally directed PC1/3 primary antiserum.28 (A) Truncation mutations and (B) missense mutations are shown. β-actin was used as a loading control. Gastroenterology 2013 145, 138-148DOI: (10.1053/j.gastro.2013.03.048) Copyright © 2013 AGA Institute Terms and Conditions

Figure 5 Enzymatic activity of wild-type PC1/3 and novel PC1/3 variants. The enzymatic activities of secreted PC1/3 proteins in conditioned medium were assayed using a fluorogenic assay. Four replicates per transfection condition were assayed in triplicate, and maximum rates were normalized to WT PC1/3. Maximum activity rates are shown as the mean ± SD (n = 4 wells). Data represent 1 of 3 independent experiments. Bars represent mean ± standard deviation, and an unpaired Student t test was used to assess differences between mutant and WT activities with *P < .001 and **P < .05. All experiments were repeated independently in triplicate wells at least 3 times, with similar results. Gastroenterology 2013 145, 138-148DOI: (10.1053/j.gastro.2013.03.048) Copyright © 2013 AGA Institute Terms and Conditions

Supplementary Figure 1 Gastroenterology 2013 145, 138-148DOI: (10.1053/j.gastro.2013.03.048) Copyright © 2013 AGA Institute Terms and Conditions

Supplementary Table 1 Gastroenterology 2013 145, 138-148DOI: (10.1053/j.gastro.2013.03.048) Copyright © 2013 AGA Institute Terms and Conditions