Nature Genetics
14, 345 - 347 (1996)
doi:10.1038/ng1196-345
Germline mutations of the RET ligand GDNF are not sufficient to cause Hirschsprung diseaseRémi Salomon1, Tania Attié1, Anna Pelet1, Christelle Bidaud1, Charis Eng2, Jeanne Amiel, Sabine Sarnacki1, Olivier Goulet1, Claude Ricour1, Claire Nihoul-Fékété1, Arnold Munnich1
& Stanislas Lyonnet1
1Unité de Recherches sur les Handicaps Génétiques de l'Enfant INSERM U-393, Fédération de Génétique, Clinique Chirurgicale Infantile and Service de Nutrition et Gastroentérologie Pédiatriques, Hôspital des Enfants Malades, Institut Necker, 149, rue de Sévres, 75743 Paris Cedex 15, France
2Division of Cancer Epidemiology and Control, Dana-Farber Cancer Institute, Department of Medicine, Harvard Medical School, D920C, 44 Binney Street, Boston, Massachussetts 02115-6054, USA Hirschsprung disease (HSCR, aganglionic megacolon) is a common congenital malformation leading to bowel obstruction, with an incidence of 1/5,000 live births. It is characterized by the absence of intrinsic ganglion cells in the myenteric and submucosal plexuses along variable lengths of the gastrointestinal tract1. As enteric neurons are derived from the vagal neural crest, HSCR is regarded as a neurocristopathy2. On the basis of a skewed sex-ratio ( M/F = 4/1) and a risk to relatives much higher than the incidence in the general population, HSCR has long been regarded as a sex-modified multifactorial disorder3,4. Accordingly, segregation analysis suggested an incompletely penetrant dominant inheritance in HSCR families with agan-glionosis extending beyond the sigmoid colon3. We and others have mapped a dominant gene for HSCR to chromosome 10q11.2 and have ascribed the disease to mutations in the RET protoonco-gene5−8. However, the lack of genotype-phenotype correlation, the low penetrance and the sex-dependent effect of RET mutations supported the existence of one or more modifier gene(s) in familial HSCR9. In addition, thus far, RET mutations only accounted for 50% and 15−20% of familial and sporadic HSCR patients, respectively9−11. RET encodes a tyrosine kinase receptor whose ligand was unknown12. Recently, the Glial cell line- derived neurotrophic factor (GDNF) has been identified to be a ligand for RET13,14. Moreover, Gdnf-/- knockout mutant mice display congenital intestinal agan-glionosis and renal agenesis15−17, a phenotype very similar to the Ret -/- mouse18. These data prompted us to hypothesize that mutations of the gene encoding GDNF could either cause or modulate the HSCR phenotype in some cases.
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