African-Americans have an increased risk of developing chronic and end-stage kidney disease, with much of it attributed to two common genetic variants in the APOL1 gene, termed G1 and G2. Direct evidence demonstrating that these APOL1 risk alleles are pathogenic is still lacking as the APOL1 gene is only present in some primates and humans; thus experimental proof of causality of these risk alleles for renal disease has been challenging. Here, we generated mice with podocyte-specific inducible expression of the APOL1 reference allele (termed G0) or each of the risk alleles (G1 or G2). We show that mice with podocyte-specific expression of either APOL1 risk allele, but not the G0 allele, develop functional (albuminuria, azotemia), structural (foot process effacement and glomerulosclerosis) and molecular (gene expression) changes that closely resemble the human kidney disease. Disease development was cell-type specific, and likely reversible, and the severity correlated with the level of expression of the risk allele. We further found that expression of the APOL1 risk alleles interferes with endosomal trafficking and blocks autophagic flux, leading ultimately to inflammatory-mediated podocyte death and glomerular scarring. In summary, this is the first in vivo demonstration that expression of APOL1 risk alleles are causal for altered podocyte function and glomerular disease.

Background: How autophagy, a cell survival mechanism, regulates intestinal epithelial tight junction barrier or paracellular permeability is unknown. Results: Autophagy reduces the paracellular permeability of small solutes and ions via degradation of the pore-forming tight junction protein claudin-2. Conclusion: Autophagy enhances tight junction barrier function by targeting claudin-2. Significance: This is the first report showing autophagy regulation of the intestinal tight junction barrier.

Neurospora crassa ARG13 and Saccharomyces cerevisiae ARG11 encode mitochondrial carrier family (MCF) proteins that transport ornithine across the mitochondrial inner membrane. We used their sequences to identify EST candidates that partially encode orthologous mammalian transporters. We thereby identified such a gene (ORNT1) that maps to 13q14 and whose expression, similar to that of other urea cycle (UC) components, was high in liver and varied with changes in dietary protein. ORNT1 expression restores ornithine metabolism in fibroblasts from patients with hyperammonaemia-hyperornithinaemia-homocitrullinuria (HHH) syndrome. In a survey of 11 HHH probands, we identified 3 ORNT1 mutant alleles that account for 21 of 22 possible mutant ORNT1 genes in our patients: F188delta, which is common in French-Canadian HHH patients and encodes an unstable protein; E180K, which encodes a stable, properly targeted protein that is inactive; and a 13q14 microdeletion. Our results show that ORNT1 encodes the mitochondrial ornithine transporter involved in UC function and is defective in HHH syndrome.

PRODH maps to 22q11 in the region deleted in the velocardiofacial syndrome/DiGeorge syndrome (VCFS/DGS) and encodes proline oxidase (POX), a mitochondrial inner-membrane enzyme that catalyzes the first step in the proline degradation pathway. At least 16 PRODH missense mutations have been identified in studies of type I hyperprolinemia (HPI) and schizophrenia, 10 of which are present at polymorphic frequencies. The functional consequences of these missense mutations have been inferred by evolutionary conservation, but none have been tested directly. Here, we report the effects of these mutations on POX activity. We find that four alleles (R185Q, L289M, A455S, and A472T) result in mild (<30%), six (Q19P, A167V, R185W, D426N, V427M, and R431H) in moderate (30%-70%), and five (P406L, L441P, R453C, T466M, and Q521E) in severe (>70%) reduction in POX activity, whereas one (Q521R) increases POX activity. The POX encoded by one severe allele (T466M) shows in vitro responsiveness to high cofactor (flavin adenine dinucleotide) concentrations. Although there is limited information on plasma proline levels in individuals of known PRODH genotype, extant data suggest that severe hyperprolinemia (>800 microM) occurs in individuals with large deletions and/or PRODH missense mutations with the most-severe effect on function (L441P and R453C), whereas modest hyperprolinemia (300-500 microM) is associated with PRODH alleles with a moderate reduction in activity. Interestingly, three of the four alleles associated with or found in schizophrenia (V427M, L441P, and R453C) resulted in severe reduction of POX activity and hyperprolinemia. These observations plus the high degree of polymorphism at the PRODH locus are consistent with the hypothesis that reduction in POX function is a risk factor for schizophrenia.