Gordon syndrome is a rare inherited monogenic form of hypertension, which is associated with hyperkalaemia and metabolic acidosis. Since the recognition of this predominantly autosomal dominant condition in the 1960s, the study of families with Gordon syndrome has revealed four genes WNK1, WNK4, KLHL3, and CUL3 to be implicated in its pathogenesis after a phenotype-genotype correlation was realised. The encoded proteins Kelch-like 3 and Cullin 3 interact to form a ring-like complex to ubiquitinate WNK-kinase 4, which, in normal circumstances, interacts with the sodium chloride co-symporter (NCC), the epithelial sodium channel (ENaC), and the renal outer medullary potassium channel (ROMK) in an inhibitory manner to maintain normokalaemia and normotension. WNK-kinase 1 has an inhibitory action on WNK-kinase 4. Mutations in WNK1, WNK4, KLHL3, and CUL3 all result in the accumulation of WNK-kinase 4 and subsequent hypertension, hyperkalaemia, and metabolic acidosis. This review explains the clinical aspects, disease mechanisms, and molecular genetics of Gordon syndrome.

译文

:Gordon综合征是一种罕见的遗传性单基因型高血压,与高钾血症和代谢性酸中毒有关。自从1960年代认识到这种主要的常染色体显性遗传状态以来,戈登综合症家族的研究已经揭示了四个基因WNK1,WNK4,KLHL3和CUL3,它们在表型与基因型相关性实现后与其发病机理有关。编码的蛋白Kelch-like 3和Cullin 3相互作用形成环状复合物以泛素化WNK激酶4,在正常情况下,WNK激酶4与氯化钠辅助符号(NCC),上皮钠通道(ENaC)相互作用,以及以抑制方式维持肾脏正常血钾和正常血压的肾外延髓钾通道(ROMK)。 WNK激酶1对WNK激酶4具有抑制作用。WNK1,WNK4,KLHL3和CUL3中的突变均导致WNK激酶4的积累,进而导致高血压,高钾血症和代谢性酸中毒。这篇综述解释了戈登综合症的临床方面,疾病机制和分子遗传学。

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