nih-gov/www.ncbi.nlm.nih.gov/omim/120070

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Entry
- *120070 - COLLAGEN, TYPE IV, ALPHA-3; COL4A3
- OMIM
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<span class="h4">*120070</span>
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<strong>Table of Contents</strong>
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<a href="#description">Description</a>
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<a href="#cloning">Cloning and Expression</a>
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<a href="#geneStructure">Gene Structure</a>
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<a href="#geneFunction">Gene Function</a>
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<a href="#biochemicalFeatures">Biochemical Features</a>
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<a href="#molecularGenetics">Molecular Genetics</a>
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<div><a href="https://www.ncbi.nlm.nih.gov/nuccore/NM_000091" class="mim-tip-hint" title="A collection of genome, gene, and transcript sequence data from several sources, including GenBank, RefSeq." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'NCBI RefSeq (MANE)', 'domain': 'ncbi.nlm.nih'})">NCBI RefSeq (MANE Select)</a></div>
<div><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?db=hg38&hgFind=omimGeneAcc&position=120070" class="mim-tip-hint" title="UCSC Genome Browser; reference sequences and working draft assemblies for a large collection of genomes." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'UCSC Genome Browser', 'domain': 'genome.ucsc.edu'})">UCSC Genome Browser</a></div>
</div>
</div>
</div>
<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
<div class="panel-heading mim-panel-heading" role="tab" id="mimProtein">
<span class="panel-title">
<span class="small">
<a href="#mimProteinLinksFold" id="mimProteinLinksToggle" class="collapsed mimSingletonTriangleToggle" role="button" data-toggle="collapse" data-parent="#mimExternalLinksAccordion">
<span id="mimProteinLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5">&#9658;</span> Protein
</a>
</span>
</span>
</div>
<div id="mimProteinLinksFold" class="panel-collapse collapse mimLinksFold" role="tabpanel">
<div class="panel-body small mim-panel-body">
<div><a href="https://hprd.org/summary?hprd_id=00354&isoform_id=00354_1&isoform_name=Isoform_1" class="mim-tip-hint" title="The Human Protein Reference Database; manually extracted and visually depicted information on human proteins." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'HPRD', 'domain': 'hprd.org'})">HPRD</a></div>
<div><a href="https://www.proteinatlas.org/search/COL4A3" class="mim-tip-hint" title="The Human Protein Atlas contains information for a large majority of all human protein-coding genes regarding the expression and localization of the corresponding proteins based on both RNA and protein data." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'HumanProteinAtlas', 'domain': 'proteinatlas.org'})">Human Protein Atlas</a></div>
<div><a href="https://www.ncbi.nlm.nih.gov/protein/177894,177896,180823,234419,408896,409107,2934702,3702452,7546854,8101726,13559798,62702185,62822122,62988864,89142730,119591254,119591255,119591256,119591257,119591258,119591259,119591260,119591261,119591262,119591263,134035067,161375736,530369765,530369772,578803611,767916531,1034611404,2217325432,2462569892,2462569894,2462569896,2462569899,2462569901,2462569903" class="mim-tip-hint" title="NCBI protein data." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'NCBI Protein', 'domain': 'ncbi.nlm.nih.gov'})">NCBI Protein</a></div>
<div><a href="https://www.uniprot.org/uniprotkb/Q01955" class="mim-tip-hint" title="Comprehensive protein sequence and functional information, including supporting data." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'UniProt', 'domain': 'uniprot.org'})">UniProt</a></div>
</div>
</div>
</div>
<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
<div class="panel-heading mim-panel-heading" role="tab" id="mimGeneInfo">
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<div id="mimGeneInfoLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5; display: table-cell;">&#9658;</div>
&nbsp;
<div style="display: table-cell;">Gene Info</div>
</div>
</a>
</span>
</span>
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<div id="mimGeneInfoLinksFold" class="panel-collapse collapse mimLinksFold" role="tabpanel">
<div class="panel-body small mim-panel-body">
<div><a href="http://biogps.org/#goto=genereport&id=1285" class="mim-tip-hint" title="The Gene Portal Hub; customizable portal of gene and protein function information." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'BioGPS', 'domain': 'biogps.org'})">BioGPS</a></div>
<div><a href="https://www.ensembl.org/Homo_sapiens/Gene/Summary?db=core;g=ENSG00000169031;t=ENST00000396578" class="mim-tip-hint" title="Orthologs, paralogs, regulatory regions, and splice variants." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'Ensembl', 'domain': 'ensembl.org'})">Ensembl</a></div>
<div><a href="https://www.genecards.org/cgi-bin/carddisp.pl?gene=COL4A3" class="mim-tip-hint" title="The Human Genome Compendium; web-based cards integrating automatically mined information on human genes." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'GeneCards', 'domain': 'genecards.org'})">GeneCards</a></div>
<div><a href="http://amigo.geneontology.org/amigo/search/annotation?q=COL4A3" class="mim-tip-hint" title="Terms, defined using controlled vocabulary, representing gene product properties (biologic process, cellular component, molecular function) across species." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'GeneOntology', 'domain': 'amigo.geneontology.org'})">Gene Ontology</a></div>
<div><a href="https://www.genome.jp/dbget-bin/www_bget?hsa+1285" class="mim-tip-hint" title="Kyoto Encyclopedia of Genes and Genomes; diagrams of signaling pathways." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'KEGG', 'domain': 'genome.jp'})">KEGG</a></div>
<dd><a href="http://v1.marrvel.org/search/gene/COL4A3" class="mim-tip-hint" title="Model organism Aggregated Resources for Rare Variant ExpLoration." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'MARRVEL', 'domain': 'marrvel.org'})">MARRVEL</a></dd>
<dd><a href="https://monarchinitiative.org/NCBIGene:1285" class="mim-tip-hint" title="Monarch Initiative." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'Monarch', 'domain': 'monarchinitiative.org'})">Monarch</a></dd>
<div><a href="https://www.ncbi.nlm.nih.gov/gene/1285" class="mim-tip-hint" title="Gene-specific map, sequence, expression, structure, function, citation, and homology data." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'NCBI Gene', 'domain': 'ncbi.nlm.nih.gov'})">NCBI Gene</a></div>
<div><a href="https://genome.ucsc.edu/cgi-bin/hgGene?db=hg38&hgg_chrom=chr2&hgg_gene=ENST00000396578.8&hgg_start=227164624&hgg_end=227314792&hgg_type=knownGene" class="mim-tip-hint" title="UCSC Genome Bioinformatics; gene-specific structure and function information with links to other databases." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'UCSC', 'domain': 'genome.ucsc.edu'})">UCSC</a></div>
</div>
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<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
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<div id="mimClinicalResourcesLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5; display: table-cell;">&#9658;</div>
&nbsp;
<div style="display: table-cell;">Clinical Resources</div>
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</a>
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<div id="mimClinicalResourcesLinksFold" class="panel-collapse collapse mimLinksFold" role="tabpanel" aria-labelledby="clinicalResources">
<div class="panel-body small mim-panel-body">
<div><a href="https://search.clinicalgenome.org/kb/gene-dosage/HGNC:2204" class="mim-tip-hint" title="A ClinGen curated resource of genes and regions of the genome that are dosage sensitive and should be targeted on a cytogenomic array." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'ClinGen Dosage', 'domain': 'dosage.clinicalgenome.org'})">ClinGen Dosage</a></div>
<div><a href="https://search.clinicalgenome.org/kb/genes/HGNC:2204" class="mim-tip-hint" title="A ClinGen curated resource of ratings for the strength of evidence supporting or refuting the clinical validity of the claim(s) that variation in a particular gene causes disease." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'ClinGen Validity', 'domain': 'search.clinicalgenome.org'})">ClinGen Validity</a></div>
<div><a href="https://www.ncbi.nlm.nih.gov/gtr/all/tests/?term=120070[mim]" class="mim-tip-hint" title="Genetic Testing Registry." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'GTR', 'domain': 'ncbi.nlm.nih.gov'})">GTR</a></div>
</div>
</div>
</div>
<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
<div class="panel-heading mim-panel-heading" role="tab" id="mimVariation">
<span class="panel-title">
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<a href="#mimVariationLinksFold" id="mimVariationLinksToggle" class=" mimSingletonTriangleToggle" role="button" data-toggle="collapse" data-parent="#mimExternalLinksAccordion">
<span id="mimVariationLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5">&#9660;</span> Variation
</a>
</span>
</span>
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<div id="mimVariationLinksFold" class="panel-collapse collapse in mimLinksFold" role="tabpanel">
<div class="panel-body small mim-panel-body">
<div><a href="https://www.ncbi.nlm.nih.gov/clinvar?term=120070[MIM]" class="mim-tip-hint" title="ClinVar aggregates information about sequence variation and its relationship to human health." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">ClinVar</a></div>
<div><a href="https://www.deciphergenomics.org/gene/COL4A3/overview/clinical-info" class="mim-tip-hint" title="DECIPHER" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'DECIPHER', 'domain': 'DECIPHER'})">DECIPHER</a></div>
<div><a href="https://gnomad.broadinstitute.org/gene/ENSG00000169031" class="mim-tip-hint" title="The Genome Aggregation Database (gnomAD), Broad Institute." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'gnomAD', 'domain': 'gnomad.broadinstitute.org'})">gnomAD</a></div>
<div><a href="https://www.ebi.ac.uk/gwas/search?query=COL4A3" class="mim-tip-hint" title="GWAS Catalog; NHGRI-EBI Catalog of published genome-wide association studies." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'GWAS Catalog', 'domain': 'gwascatalog.org'})">GWAS Catalog&nbsp;</a></div>
<div><a href="https://www.gwascentral.org/search?q=COL4A3" class="mim-tip-hint" title="GWAS Central; summary level genotype-to-phenotype information from genetic association studies." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'GWAS Central', 'domain': 'gwascentral.org'})">GWAS Central&nbsp;</a></div>
<div><a href="http://www.hgmd.cf.ac.uk/ac/gene.php?gene=COL4A3" class="mim-tip-hint" title="Human Gene Mutation Database; published mutations causing or associated with human inherited disease; disease-associated/functional polymorphisms." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'HGMD', 'domain': 'hgmd.cf.ac.uk'})">HGMD</a></div>
<div><a href="https://evs.gs.washington.edu/EVS/PopStatsServlet?searchBy=Gene+Hugo&target=COL4A3&upstreamSize=0&downstreamSize=0&x=0&y=0" class="mim-tip-hint" title="National Heart, Lung, and Blood Institute Exome Variant Server." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'NHLBI EVS', 'domain': 'evs.gs.washington.edu'})">NHLBI EVS</a></div>
<div><a href="https://www.pharmgkb.org/gene/PA26719" class="mim-tip-hint" title="Pharmacogenomics Knowledge Base; curated and annotated information regarding the effects of human genetic variations on drug response." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PharmGKB', 'domain': 'pharmgkb.org'})">PharmGKB</a></div>
</div>
</div>
</div>
<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
<div class="panel-heading mim-panel-heading" role="tab" id="mimAnimalModels">
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<div id="mimAnimalModelsLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5; display: table-cell;">&#9658;</div>
&nbsp;
<div style="display: table-cell;">Animal Models</div>
</div>
</a>
</span>
</span>
</div>
<div id="mimAnimalModelsLinksFold" class="panel-collapse collapse mimLinksFold" role="tabpanel">
<div class="panel-body small mim-panel-body">
<div><a href="https://www.alliancegenome.org/gene/HGNC:2204" class="mim-tip-hint" title="Search Across Species; explore model organism and human comparative genomics." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'Alliance Genome', 'domain': 'alliancegenome.org'})">Alliance Genome</a></div>
<div><a href="https://flybase.org/reports/FBgn0000299.html" class="mim-tip-hint" title="A Database of Drosophila Genes and Genomes." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'FlyBase', 'domain': 'flybase.org'})">FlyBase</a></div>
<div><a href="https://www.mousephenotype.org/data/genes/MGI:104688" class="mim-tip-hint" title="International Mouse Phenotyping Consortium." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'IMPC', 'domain': 'knockoutmouse.org'})">IMPC</a></div>
<div><a href="http://v1.marrvel.org/search/gene/COL4A3#HomologGenesPanel" class="mim-tip-hint" title="Model organism Aggregated Resources for Rare Variant ExpLoration." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'MARRVEL', 'domain': 'marrvel.org'})">MARRVEL</a></div>
<div><a href="http://www.informatics.jax.org/marker/MGI:104688" class="mim-tip-hint" title="Mouse Genome Informatics; international database resource for the laboratory mouse, including integrated genetic, genomic, and biological data." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'MGI Mouse Gene', 'domain': 'informatics.jax.org'})">MGI Mouse Gene</a></div>
<div><a href="https://www.mmrrc.org/catalog/StrainCatalogSearchForm.php?search_query=" class="mim-tip-hint" title="Mutant Mouse Resource & Research Centers." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'MMRRC', 'domain': 'mmrrc.org'})">MMRRC</a></div>
<div><a href="https://www.ncbi.nlm.nih.gov/gene/1285/ortholog/" class="mim-tip-hint" title="Orthologous genes at NCBI." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'NCBI Orthologs', 'domain': 'ncbi.nlm.nih.gov'})">NCBI Orthologs</a></div>
<div><a href="https://www.orthodb.org/?ncbi=1285" class="mim-tip-hint" title="Hierarchical catalogue of orthologs." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'OrthoDB', 'domain': 'orthodb.org'})">OrthoDB</a></div>
<div><a href="https://wormbase.org/db/gene/gene?name=WBGene00001263;class=Gene" class="mim-tip-hint" title="Database of the biology and genome of Caenorhabditis elegans and related nematodes." target="_blank" onclick="gtag('event', 'mim_outbound', {'name'{'name': 'Wormbase Gene', 'domain': 'wormbase.org'})">Wormbase Gene</a></div>
<div><a href="https://zfin.org/ZDB-GENE-070802-4" class="mim-tip-hint" title="The Zebrafish Model Organism Database." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'ZFin', 'domain': 'zfin.org'})">ZFin</a></div>
</div>
</div>
</div>
<div class="panel panel-default" style="margin-top: 0px; border-radius: 0px">
<div class="panel-heading mim-panel-heading" role="tab" id="mimCellularPathways">
<span class="panel-title">
<span class="small">
<a href="#mimCellularPathwaysLinksFold" id="mimCellularPathwaysLinksToggle" class="collapsed mimSingletonTriangleToggle" role="button" data-toggle="collapse" data-parent="#mimExternalLinksAccordion">
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<div id="mimCellularPathwaysLinksToggleTriangle" class="small mimSingletonTriangle" style="color: #337CB5; display: table-cell;">&#9658;</div>
&nbsp;
<div style="display: table-cell;">Cellular Pathways</div>
</div>
</a>
</span>
</span>
</div>
<div id="mimCellularPathwaysLinksFold" class="panel-collapse collapse mimLinksFold" role="tabpanel">
<div class="panel-body small mim-panel-body">
<div><a href="https://www.genome.jp/dbget-bin/get_linkdb?-t+pathway+hsa:1285" class="mim-tip-hint" title="Kyoto Encyclopedia of Genes and Genomes; diagrams of signaling pathways." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'KEGG', 'domain': 'genome.jp'})">KEGG</a></div>
<div><a href="https://reactome.org/content/query?q=COL4A3&species=Homo+sapiens&types=Reaction&types=Pathway&cluster=true" class="definition" title="Protein-specific information in the context of relevant cellular pathways." target="_blank" onclick="gtag('event', 'mim_outbound', {{'name': 'Reactome', 'domain': 'reactome.org'}})">Reactome</a></div>
</div>
</div>
</div>
</div>
</div>
</div>
<span>
<span class="mim-tip-bottom" qtip_title="<strong>Looking for this gene or this phenotype in other resources?</strong>" qtip_text="Select a related resource from the dropdown menu and click for a targeted link to information directly relevant.">
&nbsp;
</span>
</span>
</div>
<div class="col-lg-8 col-lg-pull-2 col-md-8 col-md-pull-2 col-sm-8 col-sm-pull-2 col-xs-12">
<div>
<a id="title" class="mim-anchor"></a>
<div>
<a id="number" class="mim-anchor"></a>
<div class="text-right">
&nbsp;
</div>
<div>
<span class="h3">
<span class="mim-font mim-tip-hint" title="Gene description">
<span class="text-danger"><strong>*</strong></span>
120070
</span>
</span>
</div>
</div>
<div>
<a id="preferredTitle" class="mim-anchor"></a>
<h3>
<span class="mim-font">
COLLAGEN, TYPE IV, ALPHA-3; COL4A3
</span>
</h3>
</div>
<div>
<br />
</div>
<div>
<a id="alternativeTitles" class="mim-anchor"></a>
<div>
<p>
<span class="mim-font">
<em>Alternative titles; symbols</em>
</span>
</p>
</div>
<div>
<h4>
<span class="mim-font">
COLLAGEN OF BASEMENT MEMBRANE, ALPHA-3 CHAIN
</span>
</h4>
</div>
</div>
<div>
<br />
</div>
<div>
<a id="includedTitles" class="mim-anchor"></a>
<div>
<p>
<span class="mim-font">
Other entities represented in this entry:
</span>
</p>
</div>
<div>
<span class="h3 mim-font">
TUMSTATIN, INCLUDED
</span>
</div>
<div>
<span class="h4 mim-font">
GOODPASTURE ANTIGEN, INCLUDED
</span>
</div>
</div>
<div>
<br />
</div>
</div>
<div>
<a id="approvedGeneSymbols" class="mim-anchor"></a>
<p>
<span class="mim-text-font">
<strong><em>HGNC Approved Gene Symbol: <a href="https://www.genenames.org/tools/search/#!/genes?query=COL4A3" class="mim-tip-hint" title="HUGO Gene Nomenclature Committee." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'HGNC', 'domain': 'genenames.org'})">COL4A3</a></em></strong>
</span>
</p>
</div>
<div>
<a id="cytogeneticLocation" class="mim-anchor"></a>
<p>
<span class="mim-text-font">
<strong>
<em>
Cytogenetic location: <a href="/geneMap/2/1071?start=-3&limit=10&highlight=1071">2q36.3</a>
&nbsp;
Genomic coordinates <span class="small">(GRCh38)</span> : <a href="https://genome.ucsc.edu/cgi-bin/hgTracks?db=hg38&position=chr2:227164624-227314792&dgv=pack&knownGene=pack&omimGene=pack" class="mim-tip-hint" title="UCSC Genome Browser; reference sequences and working draft assemblies for a large collection of genomes." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'UCSC Genome Browser', 'domain': 'genome.ucsc.edu'})">2:227,164,624-227,314,792</a> </span>
</em>
</strong>
<a href="https://www.ncbi.nlm.nih.gov/" target="_blank" class="small"> (from NCBI) </a>
</span>
</p>
</div>
<div>
<br />
</div>
<div>
<a id="geneMap" class="mim-anchor"></a>
<div style="margin-bottom: 10px;">
<span class="h4 mim-font">
<strong>Gene-Phenotype Relationships</strong>
</span>
</div>
<div>
<table class="table table-bordered table-condensed table-hover small mim-table-padding">
<thead>
<tr class="active">
<th>
Location
</th>
<th>
Phenotype
<span class="hidden-sm hidden-xs pull-right">
<a href="/clinicalSynopsis/table?mimNumber=104200,620536,620320" class="label label-warning" onclick="gtag('event', 'mim_link', {'source': 'Entry', 'destination': 'clinicalSynopsisTable'})">
View Clinical Synopses
</a>
</span>
</th>
<th>
Phenotype <br /> MIM number
</th>
<th>
Inheritance
</th>
<th>
Phenotype <br /> mapping key
</th>
</tr>
</thead>
<tbody>
<tr>
<td rowspan="3">
<span class="mim-font">
<a href="/geneMap/2/1071?start=-3&limit=10&highlight=1071">
2q36.3
</a>
</span>
</td>
<td>
<span class="mim-font">
Alport syndrome 3A, autosomal dominant
</span>
</td>
<td>
<span class="mim-font">
<a href="/entry/104200"> 104200 </a>
</span>
</td>
<td>
<span class="mim-font">
<abbr class="mim-tip-hint" title="Autosomal dominant">AD</abbr>
</span>
</td>
<td>
<span class="mim-font">
<abbr class="mim-tip-hint" title="3 - The molecular basis of the disorder is known">3</abbr>
</span>
</td>
</tr>
<tr>
<td>
<span class="mim-font">
Alport syndrome 3B, autosomal recessive
</span>
</td>
<td>
<span class="mim-font">
<a href="/entry/620536"> 620536 </a>
</span>
</td>
<td>
<span class="mim-font">
<abbr class="mim-tip-hint" title="Autosomal recessive">AR</abbr>
</span>
</td>
<td>
<span class="mim-font">
<abbr class="mim-tip-hint" title="3 - The molecular basis of the disorder is known">3</abbr>
</span>
</td>
</tr>
<tr>
<td>
<span class="mim-font">
Hematuria, benign familial, 2
</span>
</td>
<td>
<span class="mim-font">
<a href="/entry/620320"> 620320 </a>
</span>
</td>
<td>
<span class="mim-font">
<abbr class="mim-tip-hint" title="Autosomal dominant">AD</abbr>
</span>
</td>
<td>
<span class="mim-font">
<abbr class="mim-tip-hint" title="3 - The molecular basis of the disorder is known">3</abbr>
</span>
</td>
</tr>
</tbody>
</table>
</div>
</div>
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<strong>TEXT</strong>
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<a id="description" class="mim-anchor"></a>
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<strong>Description</strong>
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<p>Type IV collagen is found only in basement membranes, where it is the major structural component. COL4A3 is 1 of 6 alpha chains that form the heterotrimeric type IV collagen molecules. Tumstatin, a peptide fragment derived from the C-terminal noncollagenous (NC1) domain of COL4A3, has antiangiogenic activity. The NC1 domain of COL4A3 has also been referred to as the Goodpasture antigen, since it is the primary target of autoantibodies produced in Goodpasture syndrome (<a href="/entry/233450">233450</a>) (<a href="#2" class="mim-tip-reference" title="Bernal, D., Quinones, S., Saus, J. &lt;strong&gt;The human mRNA encoding the Goodpasture antigen is alternatively spliced.&lt;/strong&gt; J. Biol. Chem. 268: 12090-12094, 1993.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/8505332/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;8505332&lt;/a&gt;]" pmid="8505332">Bernal et al., 1993</a>; <a href="#29" class="mim-tip-reference" title="Mariyama, M., Leinonen, A., Mochizuki, T., Tryggvason, K., Reeders, S. T. &lt;strong&gt;Complete primary structure of the human alpha-3(IV) collagen chain: coexpression of the alpha-3(IV) and alpha-4(IV) collagen chains in human tissues.&lt;/strong&gt; J. Biol. Chem. 269: 23013-23017, 1994.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/8083201/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;8083201&lt;/a&gt;]" pmid="8083201">Mariyama et al., 1994</a>; <a href="#10" class="mim-tip-reference" title="Hamano, Y., Kalluri, R. &lt;strong&gt;Tumstatin, the NC1 domain of alpha-3 chain of type IV collagen, is an endogenous inhibitor of pathological angiogenesis and suppresses tumor growth.&lt;/strong&gt; Biochem. Biophys. Res. Commun. 333: 292-298, 2005.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/15979458/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;15979458&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/j.bbrc.2005.05.130&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="15979458">Hamano and Kalluri, 2005</a>). <a href="https://pubmed.ncbi.nlm.nih.gov/?term=8505332+15979458+8083201" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<a id="cloning" class="mim-anchor"></a>
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<strong>Cloning and Expression</strong>
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<p><a href="#3" class="mim-tip-reference" title="Butkowski, R. J., Langeveld, J. P. M., Wieslander, J., Hamilton, J., Hudson, B. G. &lt;strong&gt;Localization of the Goodpasture epitope to a novel chain of basement membrane collagen.&lt;/strong&gt; J. Biol. Chem. 262: 7874-7877, 1987.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/2438283/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;2438283&lt;/a&gt;]" pmid="2438283">Butkowski et al. (1987)</a> identified a third alpha chain of basement membrane collagen, type IV. Studying in particular the noncollagenous part of the alpha-3(IV) chain, <a href="#36" class="mim-tip-reference" title="Saus, J., Wieslander, J., Langeveld, J. P. M., Quinones, S., Hudson, B. G. &lt;strong&gt;Identification of the Goodpasture antigen as the alpha-3(IV) chain of collagen IV.&lt;/strong&gt; J. Biol. Chem. 263: 13374-13380, 1988.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/3417661/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;3417661&lt;/a&gt;]" pmid="3417661">Saus et al. (1988)</a> concluded that collagen IV is composed of a third chain (alpha-3) together with the 2 classical ones, alpha-1 (<a href="/entry/120130">120130</a>) and alpha-2 (<a href="/entry/120090">120090</a>). They also concluded that the epitope to which the major reactivity of autoantibodies are targeted in the glomerular basement membrane in patients with Goodpasture syndrome is localized to the NC1 domain of the alpha-3(IV) chain. See also <a href="#4" class="mim-tip-reference" title="Butkowski, R. J., Wieslander, J., Kleppel, M., Michael, A. F., Fish, A. J. &lt;strong&gt;Basement membrane collagen in the kidney: regional localization of novel chains related to collagen IV.&lt;/strong&gt; Kidney Int. 35: 1195-1202, 1989.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/2671463/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;2671463&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ki.1989.110&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="2671463">Butkowski et al. (1989)</a>. <a href="#33" class="mim-tip-reference" title="Morrison, K. E., Mariyama, M., Yang-Feng, T. L., Reeders, S. T. &lt;strong&gt;Sequence and localization of a partial cDNA encoding the human alpha3 chain of type IV collagen.&lt;/strong&gt; Am. J. Hum. Genet. 49: 545-554, 1991.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/1882840/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;1882840&lt;/a&gt;]" pmid="1882840">Morrison et al. (1991)</a> sequenced a partial cDNA encoding the COL4A3 gene. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=3417661+1882840+2438283+2671463" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>By PCR of adult human kidney, followed by S1 nuclease mapping and primer extension of kidney and testis total RNA, <a href="#29" class="mim-tip-reference" title="Mariyama, M., Leinonen, A., Mochizuki, T., Tryggvason, K., Reeders, S. T. &lt;strong&gt;Complete primary structure of the human alpha-3(IV) collagen chain: coexpression of the alpha-3(IV) and alpha-4(IV) collagen chains in human tissues.&lt;/strong&gt; J. Biol. Chem. 269: 23013-23017, 1994.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/8083201/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;8083201&lt;/a&gt;]" pmid="8083201">Mariyama et al. (1994)</a> obtained full-length COL4A3. The deduced 1,670-amino acid protein has a calculated molecular mass of 161.8 kD. It has a 28-amino acid leucine-rich signal peptide, followed by a 1,410-amino acid collagenous domain, and a 232-amino acid C-terminal NC1 domain. The collagenous domain begins with a 14-amino acid noncollagenous sequence that includes 4 cysteines, and the collagenous repeat gly-X-Y is interrupted 23 times by short noncollagenous sequences. Full-length COL4A3 has 5 arg-gly-asp sequences that mediate binding to integrins. COL4A3 is most similar to COL4A1 (<a href="/entry/120130">120130</a>) and COL4A5 (<a href="/entry/303630">303630</a>), indicating that it belongs to the alpha-1-like class of type IV collagen chains. Northern blot analysis detected strong expression of an approximately 8-kb COL4A3 transcript in adult kidney, skeletal muscle, and lung and in fetal kidney and lung. Expression of COL4A3 largely overlapped that of COL4A4 (<a href="/entry/120131">120131</a>), suggesting that expression of the 2 transcripts may be coregulated. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=8083201" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>The Goodpasture antigen corresponds to the C-terminal NC1 domain of COL4A3, which is encoded by the last 5 exons of the COL4A3 gene. Using RT-PCR, <a href="#2" class="mim-tip-reference" title="Bernal, D., Quinones, S., Saus, J. &lt;strong&gt;The human mRNA encoding the Goodpasture antigen is alternatively spliced.&lt;/strong&gt; J. Biol. Chem. 268: 12090-12094, 1993.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/8505332/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;8505332&lt;/a&gt;]" pmid="8505332">Bernal et al. (1993)</a> identified COL4A3 splice variants lacking 1 or 2 exons in the NC1-coding region. These variants encode identical proteins with C-terminal ends shorter than that of the full-length protein due to the introduction of a frameshift. Since the NC1 domain of COL4A3 is involved in alignment of individual alpha chains into a triple-helical structure, <a href="#2" class="mim-tip-reference" title="Bernal, D., Quinones, S., Saus, J. &lt;strong&gt;The human mRNA encoding the Goodpasture antigen is alternatively spliced.&lt;/strong&gt; J. Biol. Chem. 268: 12090-12094, 1993.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/8505332/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;8505332&lt;/a&gt;]" pmid="8505332">Bernal et al. (1993)</a> suggested that these C-terminally truncated COL4A3 isoforms may be defective in triple-helix formation. RT-PCR revealed significant expression of COL4A3 in kidney, lung, suprarenal capsule, muscle, and spleen, with very low expression in artery, fat, pericardium, and peripheral nerve. Although the COL4A3 splice variants were present in these tissues, the full-length form was most abundant. PCR analysis of kidney cortex biopsied from a Goodpasture patient revealed a small but reproducible decrease in the ratio of full-length to variant transcripts compared with normal kidney. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=8505332" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#7" class="mim-tip-reference" title="Feng, L., Xia, Y., Wilson, C. B. &lt;strong&gt;Alternative splicing of the NC1 domain of the human alpha-3(IV) collagen gene: differential expression of mRNA transcripts that predict three protein variants with distinct carboxyl regions.&lt;/strong&gt; J. Biol. Chem. 269: 2342-2348, 1994.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/8294492/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;8294492&lt;/a&gt;]" pmid="8294492">Feng et al. (1994)</a> also identified COL4A3 splice variants lacking NC1-coding exons, resulting in proteins with alternative C termini. Ribonuclease protection assays revealed changes in expression of full-length and variant transcripts during fetal kidney development and in adult human kidney. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=8294492" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>By microarray analysis, <a href="#17" class="mim-tip-reference" title="Jun, A. S., Liu, S. H., Koo, E. H., Do, D. V., Stark, W. J., Gottsch, J. D. &lt;strong&gt;Microarray analysis of gene expression in human donor corneas.&lt;/strong&gt; Arch. Ophthal. 119: 1629-1634, 2001.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/11709013/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;11709013&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1001/archopht.119.11.1629&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="11709013">Jun et al. (2001)</a> demonstrated expression of the COL4A3 gene in human donor corneas. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=11709013" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<p><a href="#12" class="mim-tip-reference" title="Heidet, L., Arrondel, C., Forestier, L., Cohen-Solal, L., Mollet, G., Gutierrez, B., Stavrou, C., Gubler, M. C., Antignac, C. &lt;strong&gt;Structure of the human type IV collagen gene COL4A3 and mutations in autosomal Alport syndrome.&lt;/strong&gt; J. Am. Soc. Nephrol. 12: 97-106, 2001.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/11134255/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;11134255&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1681/ASN.V12197&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="11134255">Heidet et al. (2001)</a> determined that the COL4A3 gene contains 52 exons and spans over 88 kb. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=11134255" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#29" class="mim-tip-reference" title="Mariyama, M., Leinonen, A., Mochizuki, T., Tryggvason, K., Reeders, S. T. &lt;strong&gt;Complete primary structure of the human alpha-3(IV) collagen chain: coexpression of the alpha-3(IV) and alpha-4(IV) collagen chains in human tissues.&lt;/strong&gt; J. Biol. Chem. 269: 23013-23017, 1994.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/8083201/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;8083201&lt;/a&gt;]" pmid="8083201">Mariyama et al. (1994)</a> determined that the COL4A3 gene has 2 closely spaced major transcription start sites. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=8083201" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#32" class="mim-tip-reference" title="Momota, R., Sugimoto, M., Oohashi, T., Kigasawa, K., Yoshioka, H., Ninomiya, Y. &lt;strong&gt;Two genes, COL4A3 and COL4A4 coding for the human alpha-3(IV) and alpha-4(IV) collagen chains are arranged head-to-head on chromosome 2q36.&lt;/strong&gt; FEBS Lett. 424: 11-16, 1998.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9537506/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9537506&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/s0014-5793(98)00128-8&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9537506">Momota et al. (1998)</a> reported that the COL4A3 and COL4A4 genes are on opposite strands of chromosome 2 and are transcribed in opposite directions. The first exon of COL4A3, which contains the translation start site, is separated from 2 alternative first exons of COL4A4 by 372 and 5 bp, respectively. The promoter region, which is shared by both genes, is composed of dense CpG dinucleotides, GC boxes, CTC boxes, and a CCAAT box, but not a TATA box. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=9537506" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<p><a href="#33" class="mim-tip-reference" title="Morrison, K. E., Mariyama, M., Yang-Feng, T. L., Reeders, S. T. &lt;strong&gt;Sequence and localization of a partial cDNA encoding the human alpha3 chain of type IV collagen.&lt;/strong&gt; Am. J. Hum. Genet. 49: 545-554, 1991.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/1882840/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;1882840&lt;/a&gt;]" pmid="1882840">Morrison et al. (1991)</a> assigned a partial COL4A3 cDNA to chromosome 2q35-q37 by a combination of somatic cell hybrid studies and in situ hybridization. <a href="#40" class="mim-tip-reference" title="Turner, N., Mason, P. J., Brown, R., Fox, M., Povey, S., Rees, A., Pusey, C. D. &lt;strong&gt;Molecular cloning of the human Goodpasture antigen demonstrates it to be the alpha-3 chain of type IV collagen.&lt;/strong&gt; J. Clin. Invest. 89: 592-601, 1992.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/1737849/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;1737849&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1172/JCI115625&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="1737849">Turner et al. (1992)</a> localized the COL4A3 gene to chromosome 2q36-q37 by analysis of somatic cell hybrids and by in situ hybridization. <a href="#32" class="mim-tip-reference" title="Momota, R., Sugimoto, M., Oohashi, T., Kigasawa, K., Yoshioka, H., Ninomiya, Y. &lt;strong&gt;Two genes, COL4A3 and COL4A4 coding for the human alpha-3(IV) and alpha-4(IV) collagen chains are arranged head-to-head on chromosome 2q36.&lt;/strong&gt; FEBS Lett. 424: 11-16, 1998.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9537506/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9537506&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1016/s0014-5793(98)00128-8&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9537506">Momota et al. (1998)</a> reported that the COL4A3 and COL4A4 genes are arranged in a head-to-head fashion on chromosome 2. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=1737849+9537506+1882840" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<a id="geneFunction" class="mim-anchor"></a>
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<strong>Gene Function</strong>
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<p>Wieslander et al. (<a href="#43" class="mim-tip-reference" title="Wieslander, J., Barr, J. F., Butkowski, R. J., Edwards, S. J., Bygren, P., Heinegard, D., Hudson, B. G. &lt;strong&gt;Goodpasture antigen of the glomerular basement membrane: localization to noncollagenous regions of type IV collagen.&lt;/strong&gt; Proc. Nat. Acad. Sci. 81: 3838-3842, 1984.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/6328527/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;6328527&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1073/pnas.81.12.3838&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="6328527">1984</a>, <a href="#44" class="mim-tip-reference" title="Wieslander, J., Langeveld, J., Butkowski, R., Jodlowski, M., Noelken, M., Hudson, B. G. &lt;strong&gt;Physical and immunochemical studies of the globular domain of type IV collagen: cryptic properties of the Goodpasture antigen.&lt;/strong&gt; J. Biol. Chem. 260: 8564-8570, 1985.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/2409091/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;2409091&lt;/a&gt;]" pmid="2409091">1985</a>) presented immunochemical evidence that the Goodpasture antibodies react with collagenase-resistant parts of the type IV collagen molecule. About 5% of cases of glomerulonephritis are mediated by autoantibodies to glomerular basement membrane (GBM). Most of these patients present with Goodpasture syndrome (glomerulonephritis and pulmonary hemorrhage). <a href="#3" class="mim-tip-reference" title="Butkowski, R. J., Langeveld, J. P. M., Wieslander, J., Hamilton, J., Hudson, B. G. &lt;strong&gt;Localization of the Goodpasture epitope to a novel chain of basement membrane collagen.&lt;/strong&gt; J. Biol. Chem. 262: 7874-7877, 1987.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/2438283/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;2438283&lt;/a&gt;]" pmid="2438283">Butkowski et al. (1987)</a> localized the Goodpasture epitope to a novel chain of type IV collagen composed of 3 distinctive subunits--M1, M2*, and M3. The Goodpasture epitope was found to be situated exclusively on M2*. <a href="#40" class="mim-tip-reference" title="Turner, N., Mason, P. J., Brown, R., Fox, M., Povey, S., Rees, A., Pusey, C. D. &lt;strong&gt;Molecular cloning of the human Goodpasture antigen demonstrates it to be the alpha-3 chain of type IV collagen.&lt;/strong&gt; J. Clin. Invest. 89: 592-601, 1992.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/1737849/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;1737849&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1172/JCI115625&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="1737849">Turner et al. (1992)</a> demonstrated that the Goodpasture antigen is the alpha-3 chain of type IV collagen (COL4A3; <a href="/entry/120070">120070</a>). <a href="https://pubmed.ncbi.nlm.nih.gov/?term=1737849+6328527+2438283+2409091" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>Although the primary defect in Alport syndrome (<a href="/entry/301050">301050</a>) involves the COL4A5 gene (<a href="/entry/303630">303630</a>), the pathogenesis of the syndrome probably involves type IV collagen molecules containing the alpha-3(IV) chain: <a href="#14" class="mim-tip-reference" title="Hudson, B. G., Kalluri, R., Gunwar, S., Weber, M., Ballester, F., Hudson, J. K., Noelken, M. E., Sarras, M., Richardson, W. R., Saus, J., Abrahamson, D. R., Glick, A. D., Haralson, M. A., Helderman, J. H., Stone, W. J., Jacobson, H. R. &lt;strong&gt;The pathogenesis of Alport syndrome involves type IV collagen molecules containing the alpha-3(IV) chain: evidence from anti-GBM nephritis after renal transplantation.&lt;/strong&gt; Kidney Int. 42: 179-187, 1992.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/1635348/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;1635348&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ki.1992.276&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="1635348">Hudson et al. (1992)</a> demonstrated that the Goodpasture autoantigen is the target alloantigen in posttransplant anti-GBM (glomerular basement membrane) nephritis in patients with Alport syndrome. <a href="#18" class="mim-tip-reference" title="Kalluri, R., Gattone, V. H., II, Noelken, M. E., Hudson, B. G. &lt;strong&gt;The alpha-3 chain of type IV collagen induces autoimmune Goodpasture syndrome.&lt;/strong&gt; Proc. Nat. Acad. Sci. 91: 6201-6205, 1994.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/8016138/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;8016138&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1073/pnas.91.13.6201&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="8016138">Kalluri et al. (1994)</a> further confirmed the unique capacity of alpha-3(IV)NC1 dimer from bovine kidney to engage aberrantly the immune system of rabbits to respond to self, mimicking the organ-specific form of the human disease, whereas the other chains of type IV collagen were nonpathogenic. The hexamer of alpha3-(IV) NC1 was nonpathogenic, suggesting the exposure of a pathogenic epitope upon dissociation of hexamer into dimers. Exposure of the pathogenic epitope by infection or organic solvents, events that are thought often to precede Goodpasture syndrome, may be a principal factor in the etiology of the disease. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=8016138+1635348" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#20" class="mim-tip-reference" title="Krafchak, C. M., Pawar, H., Moroi, S. E., Sugar, A., Lichter, P. R., Mackey, D. A., Mian, S., Nairus, T., Elner, V., Schteingart, M. T., Downs, C. A., Kijek, T. G., and 9 others. &lt;strong&gt;Mutations in TCF8 cause posterior polymorphous corneal dystrophy and ectopic expression of COL4A3 by corneal endothelial cells.&lt;/strong&gt; Am. J. Hum. Genet. 77: 694-708, 2005.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/16252232/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;16252232&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=16252232[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1086/497348&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="16252232">Krafchak et al. (2005)</a> detected a complex (core plus secondary) binding site for TCF8 (<a href="/entry/189909">189909</a>) in the promoter of the COL4A3 gene, and presented immunochemical evidence of ectopic expression of COL4A3 in corneal endothelium of a proband of a family with posterior polymorphous corneal dystrophy-3 (PPCD3; <a href="/entry/609141">609141</a>). The authors suggested that the implication of COL4A3 as a target of TCF8 regulation identifies a possible shared molecular component of disease etiology for PPCD and Alport syndrome. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=16252232" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><strong><em>Tumstatin</em></strong></p><p>
<a href="#26" class="mim-tip-reference" title="Maeshima, Y., Colorado, P. C., Torre, A., Holthaus, K. A., Grunkemeyer, J. A., Ericksen, M. B., Hopfer, H., Xiao, Y., Stillman, I. E., Kalluri, R. &lt;strong&gt;Distinct antitumor properties of a type IV collagen domain derived from basement membrane.&lt;/strong&gt; J. Biol. Chem. 275: 21340-21348, 2000.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/10766752/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;10766752&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.M001956200&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="10766752">Maeshima et al. (2000)</a> termed the noncollagenous I domain of the alpha-3 chain of type IV collagen (COL4A3) 'tumstatin.' This domain had been discovered to possess a C-terminal peptide sequence (amino acids 185 to 203) that inhibits melanoma cell proliferation by <a href="#11" class="mim-tip-reference" title="Han, J., Ohno, N., Pasco, S., Monboisse, J.-C., Borel, J. P., Kefalides, N. A. &lt;strong&gt;A cell binding domain from the alpha-3 chain of type IV collagen inhibits proliferation of melanoma cells.&lt;/strong&gt; J. Biol. Chem. 272: 20395-20401, 1997.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9252346/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9252346&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.272.33.20395&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9252346">Han et al. (1997)</a>. <a href="#25" class="mim-tip-reference" title="Maeshima, Y., Colorado, P. C., Kalluri, R. &lt;strong&gt;Two RGD-independent alpha-V-beta-3 integrin binding sites on tumstatin regulate distinct anti-tumor properties.&lt;/strong&gt; J. Biol. Chem. 275: 23745-23750, 2000.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/10837460/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;10837460&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.C000186200&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="10837460">Maeshima et al. (2000)</a> identified the antiangiogenic capacity of this domain using several in vitro and in vivo assays. Tumstatin inhibited in vivo neovascularization in matrigel plug assays and suppressed tumor growth of human renal cell carcinoma and prostate carcinoma in mouse xenograft models associated with in vivo endothelial cell-specific apoptosis. The antiangiogenic activity was localized to amino acids 54-132 using deletion mutagenesis. <a href="#37" class="mim-tip-reference" title="Shahan, T. A., Ziaie, Z., Pasco, S., Fawzi, A., Bellon, G., Monboisse, J.-C., Kefalides, N. A. &lt;strong&gt;Identification of CD47/integrin-associated protein and alpha-v-beta-3 as two receptors for the alpha-3(IV) chain of type IV collagen on tumor cells.&lt;/strong&gt; Cancer Res. 59: 4584-4590, 1999.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/10493512/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;10493512&lt;/a&gt;]" pmid="10493512">Shahan et al. (1999)</a> identified amino acids 185-203 of tumstatin as a ligand for the alpha-V-beta-3 integrin (<a href="/entry/193210">193210</a>, <a href="/entry/173470">173470</a>). <a href="#25" class="mim-tip-reference" title="Maeshima, Y., Colorado, P. C., Kalluri, R. &lt;strong&gt;Two RGD-independent alpha-V-beta-3 integrin binding sites on tumstatin regulate distinct anti-tumor properties.&lt;/strong&gt; J. Biol. Chem. 275: 23745-23750, 2000.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/10837460/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;10837460&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.C000186200&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="10837460">Maeshima et al. (2000)</a> found a distinct additional RGD-independent alpha-V-beta-3 integrin binding site within amino acids 54 to 132 of tumstatin. <a href="#28" class="mim-tip-reference" title="Maeshima, Y., Yerramalla, U. L., Dhanabal, M., Holthaus, K. A., Barbashov, S., Kharbanda, S., Reimer, C., Manfredi, M., Dickerson, W. M., Kalluri, R. &lt;strong&gt;Extracellular matrix-derived peptide binds to alpha-V-beta-3 integrin and inhibits angiogenesis.&lt;/strong&gt; J. Biol. Chem. 276: 31959-31968, 2001.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/11399763/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;11399763&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.M103024200&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="11399763">Maeshima et al. (2001)</a> demonstrated that tumstatin peptides can inhibit proliferation of endothelial cells in the presence of vitronectin (<a href="/entry/193190">193190</a>), fibronectin (<a href="/entry/135600">135600</a>), and collagen I (see <a href="/entry/120150">120150</a>). The antiangiogenic activity of tumstatin is localized to a 25-amino acid region (69-88) of tumstatin and is independent of disulfide bond linkage. <a href="#27" class="mim-tip-reference" title="Maeshima, Y., Sudhakar, A., Lively, J. C., Ueki, K., Kharbanda, S., Kahn, C. R., Sonenberg, N., Hynes, R. O., Kalluri, R. &lt;strong&gt;Tumstatin, an endothelial cell-specific inhibitor of protein synthesis.&lt;/strong&gt; Science 295: 140-143, 2002.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/11778052/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;11778052&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1126/science.1065298&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="11778052">Maeshima et al. (2002)</a> demonstrated that tumstatin functions as an endothelial cell-specific inhibitor of protein synthesis. Through a replicative interaction with alpha-V-beta-3 integrin, tumstatin inhibits activation of focal adhesion kinase (FAK; <a href="/entry/600758">600758</a>), phosphatidylinositol 3-kinase (see <a href="/entry/171834">171834</a>), protein kinase-B (<a href="/entry/164730">164730</a>), and mammalian target of rapamycin (<a href="/entry/601231">601231</a>). <a href="#27" class="mim-tip-reference" title="Maeshima, Y., Sudhakar, A., Lively, J. C., Ueki, K., Kharbanda, S., Kahn, C. R., Sonenberg, N., Hynes, R. O., Kalluri, R. &lt;strong&gt;Tumstatin, an endothelial cell-specific inhibitor of protein synthesis.&lt;/strong&gt; Science 295: 140-143, 2002.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/11778052/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;11778052&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1126/science.1065298&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="11778052">Maeshima et al. (2002)</a> further demonstrated that tumstatin prevents the dissociation of eukaryotic initiation factor 4E protein (<a href="/entry/133440">133440</a>) from 4E-binding protein-1 (<a href="/entry/602223">602223</a>). <a href="#27" class="mim-tip-reference" title="Maeshima, Y., Sudhakar, A., Lively, J. C., Ueki, K., Kharbanda, S., Kahn, C. R., Sonenberg, N., Hynes, R. O., Kalluri, R. &lt;strong&gt;Tumstatin, an endothelial cell-specific inhibitor of protein synthesis.&lt;/strong&gt; Science 295: 140-143, 2002.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/11778052/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;11778052&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1126/science.1065298&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="11778052">Maeshima et al. (2002)</a> concluded that their results establish a role for integrins in mediating cell-specific inhibition of cap-dependent protein synthesis and suggest a potential mechanism for tumstatin's selective effects on endothelial cells. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=10493512+11778052+10837460+10766752+11399763+9252346" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>Tumstatin and endostatin, 2 inhibitors of angiogenesis, derive from the precursor human collagen molecules COL4A3 and COL18A1 (<a href="/entry/120328">120328</a>), respectively. Although both of these inhibitors are NC1 domain fragments of collagens, they share only 14% amino acid homology. <a href="#38" class="mim-tip-reference" title="Sudhakar, A., Sugimoto, H., Yang, C., Lively, J., Zeisberg, M., Kalluri, R. &lt;strong&gt;Human tumstatin and human endostatin exhibit distinct antiangiogenic activities mediated by alpha-V-beta-3 and alpha-5-beta-1 integrins.&lt;/strong&gt; Proc. Nat. Acad. Sci. 100: 4766-4771, 2003.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/12682293/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;12682293&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=12682293[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1073/pnas.0730882100&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="12682293">Sudhakar et al. (2003)</a> evaluated the functional receptors, mechanism of action, and intracellular signaling induced by these 2 collagen-derived inhibitors. Tumstatin prevents angiogenesis through inhibition of endothelial cell proliferation and promotion of apoptosis with no effect on migration, whereas endostatin prevents endothelial cell migration with no effect on proliferation. <a href="#38" class="mim-tip-reference" title="Sudhakar, A., Sugimoto, H., Yang, C., Lively, J., Zeisberg, M., Kalluri, R. &lt;strong&gt;Human tumstatin and human endostatin exhibit distinct antiangiogenic activities mediated by alpha-V-beta-3 and alpha-5-beta-1 integrins.&lt;/strong&gt; Proc. Nat. Acad. Sci. 100: 4766-4771, 2003.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/12682293/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;12682293&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=12682293[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1073/pnas.0730882100&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="12682293">Sudhakar et al. (2003)</a> demonstrated that tumstatin binds to alpha-V-beta-3 integrin in a vitronectin/fibronectin/RGD cyclic peptide-independent manner, whereas endostatin competes with fibronectin/RGD cyclic peptide to bind alpha-5-beta-1 integrin (<a href="/entry/135620">135620</a>, <a href="/entry/135630">135630</a>). The activity of tumstatin is mediated by alpha-V-beta-3 integrin, whereas the activity of endostatin is mediated by alpha-5-beta-1 integrin. Because of the distinct properties of tumstatin and endostatin, indicating their diverse antiangiogenic actions, the authors suggested the 2 be combined for targeting tumor angiogenesis. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=12682293" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#6" class="mim-tip-reference" title="Eikesdal, H. P., Sugimoto, H., Birrane, G., Maeshima, Y., Cooke, V. G., Kieran, M., Kalluri, R. &lt;strong&gt;Identification of amino acids essential for the antiangiogenic activity of tumstatin and its use in combination antitumor activity.&lt;/strong&gt; Proc. Nat. Acad. Sci. 105: 15040-15045, 2008.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/18818312/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;18818312&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=18818312[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1073/pnas.0807055105&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="18818312">Eikesdal et al. (2008)</a> showed that leu78, val82, and asp84 of tumstatin were essential for its antiangiogenic activity. However, mutation of all 3 of these residues had only a modest effect on binding to cell surface alpha-V-beta-3 integrin. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=18818312" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<p><a href="#13" class="mim-tip-reference" title="Hellmark, T., Burkhardt, H., Wieslander, J. &lt;strong&gt;Goodpasture disease: characterization of a single conformational epitope as the target of pathogenic autoantibodies.&lt;/strong&gt; J. Biol. Chem. 274: 25862-25868, 1999.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/10464328/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;10464328&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.274.36.25862&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="10464328">Hellmark et al. (1999)</a> provided, for the first time, the molecular characterization of a single immunodominant conformational epitope recognized by pathogenic autoantibodies in a human autoimmune disease. Identified in Goodpasture disease, it represented the basis for the development of new epitope-specific strategies in the treatment of that disorder. <a href="#13" class="mim-tip-reference" title="Hellmark, T., Burkhardt, H., Wieslander, J. &lt;strong&gt;Goodpasture disease: characterization of a single conformational epitope as the target of pathogenic autoantibodies.&lt;/strong&gt; J. Biol. Chem. 274: 25862-25868, 1999.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/10464328/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;10464328&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.274.36.25862&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="10464328">Hellmark et al. (1999)</a> identified the epitope by replacing single residues of the COL4A3 chain with the corresponding amino acids from the nonreactive COL4A1 gene. Replacement mutations were identified that completely destroyed the Goodpasture epitope in the COL4A3 gene. The substitution of 9 discontinuous positions in the COL4A1 noncollagenous domain with amino acid residues from the COL4A3 chain resulted in the recombinant construct that was recognized by all patients' sera but by none of the sera from healthy controls. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=10464328" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<p>In a patient with deletion of 2q35-q36, <a href="#34" class="mim-tip-reference" title="Pasteris, N. G., Trask, B., Sheldon, S., Gorski, J. L. &lt;strong&gt;A chromosome deletion 2q35-36 spanning loci HuP2 and COL4A3 results in Waardenburg syndrome type III (Klein-Waardenburg syndrome). (Abstract)&lt;/strong&gt; Am. J. Hum. Genet. 51 (suppl.): A224, 1992."None>Pasteris et al. (1992)</a> demonstrated that the COL4A3 gene was deleted, as was also the PAX3 (<a href="/entry/606597">606597</a>) gene, which was situated proximally. The deletion was estimated to be less than 12.5 megabases.</p><p><strong><em>Autosomal Recessive Alport Syndrome 3B</em></strong></p><p>
In 2 families segregating autosomal recessive Alport syndrome (ATS3B; <a href="/entry/620536">620536</a>), <a href="#31" class="mim-tip-reference" title="Mochizuki, T., Lemmink, H. H., Mariyama, M., Antignac, C., Gubler, M.-C., Pirson, Y., Verellen-Dumoulin, C., Chan, B., Schroder, C. H., Smeets, H. J., Reeders, S. T. &lt;strong&gt;Identification of mutations in the alpha-3(IV) and alpha-4(IV) collagen genes in autosomal recessive Alport syndrome.&lt;/strong&gt; Nature Genet. 8: 77-81, 1994.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/7987396/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;7987396&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng0994-77&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="7987396">Mochizuki et al. (1994)</a> demonstrated homozygous mutations in the COL4A3 gene (<a href="#0001">120070.0001</a>-<a href="#0002">120070.0002</a>). <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=7987396" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#21" class="mim-tip-reference" title="Lemmink, H. H., Mochizuki, T., van den Heuvel, L. P. W. J., Schroder, C. H., Barrientos, A., Monnens, L. A. H., van Oost, B. A., Brunner, H. G., Reeders, S. T., Smeets, H. J. M. &lt;strong&gt;Mutations in the type IV collagen alpha-3 (COL4A3) gene in autosomal recessive Alport syndrome.&lt;/strong&gt; Hum. Molec. Genet. 3: 1269-1273, 1994.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/7987301/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;7987301&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1093/hmg/3.8.1269&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="7987301">Lemmink et al. (1994)</a> demonstrated compound heterozygous mutation in the COL4A3 gene (see, e.g., <a href="#0002">120070.0002</a> and <a href="#0003">120070.0003</a>) as the basis of autosomal recessive Alport syndrome. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=7987301" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#22" class="mim-tip-reference" title="Lemmink, H. H., Schroder, C. H., Monners, L. A. H., Smeets, H. J. M. &lt;strong&gt;The clinical spectrum of type IV collagen mutations.&lt;/strong&gt; Hum. Mutat. 9: 477-499, 1997.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9195222/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9195222&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/(SICI)1098-1004(1997)9:6&lt;477::AID-HUMU1&gt;3.0.CO;2-#&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9195222">Lemmink et al. (1997)</a> reviewed the clinical spectrum of type IV collagen mutations associated with renal disease. They found reports of 6 mutations in the COL4A3 gene but commented that few patients and only a small part of the gene had been studied. Patients were either homozygous or compound heterozygous for the mutations, and parents were asymptomatic carriers. All 6 COL4A3 mutations created a premature stop codon. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=9195222" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#15" class="mim-tip-reference" title="Hudson, B. G., Tryggvason, K., Sundaramoorthy, M., Neilson, E. G. &lt;strong&gt;Alport&#x27;s syndrome, Goodpasture&#x27;s syndrome, and type IV collagen.&lt;/strong&gt; New Eng. J. Med. 348: 2543-2556, 2003.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/12815141/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;12815141&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1056/NEJMra022296&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="12815141">Hudson et al. (2003)</a> reviewed the biology of type IV collagen and its relationship to Alport syndrome and the autoimmune disorder Goodpasture syndrome (<a href="/entry/233450">233450</a>). They diagrammed and reviewed the distribution and switches of collagen IV networks in development of the renal glomerulus. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=12815141" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><strong><em>Autosomal Dominant Alport Syndrome 3A</em></strong></p><p>
In affected members of a family with autosomal dominant Alport syndrome (ATS3A; <a href="/entry/104200">104200</a>) reported by <a href="#16" class="mim-tip-reference" title="Jefferson, J. A., Lemmink, H. H., Hughes, A. E., Hill, C. M., Smeets, H. J., Doherty, C. C., Maxwell, A. P. &lt;strong&gt;Autosomal dominant Alport syndrome linked to the type IV collagen alpha 3 and alpha 4 genes (COL4A3 and COL4A4).&lt;/strong&gt; Nephrol. Dial. Transplant. 12: 1595-1599, 1997.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9269635/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9269635&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1093/ndt/12.8.1595&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9269635">Jefferson et al. (1997)</a>, <a href="#41" class="mim-tip-reference" title="van der Loop, F. T. L., Heidet, L., Timmer, E. D. J., van den Bosch, B. J. C., Leinonen, A., Antignac, C., Jefferson, J. A., Maxwell, A. P., Monnens, L. A. H., Schroder, C. H., Smeets, H. J. M. &lt;strong&gt;Autosomal dominant Alport syndrome caused by a COL4A3 splice site mutation.&lt;/strong&gt; Kidney Int. 58: 1870-1875, 2000.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/11044206/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;11044206&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1111/j.1523-1755.2000.00358.x&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="11044206">van der Loop et al. (2000)</a> identified a heterozygous mutation in the COL4A3 gene (<a href="#0009">120070.0009</a>). The mutation resulted in a splice site mutation and a mutant protein with a deletion in the collagenous domain. The mutation was found in all 6 affected individuals and in none of 8 unaffected individuals. Since the noncollagenous domain remained intact, this mutant chain may be incorporated and distort the collagen triple helix, causing a dominant effect. The finding of a COL4A3 mutation in autosomal dominant Alport syndrome completed the broad spectrum of type IV collagen mutations, ranging from no effect at all and familial benign hematuria to mild autosomal dominant and severe autosomal recessive Alport syndrome. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=11044206+9269635" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><strong><em>Evidence of Digenic Inheritance in Alport Syndrome</em></strong></p><p>
Using massively parallel sequencing, <a href="#30" class="mim-tip-reference" title="Mencarelli, M. A., Heidet, L., Storey, H., van Geel, M., Knebelmann, B., Fallerini, C., Miglietti, N., Antonucci, M. F., Cetta, F., Sayer, J. A., van den Wijngaard, A., Yau, S., Mari, F., Bruttini, M., Ariani, F., Dahan, K., Smeets, B., Antignac, C., Flinter, F., Renieri, A. &lt;strong&gt;Evidence of digenic inheritance in Alport syndrome.&lt;/strong&gt; J. Med. Genet. 52: 163-174, 2015.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/25575550/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;25575550&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1136/jmedgenet-2014-102822&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="25575550">Mencarelli et al. (2015)</a> identified 11 patients with Alport syndrome who had pathogenic mutations in 2 of the 3 collagen IV genes. Seven patients had a combination of mutations in COL4A3 and COL4A4 (<a href="/entry/120131">120131</a>), whereas 4 patients had 1 or 2 mutations in COL4A4 associated with mutation in COL4A5 (<a href="/entry/303630">303630</a>). In no case were there simultaneous COL4A3 and COL4A5 mutations. Altogether, 23 unique mutations were found, including 7 in COL4A3, 12 in COL4A4, and 4 in COL4A5. The mutations involved all domains of the collagen molecules, although the majority of missense mutations (11 of 13) affected the triple-helical collagenous domain, and 11 missense mutations substituted a critical glycine residue in this domain. Thirteen mutations had been previously reported and 10 were novel. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=25575550" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><strong><em>Benign Familial Hematuria</em></strong></p><p>
In 2 unrelated families with benign familial hematuria (BFH2; <a href="/entry/620320">620320</a>), <a href="#1" class="mim-tip-reference" title="Badenas, C., Praga, M., Tazon, B., Heidet, L., Arrondel, C., Armengol, A., Andres, A., Morales. E., Camacho, J. A., Lens, X., Davila, S., Mila, M., Antignac, C., Darnell, A., Torra, R. &lt;strong&gt;Mutations in the COL4A4 and COL4A3 genes cause familial benign hematuria.&lt;/strong&gt; J. Am. Soc. Nephrol. 13: 1248-1254, 2002.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/11961012/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;11961012&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1681/ASN.V1351248&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="11961012">Badenas et al. (2002)</a> identified 2 different heterozygous missense mutations in the COL4A3 gene (<a href="#0007">120070.0007</a> and <a href="#0008">120070.0008</a>, respectively) affecting the collagenous domain of the protein. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=11961012" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><strong><em>Associations Pending Confirmation</em></strong></p><p>
For discussion of a possible association between variation in the COL4A3 gene and keratoconus, see KTCN1 (<a href="/entry/148300">148300</a>).</p>
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<a id="evolution" class="mim-anchor"></a>
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<strong>Evolution</strong>
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<p><a href="#24" class="mim-tip-reference" title="MacDonald, B. A., Sund, M., Grant, M. A., Pfaff, K. L., Holthaus, K., Zon, L. I., Kalluri, R. &lt;strong&gt;Zebrafish to humans: evolution of the alpha-3-chain of type IV collagen and emergence of the autoimmune epitopes associated with Goodpasture syndrome.&lt;/strong&gt; Blood 107: 1908-1915, 2006.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/16254142/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;16254142&lt;/a&gt;, &lt;a href=&quot;https://www.ncbi.nlm.nih.gov/pmc/?term=16254142[PMID]&amp;report=imagesdocsum&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed Image&#x27;, &#x27;domain&#x27;: &#x27;ncbi.nlm.nih.gov&#x27;})&quot;&gt;images&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1182/blood-2005-05-1814&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="16254142">MacDonald et al. (2006)</a> showed that the alpha-3(IV) chain is not present in C. elegans or Drosophila melanogaster, but is present in Danio rerio (zebrafish). However, zebrafish alpha-3(IV)NC1 does not bind Goodpasture autoantibodies. There also was complete absence of autoantibody binding to recombinant zebrafish alpha-3(VI)NC1. It appeared that evolutionary alteration of electrostatic charge and polarity due to the emergence of critical serine, aspartic acid, and lysine residues, accompanied by the loss of asparagine and glutamine, contributed to the emergence of the 2 major Goodpasture epitopes on the human alpha-3(IV)NC1 domain, as it evolved from Danio rerio over 450 million years. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=16254142" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<p>Canine X-linked hereditary nephritis is an animal model for human X-linked hereditary nephritis (Alport syndrome) (<a href="/entry/301050">301050</a>) characterized by the presence of a premature stop codon in the alpha-5 chain of collagen type IV. <a href="#39" class="mim-tip-reference" title="Thorner, P. S., Zheng, K., Kalluri, R., Jacobs, R., Hudson, B. G. &lt;strong&gt;Coordinate gene expression of the alpha-3, alpha-4, and alpha-5 chains of collagen type IV.&lt;/strong&gt; J. Biol. Chem. 271: 13821-13828, 1996.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/8662866/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;8662866&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.271.23.13821&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="8662866">Thorner et al. (1996)</a> examined expression of the canine collagen type IV genes in the kidney. They detected alpha-3, alpha-4 (<a href="/entry/120131">120131</a>), and alpha-5 chains in the noncollagenous domain of type IV collagen isolated from normal dog glomeruli but not in affected dog glomeruli. In addition to a significantly reduced level of COL4A5 gene expression (approximately 10% of normal), expression of the COL4A3 and COL4A4 genes was also decreased to 14-23% and 11-17%, respectively. These findings suggested to <a href="#39" class="mim-tip-reference" title="Thorner, P. S., Zheng, K., Kalluri, R., Jacobs, R., Hudson, B. G. &lt;strong&gt;Coordinate gene expression of the alpha-3, alpha-4, and alpha-5 chains of collagen type IV.&lt;/strong&gt; J. Biol. Chem. 271: 13821-13828, 1996.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/8662866/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;8662866&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.271.23.13821&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="8662866">Thorner et al. (1996)</a> a mechanism which coordinates the expression of these 3 basement membrane proteins. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=8662866" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#5" class="mim-tip-reference" title="Cosgrove, D., Meehan, D. T., Grunkemeyer, J. A., Kornak, J. M., Sayers, R., Hunter, W. J., Samuelson, G. C. &lt;strong&gt;Collagen COL4A3 knockout: a mouse model for autosomal Alport syndrome.&lt;/strong&gt; Genes Dev. 10: 2981-2992, 1996.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/8956999/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;8956999&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1101/gad.10.23.2981&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="8956999">Cosgrove et al. (1996)</a> produced a mouse model for the autosomal form of Alport syndrome by a COL4A3 knockout. The mice developed progressive glomerulonephritis with microhematuria and proteinuria. End-stage renal disease developed at about 14 weeks of age. Transmission electron microscopy (TEM) of glomerular basement membranes (GBM) during development of renal pathology revealed focal multilaminated thickening and thinning beginning in the external capillary loops at 4 weeks and spreading throughout the GBM by 8 weeks. By 14 weeks, half of the glomeruli were fibrotic with collapsed capillaries. Immunofluorescence analysis of the GBM showed the absence of type IV collagen alpha-3, alpha-4, and alpha-5 chains and a persistence of alpha-1 and alpha-2 chains, which are normally localized to the mesangial matrix. Northern blot analysis using probes specific for the collagen chains demonstrated the absence of COL4A3 in the knockout, whereas mRNAs for the remaining chains were unchanged. The progression of Alport renal disease was correlated in time and space with the accumulation of fibronectin, heparan sulfate proteoglycan, laminin-1 (see <a href="/entry/150320">150320</a>), and entactin (<a href="/entry/131390">131390</a>) in the GBM of the affected animals. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=8956999" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#9" class="mim-tip-reference" title="Hamano, Y., Grunkemeyer, J. A., Sudhakar, A., Zeisberg, M., Cosgrove, D., Morello, R., Lee, B., Sugimoto, H., Kalluri, R. &lt;strong&gt;Determinants of vascular permeability in the kidney glomerulus.&lt;/strong&gt; J. Biol. Chem. 277: 31154-31162, 2002.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/12039968/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;12039968&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.M204806200&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="12039968">Hamano et al. (2002)</a> showed that Col4a3-deficient mice had normal expression of podocyte- and slit diaphragm-associated proteins until 4 weeks after birth, despite significant structural defects in the glomerular basement membrane. At week 5, there were alterations within the slit diaphragm, podocyte effacement, and altered expression of nephrin (<a href="/entry/602716">602716</a>), a slit diaphragm-associated protein. <a href="#9" class="mim-tip-reference" title="Hamano, Y., Grunkemeyer, J. A., Sudhakar, A., Zeisberg, M., Cosgrove, D., Morello, R., Lee, B., Sugimoto, H., Kalluri, R. &lt;strong&gt;Determinants of vascular permeability in the kidney glomerulus.&lt;/strong&gt; J. Biol. Chem. 277: 31154-31162, 2002.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/12039968/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;12039968&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1074/jbc.M204806200&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="12039968">Hamano et al. (2002)</a> concluded that defects in glomerular basement membrane proteins lead to an insidious plasma protein leak, while breakdown of the slit diaphragms leads to precipitous plasma protein leak. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=12039968" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#23" class="mim-tip-reference" title="Lu, W., Phillips, C. L., Killen, P. D., Hlaing, T., Harrison, W. R., Elder, F. F. B., Miner, J. H., Overbeek, P. A., Meisler, M. H. &lt;strong&gt;Insertional mutation of the collagen genes Col4a3 and Col4a4 in a mouse model of Alport syndrome.&lt;/strong&gt; Genomics 61: 113-124, 1999.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/10534397/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;10534397&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1006/geno.1999.5943&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="10534397">Lu et al. (1999)</a> generated the transgenic mouse line OVE250 by microinjection of the 4.1-kb tyrosinase minigene construct TyBS into 1-cell embryos of the inbred albino strain FVB/N. Mice homozygous for the transgenic insertion exhibited severe progressive glomerulonephritis, resembling the Alport syndrome in man. The injected minigene construct created a mutation at the site of insertion on mouse chromosome 1, leading to a deletion in the Col4a3 and Col4a4 head-to-head pair region, including exons 1 through 12 of the Col4a4 gene, exons 1 and 2 of the adjacent Col4a3 gene, and the intergenic promoter region. Transcripts of Col4a3 and Col4a4 were undetectable in the mutant kidney, and both proteins were missing from the glomerular basement membrane. This animal model of human Alport syndrome, designated Col4del3-4, lacks both alpha-3 and alpha-4 chains of collagen IV. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=10534397" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<a id="allelicVariants" class="mim-anchor"></a>
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<strong>ALLELIC VARIANTS (<a href="/help/faq#1_4"></strong>
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<strong>11 Selected Examples</a>):</strong>
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<a href="/allelicVariants/120070" class="btn btn-default" role="button"> Table View </a>
&nbsp;&nbsp;<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=120070[MIM]" class="btn btn-default mim-tip-hint" role="button" title="ClinVar aggregates information about sequence variation and its relationship to human health." target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">ClinVar</a>
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown">rs1445615417 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs1445615417;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs1445615417" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs1445615417" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000671970 OR RCV001381660" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000671970, RCV001381660" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000671970...</a>
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<p>In family VB with autosomal recessive Alport syndrome (ATS3B; <a href="/entry/620536">620536</a>), <a href="#31" class="mim-tip-reference" title="Mochizuki, T., Lemmink, H. H., Mariyama, M., Antignac, C., Gubler, M.-C., Pirson, Y., Verellen-Dumoulin, C., Chan, B., Schroder, C. H., Smeets, H. J., Reeders, S. T. &lt;strong&gt;Identification of mutations in the alpha-3(IV) and alpha-4(IV) collagen genes in autosomal recessive Alport syndrome.&lt;/strong&gt; Nature Genet. 8: 77-81, 1994.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/7987396/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;7987396&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng0994-77&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="7987396">Mochizuki et al. (1994)</a> demonstrated homozygosity for a 5-bp (CTTTT) deletion in the COL4A3 gene, causing a frameshift and chain termination after 33 amino acids of the NC1 domain. The female proband had sensorineural deafness, hematuria from 4 years of age, and typical ultrastructural lesions of Alport syndrome on electron microscopy of renal biopsy. Hemodialysis was started at age 9. Renal allograft was received at age 10, following which she developed anti-GBM nephritis. In a competitive ELISA, binding of the patient's serum was inhibited by increasing concentrations of Goodpasture sera which contains autoantibodies directed toward the NC1 domain of COL4A3. The patient's brother had hematuria, deafness, and deteriorating renal function. The parents were asymptomatic. They were not known to be related, but their ancestors originated from the same small village in the Netherlands. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=7987396" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p>In a review of type IV collagen mutations, <a href="#22" class="mim-tip-reference" title="Lemmink, H. H., Schroder, C. H., Monners, L. A. H., Smeets, H. J. M. &lt;strong&gt;The clinical spectrum of type IV collagen mutations.&lt;/strong&gt; Hum. Mutat. 9: 477-499, 1997.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9195222/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9195222&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/(SICI)1098-1004(1997)9:6&lt;477::AID-HUMU1&gt;3.0.CO;2-#&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9195222">Lemmink et al. (1997)</a> stated that this mutation was deletion of 5 bp after nucleotide 4414. The deletion caused a frameshift after leu1474 with a stop 33 codons downstream. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=9195222" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>.0002&nbsp;ALPORT SYNDROME 3B, AUTOSOMAL RECESSIVE</strong>
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COL4A3, ARG1481TER
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000019036 OR RCV000760446 OR RCV001273243 OR RCV005003387" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000019036, RCV000760446, RCV001273243, RCV005003387" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000019036...</a>
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<p>In a Belgian girl (family DU), born of consanguineous parents, with autosomal recessive Alport syndrome (ATS3B; <a href="/entry/620536">620536</a>), <a href="#31" class="mim-tip-reference" title="Mochizuki, T., Lemmink, H. H., Mariyama, M., Antignac, C., Gubler, M.-C., Pirson, Y., Verellen-Dumoulin, C., Chan, B., Schroder, C. H., Smeets, H. J., Reeders, S. T. &lt;strong&gt;Identification of mutations in the alpha-3(IV) and alpha-4(IV) collagen genes in autosomal recessive Alport syndrome.&lt;/strong&gt; Nature Genet. 8: 77-81, 1994.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/7987396/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;7987396&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1038/ng0994-77&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="7987396">Mochizuki et al. (1994)</a> identified a homozygous C-to-T transition in exon 5 of the COL4A3 gene, counting from the 3-prime end (<a href="#35" class="mim-tip-reference" title="Quinones, S., Bernal, D., Garcia-Sogo, M., Elena, S. F., Saus, J. &lt;strong&gt;Exon/intron structure of the human alpha-3(IV) gene encompassing the Goodpasture antigen (alpha-3(IV)NC1): identification of a potentially antigenic region at the triple helix/NC1 domain junction.&lt;/strong&gt; J. Biol. Chem. 267: 19780-19784, 1992. Note: Erratum: J. Biol. Chem. 269: 17358 only, 1994.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/1400291/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;1400291&lt;/a&gt;]" pmid="1400291">Quinones et al., 1992</a>). This mutation replaced an arginine codon with a stop codon in the NC1 domain, shortening the alpha-3(IV) chain by 190 amino acids; it was expected to disrupt 11 of the intermolecular disulfide bonds that stabilize the homodimerization of NC1 domains. The patient was found to have proteinuria and microhematuria at age 7, resulting in end-stage renal disease by age 11. At age 11, she had renal transplant from her mother, and had not developed rejection or anti-GMB nephritis by age 16. At age 13, an audiogram showed bilateral sensorineural hearing loss. Both unaffected parents had normal renal function and urinalysis. In a catalog of COL4A3 mutations causing autosomal recessive Alport syndrome, <a href="#22" class="mim-tip-reference" title="Lemmink, H. H., Schroder, C. H., Monners, L. A. H., Smeets, H. J. M. &lt;strong&gt;The clinical spectrum of type IV collagen mutations.&lt;/strong&gt; Hum. Mutat. 9: 477-499, 1997.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9195222/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9195222&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/(SICI)1098-1004(1997)9:6&lt;477::AID-HUMU1&gt;3.0.CO;2-#&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9195222">Lemmink et al. (1997)</a> stated that this mutation was an arg1481-to-ter (R1481X) substitution caused by a a C-to-T transition at nucleotide 4441. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=9195222+7987396+1400291" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p><p><a href="#22" class="mim-tip-reference" title="Lemmink, H. H., Schroder, C. H., Monners, L. A. H., Smeets, H. J. M. &lt;strong&gt;The clinical spectrum of type IV collagen mutations.&lt;/strong&gt; Hum. Mutat. 9: 477-499, 1997.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9195222/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9195222&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/(SICI)1098-1004(1997)9:6&lt;477::AID-HUMU1&gt;3.0.CO;2-#&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9195222">Lemmink et al. (1997)</a> noted that the compound heterozygous mutations previously identified in a patient with autosomal recessive Alport syndrome and designated arg43-to-ter and ser86-to-ter by <a href="#21" class="mim-tip-reference" title="Lemmink, H. H., Mochizuki, T., van den Heuvel, L. P. W. J., Schroder, C. H., Barrientos, A., Monnens, L. A. H., van Oost, B. A., Brunner, H. G., Reeders, S. T., Smeets, H. J. M. &lt;strong&gt;Mutations in the type IV collagen alpha-3 (COL4A3) gene in autosomal recessive Alport syndrome.&lt;/strong&gt; Hum. Molec. Genet. 3: 1269-1273, 1994.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/7987301/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;7987301&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1093/hmg/3.8.1269&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="7987301">Lemmink et al. (1994)</a> were in fact R1481X and S1524X (<a href="#0003">120070.0003</a>). <a href="https://pubmed.ncbi.nlm.nih.gov/?term=9195222+7987301" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>.0003&nbsp;ALPORT SYNDROME 3B, AUTOSOMAL RECESSIVE</strong>
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COL4A3, SER1524TER
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs121912825 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs121912825;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs121912825?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs121912825" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs121912825" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000019037 OR RCV001851933" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000019037, RCV001851933" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000019037...</a>
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<p><a href="#22" class="mim-tip-reference" title="Lemmink, H. H., Schroder, C. H., Monners, L. A. H., Smeets, H. J. M. &lt;strong&gt;The clinical spectrum of type IV collagen mutations.&lt;/strong&gt; Hum. Mutat. 9: 477-499, 1997.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9195222/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9195222&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1002/(SICI)1098-1004(1997)9:6&lt;477::AID-HUMU1&gt;3.0.CO;2-#&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9195222">Lemmink et al. (1997)</a> demonstrated that a patient with autosomal recessive Alport syndrome (ATS3B; <a href="/entry/620536">620536</a>) was compound heterozygous for mutations in the COL4A3 gene: R1481X (<a href="#0002">120070.0002</a>) and a C-to-G transversion at nucleotide 4559 resulting in a ser1524-to-ter (S1524X) substitution. These mutations had previously been reported as R43X and S86X by <a href="#21" class="mim-tip-reference" title="Lemmink, H. H., Mochizuki, T., van den Heuvel, L. P. W. J., Schroder, C. H., Barrientos, A., Monnens, L. A. H., van Oost, B. A., Brunner, H. G., Reeders, S. T., Smeets, H. J. M. &lt;strong&gt;Mutations in the type IV collagen alpha-3 (COL4A3) gene in autosomal recessive Alport syndrome.&lt;/strong&gt; Hum. Molec. Genet. 3: 1269-1273, 1994.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/7987301/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;7987301&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1093/hmg/3.8.1269&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="7987301">Lemmink et al. (1994)</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=9195222+7987301" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>.0005&nbsp;MOVED TO <a href="/entry/120070#0002">120070.0002</a></strong>
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<strong>.0006&nbsp;ALPORT SYNDROME 3B, AUTOSOMAL RECESSIVE</strong>
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COL4A3, ALU INS, EX6
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs1325453230 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs1325453230;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs1325453230?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs1325453230" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs1325453230" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000019040" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000019040" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000019040</a>
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<p>In the process of screening the illegitimate transcripts of COL4A3 in lymphocytes from a patient with autosomal recessive Alport syndrome (ATS3B; <a href="/entry/620536">620536</a>), <a href="#19" class="mim-tip-reference" title="Knebelmann, B., Forestier, L., Drouot, L., Quinones, S., Chuet, C., Benessy, F., Saus, J., Antignac, C. &lt;strong&gt;Splice-mediated insertion of an Alu sequence in the COL4A3 mRNA causing autosomal recessive Alport syndrome.&lt;/strong&gt; Hum. Molec. Genet. 4: 675-679, 1995.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/7633417/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;7633417&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1093/hmg/4.4.675&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="7633417">Knebelmann et al. (1995)</a> discovered an antisense Alu sequence that had been spliced into the mature transcript after a G-to-T transversion activated a cryptic splice site located in the Alu element within intron V. The resultant 74-bp insertion was at the junction of exons IV or V and VI in the final transcript. This was the first observation of a splicing abnormality in the COL4A3 gene in autosomal recessive Alport syndrome. The precise mutation involved the insertion of an abnormally spliced intron 5 fragment (<a href="#8" class="mim-tip-reference" title="Finielz, P., Cartault, F., Chuet, C., Genin, R. &lt;strong&gt;Alport syndrome in Reunion Island: phenotypic heterogeneity of the recessive-autosomal form. (Letter)&lt;/strong&gt; Nephron 79: 237 only, 1998.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9647515/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9647515&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1159/000045039&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9647515">Finielz et al., 1998</a>). This intron 5 mutation was found in 4 families in Reunion Island. In 1 family, 3 patients, all male, were involved. Two were placed on hemodialysis for end-stage renal disease at ages 28 and 26; the third, aged 13, had normal serum creatinine concentration values. All 3 patients had hearing impairment but no ocular lesions. The 3 other families from a different town had discovery of Alport syndrome at earlier ages ranging from 3 to 13 years on the basis of macroscopic hematuria and/or proteinuria, and in only 1 case was deafness evident. Males and females seemed to be equally involved (3 boys, 3 girls). End-stage renal failure occurred earlier (ages 14, 14, 18, and 15), unrelated to sex. Auditory impairment was a constant feature; ocular impairment involved 1 patient only. Undefined environmental factors or phenotype-modulating genes (around the assay genes) were hypothesized. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=7633417+9647515" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>.0007&nbsp;HEMATURIA, BENIGN FAMILIAL, 2</strong>
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COL4A3, GLY1015GLU
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown">rs121912826 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs121912826;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs121912826" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs121912826" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000019041 OR RCV001281227" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000019041, RCV001281227" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000019041...</a>
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<p>In a family (HFB-1) with benign familial hematuria (BFH2; <a href="/entry/620320">620320</a>), <a href="#1" class="mim-tip-reference" title="Badenas, C., Praga, M., Tazon, B., Heidet, L., Arrondel, C., Armengol, A., Andres, A., Morales. E., Camacho, J. A., Lens, X., Davila, S., Mila, M., Antignac, C., Darnell, A., Torra, R. &lt;strong&gt;Mutations in the COL4A4 and COL4A3 genes cause familial benign hematuria.&lt;/strong&gt; J. Am. Soc. Nephrol. 13: 1248-1254, 2002.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/11961012/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;11961012&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1681/ASN.V1351248&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="11961012">Badenas et al. (2002)</a> identified a mutation in exon 36 of the COL4A3 gene that resulted in a gly1015-to-glu (G1015E) amino acid substitution in the collagenous domain of the protein. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=11961012" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>.0008&nbsp;HEMATURIA, BENIGN FAMILIAL, 2</strong>
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COL4A3, GLY985VAL
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs121912827 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs121912827;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs121912827?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs121912827" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs121912827" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000019042 OR RCV000485138 OR RCV000675182 OR RCV001831587" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000019042, RCV000485138, RCV000675182, RCV001831587" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000019042...</a>
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<p>In a family (HFB-2) with benign familial hematuria (BFH2; <a href="/entry/620320">620320</a>), <a href="#1" class="mim-tip-reference" title="Badenas, C., Praga, M., Tazon, B., Heidet, L., Arrondel, C., Armengol, A., Andres, A., Morales. E., Camacho, J. A., Lens, X., Davila, S., Mila, M., Antignac, C., Darnell, A., Torra, R. &lt;strong&gt;Mutations in the COL4A4 and COL4A3 genes cause familial benign hematuria.&lt;/strong&gt; J. Am. Soc. Nephrol. 13: 1248-1254, 2002.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/11961012/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;11961012&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1681/ASN.V1351248&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="11961012">Badenas et al. (2002)</a> identified a mutation in exon 35 of the COL4A3 gene that resulted in a gly985-to-val (G985V) amino acid substitution in the collagenous domain of the protein. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=11961012" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<strong>.0009&nbsp;ALPORT SYNDROME 3A, AUTOSOMAL DOMINANT</strong>
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COL4A3, IVS21DS, G-A, -1
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown">rs1553755124 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs1553755124;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs1553755124" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs1553755124" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000666899 OR RCV001807646 OR RCV001855469 OR RCV005004329" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000666899, RCV001807646, RCV001855469, RCV005004329" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000666899...</a>
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<p>In affected members of a family with autosomal dominant Alport syndrome (ATS3A; <a href="/entry/104200">104200</a>) reported by <a href="#16" class="mim-tip-reference" title="Jefferson, J. A., Lemmink, H. H., Hughes, A. E., Hill, C. M., Smeets, H. J., Doherty, C. C., Maxwell, A. P. &lt;strong&gt;Autosomal dominant Alport syndrome linked to the type IV collagen alpha 3 and alpha 4 genes (COL4A3 and COL4A4).&lt;/strong&gt; Nephrol. Dial. Transplant. 12: 1595-1599, 1997.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/9269635/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;9269635&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1093/ndt/12.8.1595&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="9269635">Jefferson et al. (1997)</a>, <a href="#41" class="mim-tip-reference" title="van der Loop, F. T. L., Heidet, L., Timmer, E. D. J., van den Bosch, B. J. C., Leinonen, A., Antignac, C., Jefferson, J. A., Maxwell, A. P., Monnens, L. A. H., Schroder, C. H., Smeets, H. J. M. &lt;strong&gt;Autosomal dominant Alport syndrome caused by a COL4A3 splice site mutation.&lt;/strong&gt; Kidney Int. 58: 1870-1875, 2000.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/11044206/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;11044206&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1111/j.1523-1755.2000.00358.x&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="11044206">van der Loop et al. (2000)</a> identified a heterozygous G-to-A transition in the last nucleotide of exon 21 of the COL4A3 gene. Although the change would predict a gly493-to-ser (G493S) substitution, mRNA analysis indicated that the mutation causes a splice site mutation, resulting in the skipping of exon 21 and a mutated chain that lacks 55 amino acids in the collagenous domain. The mutation was found in all 6 affected individuals and in none of 8 unaffected individuals. Since the noncollagenous domain is intact, this mutant chain may be incorporated and distort the collagen triple helix, causing a dominant effect. The finding of a COL4A3 mutation in autosomal dominant Alport syndrome completed the broad spectrum of type IV collagen mutations. <a href="https://pubmed.ncbi.nlm.nih.gov/?term=11044206+9269635" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<a id="0010" class="mim-anchor"></a>
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<strong>.0010&nbsp;ALPORT SYNDROME 3A, AUTOSOMAL DOMINANT</strong>
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COL4A3, GLY1167ARG
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown"><span class="text-primary">&#x25cf;</span> rs267606745 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs267606745;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://gnomad.broadinstitute.org/variant/rs267606745?dataset=gnomad_r2_1" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'gnomad.broadinstitute.org'})" style="padding-left: 8px;"><span class="text-primary">&#x25cf;</span> gnomAD</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs267606745" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs267606745" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000019044 OR RCV000673273 OR RCV000681815 OR RCV001273241 OR RCV005003388" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000019044, RCV000673273, RCV000681815, RCV001273241, RCV005003388" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000019044...</a>
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<p>In a mother and daughter with autosomal dominant Alport syndrome (ATS3A; <a href="/entry/104200">104200</a>), <a href="#12" class="mim-tip-reference" title="Heidet, L., Arrondel, C., Forestier, L., Cohen-Solal, L., Mollet, G., Gutierrez, B., Stavrou, C., Gubler, M. C., Antignac, C. &lt;strong&gt;Structure of the human type IV collagen gene COL4A3 and mutations in autosomal Alport syndrome.&lt;/strong&gt; J. Am. Soc. Nephrol. 12: 97-106, 2001.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/11134255/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;11134255&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1681/ASN.V12197&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="11134255">Heidet et al. (2001)</a> identified a heterozygous 3499G-A transition in exon 40 of the COL4A3 gene, resulting in a gly1167-to-arg (G1167R) substitution. The daughter developed end-stage renal failure at age 23 years. Her mother had microscopic hematuria and proteinuria, but still had normal renal function at age 52 years, although renal biopsy showed thinning of and splitting of the glomerular basement membrane. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=11134255" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<a id="0011" class="mim-anchor"></a>
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<strong>.0011&nbsp;ALPORT SYNDROME 3B, AUTOSOMAL RECESSIVE</strong>
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COL4A3, 24-BP DEL, NT40
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<div class="btn-group"> <button type="button" class="btn btn-default btn-xs dropdown-toggle mim-font" data-toggle="dropdown">rs876657397 <span class="caret"></span></button> <ul class="dropdown-menu"> <li><a href="https://www.ensembl.org/Homo_sapiens/Variation/Summary?v=rs876657397;toggle_HGVS_names=open" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'ensembl.org'})">Ensembl</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/snp/?term=rs876657397" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'www.ncbi.nlm.nih.gov'})">NCBI</a></li> <li><a href="https://genome.ucsc.edu/cgi-bin/hgTracks?org=Human&db=hg38&clinvar=pack&omimAvSnp=pack&position=rs876657397" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'dbSNP', 'domain': 'genome.ucsc.edu'})">UCSC</a></li> </ul> </div>
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<a href="https://www.ncbi.nlm.nih.gov/clinvar?term=RCV000172875 OR RCV000807286 OR RCV001272220 OR RCV003407638 OR RCV004609313 OR RCV005003524" target="_blank" class="btn btn-default btn-xs mim-tip-hint" title="RCV000172875, RCV000807286, RCV001272220, RCV003407638, RCV004609313, RCV005003524" onclick="gtag('event', 'mim_outbound', {'name': 'ClinVar', 'domain': 'ncbi.nlm.nih.gov'})">RCV000172875...</a>
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<p>In 3 sisters, born of unrelated parents of Ashkenazi Jewish descent, with autosomal recessive Alport syndrome (ATS3B; <a href="/entry/620536">620536</a>), <a href="#42" class="mim-tip-reference" title="Webb, B. D., Brandt, T., Liu, L., Jalas, C., Liao, J., Fedick, A., Linderman, M. D., Diaz, G. A., Kornreich, R., Trachtman, H., Mehta, L., Edelmann, L. &lt;strong&gt;A founder mutation in COL4A3 causes autosomal recessive Alport syndrome in the Ashkenazi Jewish population.&lt;/strong&gt; Clin. Genet. 86: 155-160, 2014.[PubMed: &lt;a href=&quot;https://pubmed.ncbi.nlm.nih.gov/23927549/&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;name&#x27;: &#x27;PubMed&#x27;, &#x27;domain&#x27;: &#x27;pubmed.ncbi.nlm.nih.gov&#x27;})&quot;&gt;23927549&lt;/a&gt;] [&lt;a href=&quot;https://doi.org/10.1111/cge.12247&quot; target=&quot;_blank&quot; onclick=&quot;gtag(&#x27;event&#x27;, &#x27;mim_outbound&#x27;, {&#x27;destination&#x27;: &#x27;Publisher&#x27;})&quot;&gt;Full Text&lt;/a&gt;]" pmid="23927549">Webb et al. (2014)</a> identified a homozygous 24-bp deletion (c.40_63del, NM_000091.4) in the COL4A3 gene, resulting in an in-frame deletion of 8 amino acids. The mutation, which was found by linkage analysis followed by candidate gene sequencing, segregated with the disorder in the family. Population analysis yielded a carrier frequency of 0.55% among Ashkenazi Jewish individuals, and haplotype analysis indicated a founder effect. Functional studies of the variant were not performed, but the parents were unaffected, suggesting that heterozygosity for this mutation does not predispose to disease. <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=23927549" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})"><span class="glyphicon glyphicon-plus-sign mim-tip-hint" title="Click this 'reference-plus' icon to see articles related to this paragraph in PubMed."></span></a></p>
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<a id="Butkowski1989" class="mim-anchor"></a>
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[<a href="https://doi.org/10.1101/gad.10.23.2981" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1073/pnas.0807055105" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1159/000045039" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1074/jbc.M204806200" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1016/j.bbrc.2005.05.130" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1074/jbc.272.33.20395" target="_blank">Full Text</a>]
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Heidet, L., Arrondel, C., Forestier, L., Cohen-Solal, L., Mollet, G., Gutierrez, B., Stavrou, C., Gubler, M. C., Antignac, C.
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[<a href="https://doi.org/10.1681/ASN.V12197" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1074/jbc.274.36.25862" target="_blank">Full Text</a>]
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<a id="Hudson1992" class="mim-anchor"></a>
<div class="">
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Hudson, B. G., Kalluri, R., Gunwar, S., Weber, M., Ballester, F., Hudson, J. K., Noelken, M. E., Sarras, M., Richardson, W. R., Saus, J., Abrahamson, D. R., Glick, A. D., Haralson, M. A., Helderman, J. H., Stone, W. J., Jacobson, H. R.
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[<a href="https://doi.org/10.1038/ki.1992.276" target="_blank">Full Text</a>]
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<a id="Hudson2003" class="mim-anchor"></a>
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Hudson, B. G., Tryggvason, K., Sundaramoorthy, M., Neilson, E. G.
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[<a href="https://doi.org/10.1056/NEJMra022296" target="_blank">Full Text</a>]
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Jefferson, J. A., Lemmink, H. H., Hughes, A. E., Hill, C. M., Smeets, H. J., Doherty, C. C., Maxwell, A. P.
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[<a href="https://doi.org/10.1093/ndt/12.8.1595" target="_blank">Full Text</a>]
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<a id="Jun2001" class="mim-anchor"></a>
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Jun, A. S., Liu, S. H., Koo, E. H., Do, D. V., Stark, W. J., Gottsch, J. D.
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[<a href="https://doi.org/10.1001/archopht.119.11.1629" target="_blank">Full Text</a>]
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<a id="Kalluri1994" class="mim-anchor"></a>
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Kalluri, R., Gattone, V. H., II, Noelken, M. E., Hudson, B. G.
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[<a href="https://doi.org/10.1073/pnas.91.13.6201" target="_blank">Full Text</a>]
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<a id="Knebelmann1995" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Knebelmann, B., Forestier, L., Drouot, L., Quinones, S., Chuet, C., Benessy, F., Saus, J., Antignac, C.
<strong>Splice-mediated insertion of an Alu sequence in the COL4A3 mRNA causing autosomal recessive Alport syndrome.</strong>
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[<a href="https://doi.org/10.1093/hmg/4.4.675" target="_blank">Full Text</a>]
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<a id="Krafchak2005" class="mim-anchor"></a>
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Krafchak, C. M., Pawar, H., Moroi, S. E., Sugar, A., Lichter, P. R., Mackey, D. A., Mian, S., Nairus, T., Elner, V., Schteingart, M. T., Downs, C. A., Kijek, T. G., and 9 others.
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[<a href="https://doi.org/10.1086/497348" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1093/hmg/3.8.1269" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1006/geno.1999.5943" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1182/blood-2005-05-1814" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1074/jbc.C000186200" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1074/jbc.M001956200" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1126/science.1065298" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1074/jbc.M103024200" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1136/jmedgenet-2014-102822" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1038/ng0994-77" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1016/s0014-5793(98)00128-8" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1073/pnas.0730882100" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1074/jbc.271.23.13821" target="_blank">Full Text</a>]
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[<a href="https://doi.org/10.1172/JCI115625" target="_blank">Full Text</a>]
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<strong>A founder mutation in COL4A3 causes autosomal recessive Alport syndrome in the Ashkenazi Jewish population.</strong>
Clin. Genet. 86: 155-160, 2014.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/23927549/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">23927549</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=23927549" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1111/cge.12247" target="_blank">Full Text</a>]
</p>
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<a id="43" class="mim-anchor"></a>
<a id="Wieslander1984" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Wieslander, J., Barr, J. F., Butkowski, R. J., Edwards, S. J., Bygren, P., Heinegard, D., Hudson, B. G.
<strong>Goodpasture antigen of the glomerular basement membrane: localization to noncollagenous regions of type IV collagen.</strong>
Proc. Nat. Acad. Sci. 81: 3838-3842, 1984.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/6328527/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">6328527</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=6328527" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
[<a href="https://doi.org/10.1073/pnas.81.12.3838" target="_blank">Full Text</a>]
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<a id="Wieslander1985" class="mim-anchor"></a>
<div class="">
<p class="mim-text-font">
Wieslander, J., Langeveld, J., Butkowski, R., Jodlowski, M., Noelken, M., Hudson, B. G.
<strong>Physical and immunochemical studies of the globular domain of type IV collagen: cryptic properties of the Goodpasture antigen.</strong>
J. Biol. Chem. 260: 8564-8570, 1985.
[PubMed: <a href="https://pubmed.ncbi.nlm.nih.gov/2409091/" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">2409091</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/?cmd=link&linkname=pubmed_pubmed&from_uid=2409091" target="_blank" onclick="gtag('event', 'mim_outbound', {'name': 'PubMed Related', 'domain': 'pubmed.ncbi.nlm.nih.gov'})">related citations</a>]
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Ada Hamosh - updated : 7/10/2015
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Cassandra L. Kniffin - updated : 6/1/2015<br>Marla J. F. O'Neill - updated : 5/11/2012<br>Cassandra L. Kniffin - updated : 5/21/2010<br>Patricia A. Hartz - updated : 7/22/2009<br>Victor A. McKusick - updated : 6/8/2006<br>Victor A. McKusick - updated : 10/12/2005<br>Anne M. Stumpf - updated : 7/7/2003<br>Victor A. McKusick - updated : 7/1/2003<br>Victor A. McKusick - updated : 6/6/2003<br>Patricia A. Hartz - updated : 1/23/2003<br>Jane Kelly - updated : 12/6/2002<br>Ada Hamosh - updated : 1/10/2002<br>Wilson H. Y. Lo - updated : 12/2/1999<br>Victor A. McKusick - updated : 11/2/1999<br>Victor A. McKusick - updated : 8/17/1998<br>Victor A. McKusick - updated : 6/23/1997<br>Victor A. McKusick - updated : 2/11/1997<br>Perseveranda M. Cagas - updated : 9/4/1996
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Creation Date:
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<span class="mim-text-font">
Victor A. McKusick : 10/18/1988
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alopez : 10/10/2023
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alopez : 10/06/2023<br>alopez : 10/06/2023<br>alopez : 10/06/2023<br>carol : 04/12/2023<br>alopez : 02/09/2022<br>carol : 01/09/2020<br>carol : 01/31/2019<br>carol : 10/30/2015<br>alopez : 7/13/2015<br>alopez : 7/10/2015<br>carol : 6/9/2015<br>mcolton : 6/2/2015<br>ckniffin : 6/1/2015<br>carol : 4/4/2013<br>carol : 5/11/2012<br>carol : 5/27/2010<br>ckniffin : 5/21/2010<br>mgross : 8/5/2009<br>terry : 7/22/2009<br>wwang : 7/23/2008<br>wwang : 11/20/2007<br>alopez : 6/9/2006<br>terry : 6/8/2006<br>alopez : 10/14/2005<br>terry : 10/12/2005<br>alopez : 8/19/2005<br>alopez : 8/19/2005<br>alopez : 11/25/2003<br>alopez : 7/7/2003<br>terry : 7/1/2003<br>tkritzer : 6/19/2003<br>tkritzer : 6/17/2003<br>terry : 6/6/2003<br>joanna : 5/23/2003<br>mgross : 1/23/2003<br>carol : 12/6/2002<br>terry : 3/6/2002<br>alopez : 1/18/2002<br>terry : 1/10/2002<br>carol : 1/8/2002<br>carol : 3/14/2000<br>carol : 12/6/1999<br>terry : 12/2/1999<br>carol : 11/11/1999<br>terry : 11/2/1999<br>mgross : 6/22/1999<br>psherman : 6/22/1999<br>dkim : 12/9/1998<br>alopez : 8/20/1998<br>terry : 8/17/1998<br>mark : 6/26/1997<br>jenny : 6/23/1997<br>terry : 2/11/1997<br>terry : 2/4/1997<br>mark : 9/4/1996<br>mark : 3/7/1996<br>mark : 1/25/1996<br>terry : 1/22/1996<br>mark : 6/7/1995<br>terry : 10/25/1994<br>jason : 7/12/1994<br>carol : 12/15/1992<br>carol : 8/13/1992<br>carol : 5/26/1992
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<strong>*</strong> 120070
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<span class="mim-font">
COLLAGEN, TYPE IV, ALPHA-3; COL4A3
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<em>Alternative titles; symbols</em>
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COLLAGEN OF BASEMENT MEMBRANE, ALPHA-3 CHAIN
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Other entities represented in this entry:
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TUMSTATIN, INCLUDED
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GOODPASTURE ANTIGEN, INCLUDED
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<strong><em>HGNC Approved Gene Symbol: COL4A3</em></strong>
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<strong>
<em>
Cytogenetic location: 2q36.3
&nbsp;
Genomic coordinates <span class="small">(GRCh38)</span> : 2:227,164,624-227,314,792 </span>
</em>
</strong>
<span class="small">(from NCBI)</span>
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<strong>Gene-Phenotype Relationships</strong>
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Location
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Phenotype
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Phenotype <br /> MIM number
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Inheritance
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Phenotype <br /> mapping key
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<span class="mim-font">
2q36.3
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<span class="mim-font">
Alport syndrome 3A, autosomal dominant
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<span class="mim-font">
104200
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<span class="mim-font">
Autosomal dominant
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3
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<span class="mim-font">
Alport syndrome 3B, autosomal recessive
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<span class="mim-font">
620536
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Autosomal recessive
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3
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Hematuria, benign familial, 2
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<span class="mim-font">
620320
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<span class="mim-font">
Autosomal dominant
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<span class="mim-font">
3
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<strong>TEXT</strong>
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<strong>Description</strong>
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<p>Type IV collagen is found only in basement membranes, where it is the major structural component. COL4A3 is 1 of 6 alpha chains that form the heterotrimeric type IV collagen molecules. Tumstatin, a peptide fragment derived from the C-terminal noncollagenous (NC1) domain of COL4A3, has antiangiogenic activity. The NC1 domain of COL4A3 has also been referred to as the Goodpasture antigen, since it is the primary target of autoantibodies produced in Goodpasture syndrome (233450) (Bernal et al., 1993; Mariyama et al., 1994; Hamano and Kalluri, 2005). </p>
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<strong>Cloning and Expression</strong>
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<p>Butkowski et al. (1987) identified a third alpha chain of basement membrane collagen, type IV. Studying in particular the noncollagenous part of the alpha-3(IV) chain, Saus et al. (1988) concluded that collagen IV is composed of a third chain (alpha-3) together with the 2 classical ones, alpha-1 (120130) and alpha-2 (120090). They also concluded that the epitope to which the major reactivity of autoantibodies are targeted in the glomerular basement membrane in patients with Goodpasture syndrome is localized to the NC1 domain of the alpha-3(IV) chain. See also Butkowski et al. (1989). Morrison et al. (1991) sequenced a partial cDNA encoding the COL4A3 gene. </p><p>By PCR of adult human kidney, followed by S1 nuclease mapping and primer extension of kidney and testis total RNA, Mariyama et al. (1994) obtained full-length COL4A3. The deduced 1,670-amino acid protein has a calculated molecular mass of 161.8 kD. It has a 28-amino acid leucine-rich signal peptide, followed by a 1,410-amino acid collagenous domain, and a 232-amino acid C-terminal NC1 domain. The collagenous domain begins with a 14-amino acid noncollagenous sequence that includes 4 cysteines, and the collagenous repeat gly-X-Y is interrupted 23 times by short noncollagenous sequences. Full-length COL4A3 has 5 arg-gly-asp sequences that mediate binding to integrins. COL4A3 is most similar to COL4A1 (120130) and COL4A5 (303630), indicating that it belongs to the alpha-1-like class of type IV collagen chains. Northern blot analysis detected strong expression of an approximately 8-kb COL4A3 transcript in adult kidney, skeletal muscle, and lung and in fetal kidney and lung. Expression of COL4A3 largely overlapped that of COL4A4 (120131), suggesting that expression of the 2 transcripts may be coregulated. </p><p>The Goodpasture antigen corresponds to the C-terminal NC1 domain of COL4A3, which is encoded by the last 5 exons of the COL4A3 gene. Using RT-PCR, Bernal et al. (1993) identified COL4A3 splice variants lacking 1 or 2 exons in the NC1-coding region. These variants encode identical proteins with C-terminal ends shorter than that of the full-length protein due to the introduction of a frameshift. Since the NC1 domain of COL4A3 is involved in alignment of individual alpha chains into a triple-helical structure, Bernal et al. (1993) suggested that these C-terminally truncated COL4A3 isoforms may be defective in triple-helix formation. RT-PCR revealed significant expression of COL4A3 in kidney, lung, suprarenal capsule, muscle, and spleen, with very low expression in artery, fat, pericardium, and peripheral nerve. Although the COL4A3 splice variants were present in these tissues, the full-length form was most abundant. PCR analysis of kidney cortex biopsied from a Goodpasture patient revealed a small but reproducible decrease in the ratio of full-length to variant transcripts compared with normal kidney. </p><p>Feng et al. (1994) also identified COL4A3 splice variants lacking NC1-coding exons, resulting in proteins with alternative C termini. Ribonuclease protection assays revealed changes in expression of full-length and variant transcripts during fetal kidney development and in adult human kidney. </p><p>By microarray analysis, Jun et al. (2001) demonstrated expression of the COL4A3 gene in human donor corneas. </p>
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<h4>
<span class="mim-font">
<strong>Gene Structure</strong>
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<p>Heidet et al. (2001) determined that the COL4A3 gene contains 52 exons and spans over 88 kb. </p><p>Mariyama et al. (1994) determined that the COL4A3 gene has 2 closely spaced major transcription start sites. </p><p>Momota et al. (1998) reported that the COL4A3 and COL4A4 genes are on opposite strands of chromosome 2 and are transcribed in opposite directions. The first exon of COL4A3, which contains the translation start site, is separated from 2 alternative first exons of COL4A4 by 372 and 5 bp, respectively. The promoter region, which is shared by both genes, is composed of dense CpG dinucleotides, GC boxes, CTC boxes, and a CCAAT box, but not a TATA box. </p>
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<span class="mim-font">
<strong>Mapping</strong>
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<p>Morrison et al. (1991) assigned a partial COL4A3 cDNA to chromosome 2q35-q37 by a combination of somatic cell hybrid studies and in situ hybridization. Turner et al. (1992) localized the COL4A3 gene to chromosome 2q36-q37 by analysis of somatic cell hybrids and by in situ hybridization. Momota et al. (1998) reported that the COL4A3 and COL4A4 genes are arranged in a head-to-head fashion on chromosome 2. </p>
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<h4>
<span class="mim-font">
<strong>Gene Function</strong>
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</h4>
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<span class="mim-text-font">
<p>Wieslander et al. (1984, 1985) presented immunochemical evidence that the Goodpasture antibodies react with collagenase-resistant parts of the type IV collagen molecule. About 5% of cases of glomerulonephritis are mediated by autoantibodies to glomerular basement membrane (GBM). Most of these patients present with Goodpasture syndrome (glomerulonephritis and pulmonary hemorrhage). Butkowski et al. (1987) localized the Goodpasture epitope to a novel chain of type IV collagen composed of 3 distinctive subunits--M1, M2*, and M3. The Goodpasture epitope was found to be situated exclusively on M2*. Turner et al. (1992) demonstrated that the Goodpasture antigen is the alpha-3 chain of type IV collagen (COL4A3; 120070). </p><p>Although the primary defect in Alport syndrome (301050) involves the COL4A5 gene (303630), the pathogenesis of the syndrome probably involves type IV collagen molecules containing the alpha-3(IV) chain: Hudson et al. (1992) demonstrated that the Goodpasture autoantigen is the target alloantigen in posttransplant anti-GBM (glomerular basement membrane) nephritis in patients with Alport syndrome. Kalluri et al. (1994) further confirmed the unique capacity of alpha-3(IV)NC1 dimer from bovine kidney to engage aberrantly the immune system of rabbits to respond to self, mimicking the organ-specific form of the human disease, whereas the other chains of type IV collagen were nonpathogenic. The hexamer of alpha3-(IV) NC1 was nonpathogenic, suggesting the exposure of a pathogenic epitope upon dissociation of hexamer into dimers. Exposure of the pathogenic epitope by infection or organic solvents, events that are thought often to precede Goodpasture syndrome, may be a principal factor in the etiology of the disease. </p><p>Krafchak et al. (2005) detected a complex (core plus secondary) binding site for TCF8 (189909) in the promoter of the COL4A3 gene, and presented immunochemical evidence of ectopic expression of COL4A3 in corneal endothelium of a proband of a family with posterior polymorphous corneal dystrophy-3 (PPCD3; 609141). The authors suggested that the implication of COL4A3 as a target of TCF8 regulation identifies a possible shared molecular component of disease etiology for PPCD and Alport syndrome. </p><p><strong><em>Tumstatin</em></strong></p><p>
Maeshima et al. (2000) termed the noncollagenous I domain of the alpha-3 chain of type IV collagen (COL4A3) 'tumstatin.' This domain had been discovered to possess a C-terminal peptide sequence (amino acids 185 to 203) that inhibits melanoma cell proliferation by Han et al. (1997). Maeshima et al. (2000) identified the antiangiogenic capacity of this domain using several in vitro and in vivo assays. Tumstatin inhibited in vivo neovascularization in matrigel plug assays and suppressed tumor growth of human renal cell carcinoma and prostate carcinoma in mouse xenograft models associated with in vivo endothelial cell-specific apoptosis. The antiangiogenic activity was localized to amino acids 54-132 using deletion mutagenesis. Shahan et al. (1999) identified amino acids 185-203 of tumstatin as a ligand for the alpha-V-beta-3 integrin (193210, 173470). Maeshima et al. (2000) found a distinct additional RGD-independent alpha-V-beta-3 integrin binding site within amino acids 54 to 132 of tumstatin. Maeshima et al. (2001) demonstrated that tumstatin peptides can inhibit proliferation of endothelial cells in the presence of vitronectin (193190), fibronectin (135600), and collagen I (see 120150). The antiangiogenic activity of tumstatin is localized to a 25-amino acid region (69-88) of tumstatin and is independent of disulfide bond linkage. Maeshima et al. (2002) demonstrated that tumstatin functions as an endothelial cell-specific inhibitor of protein synthesis. Through a replicative interaction with alpha-V-beta-3 integrin, tumstatin inhibits activation of focal adhesion kinase (FAK; 600758), phosphatidylinositol 3-kinase (see 171834), protein kinase-B (164730), and mammalian target of rapamycin (601231). Maeshima et al. (2002) further demonstrated that tumstatin prevents the dissociation of eukaryotic initiation factor 4E protein (133440) from 4E-binding protein-1 (602223). Maeshima et al. (2002) concluded that their results establish a role for integrins in mediating cell-specific inhibition of cap-dependent protein synthesis and suggest a potential mechanism for tumstatin's selective effects on endothelial cells. </p><p>Tumstatin and endostatin, 2 inhibitors of angiogenesis, derive from the precursor human collagen molecules COL4A3 and COL18A1 (120328), respectively. Although both of these inhibitors are NC1 domain fragments of collagens, they share only 14% amino acid homology. Sudhakar et al. (2003) evaluated the functional receptors, mechanism of action, and intracellular signaling induced by these 2 collagen-derived inhibitors. Tumstatin prevents angiogenesis through inhibition of endothelial cell proliferation and promotion of apoptosis with no effect on migration, whereas endostatin prevents endothelial cell migration with no effect on proliferation. Sudhakar et al. (2003) demonstrated that tumstatin binds to alpha-V-beta-3 integrin in a vitronectin/fibronectin/RGD cyclic peptide-independent manner, whereas endostatin competes with fibronectin/RGD cyclic peptide to bind alpha-5-beta-1 integrin (135620, 135630). The activity of tumstatin is mediated by alpha-V-beta-3 integrin, whereas the activity of endostatin is mediated by alpha-5-beta-1 integrin. Because of the distinct properties of tumstatin and endostatin, indicating their diverse antiangiogenic actions, the authors suggested the 2 be combined for targeting tumor angiogenesis. </p><p>Eikesdal et al. (2008) showed that leu78, val82, and asp84 of tumstatin were essential for its antiangiogenic activity. However, mutation of all 3 of these residues had only a modest effect on binding to cell surface alpha-V-beta-3 integrin. </p>
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<h4>
<span class="mim-font">
<strong>Biochemical Features</strong>
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<span class="mim-text-font">
<p>Hellmark et al. (1999) provided, for the first time, the molecular characterization of a single immunodominant conformational epitope recognized by pathogenic autoantibodies in a human autoimmune disease. Identified in Goodpasture disease, it represented the basis for the development of new epitope-specific strategies in the treatment of that disorder. Hellmark et al. (1999) identified the epitope by replacing single residues of the COL4A3 chain with the corresponding amino acids from the nonreactive COL4A1 gene. Replacement mutations were identified that completely destroyed the Goodpasture epitope in the COL4A3 gene. The substitution of 9 discontinuous positions in the COL4A1 noncollagenous domain with amino acid residues from the COL4A3 chain resulted in the recombinant construct that was recognized by all patients' sera but by none of the sera from healthy controls. </p>
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<h4>
<span class="mim-font">
<strong>Molecular Genetics</strong>
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<span class="mim-text-font">
<p>In a patient with deletion of 2q35-q36, Pasteris et al. (1992) demonstrated that the COL4A3 gene was deleted, as was also the PAX3 (606597) gene, which was situated proximally. The deletion was estimated to be less than 12.5 megabases.</p><p><strong><em>Autosomal Recessive Alport Syndrome 3B</em></strong></p><p>
In 2 families segregating autosomal recessive Alport syndrome (ATS3B; 620536), Mochizuki et al. (1994) demonstrated homozygous mutations in the COL4A3 gene (120070.0001-120070.0002). </p><p>Lemmink et al. (1994) demonstrated compound heterozygous mutation in the COL4A3 gene (see, e.g., 120070.0002 and 120070.0003) as the basis of autosomal recessive Alport syndrome. </p><p>Lemmink et al. (1997) reviewed the clinical spectrum of type IV collagen mutations associated with renal disease. They found reports of 6 mutations in the COL4A3 gene but commented that few patients and only a small part of the gene had been studied. Patients were either homozygous or compound heterozygous for the mutations, and parents were asymptomatic carriers. All 6 COL4A3 mutations created a premature stop codon. </p><p>Hudson et al. (2003) reviewed the biology of type IV collagen and its relationship to Alport syndrome and the autoimmune disorder Goodpasture syndrome (233450). They diagrammed and reviewed the distribution and switches of collagen IV networks in development of the renal glomerulus. </p><p><strong><em>Autosomal Dominant Alport Syndrome 3A</em></strong></p><p>
In affected members of a family with autosomal dominant Alport syndrome (ATS3A; 104200) reported by Jefferson et al. (1997), van der Loop et al. (2000) identified a heterozygous mutation in the COL4A3 gene (120070.0009). The mutation resulted in a splice site mutation and a mutant protein with a deletion in the collagenous domain. The mutation was found in all 6 affected individuals and in none of 8 unaffected individuals. Since the noncollagenous domain remained intact, this mutant chain may be incorporated and distort the collagen triple helix, causing a dominant effect. The finding of a COL4A3 mutation in autosomal dominant Alport syndrome completed the broad spectrum of type IV collagen mutations, ranging from no effect at all and familial benign hematuria to mild autosomal dominant and severe autosomal recessive Alport syndrome. </p><p><strong><em>Evidence of Digenic Inheritance in Alport Syndrome</em></strong></p><p>
Using massively parallel sequencing, Mencarelli et al. (2015) identified 11 patients with Alport syndrome who had pathogenic mutations in 2 of the 3 collagen IV genes. Seven patients had a combination of mutations in COL4A3 and COL4A4 (120131), whereas 4 patients had 1 or 2 mutations in COL4A4 associated with mutation in COL4A5 (303630). In no case were there simultaneous COL4A3 and COL4A5 mutations. Altogether, 23 unique mutations were found, including 7 in COL4A3, 12 in COL4A4, and 4 in COL4A5. The mutations involved all domains of the collagen molecules, although the majority of missense mutations (11 of 13) affected the triple-helical collagenous domain, and 11 missense mutations substituted a critical glycine residue in this domain. Thirteen mutations had been previously reported and 10 were novel. </p><p><strong><em>Benign Familial Hematuria</em></strong></p><p>
In 2 unrelated families with benign familial hematuria (BFH2; 620320), Badenas et al. (2002) identified 2 different heterozygous missense mutations in the COL4A3 gene (120070.0007 and 120070.0008, respectively) affecting the collagenous domain of the protein. </p><p><strong><em>Associations Pending Confirmation</em></strong></p><p>
For discussion of a possible association between variation in the COL4A3 gene and keratoconus, see KTCN1 (148300).</p>
</span>
<div>
<br />
</div>
<div>
<h4>
<span class="mim-font">
<strong>Evolution</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p>MacDonald et al. (2006) showed that the alpha-3(IV) chain is not present in C. elegans or Drosophila melanogaster, but is present in Danio rerio (zebrafish). However, zebrafish alpha-3(IV)NC1 does not bind Goodpasture autoantibodies. There also was complete absence of autoantibody binding to recombinant zebrafish alpha-3(VI)NC1. It appeared that evolutionary alteration of electrostatic charge and polarity due to the emergence of critical serine, aspartic acid, and lysine residues, accompanied by the loss of asparagine and glutamine, contributed to the emergence of the 2 major Goodpasture epitopes on the human alpha-3(IV)NC1 domain, as it evolved from Danio rerio over 450 million years. </p>
</span>
<div>
<br />
</div>
<div>
<h4>
<span class="mim-font">
<strong>Animal Model</strong>
</span>
</h4>
</div>
<span class="mim-text-font">
<p>Canine X-linked hereditary nephritis is an animal model for human X-linked hereditary nephritis (Alport syndrome) (301050) characterized by the presence of a premature stop codon in the alpha-5 chain of collagen type IV. Thorner et al. (1996) examined expression of the canine collagen type IV genes in the kidney. They detected alpha-3, alpha-4 (120131), and alpha-5 chains in the noncollagenous domain of type IV collagen isolated from normal dog glomeruli but not in affected dog glomeruli. In addition to a significantly reduced level of COL4A5 gene expression (approximately 10% of normal), expression of the COL4A3 and COL4A4 genes was also decreased to 14-23% and 11-17%, respectively. These findings suggested to Thorner et al. (1996) a mechanism which coordinates the expression of these 3 basement membrane proteins. </p><p>Cosgrove et al. (1996) produced a mouse model for the autosomal form of Alport syndrome by a COL4A3 knockout. The mice developed progressive glomerulonephritis with microhematuria and proteinuria. End-stage renal disease developed at about 14 weeks of age. Transmission electron microscopy (TEM) of glomerular basement membranes (GBM) during development of renal pathology revealed focal multilaminated thickening and thinning beginning in the external capillary loops at 4 weeks and spreading throughout the GBM by 8 weeks. By 14 weeks, half of the glomeruli were fibrotic with collapsed capillaries. Immunofluorescence analysis of the GBM showed the absence of type IV collagen alpha-3, alpha-4, and alpha-5 chains and a persistence of alpha-1 and alpha-2 chains, which are normally localized to the mesangial matrix. Northern blot analysis using probes specific for the collagen chains demonstrated the absence of COL4A3 in the knockout, whereas mRNAs for the remaining chains were unchanged. The progression of Alport renal disease was correlated in time and space with the accumulation of fibronectin, heparan sulfate proteoglycan, laminin-1 (see 150320), and entactin (131390) in the GBM of the affected animals. </p><p>Hamano et al. (2002) showed that Col4a3-deficient mice had normal expression of podocyte- and slit diaphragm-associated proteins until 4 weeks after birth, despite significant structural defects in the glomerular basement membrane. At week 5, there were alterations within the slit diaphragm, podocyte effacement, and altered expression of nephrin (602716), a slit diaphragm-associated protein. Hamano et al. (2002) concluded that defects in glomerular basement membrane proteins lead to an insidious plasma protein leak, while breakdown of the slit diaphragms leads to precipitous plasma protein leak. </p><p>Lu et al. (1999) generated the transgenic mouse line OVE250 by microinjection of the 4.1-kb tyrosinase minigene construct TyBS into 1-cell embryos of the inbred albino strain FVB/N. Mice homozygous for the transgenic insertion exhibited severe progressive glomerulonephritis, resembling the Alport syndrome in man. The injected minigene construct created a mutation at the site of insertion on mouse chromosome 1, leading to a deletion in the Col4a3 and Col4a4 head-to-head pair region, including exons 1 through 12 of the Col4a4 gene, exons 1 and 2 of the adjacent Col4a3 gene, and the intergenic promoter region. Transcripts of Col4a3 and Col4a4 were undetectable in the mutant kidney, and both proteins were missing from the glomerular basement membrane. This animal model of human Alport syndrome, designated Col4del3-4, lacks both alpha-3 and alpha-4 chains of collagen IV. </p>
</span>
<div>
<br />
</div>
</div>
<div>
<h4>
<span class="mim-font">
<strong>ALLELIC VARIANTS</strong>
</span>
<strong>11 Selected Examples):</strong>
</span>
</h4>
<div>
<p />
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0001 &nbsp; ALPORT SYNDROME 3B, AUTOSOMAL RECESSIVE</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
COL4A3, 5-BP DEL, NT4414
<br />
SNP: rs1445615417,
ClinVar: RCV000671970, RCV001381660
</span>
</div>
<div>
<span class="mim-text-font">
<p>In family VB with autosomal recessive Alport syndrome (ATS3B; 620536), Mochizuki et al. (1994) demonstrated homozygosity for a 5-bp (CTTTT) deletion in the COL4A3 gene, causing a frameshift and chain termination after 33 amino acids of the NC1 domain. The female proband had sensorineural deafness, hematuria from 4 years of age, and typical ultrastructural lesions of Alport syndrome on electron microscopy of renal biopsy. Hemodialysis was started at age 9. Renal allograft was received at age 10, following which she developed anti-GBM nephritis. In a competitive ELISA, binding of the patient's serum was inhibited by increasing concentrations of Goodpasture sera which contains autoantibodies directed toward the NC1 domain of COL4A3. The patient's brother had hematuria, deafness, and deteriorating renal function. The parents were asymptomatic. They were not known to be related, but their ancestors originated from the same small village in the Netherlands. </p><p>In a review of type IV collagen mutations, Lemmink et al. (1997) stated that this mutation was deletion of 5 bp after nucleotide 4414. The deletion caused a frameshift after leu1474 with a stop 33 codons downstream. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0002 &nbsp; ALPORT SYNDROME 3B, AUTOSOMAL RECESSIVE</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
COL4A3, ARG1481TER
<br />
ClinVar: RCV000019036, RCV000760446, RCV001273243, RCV005003387
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a Belgian girl (family DU), born of consanguineous parents, with autosomal recessive Alport syndrome (ATS3B; 620536), Mochizuki et al. (1994) identified a homozygous C-to-T transition in exon 5 of the COL4A3 gene, counting from the 3-prime end (Quinones et al., 1992). This mutation replaced an arginine codon with a stop codon in the NC1 domain, shortening the alpha-3(IV) chain by 190 amino acids; it was expected to disrupt 11 of the intermolecular disulfide bonds that stabilize the homodimerization of NC1 domains. The patient was found to have proteinuria and microhematuria at age 7, resulting in end-stage renal disease by age 11. At age 11, she had renal transplant from her mother, and had not developed rejection or anti-GMB nephritis by age 16. At age 13, an audiogram showed bilateral sensorineural hearing loss. Both unaffected parents had normal renal function and urinalysis. In a catalog of COL4A3 mutations causing autosomal recessive Alport syndrome, Lemmink et al. (1997) stated that this mutation was an arg1481-to-ter (R1481X) substitution caused by a a C-to-T transition at nucleotide 4441. </p><p>Lemmink et al. (1997) noted that the compound heterozygous mutations previously identified in a patient with autosomal recessive Alport syndrome and designated arg43-to-ter and ser86-to-ter by Lemmink et al. (1994) were in fact R1481X and S1524X (120070.0003). </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0003 &nbsp; ALPORT SYNDROME 3B, AUTOSOMAL RECESSIVE</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
COL4A3, SER1524TER
<br />
SNP: rs121912825,
gnomAD: rs121912825,
ClinVar: RCV000019037, RCV001851933
</span>
</div>
<div>
<span class="mim-text-font">
<p>Lemmink et al. (1997) demonstrated that a patient with autosomal recessive Alport syndrome (ATS3B; 620536) was compound heterozygous for mutations in the COL4A3 gene: R1481X (120070.0002) and a C-to-G transversion at nucleotide 4559 resulting in a ser1524-to-ter (S1524X) substitution. These mutations had previously been reported as R43X and S86X by Lemmink et al. (1994). </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-text-font">
<strong>.0004 &nbsp; MOVED TO 120070.0001</strong>
</span>
</h4>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-text-font">
<strong>.0005 &nbsp; MOVED TO 120070.0002</strong>
</span>
</h4>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0006 &nbsp; ALPORT SYNDROME 3B, AUTOSOMAL RECESSIVE</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
COL4A3, ALU INS, EX6
<br />
SNP: rs1325453230,
gnomAD: rs1325453230,
ClinVar: RCV000019040
</span>
</div>
<div>
<span class="mim-text-font">
<p>In the process of screening the illegitimate transcripts of COL4A3 in lymphocytes from a patient with autosomal recessive Alport syndrome (ATS3B; 620536), Knebelmann et al. (1995) discovered an antisense Alu sequence that had been spliced into the mature transcript after a G-to-T transversion activated a cryptic splice site located in the Alu element within intron V. The resultant 74-bp insertion was at the junction of exons IV or V and VI in the final transcript. This was the first observation of a splicing abnormality in the COL4A3 gene in autosomal recessive Alport syndrome. The precise mutation involved the insertion of an abnormally spliced intron 5 fragment (Finielz et al., 1998). This intron 5 mutation was found in 4 families in Reunion Island. In 1 family, 3 patients, all male, were involved. Two were placed on hemodialysis for end-stage renal disease at ages 28 and 26; the third, aged 13, had normal serum creatinine concentration values. All 3 patients had hearing impairment but no ocular lesions. The 3 other families from a different town had discovery of Alport syndrome at earlier ages ranging from 3 to 13 years on the basis of macroscopic hematuria and/or proteinuria, and in only 1 case was deafness evident. Males and females seemed to be equally involved (3 boys, 3 girls). End-stage renal failure occurred earlier (ages 14, 14, 18, and 15), unrelated to sex. Auditory impairment was a constant feature; ocular impairment involved 1 patient only. Undefined environmental factors or phenotype-modulating genes (around the assay genes) were hypothesized. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0007 &nbsp; HEMATURIA, BENIGN FAMILIAL, 2</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
COL4A3, GLY1015GLU
<br />
SNP: rs121912826,
ClinVar: RCV000019041, RCV001281227
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a family (HFB-1) with benign familial hematuria (BFH2; 620320), Badenas et al. (2002) identified a mutation in exon 36 of the COL4A3 gene that resulted in a gly1015-to-glu (G1015E) amino acid substitution in the collagenous domain of the protein. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0008 &nbsp; HEMATURIA, BENIGN FAMILIAL, 2</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
COL4A3, GLY985VAL
<br />
SNP: rs121912827,
gnomAD: rs121912827,
ClinVar: RCV000019042, RCV000485138, RCV000675182, RCV001831587
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a family (HFB-2) with benign familial hematuria (BFH2; 620320), Badenas et al. (2002) identified a mutation in exon 35 of the COL4A3 gene that resulted in a gly985-to-val (G985V) amino acid substitution in the collagenous domain of the protein. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0009 &nbsp; ALPORT SYNDROME 3A, AUTOSOMAL DOMINANT</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
COL4A3, IVS21DS, G-A, -1
<br />
SNP: rs1553755124,
ClinVar: RCV000666899, RCV001807646, RCV001855469, RCV005004329
</span>
</div>
<div>
<span class="mim-text-font">
<p>In affected members of a family with autosomal dominant Alport syndrome (ATS3A; 104200) reported by Jefferson et al. (1997), van der Loop et al. (2000) identified a heterozygous G-to-A transition in the last nucleotide of exon 21 of the COL4A3 gene. Although the change would predict a gly493-to-ser (G493S) substitution, mRNA analysis indicated that the mutation causes a splice site mutation, resulting in the skipping of exon 21 and a mutated chain that lacks 55 amino acids in the collagenous domain. The mutation was found in all 6 affected individuals and in none of 8 unaffected individuals. Since the noncollagenous domain is intact, this mutant chain may be incorporated and distort the collagen triple helix, causing a dominant effect. The finding of a COL4A3 mutation in autosomal dominant Alport syndrome completed the broad spectrum of type IV collagen mutations. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0010 &nbsp; ALPORT SYNDROME 3A, AUTOSOMAL DOMINANT</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
COL4A3, GLY1167ARG
<br />
SNP: rs267606745,
gnomAD: rs267606745,
ClinVar: RCV000019044, RCV000673273, RCV000681815, RCV001273241, RCV005003388
</span>
</div>
<div>
<span class="mim-text-font">
<p>In a mother and daughter with autosomal dominant Alport syndrome (ATS3A; 104200), Heidet et al. (2001) identified a heterozygous 3499G-A transition in exon 40 of the COL4A3 gene, resulting in a gly1167-to-arg (G1167R) substitution. The daughter developed end-stage renal failure at age 23 years. Her mother had microscopic hematuria and proteinuria, but still had normal renal function at age 52 years, although renal biopsy showed thinning of and splitting of the glomerular basement membrane. </p>
</span>
</div>
<div>
<br />
</div>
</div>
<div>
<div>
<h4>
<span class="mim-font">
<strong>.0011 &nbsp; ALPORT SYNDROME 3B, AUTOSOMAL RECESSIVE</strong>
</span>
</h4>
</div>
<div>
<span class="mim-text-font">
COL4A3, 24-BP DEL, NT40
<br />
SNP: rs876657397,
ClinVar: RCV000172875, RCV000807286, RCV001272220, RCV003407638, RCV004609313, RCV005003524
</span>
</div>
<div>
<span class="mim-text-font">
<p>In 3 sisters, born of unrelated parents of Ashkenazi Jewish descent, with autosomal recessive Alport syndrome (ATS3B; 620536), Webb et al. (2014) identified a homozygous 24-bp deletion (c.40_63del, NM_000091.4) in the COL4A3 gene, resulting in an in-frame deletion of 8 amino acids. The mutation, which was found by linkage analysis followed by candidate gene sequencing, segregated with the disorder in the family. Population analysis yielded a carrier frequency of 0.55% among Ashkenazi Jewish individuals, and haplotype analysis indicated a founder effect. Functional studies of the variant were not performed, but the parents were unaffected, suggesting that heterozygosity for this mutation does not predispose to disease. </p>
</span>
</div>
<div>
<br />
</div>
</div>
</div>
<div>
<h4>
<span class="mim-font">
<strong>REFERENCES</strong>
</span>
</h4>
<div>
<p />
</div>
<div>
<ol>
<li>
<p class="mim-text-font">
Badenas, C., Praga, M., Tazon, B., Heidet, L., Arrondel, C., Armengol, A., Andres, A., Morales. E., Camacho, J. A., Lens, X., Davila, S., Mila, M., Antignac, C., Darnell, A., Torra, R.
<strong>Mutations in the COL4A4 and COL4A3 genes cause familial benign hematuria.</strong>
J. Am. Soc. Nephrol. 13: 1248-1254, 2002.
[PubMed: 11961012]
[Full Text: https://doi.org/10.1681/ASN.V1351248]
</p>
</li>
<li>
<p class="mim-text-font">
Bernal, D., Quinones, S., Saus, J.
<strong>The human mRNA encoding the Goodpasture antigen is alternatively spliced.</strong>
J. Biol. Chem. 268: 12090-12094, 1993.
[PubMed: 8505332]
</p>
</li>
<li>
<p class="mim-text-font">
Butkowski, R. J., Langeveld, J. P. M., Wieslander, J., Hamilton, J., Hudson, B. G.
<strong>Localization of the Goodpasture epitope to a novel chain of basement membrane collagen.</strong>
J. Biol. Chem. 262: 7874-7877, 1987.
[PubMed: 2438283]
</p>
</li>
<li>
<p class="mim-text-font">
Butkowski, R. J., Wieslander, J., Kleppel, M., Michael, A. F., Fish, A. J.
<strong>Basement membrane collagen in the kidney: regional localization of novel chains related to collagen IV.</strong>
Kidney Int. 35: 1195-1202, 1989.
[PubMed: 2671463]
[Full Text: https://doi.org/10.1038/ki.1989.110]
</p>
</li>
<li>
<p class="mim-text-font">
Cosgrove, D., Meehan, D. T., Grunkemeyer, J. A., Kornak, J. M., Sayers, R., Hunter, W. J., Samuelson, G. C.
<strong>Collagen COL4A3 knockout: a mouse model for autosomal Alport syndrome.</strong>
Genes Dev. 10: 2981-2992, 1996.
[PubMed: 8956999]
[Full Text: https://doi.org/10.1101/gad.10.23.2981]
</p>
</li>
<li>
<p class="mim-text-font">
Eikesdal, H. P., Sugimoto, H., Birrane, G., Maeshima, Y., Cooke, V. G., Kieran, M., Kalluri, R.
<strong>Identification of amino acids essential for the antiangiogenic activity of tumstatin and its use in combination antitumor activity.</strong>
Proc. Nat. Acad. Sci. 105: 15040-15045, 2008.
[PubMed: 18818312]
[Full Text: https://doi.org/10.1073/pnas.0807055105]
</p>
</li>
<li>
<p class="mim-text-font">
Feng, L., Xia, Y., Wilson, C. B.
<strong>Alternative splicing of the NC1 domain of the human alpha-3(IV) collagen gene: differential expression of mRNA transcripts that predict three protein variants with distinct carboxyl regions.</strong>
J. Biol. Chem. 269: 2342-2348, 1994.
[PubMed: 8294492]
</p>
</li>
<li>
<p class="mim-text-font">
Finielz, P., Cartault, F., Chuet, C., Genin, R.
<strong>Alport syndrome in Reunion Island: phenotypic heterogeneity of the recessive-autosomal form. (Letter)</strong>
Nephron 79: 237 only, 1998.
[PubMed: 9647515]
[Full Text: https://doi.org/10.1159/000045039]
</p>
</li>
<li>
<p class="mim-text-font">
Hamano, Y., Grunkemeyer, J. A., Sudhakar, A., Zeisberg, M., Cosgrove, D., Morello, R., Lee, B., Sugimoto, H., Kalluri, R.
<strong>Determinants of vascular permeability in the kidney glomerulus.</strong>
J. Biol. Chem. 277: 31154-31162, 2002.
[PubMed: 12039968]
[Full Text: https://doi.org/10.1074/jbc.M204806200]
</p>
</li>
<li>
<p class="mim-text-font">
Hamano, Y., Kalluri, R.
<strong>Tumstatin, the NC1 domain of alpha-3 chain of type IV collagen, is an endogenous inhibitor of pathological angiogenesis and suppresses tumor growth.</strong>
Biochem. Biophys. Res. Commun. 333: 292-298, 2005.
[PubMed: 15979458]
[Full Text: https://doi.org/10.1016/j.bbrc.2005.05.130]
</p>
</li>
<li>
<p class="mim-text-font">
Han, J., Ohno, N., Pasco, S., Monboisse, J.-C., Borel, J. P., Kefalides, N. A.
<strong>A cell binding domain from the alpha-3 chain of type IV collagen inhibits proliferation of melanoma cells.</strong>
J. Biol. Chem. 272: 20395-20401, 1997.
[PubMed: 9252346]
[Full Text: https://doi.org/10.1074/jbc.272.33.20395]
</p>
</li>
<li>
<p class="mim-text-font">
Heidet, L., Arrondel, C., Forestier, L., Cohen-Solal, L., Mollet, G., Gutierrez, B., Stavrou, C., Gubler, M. C., Antignac, C.
<strong>Structure of the human type IV collagen gene COL4A3 and mutations in autosomal Alport syndrome.</strong>
J. Am. Soc. Nephrol. 12: 97-106, 2001.
[PubMed: 11134255]
[Full Text: https://doi.org/10.1681/ASN.V12197]
</p>
</li>
<li>
<p class="mim-text-font">
Hellmark, T., Burkhardt, H., Wieslander, J.
<strong>Goodpasture disease: characterization of a single conformational epitope as the target of pathogenic autoantibodies.</strong>
J. Biol. Chem. 274: 25862-25868, 1999.
[PubMed: 10464328]
[Full Text: https://doi.org/10.1074/jbc.274.36.25862]
</p>
</li>
<li>
<p class="mim-text-font">
Hudson, B. G., Kalluri, R., Gunwar, S., Weber, M., Ballester, F., Hudson, J. K., Noelken, M. E., Sarras, M., Richardson, W. R., Saus, J., Abrahamson, D. R., Glick, A. D., Haralson, M. A., Helderman, J. H., Stone, W. J., Jacobson, H. R.
<strong>The pathogenesis of Alport syndrome involves type IV collagen molecules containing the alpha-3(IV) chain: evidence from anti-GBM nephritis after renal transplantation.</strong>
Kidney Int. 42: 179-187, 1992.
[PubMed: 1635348]
[Full Text: https://doi.org/10.1038/ki.1992.276]
</p>
</li>
<li>
<p class="mim-text-font">
Hudson, B. G., Tryggvason, K., Sundaramoorthy, M., Neilson, E. G.
<strong>Alport&#x27;s syndrome, Goodpasture&#x27;s syndrome, and type IV collagen.</strong>
New Eng. J. Med. 348: 2543-2556, 2003.
[PubMed: 12815141]
[Full Text: https://doi.org/10.1056/NEJMra022296]
</p>
</li>
<li>
<p class="mim-text-font">
Jefferson, J. A., Lemmink, H. H., Hughes, A. E., Hill, C. M., Smeets, H. J., Doherty, C. C., Maxwell, A. P.
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