Loss-of-Function Mutations in LRRC6, a Gene Essential for Proper Axonemal Assembly of Inner and Outer Dynein Arms, Cause Primary Ciliary Dyskinesia Esther.

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Loss-of-Function Mutations in LRRC6, a Gene Essential for Proper Axonemal Assembly of Inner and Outer Dynein Arms, Cause Primary Ciliary Dyskinesia Esther Kott, Philippe Duquesnoy, Bruno Copin, Marie Legendre, Florence Dastot-Le Moal, Guy Montantin, Ludovic Jeanson, Aline Tamalet, Jean-François Papon, Jean-Pierre Siffroi, Nathalie Rives, Valérie Mitchell, Jacques de Blic, André Coste, Annick Clement, Denise Escalier, Aminata Touré, Estelle Escudier, Serge Amselem The American Journal of Human Genetics Volume 91, Issue 5, Pages 958-964 (November 2012) DOI: 10.1016/j.ajhg.2012.10.003 Copyright © 2012 The American Society of Human Genetics Terms and Conditions

Figure 1 LRRC6 Mutations and Their Impact at the Protein Level in Individuals with PCD (A) Exonic organization of the human LRRC6 cDNA, in which are shown the mutations (top) and domain-organization model of the corresponding protein (middle). The mutations’ impact at the protein level is shown for the five families described in this study (bottom). The twelve exons are indicated by empty or hashed boxes, depicting translated or untranslated sequences, respectively. According to the LRRC6 domain-organization model, derived from predictions by NCBI and UniProt/Swiss-Prot, the protein contains four LRR domains (amino acids 23–42, 46–65, 68–87, and 90–112), one modified LRR domain (amino acids 115–130) and a subsequent LRRcap (amino acids 131–146), a coiled-coil domain (amino acids 178–204), a polylysine motif (amino acids 272–286), and an α-crystallin-p23-like domain (amino acids 332–381). (B) A partial protein alignment of LRRC6 shows the evolutionary conservation of the third LRR motif and the LRRcap domain, which contains the two amino acid substitutions identified in this study. The American Journal of Human Genetics 2012 91, 958-964DOI: (10.1016/j.ajhg.2012.10.003) Copyright © 2012 The American Society of Human Genetics Terms and Conditions

Figure 2 Absence of Both DAs in Respiratory Cilia and/or Spermatozoa Flagella of Individuals with LRRC6 Mutations The electron micrographs of cross-sections of cilia and/or spermatozoa flagella from a control and individuals with identified LRRC6 mutations are shown. The blue flashes and triangles show the presence of ODAs and IDAs, respectively, and red flashes and triangles show their absence in affected individuals’ axonemes. Note the partial absence of DAs in the airway cilia of DCP193 (blue flash), whereas at the sperm level, the absence of DAs seems complete. Black scale bars represent 0.1 μm. The American Journal of Human Genetics 2012 91, 958-964DOI: (10.1016/j.ajhg.2012.10.003) Copyright © 2012 The American Society of Human Genetics Terms and Conditions

Figure 3 LRRC6 Localizes to the Cytoplasm and Cilia and Is Absent in DCP18 (A–F) In control cells, LRRC6 (green) localizes to the cytoplasm and within cilia, whereas it is absent from the individual’s cells. Axoneme-specific antibodies directed against α-β-tubulin were used as a control. Nuclei were stained with DAPI (blue). Similar experiments were performed with antibodies directed against the ODA component DNAI2 (G–L) and the IDA component DNALI1 (M–R). In control cells, DNAI2 and DNALI1 localize within the cilia, whereas labeling is absent from the individual’s cells. Airway epithelial cells were examined after labeling with a mouse LRRC6 antibody (Abnova) and a secondary goat anti-mouse Alexa Fluor-488 (green) antibody (Invitrogen). For controls, we used antibodies directed against various axonemal components: α-β-tubulin (Cell Signaling Technology), DNAI2 (Abnova), and DNALI1 (Abnova) for the visualization of microtubules, ODAs, and IDAs, respectively; primary antibodies were revealed with a secondary Alexa Fluor-594 (red) or Alexa Fluor-488 (green) antibody (Invitrogen). White scale bars represent 5 μm. The American Journal of Human Genetics 2012 91, 958-964DOI: (10.1016/j.ajhg.2012.10.003) Copyright © 2012 The American Society of Human Genetics Terms and Conditions