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Human Molecular Genetics, 2000, Vol. 9, No. 20 2937-2945
© 2000 Oxford University Press

Mice lacking renal chloride channel, CLC-5, are a model for Dent’s disease, a nephrolithiasis disorder associated with defective receptor-mediated endocytosis

Sha Sha Wang+, Olivier Devuyst1,+, Pierre J. Courtoy1, Xi-Tao Wang, Hua Wang, Yanshu Wang, Rajesh V. Thakker2, Sandra Guggino and William B. Guggino§

Johns Hopkins University School of Medicine, Departments of Physiology and Medicine, 725 North Wolfe Street, Baltimore, MD 21205, USA, 1Division of Nephrology and Cell Unit, Christian de Duve Institute of Cellular Pathology, Université Catholique de Louvain Medical School, B-1200 Brussels, Belgium and 2Molecular Endocrinology Group, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK

Received 19 October 2000; Revised and Accepted 23 October 2000.


    ABSTRACT
 TOP
 ABSTRACT
 INTRODUCTION
 RESULTS
 DISCUSSION
 MATERIALS AND METHODS
 REFERENCES
 
Nephrolithiasis (kidney stones) affects 5–10% of adults and is most commonly associated with hypercalciuria, which may be due to monogenic renal tubular disorders. One such hypercalciuric disorder is Dent’s disease, which is characterized by renal proximal tubular defects that include low molecular weight proteinuria, aminoaciduria and glycosuria, together with rickets in some patients. Dent’s disease is due to inactivating mutations of the renal-specific voltage-gated chloride channel, CLC-5, which is expressed in the proximal tubule, thick ascending limb and collecting duct. The subcellular localization of CLC-5 to the proximal tubular endosomes has suggested a role in endocytosis, and to facilitate in vivo investigations of CLC-5 in Dent’s disease we generated mice lacking CLC-5 by targeted gene disruption. CLC-5-deficient mice developed renal tubular defects which included low molecular weight (<70 kDa) proteinuria, generalized aminoaciduria that was more pronounced for neutral and polar amino acids, and glycosuria. They also developed hypercalciuria and renal calcium deposits and some had deformities of the spine. Furthermore, endocytosis as assessed by horseradish peroxidase uptake in the proximal tubule was severely impaired in CLC-5-deficient mice, thereby demonstrating a role for CLC-5 in endosomal uptake of low molecular weight proteins. Thus, CLC-5-deficient mice provide a model for Dent’s disease and this will help in elucidating the function of this chloride channel in endocytosis and renal calcium homeostasis.


    INTRODUCTION
 TOP
 ABSTRACT
 INTRODUCTION
 RESULTS
 DISCUSSION
 MATERIALS AND METHODS
 REFERENCES
 
Dent’s disease is an X-linked renal tubular disorder characterized by low molecular weight (LMW) proteinuria, aminoaciduria, glycosuria, hypercalciuria, nephrocalcinosis, nephrolithiasis and progressive renal failure, and is complicated by rickets or osteomalacia in some patients (13). The aetiology of Dent’s disease, and three other phenotypic variants referred to as X-linked recessive nephrolithiasis (XRN), X-linked recessive hypophosphataemic rickets (XLRH) and the idiopathic LMW proteinuria of Japanese children, has been established to be due to mutations of the CLCN5 gene. CLCN5 encodes CLC-5, which is a member of the CLC family of voltage-gated chloride channels (1,47). CLC-5 conducts outwardly rectifying chloride currents that are activated by strong depolarizing voltages and inhibited by DIDS (7). Mutations of CLC-5 that are associated with Dent’s disease abolish or markedly reduce these Clcurrents (1,6,7).

The expression of CLC-5 in the human nephron has been shown to be in the proximal tubule (PT), the thick ascending limb (TAL) and the intercalated cells of the collecting duct (CD) (8). Furthermore, CLC-5 has been localized intracellularly to the PT subapical endosomes and with the vacuolar H+-ATPase, thereby suggesting that it may have a role in the counterion transport mechanism that facilitates acidification within endosomes (810). These endosomes form part of the megalin receptor-mediated endocytic pathway, which reabsorbs proteins such as albumin and LMW (<70 kDa) proteins [e.g. {alpha}1-microglobulin, ß2-microglobulin, vitamin D binding protein (DBP) and Clara cell protein (CC16)] that are freely filtered (11). Thus, CLC-5 dysfunction in this pathway may be associated with the observed PT defects such as LMW proteinuria in Dent’s disease. In addition, CLC-5 mRNA expression in the renal cortex is regulated by parathyroid hormone (PTH), thereby also supporting a role for CLC-5 in calcium homeostasis (12), but the mechanisms whereby CLC-5 dysfunction results in hypercalciuria and the other features of Dent’s disease remain to be elucidated. The availability of an animal model for Dent’s disease would greatly facilitate these studies, and we therefore undertook to establish a mouse lacking CLC-5. Mice deficient for CLC-5 were found to show remarkable similarities to Dent’s disease, and demonstrated that CLC-5 is involved in receptor-mediated endocytosis and calcium homeostasis.


    RESULTS
 TOP
 ABSTRACT
 INTRODUCTION
 RESULTS
 DISCUSSION
 MATERIALS AND METHODS
 REFERENCES
 
Clcn5-deficient mice were generated by targeted deletion of exon VI, which encodes the putative third and fourth transmembrane domains of the CLC-5 channel (1,4) and replacement of these sequences by a neomycin resistance gene in embryonic stem (ES) cells (Fig. 1A). A total of 355 independently targeted ES cells were generated and Southern blot analysis using an external 3' probe and polymerase chain reaction (PCR) analysis using internal primers confirmed the homologous recombination events (Fig. 1B). Four ES clones were microinjected into C57BL/6J mouse blastocysts to produce male chimeras which were mated to C57BL/6J female mice. Germline transmission was obtained from one of the injected ES cell lines and offspring were genotyped (Fig. 1B). All F1 female mice were heterozygotes (+/–) and all male mice were wild-type (+/Y), consistent with an X-linked inheritance. Mating between F1 +/– female and +/Y male mice yielded 249 F2 progeny consisting of: 24.1% +/+; 20.1% +/–; 31.7% +/Y; 19.3% –/Y; and 4.8% deaths. Mating between F2 +/– and –/Y mice yielded 237 F3 progeny consisting of: 25.3% +/–; 16.9% –/–; 24.1% +/Y; 20.7% –/Y; and 13.0% deaths. These distributions are consistent with a Mendelian inheritance. Most of the Clcn5-deficient mice were viable at birth with normal growth and survival to reproductive age (6–9 weeks). Northern (Fig. 1C) and western (Fig. 1D) blot analyses of kidneys revealed an absence of CLC-5 in the –/Y and –/– mice.






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Figure 1. Targeted disruption of Clcn5. (A) Restriction maps of a portion of the Clcn5 gene (top), the replacement targeting vector (middle) and predicted structure of the mutant Clcn5 allele (bottom). The exons are depicted by filled boxes, and the locations of restriction enzyme sites together with a genomic fragment (shadedbox) used as a 3' probe for Southern blot analysis are shown. PCR primers were also designed to facilitate detection of wild-type and mutant alleles. Exon VI was disrupted by introduction of the PGK-Neo, which is the neomycin transferase gene linked to the phosphoglycerate (PGK) promoter, in the same transcriptional orientation (arrow) as Clcn5; the tk-DTA selection cassette was inserted in intron IV. (B) Southern blot analysis of genomic DNA extracted from mouse tails, digested with SacI and hybridized with the 3' probe. Wild-type +/Y males show the expected 8.5 kb band, and the hemizygous mutant (–/Y) males and homozygous (–/–) females show the expected 2.8 kb band. (C) Northern blot analysis of kidneys from wild-type (+/Y) mice and mutant (–/Y) mice. The expected ~9.0 kb (top) transcript is detected from +/Y mice and absent in the mutant –/Y and –/– (data not shown) mice. Methylene blue staining (bottom) of the blot reveals equal abundance of ribosomal RNA in all lanes. The sizes of molecular weight markers are indicated. (D) Western blot analysis of renal extracts from +/Y mice and –/Y mice, using antibodies directed against the N-terminus of human CLC-5. The CLC-5 protein (~80 kDa) is clearly detected in extracts from +/Y mice, but not in those from the mutant –/Y mice. Renal extracts from carrier female (+/–) mice also contain CLC-5 protein similar to the wild-type (+/Y) males (data not shown). Control immunoblotting for ß-actin is shown together with the molecular weight size markers.

 
A small number of mutant mice had deformities of the dorsal spine (Fig. 2A) and backward growth of the teeth (data not shown), but radiological evidence for osteopenia or rickets was absent. No gross morphological abnormalities were detected by radiology and magnetic resonance imaging of the kidneys, but histochemistry demonstrated the presence of microscopic calcium deposits at the cortico-medullary junction (Fig. 2B), consistent with the nephrocalcinosis observed in patients with Dent’s disease (3). Renal histology in –/Y mice was normal, but immunostaining with anti-CLC-5 antibodies verified that CLC-5 was absent from the mutant kidney (Fig. 3A). In contrast, the expression and polarity of PT markers including aminopeptidase N (a marker of the apical pole of PT epithelial cells), vacuolar H+-ATPase (a marker of the apical membrane and endosomal compartment) and Na+/K+-ATPase (a marker of the basolateral membrane) were preserved.




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Figure 2. Phenotype analysis of Clcn5 mutant mice. (A) Gross appearance of wild-type (+/Y) and mutant (–/Y) mice at 8 weeks. About 7% of the mutant mice (15 of 223 examined) had hump deformities of the dorsal spine and backward growth of teeth. Feeding a liquid diet (Peptamen; Nestle, Deerfield, IL) to these mice resulted in long-term survival but did not ameliorate the teeth and humpback deformities. (B) Radiology and magnetic resonance imaging revealed normal kidneys but renal sections stained with Von Kossa reaction and nuclear red counterstaining revealed microscopic nephrocalcinosis. In mutant mice (top), a characteristic black precipitate is seen in the basolateral area of tubule profiles and mostly at the cortico-medullary junction. An example of similar nephrocalcinosis from a human kidney is shown (bottom) for comparison (magnification, x700).

 


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Figure 3. Expression of CLC-5 and polarity markers in wild-type (+/Y) and Clcn5 mutant (–/Y) mice. (A and B) The diffuse, intracellular staining for CLC-5 in PT epithelial cells and the intense staining in the apical area of the CD intercalated cells, observed in +/Y mice, is abolished in –/Y mice. Similar staining was observed with both of the anti-CLC-5 antibodies (8). The expression and polarity of other markers: aminopeptidase N (C and D), H+-ATPase (E and F) and Na+/K+-ATPase (G and H) is preserved (original magnification, x335).

 
Plasma and urine analyses (Table 1) revealed that the –/Y mice had significant polyuria, hypercalciuria, phosphaturia, proteinuria and glycosuria that was not associated with hyperglycaemia. The polyuria, which correlated with glycosuria (r = 0.4, P < 0.03), resulted in a daily diuresis that was 50% greater than in control littermates and equivalent to 30% of body weight in some –/Y mice. The daily urinary excretion of calcium was ~2-fold higher in Clcn5-deficient mice, an increase that is similar to that observed in patients with Dent’s disease (3,13,14). Renal function, assessed by plasma creatinine and creatinine clearance standardized for body weight, remained normal. The –/Y mice also had generalized aminoaciduria (Fig. 4A), and this was more pronounced for neutral and polar amino acids, e.g. citrulline (94-fold increase over +/Y mice matched for age), hydroxyproline (24-fold increase), cysteine (22-fold increase), glutamine (11-fold increase) and threonine (10-fold increase). In contrast, plasma levels of amino acids were similar in +/Y and –/Y mice. Thus, Clcn5-deficient mice develop a phenotype that is consistent with Dent’s disease and have features of the renal Fanconi syndrome which is predominantly a renal PT disorder (15).


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Table 1. Plasma and urine values in 5- to 9-week-old mice
 




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Figure 4. Aminoaciduria and LMW proteinuria in Clcn5 mutant mice. (A) Aminoaciduria in mutant –/Y mice. Values of urinary excretion of amino acids were normalized for urinary creatinine, and expressed as ratios of mutant versus wild-type (n = 4 in each group; normal ratio = 1) and presented on a logarithmic scale. Generalized aminoaciduria, most prominent for the neutral and polar amino acids, especially citrulline, hydroxyproline, cysteine, glutamine and threonine, is observed in the –/Y mice. Amino acids are shown by the single letter code; OHP, hydroxyproline; Cit, citrulline; Orn, ornithine; Tau, taurine. Aspartic acid (D) was not detected. The mean ratio (asterisk) for taurine was 0.7. (B) Western blot analysis of urine from +/Y, +/+, +/– and –/Y mice. A band at ~70 kDa (arrow), most likely albumin, is identified in all mice. Only –/Y mice exhibit LMW proteinuria, characterized by excretion of DBP (50 kDa), and CC16 (16 kDa). Homozygous females (–/–) had LMW proteinuria similar to –/Y males (data not shown). (C) Quantification of urinary excretion of CC16 by latex immunoassay (30,31). CC16 excretion is markedly raised in –/Y and –/– mice, and intermediate (but significantly higher than +/+) in the +/– females (P < 0.0001, ANOVA).

 
The increased urinary protein excretion observed in –/Y mice (Table 1) was further characterized (Fig. 4B and C). The results showed that the mutant mice had an LMW proteinuria (Fig. 4B) which included DBP (50 kDa) and CC16 (16 kDa). Using CC16 excretion as a measure of LMW proteinuria (Fig. 4C), a marked increase of ~200-fold in urinary excretion was observed in the –/Y compared with the +/Y males, and an intermediate increase was observed in the +/– females. Plasma CC16 concentrations were similar in the mutant and wild-type mice (data not shown). These findings, which are consistent with those of an X-linked disorder, are similar to those observed for the excretion of LMW proteins in patients with Dent’s disease and its phenotypic variants, e.g. XRN and the idiopathic LMW proteinuria of Japanese children (5,14,16). LMW proteins are normally filtered at the glomerulus and avidly recaptured by megalin receptor-mediated endocytosis in PT cells (11). CLC-5 has been localized to early endosomes that form part of this pathway (8). In order to study this process more closely, mice were injected with horseradish peroxidase, a classic endocytic tracer of 40 kDa that is readily filtered by the glomerulus and taken up by endocytosis in PT cells (11). Cytochemistry and electron microscopy (Fig. 5) showed a severe impairment of protein endocytosis by PT cells in –/Y mice, such that peroxidase bound to the brush border was poorly transferred into early endocytic vesicles, and escaped the PT segment to become detectable in distal segments of the nephron. Thus, an impairment of receptor-mediated endocytosis in PT cells of Clcn5-deficient mice and patients with Dent’s disease would provide a basis for the defective uptake that would result in the increased urinary excretion of LMW proteins.




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Figure 5. Endocytosis in the renal cortex of wild-type (+/Y) and Clcn5 mutant (–/Y) mice. (A) Light microscopical cytochemistry of injected peroxidase in the renal cortex. In +/Y mice, numerous endocytic vesicles containing the characteristic brown product (diamiobenzidine polymerized by peroxidase) are located in the apical pole of essentially all PT epithelial cells. In contrast, in –/Y mice, much fewer and more faintly stained vesicles are observed, peroxidase remaining mostly located in the lumen of PT and some smaller, distal tubule profiles. Peroxidase uptake was absent in the distal tubules and CD in +/Y and –/Y mice. (Toluidine blue counterstain; magnification, x1060) (B) Ultrastructural cytochemistry of injected peroxidase. In +/Y mice, a uniform labelling of the brush border, compatible with peroxidase binding to megalin, and an intense staining of multiple intracellular structures, corresponding to primary endocytic vesicles and apical tubular endosomes, are observed, indicating active early endocytosis. One larger endosome/multivesicular body is also seen in the central bottom part of the field. In contrast, in the –/Y mice, although a similar uniform staining of the brush border is seen, much fewer primary endocytic vesicles are observed at the tip or side of the slender deep invaginations of the apical plasma membrane (small arrows); apical vesicles are not, or only weakly, stained (asterisk). Other alterations of cellular ultrastructure were not detected in the –/Y mice. In contrast to these findings in renal PT cells, a strong signal for peroxidase was obtained in liver sinusoid cells (data not shown) of both +/Y and –/Y mice, revealing that the endocytic defect in Clcn5-deficient mice is specific for renal PT cells. Thus, these results indicate that peroxidase binding to megalin occurs in Clcn5-deficient mice, but that receptor-mediated endocytosis in the PT is considerably impaired. Bars, 0.5 µm. Actual enlargement is x21 100.

 

    DISCUSSION
 TOP
 ABSTRACT
 INTRODUCTION
 RESULTS
 DISCUSSION
 MATERIALS AND METHODS
 REFERENCES
 
Our studies have established a mouse model for Dent’s disease. This mouse, which is deficient for CLC-5, develops LMW proteinuria and aminoaciduria (Fig. 4), glycosuria and hypercalciuria (Table 1) and nephrocalcinosis (Fig. 2). Renal failure, which is generally only observed in adults with Dent’s disease (3), was not observed in the CLC-5-deficient mice, and this may be due partly to the young age (5–9 weeks) of the mice at the time of assessment. Many of the manifestations observed in patients with Dent’s disease and the CLC-5-deficient mice are due to renal PT dysfunction. Our CLC-5-deficient mouse model has enabled us to further study the role of CLC-5 in the PT (Fig. 5). CLC-5 is located with the H+-ATPase in the early endosomes that form part of the receptor-mediated endocytic pathway (8,9,11) in PT cells, and these findings have suggested a role for CLC-5 in endosomal acidification. Endosomes vary in their degree of acidification (17), depending on whether their electrogenic H+-ATPase is antagonized by other transporters (e.g. by the electrogenic sodium pump) or facilitated by a coupled chloride conductance (18). Inhibition of endosomal acidification prevents the progression of early endosomes to late endosomes/lysosomes, presumably by impairing recruitment of regulatory or coat proteins (19). It is still unknown whether luminal acidification is required for the formation of primary endocytic vesicles, or if poor entry in the endocytic apparatus is a secondary defect, for example due to inefficient recycling of a rate-limiting partner of the endocytic machinery. At least two choride channels have been implicated in acidification of PT cell endosomes. A cAMP-activated chloride conductance has been demonstrated in endosomes (20) and functional defects in the cystic fibrosis transmembrane conductance regulator (CFTR) have been associated with impaired endosomal acidification (21). However, patients with cystic fibrosis have no renal phenotype and little or no increase in urinary protein excretion (22), suggesting that CFTR does not play a key role in PT endocytosis. Data from several sources (810) and also presented here indicate that CLC-5 is presumably a more important alternative. Thus, CLC-5 is abundantly expressed in the subapical cytoplasm of PT cells of mice, rats and man and it colocalizes with endocytic tracers and markers (810). Furthermore, CLC-5 accumulates in the enlarged early endosomes of a dominant-positive Rab-5 mutant in transfected cells (9). In addition, we show here that its genetic ablation impairs receptor-mediated endocytosis. All these data indicate that CLC-5 is the key mediator of chloride conductance that is necessary for early endosomal acidification and receptor-mediated reabsorption in PT cells. A failure in this process would not only lead to LMW proteinuria but also a loss of amino acids and glucose, presumably by a failure to recycle their specific transporters to the apical cell membrane (23).

A certain degree of calcium reabsorption in the PT occurs via the megalin receptor-mediated endocytosis (11), and although this may account for part of the observed hypercalciuria, it is important to note that regulated calcium reabsorption occurs in the TAL and distal tubule, and the role of CLC-5 in these segments still remains to be elucidated (12). Interestingly, Clcn5-deficient mice and patients with Dent’s disease (3) maintain a normal plasma calcium despite hypercalciuria, and it has been suggested that this is related to an increased intestinal uptake of calcium (16,24). This increased intestinal calcium uptake may be due in part to the higher observed circulating 1,25-(OH)2-vitamin D3 concentrations in patients with Dent’s disease (16), and the basis of this in the face of an increased loss of DBP (which facilitates the entry of 25-OH-vitamin D3, the substrate for the 1{alpha}-hydroxylase in PT cells) remains to be defined (25). Our establishment of a mouse model which lacks CLC-5 and develops the phenotypic features of Dent’s disease that include LMW proteinuria and hypercalciuria will help in further elucidating the role of this channel in the regulation of solute reabsorption by the renal tubule.


    MATERIALS AND METHODS
 TOP
 ABSTRACT
 INTRODUCTION
 RESULTS
 DISCUSSION
 MATERIALS AND METHODS
 REFERENCES
 
Targeting vector
Genomic clones containing portions of the murine Clcn5 gene were isolated from a Lambda Fix II murine 129/Sv genomic library using a 578 bp mouse cDNA Clcn5 probe generated by RT–PCR utilizing primers 5'-CGA GAC CGA GAT AGG CAC CG-3' and 5'-GCA GCA AGC CAC GTG CAC TA-3'. Two clones were obtained and the 16 kb genomic DNA fragment containing exons IV, V and VI was subcloned into pBluescript SK+ (Stratagene, La Jolla, CA) and restriction mapped (Fig. 1A). To generate the Clcn5-targeting vector, exon VI was disrupted by introduction of a selectable PGK-Neo cassette, in the same transcriptional orientation as Clcn5 into the unique ApaI site at codon 868 and then the disrupted exon VI was inserted in the Eco47III site in intron V. A tk-DTA negative selection cassette was inserted in the Eco47III site in intron IV at the 5' terminus of the long homology of the targeting construct of the Clcn5 genomic clone and the NotI site in the plasmid polylinker (Fig. 1A). The final 16 kb construct was linearized with NotI for transfection.

Cell culture, transfection and selection
R1 ES cells were cultured on mitotically inactivated mouse embryonic fibroblasts (MIMEFs) in standard ES cell medium (22). ES cells were electroporated (250 V, 0.32 kV) with 25 µg of linearized DNA construct and plated on MIMEFs in ES cell medium with murine leukaemia inhibitory factor (1 x 103 U/ml). G418 (250 µg/ml) was added 24 h post-transfection and the cells were maintained under selection for 6 days. Clones were picked at day 7 and grown without selection drugs on MIMEFs.

Southern blot analysis to identify targeted clones
Genomic DNA was isolated from ES cells (26) and digested with SacI, and fragments were separated on a 0.8% agarose gel. The DNA was transferred to Hybond membrane (Amersham, Little Chalfont, UK) and probed with a 600 bp HincII–SacI genomic fragment downstream to the targeting construct (Fig. 1A). Blots were prehybridized and hybridized in Rapid-hyb buffer (Amersham).

Generation of Clcn5-deficient mice
ES cells of G418-resistant, homologous recombinant clones were karyotyped and used for injection into 3.5-day-old blastocysts isolated from pregnant C57BL/6 females. Male chimeric mice were mated with C57BL/6J females (Jackson Laboratory, Bar Harbor, ME) to obtain +/– animals, which were interbred to generate hemizygous and homozygous mutant progeny. Germline transmission was observed in the coat colour of the F1 offspring. Genomic DNA was isolated from tail biopsies and assessed by Southern blot analysis as described above. Genotyping of subsequent generations was performed by PCR using primers (Fig. 1) from intron V (5'-GCT CTT GCT TCT TCA TCG ATA CAC-3') and from exon VI (5'-ACA GCA GCA AGC CAC GTG CAC CA-3'), yielding 350 bp wild-type fragments; and from the PGK-Neo cassette (5'-ATG CGG TGG GCT CTA TGG CTT CTG-3') and from intron VI, outside the homologous region (5'-TGA GTG CAG GCA CAC GTA TGT GCA-3'), yielding 1500 bp mutant fragments. PCR conditions were 35 cycles of 94°C for 1 min, 60°C for 1 min, and 72°C for 2 min.

Northern blot analysis
Total RNA was prepared from whole mouse kidneys by the Trizol protocol (Gibco BRL, Rockville, MD) and separated (20 µg/lane) on a 1% agarose gel containing 2.2 M formaldehyde. After overnight transfer to Nytran filters (Amersham), CLC-5 transcript was detected after 2 h hybridization at 65°C with a 519 bp Clcn5 cDNA fragment (base pairs 1240–1759), which was generated by RT–PCR from kidney RNA.

Immunostaining
Tissue blocks were prepared from adult mouse kidneys (+/Y and –/Y, n = 6 in each group) to perform immunohistochemistry as described (8), using affinity-purified rabbit polyclonal antibodies (Eurogentec, Seraing, Belgium) against the first extracellular loop (8) or the N-terminus of human CLC-5 (O. Devuyst, in preparation); a monoclonal antibody against the vacuolar H+-ATPase (27); a polyclonal antibody against aminopeptidase N (28); and a monoclonal antibody against the {alpha}1 subunit of the Na+/K+-ATPase (Upstate Biotechnology, Lake Placid, NY). Efficiency of transfer was assessed by Ponceau red (Sigma, St Louis, MO) and/or reprobing with a monoclonal antibody against ß-actin (Sigma). Negative controls were obtained with control or pre-immune IgG, or pre-adsorbed anti-CLC-5 antibodies. Overall histology of mouse kidneys was evaluated after haemalun–eosine staining, whereas calcium deposits were visualized after Von Kossa staining. Kidney samples from a patient with nephrocalcinosis were used as a control for the Von Kossa staining procedure.

Peroxidase cytochemistry
Mice (+/Y, n = 7; –/Y, n = 9) were anaesthetized under halothane (Sigma) and injected intravenously with 120 µg/g body wt horseradish peroxidase (Roche Diagnostics, Brussels, Belgium). Five minutes after injection, kidneys were excised, fixed for 6 h at 4°C in 4% paraformaldehyde (Boehringer, Heidelberg, Germany) and rinsed in phosphate-buffered saline (PBS). Peroxidase cytochemistry was performed as described (29). For light microscopy, 1 µm thick sections were counterstained with Toluidine blue. Alternatively, 70 nm thick sections were stained with 2% uranyl acetate and Reynold’s lead citrate and examined in a Philips CM12 electron microscope in the transmission mode under 80 kV.

Urine and plasma analyses
Mice were placed in metabolic cages with ad libidum access to normal food (Lab Diet-PMI Nutrition International, Elkridge, MD) and water. Twenty-four hour urine collections were obtained, and blood was obtained by cardiac puncture. Serum and urine levels of CC16, a 16 kDa marker for early detection of tubular dysfunction (30), were determined in duplicate by immunoassay (31). Plasma and urinary electrolytes and creatinine were measured by standard methods (Anilab, Baltimore, MD). Urine was also analysed by 10% SDS–PAGE and immunoblotting as described (8,25), using affinity-purified rabbit antibodies against (i) human LMWP; (ii) human CC16; and (iii) human DBP (Dako, Glostrup, Denmark).

GenBank accession number
The sequence of rat CLC-5 mRNA was deposited in GenBank under accession no. D50497.1.


    ACKNOWLEDGEMENTS
 
The dedicated help of V. Cebotaru, Y. Cnops, X. Dumont, G. Gou, M. Leruth, L. Tanh and P. van Der Smissen is acknowledged. We are indebted to C. Hermans, R. Beauwens, M. Stoenoiu, M.-F. Vincent and C. van Ypersele de Strihou for helpful discussions and suggestions. We thank E.F. McCarthy Jr for radiological investigations, and S. Lee, R. Reeves, S. Gluck and A. Hubbard for the gift of reagents. The blastocyst injections were performed by the Transgenic Mice Core Facility at Johns Hopkins University. This work was funded in part by NIH DK 43423 (S.E.G.); NIH DK32753 (W.B.G.); Fondation Alphonse & Jean Forton, FRSM, FNRS and Concerted Research Action (O.D.); FNRS, Concerted Research Action and Interuniversity Attraction Pole (P.J.C.); Medical Research Council of the UK (R.V.T.).


    FOOTNOTES
 
+ These authors contributed equally to this work Back

§ To whom correspondence should be addressed. Tel: +1 410 955 7166; Fax: +1 410 955 0461; Email: wguggino@bs.jhmi.edu Back


    REFERENCES
 TOP
 ABSTRACT
 INTRODUCTION
 RESULTS
 DISCUSSION
 MATERIALS AND METHODS
 REFERENCES
 
1 Lloyd, S.E., Pearce, S.H., Fisher, S.E., Steinmeyer, K., Schwappach, B., Scheinman, S.J., Harding, B., Bolino, A., Devoto, M., Goodyer, P. et al. (1996) A common molecular basis for three inherited kidney stone diseases. Nature, 379, 445–449.[Medline]

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3 Wrong, O.M., Norden, A.G. and Feest, T.G. (1994) Dent’s disease: a familial proximal renal tubular syndrome with low molecular weight proteinuria, hypercalciuria, nephrocalcinosis, metabolic bone disease, progressive renal failure and a marked male predominance. Q. J. Med., 87, 473–493.[Abstract/Free Full Text]

4 Fisher, S.E., Black, G.C.M., Lloyd, S.E., Hatchwell, E., Wrong, O., Thakker, R.V. and Craig, I.W. (1994) Isolation and characterisation of a chloride channel gene which is expressed in kidney and is a candidate for Dent’s disease (an X-linked hereditary nephrolithiasis). Hum. Mol. Genet., 3, 2053–2059.

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