Proteinuric renal disease

Gene: FAT1

Green List (high evidence)

FAT1 (FAT atypical cadherin 1)
EnsemblGeneIds (GRCh38): ENSG00000083857
EnsemblGeneIds (GRCh37): ENSG00000083857
OMIM: 600976, Gene2Phenotype
FAT1 is in 5 panels

1 review

Eleanor Williams (Genomics England Curator)

Green List (high evidence)

Comment on list classification: Changing rating from red to green. Despite concerns about possible variants in other genes in some pedigrees, and lower renal phenotype penetrance in others, it was considered that there are sufficient pedigrees and strong enough functional data to rate this gene green.
Created: 3 Apr 2019, 8:19 a.m. | Last Modified: 2 Dec 2019, 10:30 p.m.
Panel Version: 1.226
After consultation with the GMS Renal Specialist Test group and comment from Moin Saleem, it was decided that there were enough patients from different pedigrees with nephrotic range proteinuria with rare FAT1 variants compatible with AR inheritance and that the biology is strong, as the KO mice get very severe nephrosis, and expression at the podocyte slit diaphragm, so that this gene should be rated green.
Created: 3 Apr 2019, 8:17 a.m.
Not associated with any phenotype in OMIM, although one variant from Gee et al 2016 is listed as a VUS.

PMID: 26905694 - Gee et al 2016. 4 families reported with a variant in FAT1. 27 known genes previously linked to SRNS were screened in these individuals, but no explanatory mutations were detected. All affected individuals exhibited a glomerulotubular nephropathy of SRNS, tubular ectasia and microscopic haematuria among other phenotypes and were aged between 2 months and 15 years at End-Stage Renal Disease.

Family 1 - A4623, a Turkish boy from consanguineous parents with intellectual disability, pulmonary artery stenosis and bilateral blepharoptosis in early childhood, admitted to the hospital at age 15 years because of proteinuria and haematuria. Kidney biopsy showed a glomerulotubular nephropathy. Following WES and filtering of variants from normal reference sequence, 3 rare variants in FAT1, PIDD and DZIP1 remained. The variant in the FAT1 gene, is a homozygous protein truncating mutation (c.3093_3096del, p.P1032Cfs*11). This variant is classified as a VUS in OMIM.

Family 2 One child of Arab origin (A3027) presented with proteinuria and haematuria. A3027 was diagnosed with Ewing sarcoma, and lung and spinal metastasis at the age of 15 years. Following variant filtering by HM and WES, two rare missense variants in FAT1 and EHD1 remained. The variant (c.857A>F;p.N286S) in FAT1 is reported as a SNP in the dbSNP database, however, its minor allele frequency is 0.0002 and it never occurred in the homozygous state. The FAT1 variant alters an amino-acid residue conserved throughout evolution down to Drosophila melanogaster.

Families 3 and 4 - When performing highly parallel sequencing of all FAT1 exons in 1,500 additional individuals with features of NS and 800 individuals with features of tubulointerstitial nephroapathy, 2 additional families were identified. Family 3: In a female African-American girl (A789) from non-consanguineous parents, another compound-heterozygous mutation was detected (c.3008C>T, p.A1003V and c.9259C>G, p. R3087G). Further information was not available and segregation analysis was not performed. Family 4: A3507, an African girl from non-consanguineous parents, showed haematuria and proteinuria at the age of 2 years. One of the compound-heterozygous mutation (c.4517G>A, p.R1506H) was detected in her mother, but not the other. DNA from the father was not available.

Functional studies indicate an absence of FAT1 in patient fibroblasts (from family 1) and decreased migration rates compared to controls. Knockdown of FAT1 in differentiated podocytes showed similarly decreased migration rates, which were associated with decreased active RAC1 and CDC42, implicating a defect in RHO GTPase signaling in the pathogenesis.

PMID: 30862798 - Lahrouchi et al 2019 - identified homozygous frameshift variants in FAT1 by whole exome sequencing and Sanger sequencing confirmation in 10 affected individuals from five unrelated consanguineous families of Middle-Eastern, Turkish, Pakistani, and North-African descent. Patients presented with a previously undescribed syndrome including ocular abnormalities, nephropathy, syndactyly of the toes, and facial dysmorphism. 4 different variants seen. They observed a high penetrance of ocular and limb defects in affected individuals, but renal dysfunction was less prominent with 3/10 with asymptomatic proteinuria and 2/10 with severe nephrotic syndrome. A renal phenotype was seen in 3 out of the 5 families. In addition, in some of the affected individuals, proteinuria was only present intermittently.
Created: 30 Mar 2019, 5:15 p.m.
This gene was part of an initial gene list collated by Elizabeth Watson, North Bristol NHS Trust, February 2019 on behalf of the GMS Renal Specialist Test Group. Gene Symbol submitted: FAT1; Suggested initial gene rating: green; Evidence for inclusion: PMID: 26905694; Other comments: One paper (PMID 26905694) report a distinct renal disease entity in four families with a combination of SRNS, tubular ectasia, haematuria and facultative neurological involvement and rare AR FAT1 variants
Created: 4 Feb 2019, 10:41 a.m.

Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal

Phenotypes
Glomerulotubular nephropathy

Publications

Variants in this GENE are reported as part of current diagnostic practice

Details

Mode of Inheritance
BIALLELIC, autosomal or pseudoautosomal
Sources
  • Expert Review Green
  • NHS GMS
Phenotypes
  • Glomerulotubular nephropathy
Tags
gene-checked
OMIM
600976
Clinvar variants
Variants in FAT1
Penetrance
None
Publications
Panels with this gene

History Filter Activity

3 May 2022, Gel status: 3

Added Tag

Arina Puzriakova (Genomics England Curator)

Tag gene-checked tag was added to gene: FAT1.

3 Apr 2019, Gel status: 3

Entity classified by Genomics England curator

Eleanor Williams (Genomics England Curator)

Gene: fat1 has been classified as Green List (High Evidence).

30 Mar 2019, Gel status: 1

Set Phenotypes

Eleanor Williams (Genomics England Curator)

Phenotypes for gene: FAT1 were changed from to Glomerulotubular nephropathy

30 Mar 2019, Gel status: 1

Set publications

Eleanor Williams (Genomics England Curator)

Publications for gene: FAT1 were set to

30 Mar 2019, Gel status: 1

Set mode of inheritance

Eleanor Williams (Genomics England Curator)

Mode of inheritance for gene: FAT1 was changed from to BIALLELIC, autosomal or pseudoautosomal

4 Feb 2019, Gel status: 1

Created, Added New Source, Set mode of inheritance

Eleanor Williams (Genomics England Curator)

gene: FAT1 was added gene: FAT1 was added to Proteinuric renal disease. Sources: NHS GMS Mode of inheritance for gene: FAT1 was set to