Mutations of the Transcriptional Corepressor ZMYM2 Cause Syndromic Urinary Tract Malformations

Dervla M. Connaughton, Rufeng Dai, Danielle J. Owen, Jonathan Marquez, Nina Mann, Adda L. Graham-Paquin, Makiko Nakayama, Etienne Coyaud, Estelle M.N. Laurent, Jonathan R. St-Germain, Lot Snijders Blok, Arianna Vino, Verena Klämbt, Konstantin Deutsch, Chen Han Wilfred Wu, Caroline M. Kolvenbach, Franziska Kause, Isabel Ottlewski, Ronen Schneider, Thomas M. KitzlerAmar J. Majmundar, Florian Buerger, Ana C. Onuchic-Whitford, Mao Youying, Amy Kolb, Daanya Salmanullah, Evan Chen, Amelie T. van der Ven, Jia Rao, Hadas Ityel, Steve Seltzsam, Johanna M. Rieke, Jing Chen, Asaf Vivante, Daw Yang Hwang, Stefan Kohl, Gabriel C. Dworschak, Tobias Hermle, Mariëlle Alders, Tobias Bartolomaeus, Stuart B. Bauer, Michelle A. Baum, Eva H. Brilstra, Thomas D. Challman, Jacob Zyskind, Carrie E. Costin, Katrina M. Dipple, Floor A. Duijkers, Marcia Ferguson, David R. Fitzpatrick, Roger Fick, Ian A. Glass, Peter J. Hulick, Antonie D. Kline, Ilona Krey, Selvin Kumar, Weining Lu, Elysa J. Marco, Ingrid M. Wentzensen, Heather C. Mefford, Konrad Platzer, Inna S. Povolotskaya, Juliann M. Savatt, Natalia V. Shcherbakova, Prabha Senguttuvan, Audrey E. Squire, Deborah R. Stein, Isabelle Thiffault, Victoria Y. Voinova, Michael J.G. Somers, Michael A. Ferguson, Avram Z. Traum, Ghaleb H. Daouk, Ankana Daga, Nancy M. Rodig, Paulien A. Terhal, Ellen van Binsbergen, Loai A. Eid, Velibor Tasic, Hila Milo Rasouly, Tze Y. Lim, Dina F. Ahram, Ali G. Gharavi, Heiko M. Reutter, Heidi L. Rehm, Daniel G. MacArthur, Monkol Lek, Kristen M. Laricchia, Richard P. Lifton, Hong Xu, Shrikant M. Mane, Simone Sanna-Cherchi, Andrew D. Sharrocks, Brian Raught, Simon E. Fisher, Maxime Bouchard, Mustafa K. Khokha, Shirlee Shril, Friedhelm Hildebrandt*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Congenital anomalies of the kidney and urinary tract (CAKUT) constitute one of the most frequent birth defects and represent the most common cause of chronic kidney disease in the first three decades of life. Despite the discovery of dozens of monogenic causes of CAKUT, most pathogenic pathways remain elusive. We performed whole-exome sequencing (WES) in 551 individuals with CAKUT and identified a heterozygous de novo stop-gain variant in ZMYM2 in two different families with CAKUT. Through collaboration, we identified in total 14 different heterozygous loss-of-function mutations in ZMYM2 in 15 unrelated families. Most mutations occurred de novo, indicating possible interference with reproductive function. Human disease features are replicated in X. tropicalis larvae with morpholino knockdowns, in which expression of truncated ZMYM2 proteins, based on individual mutations, failed to rescue renal and craniofacial defects. Moreover, heterozygous Zmym2-deficient mice recapitulated features of CAKUT with high penetrance. The ZMYM2 protein is a component of a transcriptional corepressor complex recently linked to the silencing of developmentally regulated endogenous retrovirus elements. Using protein-protein interaction assays, we show that ZMYM2 interacts with additional epigenetic silencing complexes, as well as confirming that it binds to FOXP1, a transcription factor that has also been linked to CAKUT. In summary, our findings establish that loss-of-function mutations of ZMYM2, and potentially that of other proteins in its interactome, as causes of human CAKUT, offering new routes for studying the pathogenesis of the disorder.

Original languageEnglish
Pages (from-to)727-742
Number of pages16
JournalAmerican Journal of Human Genetics
Issue number4
StatePublished - 1 Oct 2020


FundersFunder number
National Institute of Child Health and Human DevelopmentR01HD102186


    • FIM
    • ZMYM2
    • ZNF198
    • congenital anomalies of the kidney and urinary tract
    • extra-renal features
    • genetic kidney disease
    • genomic analysis
    • syndromic CAKUT
    • transcription regulator
    • whole-exome sequencing


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