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Oxford University Press (OUP), Human Molecular Genetics, 21(22), p. 4383-4397

DOI: 10.1093/hmg/ddt288

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Birt–Hogg–Dubé syndrome is a novel ciliopathy

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Birt-Hogg-Dubé syndrome (BHD) is an autosomal dominant disorder where patients are predisposed to kidney cancer, lung and kidney cysts, and benign skin tumours. BHD is caused by heterozygous mutations affecting folliculin (FLCN), a conserved protein that is considered a tumour suppressor. Previous research has uncovered multiple roles for FLCN in cellular physiology, yet it remains unclear how these translate to BHD lesions. Since BHD manifests hallmark characteristics of ciliopathies, we speculated that FLCN might also have a ciliary role. Our data indicates that FLCN localises to motile and non-motile cilia, centrosomes and the mitotic spindle. Alteration of FLCN levels can cause changes to the onset of ciliogenesis, without abrogating it. In three-dimensional culture, abnormal expression of FLCN disrupts polarised growth of kidney cells and deregulates canonical WNT signalling. Our findings further suggest that BHD-causing FLCN mutants may retain partial functionality. Thus, several BHD symptoms may be due to abnormal levels of FLCN rather than its complete loss and accordingly, we show expression of mutant FLCN in a BHD-associated renal carcinoma. We propose that BHD is a novel ciliopathy, its symptoms at least partly due to abnormal ciliogenesis and canonical Wnt signalling.