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1 Department of Internal
Medicine, Veterans Affairs Medical Center and University of
Michigan School of Medicine, Ann Arbor, Michigan 48105;
3 Department of Medicine,
University of Pennsylvania, Philadelphia, Pennsylvania 19104; and
2 Department of Medical Genetics,
Congenital chloride diarrhea (CLD) is a
recessively inherited disorder characterized by massive loss of
chloride in stool. We previously identified mutations in the
downregulated in adenoma (DRA) gene
in patients with CLD and demonstrated that
DRA encodes an intestine-specific
sulfate transporter. To determine whether DRA is an intestinal chloride
transporter and how mutations affect transport,
Xenopus oocytes were injected with
wild-type and mutagenized DRA cRNA and
uptake of Cl
and
SO2
4 was assayed. Both
Cl
and
SO2
4 were transported by wild-type DRA and an outwardly directed pH gradient stimulated
Cl
uptake, consistent with
Cl
/OH
exchange. Among three mutants, C307W transported both anions as
effectively as wild-type, whereas transport activity was lost in
V317del and the double mutant identified in 32 of 32 Finnish CLD
patients. We conclude that DRA is a chloride transporter defective in
CLD and that V317del is a functional mutation and C307W a silent polymorphism.
Xenopus oocytes; intestine; sulfate; genetic disorders
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