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In vivo investigation of PKD1 upstream open reading frames as a therapeutic target in autosomal dominant polycystic kidney disease

Award Number: R01DK138015
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 12/15/2023
PERIOD OF PERFORMANCE END DATE: 11/30/2028

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In vivo investigation of PKD1 upstream open reading frames as a therapeutic target in autosomal dominant polycystic kidney disease - Project Summary: Autosomal dominant polycystic kidney disease (ADPKD) affects over 12 million people worldwide resulting in fluid-filled cysts in the kidney and liver and 5-10% of all kidney failure. The one FDA-approved therapy provides only a modest delay in ongoing growth of cysts in the kidney and liver that can progress to kidney failure and devastating abdominal pain. Approximately one third of ADPKD patients have non-truncating mutations in the primary disease gene PKD1/Polycystin-1(PC1), and a significant subset of these likely encode a version of PC1 that is pathogenic because of a quantitative rather than qualitative deficit at its site of action on the cell surface due to inefficient maturation of PC1. PC1 “dosage”—the functional amount of PC1 protein at its site of action—correlates with disease severity. Our laboratory has contributed to the identification of additional disease genes to explain cases of symptomatic polycystic liver disease (PLD) resulting from in inefficient maturation of PC1 in the endoplasmic reticulum (ER). Proof of concept studies using genomic alterations in mice suggest cysts could be avoided in these patients if more PC1 was expressed. Recent studies inhibiting microRNA 17 from repressing Pkd1 mRNA have provided benefit to a Pkd1 missense mouse model. We hypothesize that increasing PC1 protein expression in patients with mutations in these ER genes and in a substantial subset of patients with PKD1 non-truncating mutations in ADPKD will dramatically reduce cyst burden. We have identified that the 5’ untranslated region (5’UTR) of human PKD1 contains alternative sites of translation known as upstream open reading frames (uORFs) whose translation significantly blunts the translation of PC1 from PKD1 mRNA in vitro. Our in vitro data shows that interventions to block PKD1 uORF translation results in 3-4 times more PC1 protein, and that blocking uORF translation is achievable using antisense oligonucleotides (ASO). ASOs are approved therapies for patients with other diseases. For this proposal we will determine the role of PKD1 uORFs on cyst formation in vivo. We have made a novel humanized PKD1 5’UTR mouse model with or without single nucleotide edits to remove uORF initiation codons and we will use this to test effect of uORFs in two models of ADPKD (Dnajb11 model and a Pkd1 p.R2216W model) as well as quantify effect in primary cells in different biological contexts to consider a role for in vivo regulation. Independently, we will test our hypothesis that ASOs targeting PKD1 uORFs are effective treatment in mouse models of ADPKD and would be—due to ability to effect translation efficiency—a unique, specific, and additive approach to any previously proposed therapies.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $429,937 )
2026	2026	YALE UNIV	150 MUNSON ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	3	12/12/2025	NON-COMPETING CONTINUATION	$429,937
														Subtotal = $429,937

Issue Date FY: 2025 ( Subtotal = $429,937 )
2025	2025	YALE UNIV	150 MUNSON ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	2	5/9/2025	NON-COMPETING CONTINUATION	$42,994
2025	2025	YALE UNIV	150 MUNSON ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	11/19/2024	NON-COMPETING CONTINUATION	$386,943
														Subtotal = $429,937

Issue Date FY: 2024 ( Subtotal = $423,535 )
2024	2024	YALE UNIVERSITY	105 WALL ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	12/8/2023	NEW	$423,535
														Subtotal = $423,535

Grand Total All Awards = $1,283,409

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In vivo investigation of PKD1 upstream open reading frames as a therapeutic target in autosomal dominant polycystic kidney disease

Award Number: R01DK138015

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 12/15/2023

PERIOD OF PERFORMANCE END DATE: 11/30/2028

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