The GATA family zinc finger transcription factors GATA4 and GATA6 are known to play important roles in the development of the pancreas. In mice both Gata4 and Gata6 are required for pancreatic development. In humans GATA6 haploinsufficiency can cause pancreatic agenesis and heart defects. Congenital heart defects are also common in patients with GATA4 mutations and deletions but the role of GATA4 in the developing human pancreas is unproven.We report 5 patients with deletions (n=4) or mutations of the GATA4 gene who have diabetes and a variable exocrine phenotype. In four cases diabetes presented in the neonatal period (age at diagnosis 1-7 days). A de novo GATA4 missense mutation (p.N273K) was identified in a patient with complete absence of the pancreas confirmed at post mortem. This mutation affects a highly conserved residue located in the second zinc finger domain of the GATA4 protein. In vitro studies showed reduced DNA binding and transactivational activity of the mutant protein.We show that GATA4 mutations/deletions are a cause of neonatal or childhood-onset diabetes with or without exocrine insufficiency. These results confirm a role for GATA4 in normal development of the human pancreas.
Bibliographical noteFunding. The research leading to these results received funding from the European Community’s 7th Framework Programme (FP7/2007-2013) under grant agreement number FP7-PEOPLE-ITN-2008 (Marie Curie Initial Training Network, Biology of Liver and Pancreatic Development and Disease) and grant agreement number 223211 (Collaborative European Effort to Develop Diabetes Diagnostics), Ministerio de Economía y Competitividad (SAF2011-27086), Diabetes UK (ref. 11/0004193), and the Wellcome Trust. S.E. and A.T.H. are employed as core members of staff within the National Institute for Health Research–funded Exeter Clinical Research Facility. S.E., J.F., and A.T.H. are Wellcome Trust Senior Investigators and A.T.H. is a National Institute for Health Research Senior Investigator. M.B. and W.M. are supported by National Science Center, Poland (NCN) grant 2011/01/M/NZ5/02815 and by Innovative Economy Operational Programme–Activity 1.2 (the TEAM Programme coordinated by the Foundation for Polish Science).
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- School of Medicine, Medical Sciences & Nutrition, Molecular and Cellular Function
- School of Medicine, Medical Sciences & Nutrition, Aberdeen Cancer Centre
- School of Medicine, Medical Sciences & Nutrition, Applied Medicine - Personal Chair (Clinical)
- School of Medicine, Medical Sciences & Nutrition, Institute of Medical Sciences
Person: Clinical Academic