Autosomal-recessive mutations in MESD cause osteogenesis imperfecta

Item Type:	Article
Title:	Autosomal-recessive mutations in MESD cause osteogenesis imperfecta
Creators Name:	Moosa, S. and Yamamoto, G.L. and Garbes, L. and Keupp, K. and Beleza-Meireles, A. and Moreno, C.A. and Valadares, E.R. and de Sousa, S.B. and Maia, S. and Saraiva, J. and Honjo, R.S. and Kim, C.A. and Cabral de Menezes, H. and Lausch, E. and Lorini, P.V. and Lamounier, A. and Carniero, T.C.B. and Giunta, C. and Rohrbach, M. and Janner, M. and Semler, O. and Beleggia, F. and Li, Y. and Yigit, G. and Reintjes, N. and Altmüller, J. and Nürnberg, P. and Cavalcanti, D.P. and Zabel, B. and Warman, M.L. and Bertola, D.R. and Wollnik, B. and Netzer, C.
Abstract:	Osteogenesis imperfecta (OI) comprises a genetically heterogeneous group of skeletal fragility diseases. Here, we report on five independent families with a progressively deforming type of OI, in whom we identified four homozygous truncation or frameshift mutations in MESD. Affected individuals had recurrent fractures and at least one had oligodontia. MESD encodes an endoplasmic reticulum (ER) chaperone protein for the canonical Wingless-related integration site (WNT) signaling receptors LRP5 and LRP6. Because complete absence of MESD causes embryonic lethality in mice, we hypothesized that the OI-associated mutations are hypomorphic alleles since these mutations occur downstream of the chaperone activity domain but upstream of ER-retention domain. This would be consistent with the clinical phenotypes of skeletal fragility and oligodontia in persons deficient for LRP5 and LRP6, respectively. When we expressed wild-type (WT) and mutant MESD in HEK293T cells, we detected WT MESD in cell lysate but not in conditioned medium, whereas the converse was true for mutant MESD. We observed that both WT and mutant MESD retained the ability to chaperone LRP5. Thus, OI-associated MESD mutations produce hypomorphic alleles whose failure to remain within the ER significantly reduces but does not completely eliminate LRP5 and LRP6 trafficking. Since these individuals have no eye abnormalities (which occur in individuals completely lacking LRP5) and have neither limb nor brain patterning defects (both of which occur in mice completely lacking LRP6), we infer that bone mass accrual and dental patterning are more sensitive to reduced canonical WNT signaling than are other developmental processes. Biologic agents that can increase LRP5 and LRP6-mediated WNT signaling could benefit individuals with MESD-associated OI.
Keywords:	MESD, Osteogenesis Imperfecta, WNT Signaling, Animals, Mice
Source:	American Journal of Human Genetics
ISSN:	0002-9297
Publisher:	Cell Press
Volume:	105
Number:	4
Page Range:	836-843
Date:	3 October 2019
Official Publication:	https://doi.org/10.1016/j.ajhg.2019.08.008
PubMed:	View item in PubMed

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