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Loss-of-function and gain-of-function mutations of calcium-sensing receptor: functional analysis and the effect of allosteric modulators NPS R-568 and NPS 2143.
[familial hypocalciuric hypercalcemia]
Activating
mutations
in
the
calcium-sensing
receptor
(
CASR
)
gene
cause
autosomal
dominant
hypoparathyroidism
,
and
heterozygous
inactivating
CASR
mutations
cause
familial
hypocalciuric
hypercalcemia
.
Recently
,
there
has
been
a
focus
on
the
use
of
allosteric
modulators
to
restore
the
functional
activity
of
mutant
CASRs
.
In
this
study
,
the
effect
of
allosteric
modulators
NPS
R-
568
and
NPS
2143
on
CASR
mutants
was
studied
in
vitro
.
DNA
sequence
analysis
of
the
CASR
gene
was
undertaken
in
autosomal
dominant
hypoparathyroidism
and
familial
hypocalciuric
hypercalcemia
Japanese
patients
,
and
the
functional
consequences
for
the
Gi
-
MAPK
pathway
and
cell
surface
expression
of
CASR
were
determined
.
Furthermore
,
we
studied
the
effect
of
NPS
R-
568
and
NPS
2143
on
the
signal
transduction
activity
and
cell
surface
expression
of
each
mutant
CASR
.
We
identified
3
activating
mutations
(
S
122
C
,
P
569
H
,
and
I
839
T
)
and
2
inactivating
mutations
(
A
110
T
and
R
172
G
)
in
patients
.
The
activating
and
inactivating
mutations
caused
leftward
and
rightward
shifts
,
respectively
,
in
the
dose-response
curves
of
the
signaling
pathway
.
NPS
R-
568
rescued
the
signal
transduction
capacity
of
2
inactivating
mutants
without
increasing
cell
surface
expression
levels
.
NPS
2143
suppressed
the
enhanced
activity
of
the
activating
mutants
without
altering
cell
surface
expression
levels
,
although
A
843
E
,
which
is
a
constitutively
active
mutant
,
was
suppressed
to
a
lesser
degree
.
We
have
identified
4
novel
mutations
of
CASR
.
Moreover
,
our
results
indicate
that
allosteric
modulators
can
restore
the
activity
of
the
loss
-
and
gain-of-function
mutant
CASRs
,
identified
in
this
study
.
Diseases
Validation
Diseases presenting
"and heterozygous inactivating casr mutations cause familial hypocalciuric hypercalcemia"
symptom
familial hypocalciuric hypercalcemia
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