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Calcium-sensing receptor (CaSR) mutations and disorders of calcium, electrolyte and water metabolism.
[familial hypocalciuric hypercalcemia]
The
extracellular
calcium-sensing
receptor
(
CaSR
)
is
a
family
C
G-
protein-coupled
receptor
(
GPCR
)
that
is
expressed
at
multiple
sites
,
including
the
parathyroids
and
kidneys
.
The
human
CASR
gene
,
located
on
chromosome
3
q
21
.
1
,
encodes
a
1078
amino
acid
protein
.
More
than
230
different
disease-causing
mutations
of
the
CaSR
have
been
reported
.
Loss
-of-function
mutations
lead
to
three
hypercalcemic
disorders
,
which
are
familial
hypocalciuric
hypercalcemia
(
FHH
)
,
neonatal
severe
hyperparathyroidism
and
primary
hyperparathyroidism
.
Gain-of-function
mutations
,
on
the
other
hand
,
result
in
the
hypocalcemic
disorders
of
autosomal
dominant
hypocalcemia
and
Bartter
syndrome
type
V
.
Moreover
,
autoantibodies
directed
against
the
extracellular
domain
of
the
CaSR
have
been
found
to
be
associated
with
FHH
in
some
patients
,
and
also
in
some
patients
with
hypoparathyroidism
that
may
be
part
of
autoimmune
polyglandular
syndrome
type
1
.
Studies
of
disease-causing
CASR
mutations
have
provided
insights
into
structure-function
relationships
and
highlighted
intra-molecular
domains
that
are
critical
for
ligand
binding
,
intracellular
signaling
,
and
receptor
trafficking
.
Diseases
Validation
Diseases presenting
"neonatal severe hyperparathyroidism"
symptom
familial hypocalciuric hypercalcemia
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