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Impaired cotranslational processing of the calcium-sensing receptor due to signal peptide missense mutations in familial hypocalciuric hypercalcemia.
[familial hypocalciuric hypercalcemia]
The
CASR
,
a
cell
surface
glycoprotein
expressed
in
parathyroid
gland
and
kidney
,
is
critical
for
maintaining
extracellular
calcium
homeostasis
.
The
inherited
disorders
,
familial
hypocalciuric
hypercalcemia
(
FHH
)
and
neonatal
severe
hyperparathyroidism
(
NSHPT
)
,
are
caused
by
inactivating
mutations
in
the
CASR
gene
.
The
CASR
has
an
N-
terminal
,
19
amino
acid
signal
peptide
that
is
predicted
to
direct
the
nascent
polypeptide
chain
,
as
it
emerges
from
the
ribosome
,
into
the
endoplasmic
reticulum
(
ER
)
.
Here
,
we
report
the
functional
characterization
of
three
CASR
mutations
identified
in
hypercalcemic
/
hyperparathyroid
patients
.
The
mutations
,
L
11
S
,
L
13
P
and
T
14
A
,
lie
within
the
signal
peptide
hydrophobic
core
.
When
transiently
transfected
into
kidney
cells
,
L
11
S
and
L
13
P
mutants
demonstrated
reduced
intracellular
and
plasma
membrane
expression
and
signaling
to
the
mitogen-activated
protein
kinase
pathway
in
response
to
extracellular
calcium
relative
to
wild-
type
CASR
and
the
T
14
A
mutant
.
All
mutant
CASR
RNAs
translated
into
protein
normally
.
In
cotranslational
processing
assays
,
which
test
the
functionality
of
the
signal
peptide
in
the
early
secretory
pathway
,
the
wild-
type
CASR
and
mutant
T
14
A
nascent
polypeptides
were
targeted
to
microsomal
vesicles
,
representing
the
ER
,
translocated
into
the
vesicular
lumen
and
underwent
core
N-
glycosylation
.
In
contrast
,
the
L
11
S
and
L
13
P
mutants
failed
to
be
inserted
in
the
microsomes
and
undergo
glycosylation
.
This
is
the
first
study
examining
the
function
of
the
CASR
signal
sequence
and
reveals
that
both
L
11
S
and
L
13
P
mutants
are
markedly
impaired
with
respect
to
cotranslational
processing
,
accounting
for
the
observed
parathyroid
dysfunction
.
Diseases
Validation
Diseases presenting
"calcium homeostasis"
symptom
dentin dysplasia
familial hypocalciuric hypercalcemia
inclusion body myositis
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