hCALCRL mutation causes autosomal recessive nonimmune hydrops fetalis with lymphatic dysplasia

Duncan I Mackie, Fuad Al Mutairi, Reema B Davis, Daniel O Kechele, Natalie R Nielsen, Joshua C Snyder, Marc G Caron, Harvey J Kliman, Jonathan S Berg, John Simms, David R Poyner, Kathleen M Caron

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Abstract

We report the first case of nonimmune hydrops fetalis (NIHF) associated with a recessive, in-frame deletion of V205 in the G protein-coupled receptor, Calcitonin Receptor-Like Receptor (hCALCRL). Homozygosity results in fetal demise from hydrops fetalis, while heterozygosity in females is associated with spontaneous miscarriage and subfertility. Using molecular dynamic modeling and in vitro biochemical assays, we show that the hCLR(V205del) mutant results in misfolding of the first extracellular loop, reducing association with its requisite receptor chaperone, receptor activity modifying protein (RAMP), translocation to the plasma membrane and signaling. Using three independent genetic mouse models we establish that the adrenomedullin-CLR-RAMP2 axis is both necessary and sufficient for driving lymphatic vascular proliferation. Genetic ablation of either lymphatic endothelial Calcrl or nonendothelial Ramp2 leads to severe NIHF with embryonic demise and placental pathologies, similar to that observed in humans. Our results highlight a novel candidate gene for human congenital NIHF and provide structure-function insights of this signaling axis for human physiology.

Original languageEnglish
Pages (from-to)2339-2353
Number of pages15
JournalJournal of Experimental Medicine
Volume215
Issue number9
Early online date16 Aug 2018
DOIs
Publication statusPublished - 3 Sep 2018

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Hydrops Fetalis
Mutation
Receptor Activity-Modifying Proteins
Calcitonin Receptor-Like Protein
Adrenomedullin
Fetal Death
Genetic Models
Spontaneous Abortion
Protein Transport
Molecular Dynamics Simulation
G-Protein-Coupled Receptors
Infertility
Blood Vessels
Cell Membrane
Pathology
Genes

Bibliographical note

Copyright © and Moral Rights are retained by the author(s) and/ or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This item cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders.

Keywords

  • Journal Article

Cite this

Mackie, D. I., Al Mutairi, F., Davis, R. B., Kechele, D. O., Nielsen, N. R., Snyder, J. C., ... Caron, K. M. (2018). hCALCRL mutation causes autosomal recessive nonimmune hydrops fetalis with lymphatic dysplasia. Journal of Experimental Medicine, 215(9), 2339-2353. https://doi.org/10.1084/jem.20180528

hCALCRL mutation causes autosomal recessive nonimmune hydrops fetalis with lymphatic dysplasia. / Mackie, Duncan I; Al Mutairi, Fuad; Davis, Reema B; Kechele, Daniel O; Nielsen, Natalie R; Snyder, Joshua C; Caron, Marc G; Kliman, Harvey J; Berg, Jonathan S; Simms, John; Poyner, David R; Caron, Kathleen M.

In: Journal of Experimental Medicine, Vol. 215, No. 9, 03.09.2018, p. 2339-2353.

Research output: Contribution to journalArticle

Mackie, DI, Al Mutairi, F, Davis, RB, Kechele, DO, Nielsen, NR, Snyder, JC, Caron, MG, Kliman, HJ, Berg, JS, Simms, J, Poyner, DR & Caron, KM 2018, 'hCALCRL mutation causes autosomal recessive nonimmune hydrops fetalis with lymphatic dysplasia' Journal of Experimental Medicine, vol. 215, no. 9, pp. 2339-2353. https://doi.org/10.1084/jem.20180528
Mackie DI, Al Mutairi F, Davis RB, Kechele DO, Nielsen NR, Snyder JC et al. hCALCRL mutation causes autosomal recessive nonimmune hydrops fetalis with lymphatic dysplasia. Journal of Experimental Medicine. 2018 Sep 3;215(9):2339-2353. https://doi.org/10.1084/jem.20180528
Mackie, Duncan I ; Al Mutairi, Fuad ; Davis, Reema B ; Kechele, Daniel O ; Nielsen, Natalie R ; Snyder, Joshua C ; Caron, Marc G ; Kliman, Harvey J ; Berg, Jonathan S ; Simms, John ; Poyner, David R ; Caron, Kathleen M. / hCALCRL mutation causes autosomal recessive nonimmune hydrops fetalis with lymphatic dysplasia. In: Journal of Experimental Medicine. 2018 ; Vol. 215, No. 9. pp. 2339-2353.
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