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

doi:10.1084/jem.20180528

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

University of North Carolina
King Abdullah International Medical Research Center
Duke University Medical Center
Yale University
Aston University

Research output: Contribution to journal › Article › peer-review

34 Citations (Scopus)

115 Downloads (Pure)

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 language	English
Pages (from-to)	2339-2353
Number of pages	15
Journal	Journal of Experimental Medicine
Volume	215
Issue number	9
Early online date	16 Aug 2018
DOIs	https://doi.org/10.1084/jem.20180528
Publication status	Published - 3 Sept 2018

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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.

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Journal Article

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title = "hCALCRL mutation causes autosomal recessive nonimmune hydrops fetalis with lymphatic dysplasia",

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.",

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AU - Mackie, Duncan I

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AU - Nielsen, Natalie R

AU - Snyder, Joshua C

AU - Caron, Marc G

AU - Kliman, Harvey J

AU - Berg, Jonathan S

AU - Simms, John

AU - Poyner, David R

AU - Caron, Kathleen M

N1 - 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.

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N2 - 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.

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hCALCRL mutation causes autosomal recessive nonimmune hydrops fetalis with lymphatic dysplasia

Abstract

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