Identification of compound heterozygous variants in LRP4 D\demonstrates that a pathogenic variant outside the third beta-propeller domain can cause sclerosteosis

Huybrechts, Y.; Boudin, E.; Hendrickx, G.; Steenackers, E.; Hamdy, N.; Mortier, G.; Diaz-Guerra, G.M.; Bracamonte, M.S.; Appelman-Dijkstra, N.M.; Hul, W. van

doi:doi:10.3390/genes13010080

Persistent URL of this record https://hdl.handle.net/1887/3276900

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$Identification of compound heterozygous variants in LRP4 D\demonstrates that a pathogenic variant outside the third beta-propeller domain can cause sclerosteosis$

Huybrechts, Y.; Boudin, E.; Hendrickx, G.; Steenackers, E.; Hamdy, N.; Mortier, G.; ... ; Hul, W. van (2022)

Identification of compound heterozygous variants in LRP4 D\demonstrates that a pathogenic variant outside the third beta-propeller domain can cause sclerosteosis

Article / Letter to editor

Sclerosteosis is a high bone mass disorder, caused by pathogenic variants in the genes encoding sclerostin or LRP4. Both proteins form a complex that strongly inhibits canonical WNT signaling activity, a pathway of major importance in bone formation. So far, all reported disease-causing variants are located in the third beta-propeller domain of LRP4, which is essential for the interaction with sclerostin. Here, we report the identification of two compound heterozygous variants, a known p.Arg1170Gln and a novel p.Arg632His variant, in a patient with a sclerosteosis phenotype. Interestingly, the novel variant is located in the first beta-propeller domain, which is known to be indispensable for the interaction with agrin. However, using luciferase reporter assays, we demonstrated that both the p.Arg1170Gln and the p.Arg632His variant in LRP4 reduced the inhibitory capacity of sclerostin on canonical WNT signaling activity. In conclusion, this study is the first to demonstrate that a...Show moreSclerosteosis is a high bone mass disorder, caused by pathogenic variants in the genes encoding sclerostin or LRP4. Both proteins form a complex that strongly inhibits canonical WNT signaling activity, a pathway of major importance in bone formation. So far, all reported disease-causing variants are located in the third beta-propeller domain of LRP4, which is essential for the interaction with sclerostin. Here, we report the identification of two compound heterozygous variants, a known p.Arg1170Gln and a novel p.Arg632His variant, in a patient with a sclerosteosis phenotype. Interestingly, the novel variant is located in the first beta-propeller domain, which is known to be indispensable for the interaction with agrin. However, using luciferase reporter assays, we demonstrated that both the p.Arg1170Gln and the p.Arg632His variant in LRP4 reduced the inhibitory capacity of sclerostin on canonical WNT signaling activity. In conclusion, this study is the first to demonstrate that a pathogenic variant in the first beta-propeller domain of LRP4 can contribute to the development of sclerosteosis, which broadens the mutational spectrum of the disorder.Show less

sclerosteosis

canonical WNT signaling