RAP1-mediated MEK/ERK pathway defects in Kabuki syndrome

J Clin Invest. 2015 Sep;125(9):3585-99. doi: 10.1172/JCI80102. Epub 2015 Aug 17.

Abstract

The genetic disorder Kabuki syndrome (KS) is characterized by developmental delay and congenital anomalies. Dominant mutations in the chromatin regulators lysine (K)-specific methyltransferase 2D (KMT2D) (also known as MLL2) and lysine (K)-specific demethylase 6A (KDM6A) underlie the majority of cases. Although the functions of these chromatin-modifying proteins have been studied extensively, the physiological systems regulated by them are largely unknown. Using whole-exome sequencing, we identified a mutation in RAP1A that was converted to homozygosity as the result of uniparental isodisomy (UPD) in a patient with KS and a de novo, dominant mutation in RAP1B in a second individual with a KS-like phenotype. We elucidated a genetic and functional interaction between the respective KS-associated genes and their products in zebrafish models and patient cell lines. Specifically, we determined that dysfunction of known KS genes and the genes identified in this study results in aberrant MEK/ERK signaling as well as disruption of F-actin polymerization and cell intercalation. Moreover, these phenotypes could be rescued in zebrafish models by rebalancing MEK/ERK signaling via administration of small molecule inhibitors of MEK. Taken together, our studies suggest that the KS pathophysiology overlaps with the RASopathies and provide a potential direction for treatment design.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abnormalities, Multiple / genetics*
  • Abnormalities, Multiple / metabolism
  • Actins / genetics
  • Actins / metabolism
  • Animals
  • Cattle
  • Child
  • Child, Preschool
  • DNA-Binding Proteins / genetics
  • DNA-Binding Proteins / metabolism
  • Disease Models, Animal
  • Exome*
  • Face / abnormalities*
  • Hematologic Diseases / genetics*
  • Hematologic Diseases / metabolism
  • Histone Demethylases / genetics
  • Histone Demethylases / metabolism
  • Humans
  • MAP Kinase Signaling System / genetics*
  • Male
  • Mice
  • Monomeric GTP-Binding Proteins / genetics*
  • Monomeric GTP-Binding Proteins / metabolism
  • Mutation*
  • Neoplasm Proteins / genetics
  • Neoplasm Proteins / metabolism
  • Nuclear Proteins / genetics
  • Nuclear Proteins / metabolism
  • Rats
  • Shelterin Complex
  • Telomere-Binding Proteins / genetics*
  • Telomere-Binding Proteins / metabolism
  • Vestibular Diseases / genetics*
  • Vestibular Diseases / metabolism
  • Zebrafish
  • Zebrafish Proteins / genetics*
  • Zebrafish Proteins / metabolism

Substances

  • Actins
  • DNA-Binding Proteins
  • KMT2D protein, human
  • Neoplasm Proteins
  • Nuclear Proteins
  • Shelterin Complex
  • TERF2IP protein, human
  • Telomere-Binding Proteins
  • Zebrafish Proteins
  • Histone Demethylases
  • KDM6A protein, human
  • Monomeric GTP-Binding Proteins
  • terf2ip protein, zebrafish

Supplementary concepts

  • Kabuki syndrome