Compound heterozygous c-Mpl mutations in a child with congenital amegakaryocytic thrombocytopenia: Functional characterization and a review of the literature

TY - JOUR

T1 - Compound heterozygous c-Mpl mutations in a child with congenital amegakaryocytic thrombocytopenia

T2 - Functional characterization and a review of the literature

AU - Fox, Norma E.

AU - Chen, Rose

AU - Hitchcock, Ian

AU - Keates-Baleeiro, Jennifer

AU - Frangoul, Haydar

AU - Geddis, Amy E.

PY - 2009/4

Y1 - 2009/4

N2 - OBJECTIVE: To genetically and functionally characterize mutations of c-Mpl that lead to thrombocytopenia in a child with congenital amegakaryocytic thrombocytopenia.MATERIALS AND METHODS: We identified two c-Mpl mutations in a child with clinical features of congenital amegakaryocytic thrombocytopenia, one a previously described mutation in the extracellular domain (R102P) and the other a novel mutation leading to truncation of the receptor after the box 1 homology domain (541Stop). Cell line models were created to examine the ability of the mutant receptors to signal in response to thrombopoietin and thrombopoietin-like agonists.RESULTS: Data from cell-line models indicate that c-Mpl R102P does not support significant signaling in response to thrombopoietin due to impaired trafficking of the mutant receptor to the cell surface. Alternative thrombopoietic agents do not circumvent this block to signaling, likely due to the inaccessibility of the receptor. In addition, previous data indicate that c-Mpl 541Stop does not support intracellular signaling due to the loss of critical intracellular domains.CONCLUSIONS: This case demonstrates two different mechanisms by which c-Mpl mutations can impair thrombopoietin signaling, and suggests that mutations in the extracellular domain will not be rescued by c-Mpl agonists if they interfere with normal receptor expression.

AB - OBJECTIVE: To genetically and functionally characterize mutations of c-Mpl that lead to thrombocytopenia in a child with congenital amegakaryocytic thrombocytopenia.MATERIALS AND METHODS: We identified two c-Mpl mutations in a child with clinical features of congenital amegakaryocytic thrombocytopenia, one a previously described mutation in the extracellular domain (R102P) and the other a novel mutation leading to truncation of the receptor after the box 1 homology domain (541Stop). Cell line models were created to examine the ability of the mutant receptors to signal in response to thrombopoietin and thrombopoietin-like agonists.RESULTS: Data from cell-line models indicate that c-Mpl R102P does not support significant signaling in response to thrombopoietin due to impaired trafficking of the mutant receptor to the cell surface. Alternative thrombopoietic agents do not circumvent this block to signaling, likely due to the inaccessibility of the receptor. In addition, previous data indicate that c-Mpl 541Stop does not support intracellular signaling due to the loss of critical intracellular domains.CONCLUSIONS: This case demonstrates two different mechanisms by which c-Mpl mutations can impair thrombopoietin signaling, and suggests that mutations in the extracellular domain will not be rescued by c-Mpl agonists if they interfere with normal receptor expression.

KW - Base Sequence

KW - Cell Line

KW - Child, Preschool

KW - Female

KW - Glycosylation

KW - Heterozygote

KW - Humans

KW - Megakaryocytes

KW - Molecular Sequence Data

KW - Mutation

KW - Protein Binding

KW - Receptors, Thrombopoietin

KW - Signal Transduction

KW - Thrombocytopenia

U2 - 10.1016/j.exphem.2009.01.001

DO - 10.1016/j.exphem.2009.01.001

M3 - Article

C2 - 19302922

SN - 0301-472X

VL - 37

SP - 495

EP - 503

JO - Experimental hematology

JF - Experimental hematology

IS - 4

ER -