Specific heterozygous variants in MGP lead to endoplasmic reticulum stress and cause spondyloepiphyseal dysplasia

Ophélie Gourgas, Gabrielle Lemire, Alison J. Eaton, Sultanah Alshahrani, Angela L. Duker, Jingjing Li, Ricki S. Carroll, Stuart Mackenzie, Sarah M. Nikkel, Michael B. Bober, Kym M. Boycott and Monzur Murshed ()
Additional contact information
Ophélie Gourgas: McGill University
Gabrielle Lemire: Children’s Hospital of Eastern Ontario Research Institute, University of Ottawa
Alison J. Eaton: Children’s Hospital of Eastern Ontario Research Institute, University of Ottawa
Sultanah Alshahrani: McGill University
Angela L. Duker: Nemours Children’s Health
Jingjing Li: McGill University
Ricki S. Carroll: Nemours Children’s Health
Stuart Mackenzie: Nemours Children’s Health
Sarah M. Nikkel: University of British Columbia
Michael B. Bober: Nemours Children’s Health
Kym M. Boycott: Children’s Hospital of Eastern Ontario Research Institute, University of Ottawa
Monzur Murshed: McGill University

Nature Communications, 2023, vol. 14, issue 1, 1-20

Abstract: Abstract Matrix Gla protein (MGP) is a vitamin K-dependent post-translationally modified protein, highly expressed in vascular and cartilaginous tissues. It is a potent inhibitor of extracellular matrix mineralization. Biallelic loss-of-function variants in the MGP gene cause Keutel syndrome, an autosomal recessive disorder characterized by widespread calcification of various cartilaginous tissues and skeletal and vascular anomalies. In this study, we report four individuals from two unrelated families with two heterozygous variants in MGP, both altering the cysteine 19 residue to phenylalanine or tyrosine. These individuals present with a spondyloepiphyseal skeletal dysplasia characterized by short stature with a short trunk, diffuse platyspondyly, midface retrusion, progressive epiphyseal anomalies and brachytelephalangism. We investigated the cellular and molecular effects of one of the heterozygous deleterious variants (C19F) using both cell and genetically modified mouse models. Heterozygous ‘knock-in’ mice expressing C19F MGP recapitulate most of the skeletal anomalies observed in the affected individuals. Our results suggest that the main underlying mechanism leading to the observed skeletal dysplasia is endoplasmic reticulum stress-induced apoptosis of the growth plate chondrocytes. Overall, our findings support that heterozygous variants in MGP altering the Cys19 residue cause autosomal dominant spondyloepiphyseal dysplasia, a condition distinct from Keutel syndrome both clinically and molecularly.

Date: 2023
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DOI: 10.1038/s41467-023-41651-6

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