Compound heterozygous c-Mpl mutations in a child with congenital amegakaryocytic thrombocytopenia: functional characterization and a review of the literature.
OBJECTIVE
To genetically and functionally characterize mutations of c-Mpl that lead to thrombocytopenia in a child with congenital amegakaryocytic thrombocytopenia.


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.
Fox
Norma E
NE
Department of Pediatrics, University of California, San Diego, La Jolla, CA 92017, USA.
Chen
Rose
R
Hitchcock
Ian
I
Keates-Baleeiro
Jennifer
J
Frangoul
Haydar
H
Geddis
Amy E
AE
D001483:Base Sequence; D002460:Cell Line; D002675:Child, Preschool; D005260:Female; D006031:Glycosylation; D006579:Heterozygote; D006801:Humans; D008533:Megakaryocytes / Q000473:pathology; D008969:Molecular Sequence Data; D009154:Mutation; D011485:Protein Binding; D053628:Receptors, Thrombopoietin / Q000235:genetics* / Q000378:metabolism; D015398:Signal Transduction; D013921:Thrombocytopenia / Q000151:congenital* / Q000235:genetics*
D053628:Receptors, Thrombopoietin; C082218:MPL protein, human