title: Exploring the spectrum of 3-M syndrome, a primordial short stature disorder of disrupted ubiquitination.
abstract: 3-M syndrome is an autosomal recessive primordial growth disorder characterized by small birth size and post-natal growth restriction associated with a spectrum of minor anomalies (including a triangular-shaped face, flat cheeks, full lips, short chest and prominent fleshy heels). Unlike many other primordial short stature syndromes, intelligence is normal and there is no other major system involvement, indicating that 3-M is predominantly a growth-related condition. From an endocrine perspective, serum GH levels are usually normal and IGF-I normal or low, while growth response to rhGH therapy is variable but typically poor. All these features suggest a degree of resistance in the GH-IGF axis. To date, mutations in three genes CUL7, OBSL1 and CCDC8 have been shown to cause 3-M. CUL7 acts an ubiquitin ligase and is known to interact with p53, cyclin D-1 and the growth factor signalling molecule IRS-1, the link with the latter may contribute to the GH-IGF resistance. OBSL1 is a putative cytoskeletal adaptor that interacts with and stabilizes CUL7. CCDC8 is the newest member of the pathway and interacts with OBSL1 and, like CUL7, associates with p53, acting as a co-factor in p53-medicated apoptosis. 3-M patients without a mutation have also been identified, indicating the involvement of additional genes in the pathway. Potentially damaging sequence variants in CUL7 and OBSL1 have been identified in idiopathic short stature (ISS), including those born small with failure of catch-up growth, signifying that the 3-M pathway could play a wider role in disordered growth.
authors.affiliation: Developmental Biomedicine, Manchester Academic Health Sciences Centre (MAHSC), School of Biomedicine, University of Manchester, UK. peter.clayton@manchester.ac.uk
authors.forename: Peter E
authors.initials: PE
authors.lastname: Clayton
authors.forename: Dan
authors.initials: D
authors.lastname: Hanson
authors.forename: Lucia
authors.initials: L
authors.lastname: Magee
authors.forename: Philip G
authors.initials: PG
authors.lastname: Murray
authors.forename: Emma
authors.initials: E
authors.lastname: Saunders
authors.forename: Sayeda N
authors.initials: SN
authors.lastname: Abu-Amero
authors.forename: Gudrun E
authors.initials: GE
authors.lastname: Moore
authors.forename: Graeme C M
authors.initials: GC
authors.lastname: Black
mesh_terms: D002352:Carrier Proteins / Q000235:genetics; D002648:Child; D044842:Cullin Proteins / Q000235:genetics; D003598:Cytoskeletal Proteins / Q000235:genetics; D003937:Diagnosis, Differential; D004392:Dwarfism / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics / Q000378:metabolism; D005260:Female; D005317:Fetal Growth Retardation / Q000235:genetics; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008297:Male; D053858:Metabolic Networks and Pathways; D009123:Muscle Hypotonia / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics / Q000378:metabolism; D009154:Mutation; D011247:Pregnancy; D056730:Silver-Russell Syndrome / Q000175:diagnosis / Q000235:genetics; D013131:Spine / Q000002:abnormalities / Q000378:metabolism; D054875:Ubiquitination
chemical_list: C569196:CCDC8 protein, human; C506299:CUL7 protein, human; D002352:Carrier Proteins; D044842:Cullin Proteins; D003598:Cytoskeletal Proteins; C522000:OBSL1 protein, human; D019382:Human Growth Hormone