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Loss of function and inhibitory effects of human CSX/NKX2.5 homeoprotein mutations associated with congenital heart disease
Hideko Kasahara, Bora Lee, Jean-Jacques Schott, D. Woodrow Benson, J.G. Seidman, Christine E. Seidman, Seigo Izumo
Hideko Kasahara, Bora Lee, Jean-Jacques Schott, D. Woodrow Benson, J.G. Seidman, Christine E. Seidman, Seigo Izumo
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Article

Loss of function and inhibitory effects of human CSX/NKX2.5 homeoprotein mutations associated with congenital heart disease

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Abstract

CSX/NKX2.5 is an evolutionarily conserved homeodomain-containing (HD-containing) transcription factor that is essential for early cardiac development. Recently, ten different heterozygous CSX/NKX2.5 mutations were found in patients with congenital heart defects that are transmitted in an autosomal dominant fashion. To determine the consequence of these mutations, we analyzed nuclear localization, DNA binding, transcriptional activation, and dimerization of mutant CSX/NKX2.5 proteins. All mutant proteins were translated and located to the nucleus, except one splice-donor site mutant whose protein did not accumulate in the cell. All mutants that had truncation or missense mutations in the HD had severely reduced DNA binding activity and little or no transcriptional activation function. In contrast, mutants with intact HDs exhibit normal DNA binding to the monomeric binding site but had three- to ninefold reduction in DNA binding to the dimeric binding sites. HD missense mutations that preserved homodimerization ability inhibited the activation of atrial natriuretic factor by wild-type CSX/NKX2.5. Although our studies do not characterize the genotype-phenotype relationship of the ten human mutations, they identify specific abnormalities of CSX/NKX2.5 function essential for transactivation of target genes.

Authors

Hideko Kasahara, Bora Lee, Jean-Jacques Schott, D. Woodrow Benson, J.G. Seidman, Christine E. Seidman, Seigo Izumo

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Figure 3

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DNA binding affinity of group 1, 2, and 5 mutant proteins versus wild-ty...
DNA binding affinity of group 1, 2, and 5 mutant proteins versus wild-type CSX/NKX2.5. (a) Sequence of two consensus CSX/NKX2.5 binding sites (–242 bp and –87 bp sites) in rat ANF promoter; the paired binding sites in –242 bp site, and a single binding site in –87 bp site. (b) –242 bp site was used for the DNA binding assay (lane 1) mixed with threefold serially increased CSX/NKX2.5 fusion proteins (0.018–4.4 μg/mL of MBP-CSX/NKX2.5 fusion protein) (lanes 2–7). Wild-type CSX/NKX2.5 bound as a monomer (M) as well as a dimer (D) depending on the protein concentration. No shifted bands were observed in groups 1 and 5 (M149, M170, and M112). (c) The EMSA of the group 2 mutant proteins that have a single missense mutation in the HD. 178Thr-Met (M178) mutation was located just before the third helix, and 188Asn-Lys (M188), 189Arg-Gly (M189), and 191Tyr-Cys (M191) were located in the third helix. Two conserved amino acid mutations were identified: 188Asn (51Asn in HD) is conserved in all the HD protein that is directly bound to the major groove of DNA, and 191Tyr (54Tyr in HD) is conserved in all NK2 class homeoprotein. All four mutant proteins show dramatically reduced DNA binding affinity compared with the wild-type CSX/NKX2.5. D, dimer; M, monomer; F, free probe. Mutation sites of group 2 are indicated with white asterisks.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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