The P-Rex family are Dbl-type guanine-nucleotide exchange factors for Rac family small G proteins. They are distinguished from other Rac-GEFs through their synergistic mode of activation by the lipid second messenger phosphatidyl inositol (3,4,5) trisphosphate and the Gbg subunits of heterotrimeric G proteins, thus acting as coincidence detectors for phosphoinositide 3-kinase and G protein coupled receptor signaling. Work in geneticallymodified mice has shown that P-Rex1 has physiological importance in the inflammatory response and the migration of melanoblasts during development, whereas P-Rex2 controls the dendrite morphology of cerebellar Purkinje neurons as well as glucose homeostasis in liver and adipose tissue. Deregulation of P-Rex1 and P-Rex2 expression occurs in many types of cancer, and P-Rex2 is frequently mutated in melanoma. Both GEFs promote tumor growth or metastasis. This review critically evaluates the P-Rex literature and tools available and highlights exciting recent developments and open questions.Rac family small G proteins (Rac1, Rac2, Rac3 and RhoG; a branch of the Rho family) control a myriad of essential cell responses, including adhesion, migration, reactive oxygen species formation and gene expression.1-3 They can be activated by 2 types of guanine-nucleotide exchange factors (GEFs), Dbl or DOCK, which are characterized by the structure of their catalytic domains. Rac-GEFs promote the release of GDP from Rac, allowing excess free cellular GTP to bind, and thus induce the active conformation of Rac which is able to engage downstream targets and stimulate cell responses [4][5][6] (Fig. 1).The P-Rex family are Dbl-type Rac-GEFs. The founding member, PIP 3 -dependent Rac exchanger 1, P-Rex1 (PREX1), was discovered during a search for factors that activate Rac when stimulated by the lipid second messenger phosphatidyl inositol (3,4,5) trisphosphate (PIP 3 ) which is generated by class I phosphoinositide 3-kinase (PI3K).7 P-Rex2 (PREX2) and P-Rex2b were discovered on the basis of their sequence homology with PRex1.8,9 P-Rex family proteins differ from other Dbl-type RacGEFs such as Vav, Tiam or Trio 4-6 in their domain structure and mechanisms of regulation. They have a number of physiological functions that are described in section "Physiological Function", an emerging role in metabolic disease that is discussed in section "Insulin Resistance and Type 2 Diabetes", and important roles in cancer progression that are described in section "Cancer".
Genes and ProteinsThe coding sequence of the 2 P-Rex genes is 49% identical and conserved throughout vertebrates but absent from invertebrates.8 In humans, the P-Rex1 gene (PREX1; NM_020820) is located in chromosome 20 (20q13.13), near a region associated with type 2 diabetes, and the P-Rex2 gene (PREX2; NM_024870) on chromosome 8 (8q13.2), in a region linked to aggressive cancers and metastasis. PREX1 encodes the protein P-Rex1 (185 kDa, 1659 amino acids (aa); NP_065871), and PREX2 encodes 2 proteins, full-length P-Rex2 (also known as P-Rex2a; 183 k...