The lamin B receptor (LBR) is an inner nuclear membrane protein with a structural function interacting with chromatin and lamins, and an enzymatic function as a sterol reductase. Heterozygous LBR mutations cause nuclear hyposegmentation in neutrophils (Pelger anomaly), while homozygous mutations cause prenatal death with skeletal defects and abnormal sterol metabolism (Greenberg dysplasia). It has remained unclear whether the lethality in Greenberg dysplasia is due to cholesterol defects or altered nuclear morphology.To answer this question we characterized two LBR missense mutations and showed that they cause Greenberg dysplasia. Both mutations affect residues that are evolutionary conserved among sterol reductases. In contrast to wildtype LBR, both mutations failed to rescue C14 sterol reductase deficient yeast, indicating an enzymatic defect. We found no Pelger anomaly in the carrier parent excluding marked effects on nuclear structure. We studied Lbr in mouse embryos and demonstrate expression in skin and the developing skeletal system consistent with sites of histological changes in Greenberg dysplasia. Unexpectedly we found in disease-relevant cell types not only nuclear but also cytoplasmatic LBR localization. The cytoplasmatic LBR staining co-localized with ER-markers and is thus consistent with the sites of endogeneous sterol synthesis.We conclude that LBR missense mutations can abolish sterol reductase activity, causing lethal Greenberg dysplasia but not Pelger anomaly. The findings separate the metabolic from the structural function and indicate that the sterol reductase activity is essential for human intrauterine development.
ResultsWe studied three fetuses that all fulfilled the clinical criteria of Greenberg dysplasia, namely intrauterine growth retardation, massive generalized edema (hydrops), extreme shortening of long bones (tetrabrachymelia) with a moth-eaten appearance of tubular bones, ectopic calcification centers and a narrow thorax (Fig. 1A, Suppl. Table 1). Detailed clinical examination was obtained from fetus A; fetus B has been described previously.
25Sterol analyses were performed in muscle tissue of fetus B and revealed the abnormal sterol metabolite 5α-cholest-8,14-dien-3β-ol, 25 that was previously shown to be associated with Greenberg dysplasia.18 Sterol analysis was not available for the other two fetuses.Sequence analysis revealed frameshift and missense mutations in the LBR gene. We sequenced LBR and identified mutations in all three families (Fig. 1B, sequence traces and segregation in Suppl. Fig. 1A). Fetus A showed a homozygous frameshift mutation c.1492delT that is predicted to change residues 468 to 474 and to create a premature stop in codon 475 (p.Y468TfsX475). Fetus B revealed two different mutations, c.32delTGGT and c.1748G>A. The first is a deletion of 4 base pairs causing a frame shift with subsequent premature stop in codon 24 (p.V11EfsX24). The second is a missense mutation replacing arginine by glutamine at residue 583 (R583Q). Both parents of fetus C were carrie...