A Sonic Hedgehog Missense Mutation Associated with Holoprosencephaly Causes Defective Binding to GAS1

Holoprosencephaly (HPE) is a common birth defect predominantly affecting the forebrain and face and has been linked to mutations in the sonic hedgehog (SHH) gene. HPE is genetically heterogeneous, and clinical presentation represents a spectrum of phenotypes. We have previously shown that Gas1 encodes a cell-autonomous Hedgehog signaling enhancer. Combining cell surface binding, in vitro activity, and explant culture assays, we provide evidence that SHH contains a previously unknown unique binding surface for its interaction with GAS1 and that this surface is also important for maximal signaling activity. Within this surface, the Asn-115 residue of human SHH has been documented to associate with HPE when mutated to lysine (N115K). We provide evidence that HPE associated with this mutation can be mechanistically explained by a severely reduced binding of SHH to GAS1, and we predict a similar result if a mutation were to occur at Tyr-80. Our data should encourage future searches for mutations in GAS1 as possible modifiers contributing to the wide spectrum of HPE.Holoprosencephaly (HPE)² is a developmental defect of the brain and face estimated to affect 1 in 250 conceptuses (1). Clinical presentation represents a spectrum of phenotypes, ranging from the most severe (alobar), where embryos have cyclopia and the prosencephalon fails to divide into hemispheres, to relatively mild defects (microform HPE) such as maxillary central incisor fusion, midfacial hypoplasia and clefting, and the presence of a single nostril (2). The use of mice as a model has proven invaluable for investigating the molecular and genetic causes of HPE. We have previously reported that microform HPE develops in growth arrest-specific gene 1 (Gas1) mutant mice (3, 4). Additionally, we determined that the 37-kDa, cell surface-presented, and glycosylphosphatidylinositol-anchored GAS1 protein binds to the secreted cell-cell signaling protein Sonic hedgehog (SHH) and that it functions as a cell-autonomous enhancer of SHH signaling activity (3, 5, 6). Consistently, the Gas1 mutant phenotype is more severe when an allele of Shh is removed, supporting a genetic interaction between the two genes (3, 4). Given the strong evidence that mutations in Shh can cause HPE in mice and humans (7–11), we investigated the hypothesis that some of these mutations cause defective SHH signaling due to a failed interaction with GAS1.Here we identify specific residues on SHH that are required for maximal binding to GAS1 and show, in both cell culture and explant culture assays, that these mutant SHH proteins have decreased signaling activity due to their defective interaction with GAS1. Significantly, one of these mutations has been associated with autosomal dominant HPE in a human family (9). These results lead us to propose that human embryos carrying this mutation may develop HPE due to a failed GAS1-SHH protein interaction.