The primary cilium is an antenna-like structure that protrudes from the cell surface of quiescent/differentiated cells and participates in extracellular signal processing [1][2][3] . Here, we report that mice deficient for the lipid 5-phosphatase Inpp5e develop a multiorgan disorder associated with structural defects of the primary cilium. In ciliated mouse embryonic fibroblasts, Inpp5e is concentrated in the axoneme of the primary cilium. Inpp5e inactivation did not impair ciliary assembly but altered the stability of pre-established cilia after serum addition. Blocking phosphoinositide 3-kinase (PI3K) activity or ciliary platelet-derived growth factor receptor a (PDGFRa) restored ciliary stability. In human INPP5E, we identified a mutation affecting INPP5E ciliary localization and cilium stability in a family with MORM syndrome, a condition related to Bardet-Biedl syndrome. Together, our results show that INPP5E plays an essential role in the primary cilium by controlling ciliary growth factor and PI3K signaling and stability, and highlight the consequences of INPP5E dysfunction.Lipid 5-phosphatases selectively remove the phosphate from position D-5 of the inositol ring of phosphoinositides and inositolphosphates 4,5 . To characterize the functions of the 5-phosphatase Inpp5e 6-8 , we generated Inpp5e D/+ mice ( Supplementary Fig. 1a). We obtained no adult Inpp5e D/D mutant mice from intercrosses between Inpp5e D/+ mice. However, at embryonic day 13.5 (E13.5) and E18.5, 16.9% (11/65) and 14.8% (12/81) of embryos were homozygous for the deletion allele, respectively. The mutant mice died soon after birth, indicating that total inactivation of Inpp5e led to embryonic and postnatal death. Analyses confirmed the absence of Inpp5e protein in mutant cells and tissues (Fig. 1a). Inpp5e D/D mice presented with bilateral anophthalmos (100%, n ¼ 43) and postaxial hexadactyly (62.5%, n ¼ 16; Fig. 1b,c). Histological analyses revealed that eye development ceased at the optic vesicle stage, just before the appearance of the optic cup (Fig. 1d). Analysis of kidneys from the mice revealed the presence of multiple cysts (100%, n ¼ 10; Fig. 1e). Of the cysts, 84% expressed AQP2 and 14% expressed AQP1, indicating an origin in cortical collecting and connecting ducts (when AQP2 + ) as well as proximal tubules and the descending limb of the loop of Henle (when AQP1 + ) ( Supplementary Fig. 2). Only 2% of the renal glomeruli were cystic. Inpp5e D/D embryos had skeletal abnormalities such as a bifid sternum (50%, n ¼ 6), delayed ossification of metacarpals and phalanges (100%, n ¼ 5) and cleft palate (75%, n ¼ 4; Fig. 1f-h). We identified cerebral developmental defects, such as anencephaly and exencephaly, in 30% of Inpp5e D/D embryos at E15.5 (n ¼ 30; Fig. 1i,j). We did not detect liver alterations, laterality defects or respiratory cilium defects in mutant animals. The tissue localization of lesions observed in Inpp5e D/D embryos matched the tissue expression of Inpp5e mRNA during mouse embryogenesis ( Supplementary Fig. 3).Becau...

SUMMARY Primary cilia interpret vertebrate Hedgehog (Hh) signals. Why cilia are essential for signaling is unclear. One possibility is that some forms of signaling require a distinct membrane lipid composition, found at cilia. We found that the ciliary membrane contains a particular phosphoinositide, PI(4)P, whereas a different phosphoinositide, PI(4,5)P2, is restricted to the membrane of the ciliary base. This distribution is created by Inpp5e, a ciliary phosphoinositide 5-phosphatase. Without Inpp5e, ciliary PI(4,5)P2 levels are elevated and Hh signaling is disrupted. Inpp5e limits the ciliary levels of inhibitors of Hh signaling, including Gpr161 and the PI(4,5)P2-binding protein Tulp3. Increasing ciliary PI(4,5)P2 levels or conferring the ability to bind PI(4)P on Tulp3 increases the ciliary localization of Tulp3. Lowering Tulp3 in cells lacking Inpp5e reduces ciliary Gpr161 levels and restores Hh signaling. Therefore, Inpp5e regulates ciliary membrane phosphoinositide composition, and Tulp3 reads out ciliary phosphoinositides to control ciliary protein localization, enabling Hh signaling.

Phosphotidylinositol (PtdIns) signaling is tightly regulated, both spatially and temporally, by subcellularly localized PtdIns kinases and phosphatases that dynamically alter downstream signaling events 1. Joubert Syndrome (JS) characterized by a specific midbrain-hindbrain malformation (“molar tooth sign”) and variably associated retinal dystrophy, nephronophthisis, liver fibrosis and polydactyly 2, and is included in the newly emerging group of “ciliopathies”. In patients linking to JBTS1, we identified mutations in the INPP5E gene, encoding inositol polyphosphate-5-phosphatase E, which hydrolyzes the 5-phosphate of PtdIns(3,4,5)P3 and PtdIns(4,5)P2. Mutations clustered in the phosphatase domain and impaired 5-phosphatase activity, resulting in altered cellular PtdIns ratios. INPP5E localized to cilia in major organs affected in JS, and mutations promoted premature destabilization of cilia in response to stimulation. Thus, these data links PtdIns signaling to the primary cilium, a cellular structure that is becoming increasingly appreciated for its role in mediating cell signals and neuronal function.

Ciliary transport is required for ciliogenesis, signal transduction, and trafficking of receptors to the primary cilium. Mutations in inositol polyphosphate 5-phosphatase E (INPP5E) have been associated with ciliary dysfunction; however, its role in regulating ciliary phosphoinositides is unknown. Here we report that in neural stem cells, phosphatidylinositol 4-phosphate (PI4P) is found in high levels in cilia whereas phosphatidylinositol (4,5)-bisphosphate (PI(4,5)P2) is not detectable. Upon INPP5E inactivation, PI(4,5)P2 accumulates at the ciliary tip whereas PI4P is depleted. This is accompanied by recruitment of the PI(4,5)P2-interacting protein TULP3 to the ciliary membrane, along with Gpr161. This results in an increased production of cAMP and a repression of the Shh transcription gene Gli1. Our results reveal the link between ciliary regulation of phosphoinositides by INPP5E and Shh regulation via ciliary trafficking of TULP3/Gpr161 and also provide mechanistic insight into ciliary alterations found in Joubert and MORM syndromes resulting from INPP5E mutations.