Apert syndrome is an autosomal dominant disease characterized by craniosynostosis and bony syndactyly associated with point mutations (S252W and P253R) in the fibroblast growth factor receptor (FGFR) 2 that cause FGFR2 activation. Here we investigated the role of the S252W mutation of FGFR2 on osteoblastic differentiation. Osteoblastic cells derived from digital bone in two Apert patients with the S252W mutation showed more prominent alkaline phosphatase activity, osteocalcin and osteopontin mRNA expression, and mineralized nodule formation compared with the control osteoblastic cells derived from two independent non-syndromic polydactyly patients. Stable clones of the human MG63 osteosarcoma cells (MG63-Ap and MG63-IIIc) overexpressing a splice variant form of FGFR2 with or without the S252W mutation (FGFR2IIIcS252W and FGFR2IIIc) showed a higher RUNX2 mRNA expression than parental MG63 cells. Furthermore MG63-Ap exhibited a higher osteopontin mRNA expression than did MG63-IIIc. The enhanced osteoblastic marker gene expression and mineralized nodule formation of the MG63-Ap was inhibited by the conditioned medium from the COS-1 cells overexpressing the soluble FGFR2IIIcS252W. Furthermore the FGF2-induced osteogenic response in the mouse calvarial organ culture system was blocked by the soluble FGFR2IIIcS252W. These results show that the S252W mutation in the FGFR2 gene enhances the osteoblast phenotype in human osteoblasts and that a soluble FGFR2 with the S252W mutation controls osteoblast differentiation induced by the S252W mutation through a dominant negative effect on FGFR2 signaling in Apert syndrome.Apert syndrome is an autosomal dominantly inherited syndrome characterized by craniosynostosis, which results in skull deformity, and symmetric bony syndactyly of the hands and feet. Its prevalence is ϳ15.5/1,000,000 newborns (1) and accounts for about 4.5% of all cases of craniosynostosis (2). Mutations of the human fibroblast growth factor receptors (FGFRs) 1 have been identified to be the cause of a number of craniosynostosis syndromes such as Crouzon, Pfeiffer, JacksonWeiss, Apert, Beare-Stevenson, and Muenke syndromes (3-8).With rare exceptions, Apert syndrome is caused by one of the two missense mutations of the FGFR2 gene involving an amino acid substitution, S252W or P253R, in the linker region between the second and third extracellular Ig domains (4, 9, 10). S252W results from a C755G missense mutation and is more common than P253R caused by C758G in Apert patients (11), and each mutation shows differential effects on the phenotype of syndactyly and cleft palate in this syndrome (12, 13). Most of the Apert patients are sporadic cases and are exclusively affected by mutations arising in the paternal germ line (14). Apert mutation in the FGFR2 gene serves as a gain-offunction mutation by decreasing the dissociation rate of FGFs from FGFR2 (15, 16) as well as by evoking the liganddependent receptor activation. In addition to the retained ligand dependence for the receptor activation, the loss of ligand ...