Transforming growth factor (TGF)-1 is secreted as a latent form, which consists of its mature form and a latency-associated peptide (1-LAP) in either the presence or the absence of additional latent TGF-1-binding protein. We recently reported that three different missense mutations (R218H, R218C, and C225R) of 1-LAP cause the Camurati-Engelmann disease (CED), an autosomal dominant disorder characterized by hyperosteosis and sclerosis of the diaphysis of the long bones. Pulse-chase experiments using fibroblasts from CED patients and expression experiments of the mutant genes in an insect cell system suggest that these mutations disrupt the association of 1-LAP and TGF-1 and the subsequent release of the mature TGF-1. Furthermore, the cell growth of fibroblasts from a CED patient and mutant gene-transfected fibroblasts was suppressed via TGF-1. The growth suppression observed was attenuated by neutralizing antibody to TGF-1 or by treatment of dexamethasone. On the other hand, the proliferation of human osteoblastic MG-63 cells was accelerated by coculture with CED fibroblasts. These data suggest that the domain-specific mutations of 1-LAP result in a more facile activation of TGF-1, thus causing CED.
Transforming growth factor-1 (TGF-1)1 is a multifunctional protein acting on cell growth, differentiation, and morphogenesis of many different-type cells. In skeletal tissue, TGF-1 serves as a systematic regulator that couples bone formation and resorption by regulating the function of the osteoblasts and osteoclasts (1-5).The mature form of TGF-1 is proteolytically cleaved from the N-terminal remnant of the TGF-1 precursor, designated as TGF-1 latency-associated peptide (1-LAP) but remains non-covalently associated with the rest of the complex, which plays a role in latency of TGF-1 (6). TGF-1 is ubiquitously distributed, and the activation of the latent form is likely an important step, because it exists as either a large latent form, composed of 1-LAP, TGF-1, and latent TGF-1-binding protein (LTBP), or a small latent form, which is devoid of LTBP (7). Under normal conditions, activation of the latent TGF-1 is strictly controlled as follows. The large latent form is temporarily converted to the small latent form, which is then cleaved by plasmin or the plasmin-like protease to give the mature TGF-1 (6, 8, 9).Camurati-Engelmann disease (CED) or progressive diaphyseal dysplasia (DPD1) is an autosomal dominant disorder that is characterized by hyperosteosis and sclerosis of the diaphysis of the long bones (10). The onset of CED is often during early childhood with severe pain in the legs, muscle weakness, a waddling gait, and easy fatigability. The patients occasionally suffer from systemic manifestations, such as anemia, leukopenia, or hepatosplenomegaly (11). We, as well as two other groups, previously assigned the locus for CED to chromosome 19q13. 1-q13.3 (12-14). By a positional candidate gene approach and haplotype analyses, three different missense mutations (R218H, R218C, and C225R), wh...