BMP1 mutations in autosomal recessive osteogenesis imperfecta

Mutations in BMP1 cause osteogenesis imperfect (OI) type XIII (MIM 614856), a probably not so uncommon form of autosomal recessive OI. (Editor's Note: See Chapters 1 and 2 for discussion of OI types related to specific mutations.) We have studied an Egyptian consanguineous family with two children initially diagnosed as OI type III. They had blue sclera, severe kyphoscoliosis and large umbilical hernia. Genetic analysis of this family performed by homozygosity mapping showed lack of linkage to any of the previously known AR-OI loci but identified a homozygous 10.27. Mb DNA segment on chromosome 8p in both affected children comprising the type I collagen C-propeptide protease gene BMP1. Direct sequencing of BMP1 in the proband revealed a Phe249Leu homozygous missense change within the BMP1/mTLD astacin protease domain. Phe249 is a residue which is invariable in all invertebrate and vertebrate members of the astacin family of metalloproteases. A few months later, using a combination of whole-exome sequencing and filtering for homozygous stretches of identified variants, another mutation was reported by other authors in two affected sibs of a consanguineous family from Turkey. They showed increased bone mineral density and multiple recurrent fractures. The mutation in BMP1, a 34. G>C transversion in exon 1 resulting in a Gly12Arg (G12R) substitution within the signal peptide, impaired protein's localization to the endoplasmic reticulum, the correct post-translational glycosylation and its secretion. BMP1 expands the number of growing genes involved in AR-OI and demonstrates the high genetic complexity of the collagen I pathway disorders.