X-linked congenital stationary night blindness (XLCSNB) is a nonprogressive retinal disorder characterized by impaired night vision and other ocular symptoms such as myopia, hyperopia, nystagmus, and reduced visual acuity.
1 According to the clinical phenotype, XLCSNB can be divided into two types: complete (CSNB1) and incomplete (CSNB2). These two subtypes can be distinguished on the basis of electroretinogram (ERG) and by genetic means.
2 3 CSNB2 is associated with a reduced rod b-wave and substantially reduced cone response and is due to mutations in
CACNA1F, an X chromosomal gene encoding the α1-subunit of an L-type calcium channel.
4 5 CSNB1 is characterized by the complete absence of the rod b-wave, but largely normal cone amplitudes. By positional cloning we and others have isolated a gene in Xp11.4 (
NYX, nyctalopin on chromosome X) that is mutated in patients with CSNB1.
6 7 The gene consists of three exons and codes for a novel protein belonging to the leucine-rich repeat (LRR) superfamily. The predicted polypeptide contains an N-terminal ER signal peptide, a C-terminal glycosylphosphatidylinositol (GPI) membrane anchor, and 11 leucine-rich repeats (LRR), flanked by cysteine-rich LRRs. LRRs are short-sequence motifs present in a number of proteins with diverse functions and cellular localization. Functionally, these repeats are suggested to mediate protein-protein interactions.
8 Several membrane proteins have been shown to be linked to the outer leaflet of the lipid bilayer through a GPI anchor.
9 10 They are synthesized and attached at the endoplasmic reticulum (ER) before modification and are then transported to the cell surface through the secretory pathway.
11 The mammalian Golgi apparatus is the central organelle within the secretory machinery. It plays an important role in processing, maturation, and sorting of newly synthesized secretory and membrane proteins received from the ER.
12 13 GPI-anchored proteins may be localized in microdomains
14 and have been implicated in processes such as protein sorting.
15 T4-cell activation,
16 and cell signaling.
17 18 Most notably, it has been shown that connectin and chaoptin, two prominent GPI-anchored LRR proteins, have a pivotal role in photoreceptor cell adhesion and axon guidance processes.
19 20