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When EGF is offside, magnesium is wasted
Shmuel Muallem, Orson W. Moe
Shmuel Muallem, Orson W. Moe
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Commentary

When EGF is offside, magnesium is wasted

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Abstract

Our understanding of magnesium (Mg2+) regulation has recently been catapulted forward by the discovery of several disease loci for monogenic disorders of Mg2+ homeostasis. In this issue of the JCI, Groenestege et al. report that their study of a rare inherited Mg2+ wasting disorder in consanguineous kindred shows that EGF acts as an autocrine/paracrine magnesiotropic hormone (see the related article beginning on page 2260). EGF stimulates Mg2+ reabsorption in the renal distal convoluted tubule (DCT) via engagement of its receptor on the basolateral membrane of DCT cells and activation of the Mg2+ channel TRPM6 (transient receptor potential cation channel, subfamily M, member 6) in the apical membrane. These authors show that a point mutation in pro-EGF retains EGF secretion to the apical but not the basolateral membrane, disrupting this cascade and causing renal Mg2+ wasting. This work is another seminal example of the power of the study of monogenic disorders in the quest to understand human physiology.

Authors

Shmuel Muallem, Orson W. Moe

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Figure 2

Model of the autocrine/paracrine action of EGF in the DCT cell and potential mechanisms by which EGF can regulate TRPM6 activity.

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Model of the autocrine/paracrine action of EGF in the DCT cell and poten...
Mg2+ influx across the luminal membrane is mediated by TRPM6 and may require the ubiquitous TRPM7. In this issue of the JCI, Groenestege et al. (11) report that EGF is a magnesiotropic hormone that regulates renal Mg2+ reabsorption by stimulating the EGFR, which then increases the activity of TRPM6. Aberrant targeting of pro-EGF to the basolateral membrane by the P1070L mutation results in reduced EGF production at the basolateral membrane, reduced activation of EGFR, reduced TRPM6 activity, and, consequently, Mg2+ wasting. Future studies should reveal which of the pathways activated by EGF mediates activation of TRPM6 and the mechanism by which TRPM6 activity is increased. As indicated by the long arrows, activation of EGFR by EGF and its tyrosine phosphorylation may directly activate TRPM6 and/or TRPM7 channel activity or may regulate insertion or retrieval or TRPM6 present in intracellular vesicular compartments. Because of the proximity of the DCT and proximal tubule, EGF generated by the DCT may activate EGFRs at the proximal tubule and therefore affect Mg2+ handling by this nephron segment, which reabsorbs 25% of filtered Mg2+. DAG, diacylglycerol; IP3, inositol-1,4,5 trisphosphate; PIP2, phosphatidylinositol 4,5-bisphosphate; PLCγ, phospholipase Cγ; P, phosphate.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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