We report 21 families displaying neurodevelopmental differences and multiple congenital anomalies while bearing a series of rare variants in mitogen-activated protein kinase kinase kinase kinase 4 (MAP4K4). MAP4K4 has been implicated in many signaling pathways including c-Jun N-terminal and RAS kinases and is currently under investigation as a druggable target for multiple disorders. Using several zebrafish models, we demonstrate that these human variants are either loss-of-function or dominant-negative alleles and show that decreasing Map4k4 activity causes developmental defects. Furthermore, MAP4K4 can restrain hyperactive RAS signaling in early embryonic stages. Together, our data demonstrate that MAP4K4 negatively regulates RAS signaling in the early embryo and that variants identified in affected humans abrogate its function, establishing MAP4K4 as a causal locus for individuals with syndromic neurodevelopmental differences.
FörderungenNational Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health New Jersey Health Foundation Inc. Duke/UNC CTSA Consortium Collaborative Translational Research Grant National Human Genome Research Institute National Institute of Mental Health National Center for Advancing Translational Sciences National Institute of Arthritis and Musculoskeletal and Skin Diseases National Institute of General Medical Sciences National Institute of Child Health and Human Development