Recently, we reported a case of an infant with neonatal severe under-mineralizing skeletal
dysplasia caused by mutations within both alleles of the TRPV6 gene. One mutation results in
an in frame stop codon (R510stop) that leads to a truncated, nonfunctional TRPV6 channel, and
the second in a point mutation (G660R) that, surprisingly, does not affect the Ca2+ permeability of
TRPV6. We mimicked the subunit composition of the unaffected heterozygous parent and child
by coexpressing the TRPV6 G660R and R510stop mutants and combinations with wild type TRPV6.
We show that both the G660R and R510stop mutant subunits are expressed and result in decreased
calcium uptake, which is the result of the reduced abundancy of functional TRPV6 channels within
the plasma membrane. We compared the proteomic profiles of a healthy placenta with that of the
diseased infant and detected, exclusively in the latter two proteases, HTRA1 and cathepsin G. Our
results implicate that the combination of the two mutant TRPV6 subunits, which are expressed in the
placenta of the diseased child, is responsible for the decreased calcium uptake, which could explain
the skeletal dysplasia. In addition, placental calcium deficiency also appears to be associated with an
increase in the expression of proteases