Mutations. Gain-of-function mutations in the coding gene can develop dysfunctional proteins "that impede cartilage growth and development and impair chondrocyte proliferation and calcification". Mutaions can lead to craniosynostosis and various types of skeletal dysplasia (osteochondrodysplasia).
In achondroplasia, the FGFR3 gene has a missense mutation at nucleotide 1138 resulting from either a G>A or G>C (Foldynova-Trantirkova S et al. 2013). This point mutation in the FGFR3 gene causes hydrogen bonds to form between two arginine side chains, resulting in ligand-independent stabilization of FGFR3 dimers. Overactivity of FGFR3 inhibits chondrocyte proliferation and limits long bone length.
FGFR3 mutations are also associated with spermatocyte tumors, which are more common in older men (Kelleher FC et al. 2013).
Defects in the FGFR3 gene have been associated with several diseases, including craniosynostosis and in epidermal nevi as well as seborrheic keratoses (Hafner C et al (2007).
Urinary bladder carcinoma: Mutations of FGFR3, FGFR3-TACC3 and FGFR3-BAIAP2L1 fusion proteins are frequently associated with bladder carcinoma, with some FGFR3 mutations also associated with better prognosis. Therefore, FGFR3 represents a potential therapeutic target for the treatment of bladder cancer (di Martino E et al 2016). In bladder carcinoma, post-translational modifications of FGFR3 occur that are physiologically absent and can be targeted by immunotherapeutic antibodies.
Glioblastoma: FGFR3-TACC3 fusions have been identified as a primary mitogenic driver in a subset of glioblastomas (approximately 4%) and other gliomas and may be associated with slightly improved overall survival (Mata, Douglas A et al 2020). FGFR3-TACC3 fusion represents a potential therapeutic target in glioblastoma.
Achondroplasia: Achondroplasia is a dominant genetic disorder caused by mutations in FGFR3 that render the resulting protein overactive. Individuals with this mutation have a head circumference that is larger than normal and are significantly smaller in height. Only a single copy of the mutated FGFR3 gene causes achondroplasia. It is generally caused by spontaneous mutations in germ cells; in about 80 percent of cases, parents with children who have this disorder are normal in height.
Thanatophoric dysplasia: Thanatophoric dysplasia is a genetic disorder caused by gain-of-function mutations in FGFR3 and is often fatal in the perinatal period. There are two types. TD type I is caused by a stop codon mutation located in a portion of the gene that encodes the extracellular domain of the protein. TD type II is caused by a substitution in an Lsy650Glu located in the tyrosine kinase domain of FGFR3 (Karczeski B et al. 1993).