Understanding the role of NOTCH2 mutation in centronuclear myopathy

NOTCH2 is a widely expressed protein that plays a crucial role in the normal development and function of various tissues, including skeletal muscle. This study focused on a pedigree with centronuclear myopathy, primarily characterized by muscle weakness and centralized nuclei, and identified the autosomal recessive NOTCH2 p.I1689F mutation through whole-exome sequencing. Using a homologous mutant mouse model, several defects were identified that elucidate the muscle phenotype. These defects include a reduction in Pax7-expressing, proliferating myoblasts and the functional consequences of this reduction. In vitro studies demonstrated that the Notch2 mutation impaired proliferation and causing premature differentiation of myogenic progenitor cells. Mechanistically, the Notch2 mutation resulted in decreased production of the Notch2 intracellular domain from γ-secretase S3 cleavage, which affected the function of Pax7⁺ cells through the Notch2-Hey1-MyoD axis. Overall, our findings reveal impaired muscle regeneration in mice with the Notch2 mutation, contributing to the understanding of centronuclear myopathy by identifying a previously unreported gene and mutation site of NOTCH2.