Missense mutations in the PTPN11 locus are associated with both
Noonan syndrome and
Leopard syndrome. At least 79 disease-causing mutations in this gene have been discovered.
Noonan syndrome In the case of Noonan syndrome, mutations are broadly distributed throughout the coding region of the gene but all appear to result in hyper-activated, or unregulated mutant forms of the protein. Most of these mutations disrupt the binding interface between the N-SH2 domain and catalytic core necessary for the enzyme to maintain its auto-inhibited conformation. ===
Noonan syndrome with multiple lentigines=== The mutations that cause Noonan syndrome with multiple lentigines (formerly known as leopard syndrome) are restricted regions affecting the catalytic core of the enzyme producing catalytically impaired Shp2 variants. It is currently unclear how mutations that give rise to mutant variants of Shp2 with biochemically opposite characteristics result in similar human genetic syndromes.
Metachondromatosis It has also been associated with
metachondromatosis.
Cancer Patients with a subset of Noonan syndrome PTPN11 mutations also have a higher prevalence of
juvenile myelomonocytic leukemias (JMML). Activating Shp2 mutations have also been detected in
neuroblastoma,
melanoma,
acute myeloid leukemia,
breast cancer,
lung cancer,
colorectal cancer. Recently, a relatively high prevalence of PTPN11 mutations (24%) were detected by
next-generation sequencing in a cohort of
NPM1-mutated
acute myeloid leukemia patients, although the prognostic significance of such associations has not been clarified. These data suggests that Shp2 may be a
proto-oncogene. However, it has been reported that PTPN11/Shp2 can act as either tumor
promoter or
suppressor. The bacterium
Helicobacter pylori has been associated with
gastric cancer, and this is thought to be mediated in part by the interaction of its virulence factor
CagA with SHP2.
H Pylori CagA virulence factor CagA is a protein and
virulence factor inserted by
Helicobacter pylori into gastric epithelia. Once activated by SRC phosphorylation, CagA binds to SHP2, allosterically activating it. This leads to morphological changes, abnormal mitogenic signals and sustained activity can result in
apoptosis of the host cell. Epidemiological studies have shown roles of cagA- positive
H. pylori in the development of
atrophic gastritis,
peptic ulcer disease and
gastric carcinoma. == Interactions ==