KDR (kinase insert domain receptor)/Vascular Endothelial Growth Factor Receptor 2 (VEGFR2)

2015-10-01   Noah Sorrelle , Rolf Brekken 

University of Texas Southwestern Medical Center noah.sorrelle@utsouthwestern.edu, rolf.brekken@utsouthwestern.edu

Identity

HGNC
LOCATION
4q12
LOCUSID
ALIAS
CD309,FLK1,VEGFR,VEGFR2
FUSION GENES

Abstract

This is a concise review of the KDR\/VEGFR2 gene, including expression, function, and implications of VEGFR2 expression in cancer.

DNA/RNA

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Description

The human KDR/VEGFR2 gene was cloned in 1991 and mapped in 1992 (Terman BI et al., 1991, Terman BI et al., 1992). The human gene (Kdr/VEGFR2) maps to human chromosome 4. The mouse gene (Kdr/Vegfr2/Flk-1) was cloned in 1991(Matthews W et al., 1991). The mouse gene (Flk-1/Vegfr2) is located on mouse chromosome 5.

Transcription

In humans, the KDR gene consists of 30 exons, spanning 47,337 bp of DNA on the reverse strand of Chromosome 4. Exon 1 contains 5 UTR and exon 30 contains 3 UTR. All 30 exons contain translated sequence. Three splice variants have been reported in Ensembl. Alternative splicing results in partial retention of intron 13 and an alternative stop codon, encoding a unique C-terminal sequence. Transcription factors regulating Vegfr2 expressing include ETS1 and ETS2 (Elvert G et al., 2003, Kappel A et al., 2000), EPAS1 (hypoxia inducible factor 2 alpha) (Elvert G et al., 2003), ETV2 (ER71/etsrp) (Lee D et al., 2008), and OVOL2 (Kim JY et al., 2014).

Proteins

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Description

The canonical form of VEGFR2 comprises 1356 amino acids in humans and 1345 in mice. VEGFR2 is translated into a 150 kDa protein. Glycosylation of the extracellular domain results in the mature form at the cell surface which migrates at 230 kDa via western blot.
VEGFR2 is composed of three domains: an extracellular domain, transmembrane domain, and a cytosolic domain. The extracellular domain (including N-terminus) is composed of a signal peptide (aa: 1-20) and seven Ig-like subdomains (aa: 20-764). The second and third Ig-like subdomains (aa: 141-207, 224-320) facilitate binding of the principal VEGFR2 ligand, VEGFA (Fug G et al., 1998, Shinkai A et al., 1998). This is followed by a single-pass type I transmembrane domain (aa: 765-785).
The intracellular region (aa: 786-1356) consists of a juxtamembrane domain (JMD) and kinase domain. Biochemical analyses by Solowiej et al. (2009) determined that the JMD promotes autophosphorylation of the kinase domain, which is preceded by phosphorylation of the JMD residue, Y801(Solowiej J et al., 2009). Replacing the VEGFR2 JMD with the VEGFR1 JMD reduces the kinase activity of VEGFR2 in vitro. Conversely, replacing the VEGFR1 JMD with the VEGFR2 JMD increases the kinase activity of VEGFR1(Gille H et al., 2000). These data suggest that the higher kinase activity of VEGFR2 relative to VEGFR1 may be partially explained by differences in the JMD.
The kinase domain (KD; aa: 834-1162) is split by a 70 amino acid insert (aa: 930-1000). Phosphorylation of the KD activation loop residues Y1054 and Y1059 is required for kinase activity(Kendall RL et al., 1999). Additional phosphorylation sites in the intracellular domain facilitate specific interactions of between VEGFR2 and signaling mediators, including PLC gamma, SHB, SCK, SHCA, GRB2, son of sevenless (SOS), and NCK. For further review, see S. Koch and L. Claesson-Welsh, 2012, and Claesson-Welsh and Welsh, 2013 (Claesson-Welsh L et al., 2013, Koch S et al., 2012).
Co-receptors:
Integrins, neuropilin-1, and CD146 promote VEGFR2 activation, and mediate VEGFR2 activities, including endothelial cell migration, permeability, and angiogenesis. For more information, see Table 1 and Koch and Claesson-Welsh, 2012.
Alternative Isoforms:
In 2009, Albuquerque et al. discovered that alternative splicing produces a soluble form of VEGFR2, present in mouse and human cornea (Albuquerque RJ et al., 2009). This isoform results from inclusion of the intron following exon 13 and results in a truncated product which migrates at 75 kDa via western blot. This isoform contains only the extracellular domain of VEGFR2 and a unique C-terminal sequence. Characterization of sVEGFR2 revealed that it may play a role as an endogenous inhibitor of lymphoangiogenesis via antagonizing VEGF-C/VEGFR3 signaling (Albuquerque RJ et al., 2009).
Ligands:
VEGF-A (Terman BI et al., 1992), VEGF-C (Joukov V et al., 1996), VEGF-D (Achen MG et al., 1998), and VEGF-E (M Meyer et al., 1999, Ogawa S et al., 1998). VEGF-A is the primary endogenous ligand activating VEGFR2 signaling, while VEGF-C and VEGF-D signal mostly through VEGFR3. VEGF-E is encoded by the Orf virus and activates VEGFR2 similarly to VEGF-A. Unlike VEGF-A, however, VEGF-E is a VEGFR2-exclusive ligand.
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Expression

VEGFR2 is the principal VEGF receptor expressed on blood endothelial cells. Vegfr2-null mice die at E8.5 due to inadequate development of endothelial and hematopoietic cells(Shalaby F et al., 1995). Vegfr2 expression levels peak during embryonic angiogenesis and vasculogenesis(Millauer B et al., 1993, Oelrichs RB et al., 1993). In adults, VEGFR2 is expressed prominently on vascular endothelial cells, where its expression is, in part, regulated by fibroblast growth factor signaling(Michael S. Pepper et al., 1998, Murakami M et al., 2011). Expression is also observed on hematopoietic stem cells and megakaryocytes(Casella I et al., 2003, Katoh O et al., 1995, Larrivée B et al., 2003).

Localisation

Full length VEGFR2 is localized on the plasma membrane and is internalized in a VEGF binding-dependent manner(Koch S et al., 2012, Waltenberger J et al., 1994). Soluble VEGFR2 is secreted from the cell.
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Function

VEGFR2 is the premier receptor mediating VEGF-A activity on endothelial cells, where it functions to enhance proliferation, migration, and survival(Gerber HP et al., 1998, Jia H et al., 2004, Terman BI et al., 1992, Waltenberger J et al., 1994). Vegfr2 also promotes the survival of hematopoietic stem cells(Larrivée B et al., 2003).
VEGFR2 is the principal VEGF receptor involved in vascular angiogenesis and the regulation of vascular permeability(Kowanetz M et al., 2006, Terman BI et al., 1992). VEGFR2 activity on vascular endothelial cells in tumors promotes tumor angiogenesis(K. H. Plate et al., 1993, Millauer B et al., 1994). For the effects of VEGFR2 signaling on different cell types, see Table 2.
VEGF Signaling Inhibitors:
Strategies employed to target VEGF signaling are multifocal, consisting of monoclonal antibodies for both the ligands and VEGFRs, recombinant VEGFR extracellular domain fusion proteins (Table 3), and small molecule receptor tyrosine kinase inhibitors (Table 4)
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Mutations

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Somatic

Increased VEGFR2 copy number has been identified in breast(Johansson I et al., 2012), non-small cell lung cancer (Yang F et al., 2011), and neurological malignancies (Blom T et al., 2010, Puputti M et al., 2006). Missense mutations have been identified in hemangioma, leading to constitutive activation of VEGFR2 (Antonescu CR et al., 2009, Jinnin M et al., 2008, Walter JW et al., 2002). Wang et al., 2007, identified that polymorphisms in the VEGFR2 were associated with coronary heart disease(Wang Y et al., 2007) (Table 5).
Glubb et al., 2011, characterized the significance of selected single nucleotide polymorphisms on VEGFR2 function and expression (Table 6). Of particular note, Glubb et al., 2011, identified that a SNP that results in the amino acid change Q472H, which was associated with increased VEGFR2 activity, and was correlated with increased microvessel density in non-small cell lung cancer patients (Glubb DM et al., 2011) (Table 6).

Implicated in

Entity name
Various Cancers (see Table)
Note
The expression VEGFR2 is increased by endothelial cells during tumor angiogenesis (K. H. Plate et al., 1993, Millauer B et al., 1994). VEGFR2 expression has also been identified on myeloid-derived suppressor cells, where it functions in splenic MDSC expansion and the chemotaxis of MDSCs into tumors (Dineen et al., 2008, Huang Y et al., 2007, Roland CL et al., 2009).
In addition to stromal cells, VEGFR2 expression by tumor cells has been identified in a variety of cancers, including bladder (Xia G et al., 2006), brain (Knizetova P et al., 2008, Nobusawa S1 et al., 2011, Puputti M et al., 2006, Yao X et al., 2013), breast (Ghosh S et al., 2008, Nakopoulou L et al., 2002, Yan JD et al., 2015), carcinoid (Silva SR et al., 2011), cervical (Longatto-Filho A et al., 2009), colon (Giatromanolaki A et al., 2007, Takahashi Y et al., 1995), endometrial ID: 5045> (Giatromanolaki A et al., 2006), esophageal (Gockel I et al., 2008), gastric (Ozdemir F et al., 2006), head and neck (Lalla RV et al., 2003, Neuchrist C et al., 2001), lung (Carrillo de Santa Pau E et al., 2009, Chatterjee S et al., 2013, Decaussin M et al., 1999, Seto T et al., 2006, Yang F et al., 2011), melanoma (Straume O et al., 2003), mesothelioma (Strizzi L et al., 2001), multiple myeloma (Giatromanolaki A et al., 2010), myeloid leukemia (Padró T et al., 2002), ovarian (Chen H et al., 2004, Spannuth WA et al., 2009), pancreatic (Chung GG et al., 2006, Itakura J et al., 2000, von Marschall Z et al., 2000), prostate (Jackson MW et al., 2002, Köllermann J et al., 2001), renal cell carcinoma (Badalian G et al., 2007), squamous (Sato H et al., 2009), and thyroid (Rodrèguez-Antona C et al., 2010), (Table 7).
In some cases, tumor cell expression of VEGFR2 appears to play an important function in tumor progression and correlates with worse prognosis. For example, Yang et al. (2011) identified VEGFR2 copy number gains (CNG) in 32% of tumors, which was associated with increased VEGFR2 protein, tumor angiogenesis, and correlated with poor prognosis(Yang F et al., 2011). Furthermore, Chatterjee et al. (2013) identified that the levels of VEGF/VEGFR2 binding on tumor cells strongly correlated with tumor angiogenesis, and selective VEGFR2 inhibition had a significant combinatorial effect with MEK inhibitors in reducing tumor growth in preclinical models of NSCLC(Chatterjee S et al., 2013).
Yan et al. (2015) found that VEGFR2 expression by breast tumor cells was significantly correlated with increased lymph node metastasis, epithelial to mesenchymal transition (EMT) marker expression, and reduced overall survival(Yan JD et al., 2015).
For further review of expression and function of VEGFR2 in different cancers, see Table 7 and Goel and Mercurio, 2013(Goel HL et al., 2013).
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Entity name
Coronary Heart Disease
Note
Wang et al., 2007, identified that polymorphisms in the VEGFR2 were associated with coronary heart disease (Wang Y et al., 2007) (Table 5).
Entity name
Hemangioma
Note
Missense mutations have been identified in hemangioma, leading to constitutive activation of VEGFR2 (Antonescu CR et al., 2009, Jinnin M et al., 2008, Walter JW et al., 2002).

Bibliography

Pubmed IDLast YearTitleAuthors

Other Information

Locus ID:

NCBI: 3791
MIM: 191306
HGNC: 6307
Ensembl: ENSG00000128052

Variants:

dbSNP: 3791
ClinVar: 3791
TCGA: ENSG00000128052
COSMIC: KDR

RNA/Proteins

Gene IDTranscript IDUniprot
ENSG00000128052ENST00000263923P35968
ENSG00000128052ENST00000263923A0A024RD88

Expression (GTEx)

0
10
20
30
40
50
60
70
80
90

Pathways

PathwaySourceExternal ID
Cytokine-cytokine receptor interactionKEGGko04060
VEGF signaling pathwayKEGGko04370
Focal adhesionKEGGko04510
Cytokine-cytokine receptor interactionKEGGhsa04060
VEGF signaling pathwayKEGGhsa04370
Focal adhesionKEGGhsa04510
EndocytosisKEGGko04144
EndocytosisKEGGhsa04144
PI3K-Akt signaling pathwayKEGGhsa04151
PI3K-Akt signaling pathwayKEGGko04151
Proteoglycans in cancerKEGGhsa05205
Proteoglycans in cancerKEGGko05205
Ras signaling pathwayKEGGhsa04014
Rap1 signaling pathwayKEGGhsa04015
Rap1 signaling pathwayKEGGko04015
Signal TransductionREACTOMER-HSA-162582
Signaling by VEGFREACTOMER-HSA-194138
VEGF ligand-receptor interactionsREACTOMER-HSA-194313
VEGF binds to VEGFR leading to receptor dimerizationREACTOMER-HSA-195399
VEGFA-VEGFR2 PathwayREACTOMER-HSA-4420097
VEGFR2 mediated cell proliferationREACTOMER-HSA-5218921
Neurophilin interactions with VEGF and VEGFRREACTOMER-HSA-194306
Extracellular matrix organizationREACTOMER-HSA-1474244
Integrin cell surface interactionsREACTOMER-HSA-216083
Developmental BiologyREACTOMER-HSA-1266738
Axon guidanceREACTOMER-HSA-422475
EPH-Ephrin signalingREACTOMER-HSA-2682334
EPHA-mediated growth cone collapseREACTOMER-HSA-3928663
EGFR tyrosine kinase inhibitor resistanceKEGGko01521
EGFR tyrosine kinase inhibitor resistanceKEGGhsa01521
Fluid shear stress and atherosclerosisKEGGko05418
Fluid shear stress and atherosclerosisKEGGhsa05418

Protein levels (Protein atlas)

Not detected
Low
Medium
High

PharmGKB

Entity IDNameTypeEvidenceAssociationPKPDPMIDs
PA162372840sunitinibChemicalMultilinkAnnotation, Pathwayassociated12538485, 19248971, 20124951
PA164924492brivanibChemicalPathwayassociated20124951
PA164924493axitinibChemicalPathwayassociated20124951
PA165291492pazopanibChemicalClinicalAnnotationassociatedPD25411163
PA166114377hand-foot syndromeDiseaseClinicalAnnotationassociatedPD20630084
PA166118340motesanibChemicalPathwayassociated20124951
PA166118341vandetanibChemicalPathwayassociated20124951
PA26946CSKGenePathwayassociated20124951
PA29444HRASGenePathwayassociated28362716
PA30196KRASGenePathwayassociated28362716
PA31768NRASGenePathwayassociated28362716
PA31783NRP1GenePathwayassociated20124951
PA33304PIK3C2AGenePathwayassociated28362716
PA33305PIK3C2BGenePathwayassociated28362716
PA33308PIK3CAGenePathwayassociated28362716
PA33309PIK3CBGenePathwayassociated28362716
PA33310PIK3CDGenePathwayassociated28362716
PA33311PIK3CGGenePathwayassociated28362716
PA33312PIK3R1GenePathwayassociated28362716
PA33313PIK3R2GenePathwayassociated28362716
PA33314PIK3R3GenePathwayassociated28362716
PA33392PLCG1GenePathwayassociated20124951
PA33393PLCG2GenePathwayassociated20124951
PA36528TIMP3GenePathwayassociated20124951
PA37302VEGFAGenePathwayassociated20124951
PA37303VEGFBGenePathwayassociated20124951
PA37304VEGFCGenePathwayassociated20124951
PA443624Carcinoma, Renal CellDiseaseClinicalAnnotationassociatedPD
PA444447Carcinoma, HepatocellularDiseaseClinicalAnnotationassociatedPD25182707
PA444552HypertensionDiseaseClinicalAnnotationassociatedPD20630084
PA444685Kidney NeoplasmsDiseaseClinicalAnnotationassociatedPD25411163
PA7000sorafenibChemicalClinicalAnnotation, PathwayassociatedPD20124951, 20630084, 24510746, 25182707, 25816720, 28362716

References

Pubmed IDYearTitleCitations
193723762009Upstream open reading frames cause widespread reduction of protein expression and are polymorphic among humans.299
168939702006Vascular endothelial cadherin controls VEGFR-2 internalization and signaling from intracellular compartments.216
227895362012VEGF inhibits tumor cell invasion and mesenchymal transition through a MET/VEGFR2 complex.209
274613912016Mechanisms and regulation of endothelial VEGF receptor signalling.194
188247142008Association of vascular endothelial growth factor and vascular endothelial growth factor receptor-2 genetic polymorphisms with outcome in a trial of paclitaxel compared with paclitaxel plus bevacizumab in advanced breast cancer: ECOG 2100.192
231723032013Vascular endothelial growth factor and its receptor system: physiological functions in angiogenesis and pathological roles in various diseases.180
200481822010Phase I pharmacologic and biologic study of ramucirumab (IMC-1121B), a fully human immunoglobulin G1 monoclonal antibody targeting the vascular endothelial growth factor receptor-2.144
181946502008Angiopoietin-1 prevents VEGF-induced endothelial permeability by sequestering Src through mDia.141
223931262012Autocrine VEGF-VEGFR2-Neuropilin-1 signaling promotes glioma stem-like cell viability and tumor growth.141
286873572017Circular RNA MYLK as a competing endogenous RNA promotes bladder cancer progression through modulating VEGFA/VEGFR2 signaling pathway.139

Citation

Noah Sorrelle ; Rolf Brekken

KDR (kinase insert domain receptor)/Vascular Endothelial Growth Factor Receptor 2 (VEGFR2)

Atlas Genet Cytogenet Oncol Haematol. 2015-10-01

Online version: http://atlasgeneticsoncology.org/gene/41055/css/lib/bootstrap.min.css