The main function of the SEC23A protein is to hydrolyze or break down a guanosine triphosphate (GTP) molecule bound to the SAR1A protein at the start of the COPII pathway. The energy released from the breaking of the GTP bond provides energy necessary to undergo another reaction. This triggers uncoating of the vesicle (a membrane bound carrying compartment for molecules) containing a secretory protein destined for packaging in the Golgi apparatus of the cell. Uncoating the vesicle exposes SNARE proteins which are needed for the vesicle to bind to the membrane site on the endoplasmic reticulum. A mutation in the SEC23A gene prevents the vesicle from uncoating so it will not bind to the receptor site on the endoplasmic reticulum to be released into the cytoplasm for transport to the Golgi apparatus. Thus, the vesicles will accumulate in the endoplasmic reticulum, causing it to become enlarged or distended. Ultimately, this causes the craniofacial symptoms present in patients with CLSD. This is probably due to abnormal secretion of collagen and possibly other secretory proteins which have accumulated in the endoplasmic reticulum. Collagen is responsible to for skull ossification, among other things.
Cranio-lenticulo-sutural dysplasia
Dandy–Walker malformation
Regional odontodysplasia
Congenital fourth nerve palsy
Choroid plexus tumor
Craniodiaphyseal dysplasia
Nasal glial heterotopia
Ischiopatellar dysplasia