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

Atlas Image

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.
Atlas Image

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.
Atlas Image

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

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232168362013VEGFA and tumour angiogenesis.Claesson-Welsh L et al
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95566091998Requirements for binding and signaling of the kinase domain receptor for vascular endothelial growth factor.Fuh G et al
98047961998Vascular endothelial growth factor regulates endothelial cell survival through the phosphatidylinositol 3'-kinase/Akt signal transduction pathway. Requirement for Flk-1/KDR activation.Gerber HP et al
187156212008High levels of vascular endothelial growth factor and its receptors (VEGFR-1, VEGFR-2, neuropilin-1) are associated with worse outcome in breast cancer.Ghosh S et al
206830192010Hypoxia and activated VEGF/receptor pathway in multiple myeloma.Giatromanolaki A et al
109218872000A repressor sequence in the juxtamembrane domain of Flt-1 (VEGFR-1) constitutively inhibits vascular endothelial growth factor-dependent phosphatidylinositol 3'-kinase activation and endothelial cell migration.Gille H et al
217124472011Novel functional germline variants in the VEGF receptor 2 gene and their effect on gene expression and microvessel density in lung cancer.Glubb DM et al
188138252008Co-expression of receptor tyrosine kinases in esophageal adenocarcinoma and squamous cell cancer.Gockel I et al
242631902013VEGF targets the tumour cell.Goel HL et al
163941782006Regulation of the vascular endothelial growth factor (VEGF) receptor Flk-1/KDR by estradiol through VEGF in uterus.Hervé MA et al
173768912007Distinct roles of VEGFR-1 and VEGFR-2 in the aberrant hematopoiesis associated with elevated levels of VEGF.Huang Y et al
105855782000Concomitant over-expression of vascular endothelial growth factor and its receptors in pancreatic cancer.Itakura J et al
118305432002A potential autocrine role for vascular endothelial growth factor in prostate cancer.Jackson MW et al
152152512004Vascular endothelial growth factor (VEGF)-D and VEGF-A differentially regulate KDR-mediated signaling and biological function in vascular endothelial cells.Jia H et al
189316842008Suppressed NFAT-dependent VEGFR1 expression and constitutive VEGFR2 signaling in infantile hemangioma.Jinnin M et al
221707302012Increased gene copy number of KIT and VEGFR2 at 4q12 in primary breast cancer is related to an aggressive phenotype and impaired prognosis.Johansson I et al
86172041996A novel vascular endothelial growth factor, VEGF-C, is a ligand for the Flt4 (VEGFR-3) and KDR (VEGFR-2) receptor tyrosine kinases.Joukov V et al
114477402001Expression of vascular endothelial growth factor (VEGF) and VEGF receptor Flk-1 in benign, premalignant, and malignant prostate tissue.Köllermann J et al
110499872000Role of SCL/Tal-1, GATA, and ets transcription factor binding sites for the regulation of flk-1 expression during murine vascular development.Kappel A et al
75856551995Expression of the vascular endothelial growth factor (VEGF) receptor gene, KDR, in hematopoietic cells and inhibitory effect of VEGF on apoptotic cell death caused by ionizing radiation.Katoh O et al
100377371999Vascular endothelial growth factor receptor KDR tyrosine kinase activity is increased by autophosphorylation of two activation loop tyrosine residues.Kendall RL et al
252671992014OVOL2 is a critical regulator of ER71/ETV2 in generating FLK1+, hematopoietic, and endothelial cells from embryonic stem cells.Kim JY et al
187193732008Autocrine regulation of glioblastoma cell cycle progression, viability and radioresistance through the VEGF-VEGFR2 (KDR) interplay.Knizetova P et al
227620162012Signal transduction by vascular endothelial growth factor receptors.Koch S et al
169512162006Vascular endothelial growth factor signaling pathways: therapeutic perspective.Kowanetz M et al
129253492003Expression of vascular endothelial growth factor receptors on tumor cells in head and neck squamous cell carcinoma.Lalla RV et al
184626992008ER71 acts downstream of BMP, Notch, and Wnt signaling in blood and vessel progenitor specification.Lee D et al
195636582009Molecular characterization of EGFR, PDGFRA and VEGFR2 in cervical adenosquamous carcinoma.Longatto-Filho A et al
17179951991A receptor tyrosine kinase cDNA isolated from a population of enriched primitive hematopoietic cells and exhibiting close genetic linkage to c-kit.Matthews W et al
98891931999A novel vascular endothelial growth factor encoded by Orf virus, VEGF-E, mediates angiogenesis via signalling through VEGFR-2 (KDR) but not VEGFR-1 (Flt-1) receptor tyrosine kinases.Meyer M et al
81078271994Glioblastoma growth inhibited in vivo by a dominant-negative Flk-1 mutant.Millauer B et al
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123785092002Expression of the vascular endothelial growth factor receptor-2/Flk-1 in breast carcinomas: correlation with proliferation.Nakopoulou L et al
118019542001Vascular endothelial growth factor receptor 2 (VEGFR2) expression in squamous cell carcinomas of the head and neck.Neuchrist C et al
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84239881993NYK/FLK-1: a putative receptor protein tyrosine kinase isolated from E10 embryonic neuroepithelium is expressed in endothelial cells of the developing embryo.Oelrichs RB et al
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167616232006The effects of VEGF and VEGFR-2 on survival in patients with gastric cancer.Ozdemir F et al
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76947951993Up-regulation of vascular endothelial growth factor and its cognate receptors in a rat glioma model of tumor angiogenesis.Plate KH et al
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14178311992Identification of the KDR tyrosine kinase as a receptor for vascular endothelial cell growth factor.Terman BI et al
13241381992The KDR gene maps to human chromosome 4q31.2----q32, a locus which is distinct from locations for other type III growth factor receptor tyrosine kinases.Terman BI et al
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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/kdr