NOTCH3 Gene: History
Please note this is an old version of this entry, which may differ significantly from the current revision.

notch 3

  • genes

1. Introduction

The NOTCH3 gene provides instructions for making a protein with one end (the intracellular end) that remains inside the cell, a middle (transmembrane) section that spans the cell membrane, and another end (the extracellular end) that projects from the outer surface of the cell. The NOTCH3 protein is called a receptor protein because certain other proteins, called ligands, attach (bind) to the extracellular end of NOTCH3, fitting like a key into a lock. This binding causes detachment of the intracellular end of the NOTCH3 protein, called the NOTCH3 intracellular domain, or NICD. The NICD enters the cell nucleus and helps control the activity (transcription) of other genes.

The NOTCH3 protein plays a key role in the function and survival of vascular smooth muscle cells, which are muscle cells that surround blood vessels. This protein is thought to be essential for the maintenance of blood vessels, including those that supply blood to the brain.

2. Health Conditions Related to Genetic Changes

2.1. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy

More than 270 mutations in the NOTCH3 gene have been found to cause cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, commonly known as CADASIL. Almost all of these mutations change a single protein building block (amino acid) in the NOTCH3 protein. The amino acid involved in most mutations is cysteine. The addition or deletion of a cysteine molecule in a certain area of the NOTCH3 protein, known as the EGF-like domain, presumably affects NOTCH3 function in vascular smooth muscle cells. Disruption of NOTCH3 functioning can lead to the self-destruction (apoptosis) of these cells. Damage to vascular smooth muscle cells is thought to cause recurrent strokes and other signs and symptoms of CADASIL.

2.2. Lateral meningocele syndrome

At least six NOTCH3 gene mutations have been identified in people with lateral meningocele syndrome. This disorder affects the nervous system, the bones and muscles, and other body systems. The condition is characterized by abnormalities known as lateral meningoceles. Lateral meningoceles are protrusions of the membranes surrounding the spinal cord (known as the meninges) through gaps in the bones of the spine (vertebrae). The protrusions are most common and typically larger in the lower spine. The meningoceles associated with this disorder may damage the nerves that spread from the spine to the rest of the body.

The mutations that cause lateral meningocele syndrome occur at the end of the gene in a region known as exon 33. These gene mutations result in a NOTCH3 protein with an abnormally short (truncated) NICD. The shortened protein is missing the portion that normally causes the breakdown of the NICD after it has performed its function in the cell nucleus and is no longer needed. As a result, the presence of the NICD in the cell is prolonged, and the protein continues to affect the activity of other genes. However, the result of this prolonged NICD activity and its connection to the specific features of lateral meningocele syndrome are not well understood.

3. Other Names for This Gene

  • Neurogenic locus notch homolog protein 3
  • Notch homolog 3
  • Notch homolog 3 (Drosophila)

This entry is adapted from the peer-reviewed paper


  1. Arboleda-Velasquez JF, Zhou Z, Shin HK, Louvi A, Kim HH, Savitz SI, Liao JK,Salomone S, Ayata C, Moskowitz MA, Artavanis-Tsakonas S. Linking Notch signaling to ischemic stroke. Proc Natl Acad Sci U S A. 2008 Mar 25;105(12):4856-61. doi:10.1073/pnas.0709867105.
  2. Dichgans M. Cerebral autosomal dominant arteriopathy with subcortical infarctsand leukoencephalopathy: phenotypic and mutational spectrum. J Neurol Sci. 2002Nov 15;203-204:77-80. Review.
  3. Ejaz R, Carter M, Gripp K. Lateral Meningocele Syndrome. 2016 Jun 23. In: AdamMP, Ardinger HH, Pagon RA, Wallace SE, Bean LJH, Stephens K, Amemiya A, editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle;1993-2020. Available from
  4. Gripp KW, Robbins KM, Sobreira NL, Witmer PD, Bird LM, Avela K, Makitie O,Alves D, Hogue JS, Zackai EH, Doheny KF, Stabley DL, Sol-Church K. Truncatingmutations in the last exon of NOTCH3 cause lateral meningocele syndrome. Am J MedGenet A. 2015 Feb;167A(2):271-81. doi: 10.1002/ajmg.a.36863.
  5. Haritunians T, Boulter J, Hicks C, Buhrman J, DiSibio G, Shawber C, WeinmasterG, Nofziger D, Schanen C. CADASIL Notch3 mutant proteins localize to the cellsurface and bind ligand. Circ Res. 2002 Mar 22;90(5):506-8.
  6. Kalaria RN, Viitanen M, Kalimo H, Dichgans M, Tabira T; CADASIL Group ofVas-Cog. The pathogenesis of CADASIL: an update. J Neurol Sci. 2004 Nov15;226(1-2):35-9. Review.
  7. Louvi A, Arboleda-Velasquez JF, Artavanis-Tsakonas S. CADASIL: a critical lookat a Notch disease. Dev Neurosci. 2006;28(1-2):5-12. Review.
  8. Rafalowska J, Dziewulska D, Fidzianska A. CADASIL: what component of thevessel wall is really a target for Notch 3 gene mutations? Neurol Res. 2004Jul;26(5):558-62. Review.
  9. Rutten JW, Haan J, Terwindt GM, van Duinen SG, Boon EM, Lesnik Oberstein SA.Interpretation of NOTCH3 mutations in the diagnosis of CADASIL. Expert Rev MolDiagn. 2014 Jun;14(5):593-603. doi: 10.1586/14737159.2014.922880. Review.
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