Inositol 1,4,5-trisphosphate receptors (IP3Rs) are ubiquitous intracellular Ca2+ release channels. Their activation, subcellular localization, abundance, and regulation play major roles in defining the spatiotemporal characteristics of intracellular Ca2+ signals, which are in turn fundamental to the appropriate activation of effectors that control a myriad of cellular events. Over the past decade, ∼100 mutations in ITPRs associated with human diseases have been documented. Mutations have been detailed in all three IP3R subtypes and all functional domains of the protein, resulting in both gain and loss of receptor function. IP3R mutations are associated with a diverse array of pathology including spinocerebellar ataxia, peripheral neuropathy, immunopathy, anhidrosis, hyperparathyroidism, and squamous cell carcinoma. This review focuses on how studying the altered activity of these mutations provides information relating to IP3R structure and function, the physiology underpinned by specific IP3R subtypes, and the pathological consequences of dysregulated Ca2+ signaling in human disease.
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