id: MODULE:nmj_achr_clustering
title: Neuromuscular junction acetylcholine receptor clustering — neural agrin, LRP4 coreceptor, MuSK kinase activation by DOK7, CRK/CRKL adaptors and rapsyn anchoring; AGRN/LRP4/MUSK/DOK7/CRK/CRKL/RAPSN
description: >-
  At the vertebrate neuromuscular junction, nicotinic acetylcholine receptors (AChRs) are
  packed into the postsynaptic membrane of the skeletal muscle fiber at about
  10,000 per square micrometre, directly opposite the motor nerve terminal. They get
  there in two ways: subsynaptic nuclei transcribe the receptor genes at a higher rate,
  and receptors already in the membrane are clustered by tethering to a subsynaptic
  scaffold. The clustering signal starts with neural agrin, the z+ splice forms of
  AGRN that motor neurons secrete into the synaptic basal lamina. Agrin binds LRP4, a
  single-pass LDL-receptor-family protein on the muscle surface. LRP4 also binds the
  muscle-specific receptor tyrosine kinase MuSK. The arc-shaped LRP4 ectodomain holds
  agrin and MuSK together in a ternary complex, and this activates MuSK. Inside the
  cell, the adaptor DOK7 binds the phosphorylated NPXY juxtamembrane motif of MuSK
  through its PTB domain. Its PH-PTB region dimerises, which drives
  trans-autophosphorylation of the MuSK activation loop, so DOK7 acts as an
  intracellular activator of the kinase. MuSK then phosphorylates two tyrosines in the
  DOK7 C-terminal tail, and these recruit the adaptors CRK and CRKL, which relay the
  signal towards the actin cytoskeleton. Rapsyn (RAPSN), a 43 kDa peripheral membrane
  protein on the cytoplasmic face of the postsynaptic membrane, binds the AChR and
  links it to the MuSK-containing scaffold. Without rapsyn, receptors do not form
  clusters at all. Before innervation, MuSK, LRP4, rapsyn and AChRs already form
  aneural clusters in the central region of the muscle (prepatterning); nerve-derived
  agrin then sharpens and stabilises these clusters at the synapse. Loss-of-function
  variants in AGRN, LRP4, MUSK, DOK7 or RAPSN cause congenital myasthenic syndromes.
  Autoantibodies against MuSK or LRP4 cause forms of myasthenia gravis.
status: DRAFT
scope: CONCRETE
evidence:
  - source_id: PW:0000842
    title: acetylcholine signaling pathway via nicotinic acetylcholine receptor
    statement: >-
      This module covers one part of the PW:0000842 diagram: the separate cluster in which
      Agrn is associated with Lrp4, Lrp4 and Dok7 are each associated with Musk, Rapsn is
      associated with the NMJ nAChR node, and Musk positively affects NMJ nAChR. It also
      covers the record text that describes this cluster as the prepatterning and
      stabilisation machinery that localises NMJ receptors (agrin binding Lrp4, Lrp4
      interacting with MuSK, MuSK activation requiring Dok7, and clustering requiring
      rapsyn). The rest of the PW:0000842 diagram (ACh synthesis, vesicular loading,
      nicotinic reception and AChE clearance) is modelled in acetylcholine_signaling, which
      also cites PW:0000842. Derived through projects/RGD_PATHWAY_ONTOLOGY
      (pathways/PW_0000842.yaml).
  - source_id: GO:0071340
    title: skeletal muscle acetylcholine-gated channel clustering
    statement: >-
      The GO process this module realises. It is_a receptor clustering (GO:0043113) and is
      part_of neuromuscular junction development (GO:0007528) and postsynaptic membrane
      organization (GO:0001941). In GOA it is carried by Agrn, Lrp4, Musk, Rapsn, Fnta and
      Dnaja3 (and their orthologues), and by none of the AChR subunits.
  - source_id: PMID:7675108
    title: Failure of postsynaptic specialization to develop at neuromuscular junctions of rapsyn-deficient mice.
    statement: >-
      Separates the two routes to postsynaptic AChR accumulation. This module models the
      clustering route; synapse-specific transcription of the subunit genes is outside it.
    supporting_text: At least two distinct processes contribute to this accumulation. One is local synthesis
  - source_id: PMID:10320756
    title: Distinct phenotypes of mutant mice lacking agrin, MuSK, or rapsyn.
    statement: >-
      Agrin, MuSK and rapsyn act in one pathway from the nerve signal to the receptor
      scaffold, and rapsyn is the component that is essential for cluster formation itself.
    supporting_text: Thus, although both MuSK and rapsyn are required for AChR clustering in vivo, only rapsyn is essential for cluster formation per se.
notes: >-
  Derivation. This module was split out of modules/acetylcholine_signaling.yaml, whose
  boundary decision (4) excludes the agrin-LRP4-MuSK-DOK7-rapsyn set. The reason is that
  those proteins build the synapse rather than receiving or transducing the ACh signal.
  That module names GO:0071340 and the mouse GO-CAM gomodel:64c3044100000089 as the
  grounding for a separate module. The members come from the RGD Pathway Ontology diagram
  PW:0000842, which draws Agrn/Lrp4/Musk/Dok7/Rapsn as a cluster acting on the NMJ nAChR.
  PW:0000842 is listed as an evidence source of this module as well, because this module
  is derived from that cluster of the diagram. PW:0000841 (the ACh overview) and
  PW:0000843 (muscarinic) are not cited, because they do not draw this machinery.
  Boundary decisions.
  (1) The muscle AChR is the cargo of this process, not a participant in it, and is
  therefore not a part. The CLAUDE.md test is whether a product does any of the work of
  the process. Rapsyn does: it binds the receptor and tethers it to the scaffold, and
  without it no clusters form (PMID:7675108, PMID:10320756). The AChR pentamer is the
  thing that is gathered. Comparator check (QuickGO, GO:0071340 with is_a/part_of
  descendants, human/mouse/rat, October 2026): the term and its regulation children are
  carried by Agrn, Lrp4, Musk, Rapsn, Fnta, Dnaja3, Colq, Dvl1, Etv5 and Rer1 (several
  as acts_upstream_of_or_within), and by none of Chrna1, Chrnb1, Chrnd, Chrne or Chrng.
  Human CHRNA1 instead carries channel, signalling and NMJ-location terms (GO:0022848,
  GO:0095500, GO:0007274, GO:0031594), and the gene reviews used for
  acetylcholine_signaling record those as its core. The term's parent GO:0043113 receptor
  clustering is a protein-localisation process (is_a GO:0072657 protein localization to
  membrane), and such terms name the machinery that moves or holds the protein, not the
  protein that is localised. The receptor therefore appears only as the target of the
  rapsyn adaptor function (acetylcholine-gated channel complex GO:0005892, with CHRNA1 as
  the representative subunit). Its channel function is modelled in
  acetylcholine_signaling#nachr_muscle and is not repeated here. A module_ref part was
  deliberately not used, because it would make the receptor a required step of the
  clustering process.
  (2) Agrin is modelled as the neural (z+) splice class of AGRN on the canonical
  accession O00468. The UniProt record states that isoforms 1, 4 and 5 are the
  neuron-specific z+ forms that activate AChR clustering, and that the z8 insert is
  needed for LRP4 binding. The z- muscle and endothelial forms lack this activity. The
  annoton uses the AGRN gene-review core function, transmembrane receptor protein
  tyrosine kinase activator activity GO:0030297. This is defensible because the agrin
  LRP4 MuSK cryo-EM structure shows that LRP4 brings agrin into direct contact with
  MuSK (PMID:37252960). The mouse GO-CAM uses receptor ligand activity GO:0048018 for
  Agrn; that term is a sibling under signaling receptor activator activity GO:0030546,
  not a conflict. Agrin's laminin and dystroglycan binding, which anchor it in the
  basal lamina, are recorded in the AGRN review and are not modelled here.
  (3) LRP4 coreceptor activity GO:0015026 follows the LRP4 review core function and the
  GO-CAM. LRP4 also has a second role as a retrograde signal: muscle LRP4 binds the motor
  axon and promotes presynaptic differentiation. That role is a presynaptic-assembly
  process and is out of scope, like the LRP4 sclerostin/Wnt role in bone.
  (4) MuSK activation is one node with two annotons. MUSK carries transmembrane receptor
  protein tyrosine kinase activity GO:0004714 (GOA IBA plus EXP for GO:0004713). DOK7
  carries protein tyrosine kinase activator activity GO:0030296, the first core function
  in the DOK7 review, supported by the Dok7 PH-PTB dimer structure (PMID:20603078).
  (5) The DOK7 C-terminal tail to CRK/CRKL relay is a required part. DOK7's second
  review core function is transmembrane receptor protein tyrosine kinase adaptor activity
  GO:0005068, and CRK and CRKL carry signaling adaptor activity GO:0035591. CRK has this
  by IDA; CRKL has it by IBA, and the mouse GO-CAM uses it for both Crk and Crkl. Crk and
  Crk-L are redundant, so they are one family annoton, and only loss of both in muscle
  gives severe NMJ defects (PMID:21041412). Further downstream, the GO-CAM continues
  through FARP1 guanyl-nucleotide exchange factor activity, protein
  geranylgeranyltransferase I (FNTA), RAC1 and positive regulation of Rac protein signal
  transduction (GO:0035022) to postsynaptic actin organisation. That Rac/actin effector
  arm is not modelled, because RGD does not draw it and its members (FARP1, FNTA, RAC1,
  and the Abl/Src-family kinases that phosphorylate the AChR beta subunit) are not on the
  RGD gene list. It is a candidate for a later extension.
  (6) Candidates considered and not added. TID1/DNAJA3 binds MuSK and is required for
  agrin-induced clustering in mouse myotubes. Its human and rat GOA rows for GO:0071340
  are ISS/ISO only, and no paper on it was cached and read for this module, so it is
  recorded here only. Neuregulin/ErbB-driven synapse-specific transcription, the Wnt
  coreceptor roles of MuSK and LRP4, ColQ/perlecan anchoring of AChE (which sits in
  acetylcholine_signaling), and NMJ formation in general (GO:0007528, GO:0051124) are
  out of scope. ACh reception itself is acetylcholine_signaling.
  (7) Rapsyn's molecular function is protein-macromolecule adaptor activity GO:0030674,
  as in the mouse GO-CAM. The only experimental MF row in GOA is acetylcholine receptor
  binding GO:0033130 (mouse IDA, transferred to human by IBA), which describes the
  binding but not the bridging role.
  GO-CAM. gomodel:64c3044100000089 "Skeletal muscle acetylcholine-gated channel
  clustering 1 (Mouse)" contains every annoton modelled here: Agrn, Lrp4, Musk (two
  activities), Dok7 (two activities), Crk, Crkl and Rapsn. Its activity links are
  recorded under gocam_associations. Possible upstream issue: in that model the Rapsn
  activity (GO:0030674, part_of GO:0071340) has input Chrna9 (MGI:MGI:1202403). The
  evidence cited for it is PMID:18420419, an inner-ear hair-cell study of rapsyn and the
  alpha9 receptor. In a skeletal-muscle clustering model the expected input would be the
  muscle receptor (Chrna1 and partners), so the has_input may have been carried over
  from the hair-cell paper. PMID:18420419 is not cached and its full text was not read,
  so this is flagged as a question rather than asserted as an error. No human GO-CAM covers this pathway.
  Gene reviews exist for AGRN, LRP4 and DOK7, and their core molecular functions were
  used. MUSK, RAPSN, CRK and CRKL have no review yet; their functions come from GOA and
  the cited literature. PANTHER family ids and PTNs are deliberately not asserted.
module:
  id: nmj_achr_clustering
  label: Neuromuscular junction acetylcholine receptor clustering
  module_type: BIOLOGICAL_PROCESS
  concepts:
    - preferred_term: skeletal muscle acetylcholine-gated channel clustering
      term:
        id: GO:0071340
        label: skeletal muscle acetylcholine-gated channel clustering
      description: >-
        The process as a whole: gathering of muscle AChRs into a dense postsynaptic patch
        opposite the nerve terminal. Part of neuromuscular junction development
        (GO:0007528), which is broader and is not asserted.
  context:
    taxa:
      - preferred_term: Homo sapiens
        term:
          id: NCBITaxon:9606
          label: Homo sapiens
    cell_types:
      - preferred_term: skeletal muscle fiber
        term:
          id: CL:0008002
          label: skeletal muscle fiber
    cellular_components:
      - preferred_term: neuromuscular junction
        term:
          id: GO:0031594
          label: neuromuscular junction
  parts:
    - order: 1
      role: nerve-derived clustering signal
      node:
        id: agrin_signal
        label: Neural (z+) agrin from the motor nerve terminal
        module_type: SIGNALING_PATHWAY
        description: >-
          Motor neurons secrete z+ agrin, which is held in the synaptic basal lamina and
          engages LRP4 on the muscle surface. Agrin also contacts MuSK directly once both
          are bound to LRP4.
        annotons:
          - id: agrn_musk_activator
            label: Neural agrin activates MuSK through LRP4
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: AGRN (neural z+ isoforms)
                term:
                  id: UniProtKB:O00468
                  label: Agrin
            function:
              preferred_term: transmembrane receptor protein tyrosine kinase activator activity
              term:
                id: GO:0030297
                label: transmembrane receptor protein tyrosine kinase activator activity
              targets:
                - preferred_term: MUSK
                  term:
                    id: UniProtKB:O15146
                    label: Muscle, skeletal receptor tyrosine-protein kinase
            processes:
              - preferred_term: cell surface receptor protein tyrosine kinase signaling pathway
                term:
                  id: GO:0007169
                  label: cell surface receptor protein tyrosine kinase signaling pathway
            locations:
              - preferred_term: basement membrane
                term:
                  id: GO:0005604
                  label: basement membrane
            role_description: >-
              The instructive nerve signal. Only the neuron-specific z+ splice forms carry
              clustering activity; this matches the AGRN gene-review core function.
            evidence:
              - source_id: file:human/AGRN/AGRN-uniprot.txt
                statement: Only the neural z+ agrin isoforms are potent AChR-clustering activators.
                supporting_text: 'Isoform 1, isoform 4 and isoform 5: neuron-specific (z+) isoforms that contain C-terminal insertions of 8-19 AA are potent activators of AChR clustering.'
              - source_id: PMID:8653787
                statement: Agrin signals through a MuSK-containing receptor complex with a myotube-specific accessory component (later identified as LRP4).
                supporting_text: Here we demonstrate that agrin acts via a receptor complex that includes MuSK as well as a myotube-specific accessory component.
              - source_id: PMID:37252960
                statement: In the ternary complex LRP4 brings agrin into direct contact with MuSK.
                supporting_text: This structure reveals that arc-shaped LRP4 simultaneously recruits both agrin and MuSK to its central cavity, thereby promoting a direct interaction between agrin and MuSK.
            gocam_associations:
              - model: gomodel:64c3044100000089
                activity: gomodel:64c3044100000089/64c3044100000098
                title: Skeletal muscle acetylcholine-gated channel clustering 1 (Mouse)
                description: >-
                  Agrn receptor ligand activity (GO:0048018) in extracellular region,
                  directly positively regulating Lrp4 coreceptor activity.
    - order: 2
      role: agrin coreceptor
      node:
        id: lrp4_coreceptor
        label: LRP4 binds agrin and MuSK
        module_type: SIGNALING_PATHWAY
        description: >-
          Muscle LRP4 binds neural agrin and MuSK and assembles the extracellular
          agrin/LRP4/MuSK signalling complex.
        annotons:
          - id: lrp4_agrin_coreceptor
            label: LRP4 coreceptor activity
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: LRP4
                term:
                  id: UniProtKB:O75096
                  label: Low-density lipoprotein receptor-related protein 4
            function:
              preferred_term: coreceptor activity
              term:
                id: GO:0015026
                label: coreceptor activity
            processes:
              - preferred_term: cell surface receptor protein tyrosine kinase signaling pathway
                term:
                  id: GO:0007169
                  label: cell surface receptor protein tyrosine kinase signaling pathway
            locations:
              - preferred_term: postsynaptic membrane
                term:
                  id: GO:0045211
                  label: postsynaptic membrane
            role_description: >-
              The agrin receptor of muscle; it is needed for agrin binding, MuSK activation and
              AChR clustering. This matches the LRP4 gene-review core function.
            evidence:
              - source_id: PMID:18848351
                statement: Lrp4 is the agrin receptor and forms a complex with MuSK.
                supporting_text: Here, we report that Lrp4, a member of the LDLR family, is a receptor for Agrin, forms a complex with MuSK, and mediates MuSK activation by Agrin.
              - source_id: PMID:18957220
                statement: LRP4 knockdown reduces agrin binding, MuSK phosphorylation and AChR clustering.
                supporting_text: Suppression of LRP4 expression in muscle cells attenuates agrin binding, agrin-induced MuSK tyrosine phosphorylation, and AChR clustering.
              - source_id: PMID:18957220
                statement: The LRP4-MuSK complex is stimulated by agrin.
                supporting_text: LRP4 also forms a complex with MuSK in a manner that is stimulated by agrin.
            gocam_associations:
              - model: gomodel:64c3044100000089
                activity: gomodel:64c3044100000089/64c3044100000674
                title: Skeletal muscle acetylcholine-gated channel clustering 1 (Mouse)
                description: Lrp4 coreceptor activity (GO:0015026), directly positively regulating Musk.
    - order: 3
      role: MuSK kinase activation
      node:
        id: musk_activation
        label: MuSK activation, with DOK7 as cytoplasmic activator
        module_type: SIGNALING_PATHWAY
        description: >-
          Agrin-bound LRP4 activates MuSK. DOK7 binds the phosphorylated MuSK juxtamembrane
          NPXY motif, dimerises through its PH-PTB region and promotes
          trans-autophosphorylation of the MuSK activation loop. Overexpressed DOK7 can
          activate MuSK without agrin, which is thought to underlie aneural prepatterning.
        annotons:
          - id: musk_rtk
            label: MuSK receptor tyrosine kinase
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: MUSK
                term:
                  id: UniProtKB:O15146
                  label: Muscle, skeletal receptor tyrosine-protein kinase
            function:
              preferred_term: transmembrane receptor protein tyrosine kinase activity
              term:
                id: GO:0004714
                label: transmembrane receptor protein tyrosine kinase activity
              targets:
                - preferred_term: DOK7
                  term:
                    id: UniProtKB:Q18PE1
                    label: Protein Dok-7
            processes:
              - preferred_term: cell surface receptor protein tyrosine kinase signaling pathway
                term:
                  id: GO:0007169
                  label: cell surface receptor protein tyrosine kinase signaling pathway
            locations:
              - preferred_term: postsynaptic membrane
                term:
                  id: GO:0045211
                  label: postsynaptic membrane
            role_description: >-
              The signalling kinase of the pathway; it autophosphorylates and also
              phosphorylates the DOK7 C-terminal tail.
            evidence:
              - source_id: PMID:8653787
                statement: MuSK is the receptor tyrosine kinase of the motor endplate through which agrin acts.
                supporting_text: MuSK is a receptor tyrosine kinase localized to the motor endplate, seemingly well positioned to receive a key nerve-derived signal.
              - source_id: PMID:21041412
                statement: Agrin-activated MuSK phosphorylates the DOK7 C-terminal tail.
                supporting_text: We show that Agrin stimulates phosphorylation of two tyrosine residues in the C-terminal domain of Dok-7
            gocam_associations:
              - model: gomodel:64c3044100000089
                activity: gomodel:64c3044100000089/64c3044100000096
                title: Skeletal muscle acetylcholine-gated channel clustering 1 (Mouse)
                description: >-
                  Musk protein tyrosine kinase activity (GO:0004713) in postsynaptic membrane,
                  directly positively regulating Dok7 and Fnta.
              - model: gomodel:64c3044100000089
                activity: gomodel:64c3044100000089/64d5781900001202
                title: Skeletal muscle acetylcholine-gated channel clustering 1 (Mouse)
                description: >-
                  Second Musk kinase activity with Dok7 as input, directly positively
                  regulating the Dok7 activity that recruits Crk/Crkl.
          - id: dok7_musk_activator
            label: DOK7 activates MuSK from the cytoplasm
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: DOK7
                term:
                  id: UniProtKB:Q18PE1
                  label: Protein Dok-7
            function:
              preferred_term: protein tyrosine kinase activator activity
              term:
                id: GO:0030296
                label: protein tyrosine kinase activator activity
              targets:
                - preferred_term: MUSK
                  term:
                    id: UniProtKB:O15146
                    label: Muscle, skeletal receptor tyrosine-protein kinase
            processes:
              - preferred_term: cell surface receptor protein tyrosine kinase signaling pathway
                term:
                  id: GO:0007169
                  label: cell surface receptor protein tyrosine kinase signaling pathway
            locations:
              - preferred_term: postsynaptic membrane
                term:
                  id: GO:0045211
                  label: postsynaptic membrane
            role_description: >-
              Needed for MuSK activation, AChR clustering and synapse formation. This matches
              the first core function in the DOK7 gene review.
            evidence:
              - source_id: PMID:20603078
                statement: DOK7 is both a MuSK substrate and an activator of the MuSK kinase.
                supporting_text: Unique among adaptor proteins recruited to RTKs, Dok7 is not only a substrate of MuSK, but also an activator of MuSK
              - source_id: PMID:20603078
                statement: The Dok7 PH-PTB dimer drives MuSK trans-autophosphorylation.
                supporting_text: The structure and biochemical data reveal a dimeric arrangement of Dok7 PH-PTB that facilitates trans-autophosphorylation of the kinase activation loop.
              - source_id: PMID:16794080
                statement: Dok-7-null mice form no AChR clusters.
                supporting_text: Mice lacking Dok-7 formed neither acetylcholine receptor clusters nor neuromuscular synapses.
            gocam_associations:
              - model: gomodel:64c3044100000089
                activity: gomodel:64c3044100000089/64c3044100000694
                title: Skeletal muscle acetylcholine-gated channel clustering 1 (Mouse)
                description: >-
                  Dok7 signaling adaptor activity (GO:0035591) with Musk as input, directly
                  positively regulating Musk.
    - order: 4
      role: DOK7-CRK/CRKL downstream relay
      node:
        id: dok7_crk_relay
        label: Phospho-DOK7 recruits CRK and CRKL
        module_type: SIGNALING_PATHWAY
        description: >-
          MuSK phosphorylates two tyrosines in the DOK7 C-terminal tail. These recruit the
          SH2-SH3 adaptors CRK and CRKL, which relay the signal towards the postsynaptic
          actin cytoskeleton.
        annotons:
          - id: dok7_tail_adaptor
            label: DOK7 C-terminal tail adaptor for CRK/CRKL
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: DOK7
                term:
                  id: UniProtKB:Q18PE1
                  label: Protein Dok-7
            function:
              preferred_term: transmembrane receptor protein tyrosine kinase adaptor activity
              term:
                id: GO:0005068
                label: transmembrane receptor protein tyrosine kinase adaptor activity
            processes:
              - preferred_term: cell surface receptor protein tyrosine kinase signaling pathway
                term:
                  id: GO:0007169
                  label: cell surface receptor protein tyrosine kinase signaling pathway
            locations:
              - preferred_term: postsynaptic membrane
                term:
                  id: GO:0045211
                  label: postsynaptic membrane
            role_description: >-
              The second DOK7 core function in its gene review; most congenital myasthenia
              mutations in DOK7 truncate this C-terminal region.
            evidence:
              - source_id: PMID:21041412
                statement: Phosphorylated DOK7 tail tyrosines recruit Crk and Crk-L.
                supporting_text: "which leads to recruitment of two adapter proteins: Crk and Crk-L"
            gocam_associations:
              - model: gomodel:64c3044100000089
                activity: gomodel:64c3044100000089/64d5781900001209
                title: Skeletal muscle acetylcholine-gated channel clustering 1 (Mouse)
                description: Dok7 signaling adaptor activity, directly positively regulating Crk and Crkl.
          - id: crk_crkl_adaptor
            label: CRK/CRKL signaling adaptors
            participant:
              selector_type: FAMILY
              family:
                preferred_term: CRK-family SH2-SH3 adaptors (CRK, CRKL)
                representative_members:
                  - preferred_term: CRK
                    term:
                      id: UniProtKB:P46108
                      label: Adapter molecule crk
                  - preferred_term: CRKL
                    term:
                      id: UniProtKB:P46109
                      label: Crk-like protein
            function:
              preferred_term: signaling adaptor activity
              term:
                id: GO:0035591
                label: signaling adaptor activity
            processes:
              - preferred_term: cell surface receptor protein tyrosine kinase signaling pathway
                term:
                  id: GO:0007169
                  label: cell surface receptor protein tyrosine kinase signaling pathway
            role_description: >-
              CRK and CRKL are redundant here; loss of both in muscle is needed to produce
              severe NMJ defects.
            evidence:
              - source_id: PMID:21041412
                statement: Muscle-specific loss of both Crk and Crk-L severely disrupts neuromuscular synapses.
                supporting_text: selective inactivation of Crk and Crk-L in skeletal muscle leads to severe defects in neuromuscular synapses in vivo
            gocam_associations:
              - model: gomodel:64c3044100000089
                activity: gomodel:64c3044100000089/64d5781900001211
                title: Skeletal muscle acetylcholine-gated channel clustering 1 (Mouse)
                description: Crk signaling adaptor activity, directly positively regulating Farp1.
              - model: gomodel:64c3044100000089
                activity: gomodel:64c3044100000089/64d5781900001218
                title: Skeletal muscle acetylcholine-gated channel clustering 1 (Mouse)
                description: Crkl signaling adaptor activity.
    - order: 5
      role: AChR anchoring and cluster formation
      node:
        id: rapsyn_anchoring
        label: Rapsyn tethers AChRs to the MuSK-containing scaffold
        module_type: BIOLOGICAL_PROCESS
        description: >-
          Rapsyn, on the cytoplasmic face of the postsynaptic membrane, binds the AChR and
          links it to the subsynaptic scaffold organised around MuSK, gathering receptors
          into high-density clusters. The receptor is the cargo of this step.
        annotons:
          - id: rapsn_achr_adaptor
            label: Rapsyn AChR-scaffold adaptor
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: RAPSN
                term:
                  id: UniProtKB:Q13702
                  label: 43 kDa receptor-associated protein of the synapse
            function:
              preferred_term: protein-macromolecule adaptor activity
              term:
                id: GO:0030674
                label: protein-macromolecule adaptor activity
              targets:
                - preferred_term: muscle nicotinic acetylcholine receptor
                  term:
                    id: GO:0005892
                    label: acetylcholine-gated channel complex
                - preferred_term: CHRNA1 (representative muscle AChR subunit)
                  term:
                    id: UniProtKB:P02708
                    label: Acetylcholine receptor subunit alpha
            processes:
              - preferred_term: skeletal muscle acetylcholine-gated channel clustering
                term:
                  id: GO:0071340
                  label: skeletal muscle acetylcholine-gated channel clustering
            locations:
              - preferred_term: postsynaptic specialization membrane
                term:
                  id: GO:0099634
                  label: postsynaptic specialization membrane
            role_description: >-
              The receptor-anchoring component. Of the pathway members, rapsyn is the one
              essential for cluster formation itself.
            evidence:
              - source_id: PMID:7675108
                statement: Rapsyn is the key component of the subsynaptic complex that AChRs tether to.
                supporting_text: they form high-density clusters by tethering to a subsynaptic cytoskeletal complex. A key component of this complex is rapsyn
              - source_id: PMID:7675108
                statement: Rapsyn-null mice form no AChR clusters.
                supporting_text: We report that rapsyn is essential for the formation of AChR clusters
              - source_id: PMID:9136771
                statement: MuSK forms the primary scaffold to which rapsyn attaches AChRs and other synaptic components.
                supporting_text: suggesting that MuSK forms a primary structural scaffold to which rapsyn attaches other synaptic components
            gocam_associations:
              - model: gomodel:64c3044100000089
                activity: gomodel:64c3044100000089/64c3044100000676
                title: Skeletal muscle acetylcholine-gated channel clustering 1 (Mouse)
                description: >-
                  Rapsn protein-macromolecule adaptor activity (GO:0030674) part_of GO:0071340;
                  its has_input is Chrna9 rather than a muscle subunit (see notes).
  connections:
    - source: agrin_signal
      target: lrp4_coreceptor
      connection_type: POSITIVELY_REGULATES
      description: Neural agrin binds and engages LRP4.
    - source: lrp4_coreceptor
      target: musk_activation
      connection_type: POSITIVELY_REGULATES
      description: The agrin-LRP4 complex activates MuSK.
    - source: musk_activation
      target: dok7_crk_relay
      connection_type: POSITIVELY_REGULATES
      description: Active MuSK phosphorylates the DOK7 tail, which recruits CRK/CRKL.
    - source: musk_activation
      target: rapsyn_anchoring
      connection_type: POSITIVELY_REGULATES
      description: >-
        MuSK signalling organises the scaffold to which rapsyn tethers AChRs (RGD's "Musk
        positively affects NMJ nAChR" edge, read as receptor localisation).
