Abstract:
OBJECTIVE: To characterize the molecular basis of the 21-hydroxylase deficiency in a group of Argentine patients presenting the classical and nonclassical forms of the disease. DESIGN: To analyse the frequency of point mutations in the CYP21 gene by DNA amplification and mutation detection. PATIENTS: Forty-one patients from 36 nonrelated families: 25 nonclassical (NC), 11 salt-wasting (SW) and five simple virilising (SV). A total of 27 parents and 13 nonaffected siblings were also analysed. MEASUREMENTS: Basal steroid hormones and 17-hydroxyprogesterone levels following adrenal stimulation with adrenocorticotrophic hormone were measured, together with an analysis of 10 point mutations in the CYP21 gene. RESULTS: A total of 83% and 74.4% classical and non-classical chromosomes, respectively, were characterized. The intron 2 mutation was the most prevalent among classical alleles. In addition, a high frequency for R356W was observed in both groups (13.3 and 6.9%, respectively), while V281L was the most frequent mutation among the nonclassical patients with a frequency of 39.5%. No alleles containing P30L were observed, and onede novo mutation (R356W) was found. A total of 68.3% patients were fully genotyped, and all but one showed no genotype/phenotype discrepancy. Though the cut-off value for post-ACTH 17-hydroxyprogesterone stimulation was 30.25 nmol/l (10.00 μg/l), the lowest value observed in the fully genotyped nonclassical group was 42.35 nmol/l (14.00 μg/l). CONCLUSIONS: The high number of unidentified alleles in the nonclassical group suggests that less frequent mutations, or the presence of new ones, might be the cause of the disease in the Argentine population. Alternatively, the cut-off value in the ACTH-stimulated 17-hydroxyprogesterone test might overestimate the diagnosis of the nonclassical form by including some patients with heterozygous status.
Registro:
Documento: |
Artículo
|
Título: | Classical and nonclassical 21-hydroxylase deficiency: A molecular study of Argentine patients |
Autor: | Dain, L.B.; Buzzalino, N.D.; Oneto, A.; Belli, S.; Stivel, M.; Pasqualini, T.; Minutolo, C.; Charreau, E.H.; Alba, L.G. |
Filiación: | Centro Nacional de Genética Médica, Argentina División de Endocrinología Hospital Durand, Universidad de Buenos Aires, Argentina Servicio de Pediatría Hospital Italiano, Universidad de Buenos Aires, Argentina Instituto de Biología y Medicina Experimental, Universidad de Buenos Aires, Argentina Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Argentina Centro Nacional de Genética Médica, Avda. Las Heras 2670, (1425) Buenos Aires, Argentina
|
Palabras clave: | corticotropin; hydroxyprogesterone; steroid 21 monooxygenase; steroid hormone; adrenal gland; allele; Argentina; article; chromosome analysis; clinical article; congenital adrenal hyperplasia; controlled study; enzyme deficiency; female; gene; gene amplification; gene frequency; genotype phenotype correlation; heterozygote; hormone determination; human; intron; male; mutation rate; parent; point mutation; prevalence; priority journal; salt losing nephritis; sibling; virilization; 17-alpha-Hydroxyprogesterone; Adrenal Hyperplasia, Congenital; Adrenocorticotropic Hormone; Alleles; Argentina; Female; Genotype; Heterozygote; Homozygote; Humans; Male; Point Mutation; Steroid 21-Hydroxylase |
Año: | 2002
|
Volumen: | 56
|
Número: | 2
|
Página de inicio: | 239
|
Página de fin: | 245
|
DOI: |
http://dx.doi.org/10.1046/j.0300-0664.2001.01419.x |
Título revista: | Clinical Endocrinology
|
Título revista abreviado: | Clin. Endocrinol.
|
ISSN: | 03000664
|
CODEN: | CLENA
|
CAS: | 17-alpha-Hydroxyprogesterone, 68-96-2; Adrenocorticotropic Hormone, 9002-60-2; Steroid 21-Hydroxylase, EC 1.14.99.10
|
Registro: | https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_03000664_v56_n2_p239_Dain |
Referencias:
- Azziz, R., Dewailly, D., Owerbach, D., Clinical review 56: Non-classic adrenal hyperplasia: Current concepts (1994) Journal of Clinical Endocrinology and Metabolism, 78, pp. 810-815
- Bachega, T.A., Billerbeck, A.E., Madureira, G., Marcondes, J.A.M., Longui, C.A., Leite, M.V., Arnhold, I.J.P., Mendonca, B.B., Molecular genotyping in Brazilian patients with the classical and nonclassical forms of 21-hydroxylase deficiency (1998) Journal of Clinical Endocrinology and Metabolism, 83, pp. 4416-4419
- Balsamo, A., Cacciari, E., Baldazzi, L., Tartaglia, L., Cassio, A., Montovani, V., Piazzi, S., Zapulla, F., CYP21 analysis and phenotype/genotype relationship in the screened population of the Italian Emilia Romagna region (2000) Clinical Endocrinology, 53, pp. 117-125
- Blanché, H., Vexiau, P., Clauin, S., Le Gall, I., Fiet, J., Mornet, E., Dausset, J., Bellanné-Chantelot, C., Exhaustive screening of 21-hydroxylase gene in a population of hyperandrogenic women (1997) Human Genetics, 101, pp. 56-60
- Bobba, A., Marra, E., Giannasttasio, S., Iolascon, A., Monno, F., Di Maio, S., 21-Hydroxylase deficiency in Italy: A distinct distribution pattern of CYP21 mutations in a sample from southern Italy (1999) Journal of Medical Genetics, 36, pp. 648-650
- Carrera, P., Bordone, L., Azzani, T., Brunelli, V., Garancini, M.P., Chiumello, G., Ferrari, M., Point mutations in Italian patients with cassic, non-classis, and cryptic forms of steroid 21-hydroxylase deficiency (1996) Human Genetics, 98, pp. 662-665
- Carroll, M.C., Campbell, R.D., Porter, R.R., Mapping of steroid 21-hydroxylase genes adjacent to complement component C4 genes in HLA, the major histocompatibility complex in man (1985) Proceedings of the National Academy of Sciences USA, 82, pp. 521-525
- Dardis, A., Bergadá, I., Bergadá, C., Rivarola, M., Belgorovsky, A., Mutations of the steroid 21-hydroxylase gene in an Argentinian population of 36 patients with classical congenital adrenal hyperplasia (1997) Journal of Pediatric Endocrinology and Metabolism, 10, pp. 55-61
- Donohoue, P.A., Van Dop, C., McLean, R.H., Bias, W., Migeon, C.J., Gene conversion in salt-losing congenital adrenal hyperplasia with absent complement C4B protein (1986) Journal of Clinical Endocrinology and Metabolism, 62, pp. 995-1002
- Ezquieta, B., Oliver, A., Gracía, R., Gancedo, P.G., Analysis of steroid 21-hydroxylase gene mutations in Spanish population (1995) Human Genetics, 96, pp. 198-204
- Fardella, C.E., Poggi, H., Pineda, P., Soto, J., Torrealba, I., Cattani, A., Oestreicher, E., Foradori, A., Salt-wasting congenital adrenal hyperplasia: Detection of mutations in CP21B gene in Chilean population (1998) Journal of Clinical Endocrinology and Metabolism, 83, pp. 3357-3360
- Fardella, C.E., Poggi, H., Soto, J., Torrealba, I., Cattani, A., Ugarte, F., Cortinez, A., Foradori, A., Mutations in the CYP21 B gene in a Chilean population with simple virilizing congenital adrenal hyperplasia (2000) Journal of Endocrinological Investigation, 23, pp. 412-416
- Helmberg, A., Tusie-Luna, M.T., Tabarelli, M., Kofler, R., White, P.C., R339H and P453S: CYP21 mutations associated with non-classic steroid 21-hydroxylase deficiency that are not apparent gene conversion (1992) Molecular Endocrinology, 6, pp. 1318-1322
- Higashi, Y., Yoshioka, H., Yamane, M., Gotoh, O., Fujii-Kuriyama, Y., Complete nucleotide sequence of two steroid 21-hydroxylase genes tandemly arranged in human chromosome: A pseudogene and a genuine gene (1986) Proceedings of the National Academy of Sciences USA, 83, pp. 2841-2845
- Higashi, Y., Tanae, A., Inohue, H., Fujii-Kuriyama, Y., Evidence for frequent gene conversions in the steroid 21-hydroxylase (P-450c21) gene: Implications for 21-hydroxylase deficiency (1988) American Journal of Human Genetics, 42, pp. 17-25
- Jääskeläinen, J., Levo, A., Voutilainen, R., Partanen, J., Population-wide evaluation of disease manifestation in relation to molecular genotype in steroid 21-hydroxylase (CYP21) deficiency: Good correlation in a well defined population (1997) Journal of Clinical Endocrinology and Metabolism, 82, pp. 3293-3297
- Killeen, A.A., Jiddou, R.R., Sane, K.S., Characterization of frequent polymorphism in intron 2 of CYP21: Application to segregation analysis of CYP21 alleles (1998) Clinical Chemistry, 12, pp. 2410-2415
- Lako, M., Ramsden, S., Campbell, R.D., Strachan, T., Mutation screening in British 21-hydroxylase deficiency families and development of novel microsatellite based approaches to preantal diagnosis (1999) Journal of Medical Genetics, 36, pp. 119-124
- Lobato, M.N., Ordoñez-Sánchez, M.L., Tusie-Luna, M.T., Meseguer, A., Mutation analysis in patients with adrenal hyperplasia in the Spanish population: Identification of putative novel steroid 21-hydroxylase deficiency alleles associated with the classical form of the disease (1999) Human Heredity, 49, pp. 169-175
- Miller, W.L., Genetics, diagnosis and management of 21-hydroxylase deficiency (1994) Journal of Clinical Endocrinology and Metabolism, 78, pp. 241-246
- Mornet, E., Crété, P., Kuttenn, F., Raux-Demay, M.-C., Boué, J., White, P.C., Boué, A., Distribution of deletions and seven point mutations on CYP21B genes in three clinical forms of steroid 21-hydroxylase deficiency (1991) American Journal of Human Genetics, 48, pp. 79-88
- New, M.I., Lorenzen, F., Lerner, A.J., Kohn, B., Oberfield, S.E., Pollack, M.S., Dupont, B., Speiser, P.W., Genotyping steroid 21-hydroxylase deficiency: Hormonal reference data (1983) Journal of Clinical Endocrinology and Metabolism, 57, pp. 320-326
- New, M.I., White, P.C., Pang, S., Dupont, B., Speiser, P.W., The adrenal hyperplasias (1989) The Metabolic Basis of Inherited Disease, pp. 1881-1917. , (eds C.R. Scriver, A.L. Beaudet, S. Sly & D. Valle), 6th edn. McGraw-Hill, New York
- Ordoñez-Sánchez, M.L., Ramírez-Jiménez, S., López-Gutierrez, A.U., Riba, L., Gamboa-Cardiel, S., Cerrillo-Hinojos, M., Altamirano-Bustamente, N., Tusié-Luna, M.T., Molecular genetic analysis of patients carrying steroid 21-hydroxylase deficiency in the Mexican population: Identification of possible new mutations and high prevalence of apparent germ-line mutations (1998) Human Genetics, 102, pp. 170-177
- Owerbach, D., Ballard, L., Draznin, M.B., Salt-wasting congenital adrenal hyperplasia: Detection and characterization of mutations in the steroid 21-hydroxylase gene, CYP21, using the polymerase chain reaction (1992) Jounal of Clinical Endocrinology and Metabolism, 74, pp. 553-558
- Owerbach, D., Sherman, L., Ballard, A.-L., Azziz, R., Pro-453 to Ser mutation in CYP21 is associated with nonclassic steroid 21-hydroxylase deficiency (1992) Molecular Endocrinology, 6, pp. 1211-1215
- Pang, S., Clark, A., Congenital adrenal hyperplasia due to 21-hydroxylase deficiency: Newborn screening and its relantionship to the diagnosis and treatment of the disorder (1993) Screening, 2, pp. 105-139
- Speiser, P.W., Dupont, B., Rubinstein, P., Piazza, A., Kastelan, A., New, M.I., High frequency of non-classical steroid 21-hydroxylase deficiency (1985) American Journal of Human Genetics, 37, pp. 650-667
- Speiser, P.W., Dupont, B., Zhu, D., Serrat, J., Buegeleisen, M., Tusie-Luna, M.T., Lesser, M., White, P.C., Disease expression and molecular genotype in congenital adrenal hyperplasia due to 21-hydroxylase deficiency (1992) Journal of Clinical Investigation, 90, pp. 584-595
- Tusie-Luna, M.T., Traktman, P., White, P.C., Determination of functional effects of mutations in the steroid 21-hydroxylase general (CYP21) using recombinant vaccinia virus (1990) Journal of Biological Chemistry, 265, pp. 20916-20922
- Wedell, A., Luthman, H., Steroid 21-hydroxilase deficiency: Two additional mutations in salt-wasting disease and rapid screening of disease-causing mutations (1993) Human Molecular Genetics, 2, pp. 499-504
- Wedell, A., Thilén, A., Ritzén, E.M., Stengler, B., Luthman, H., Mutational spectrum of the steroid 21-hydroxylase gene in Sweden: Implication for genetic diagnosis and association with disease manifestation (1994) Journal of Clinical Endocrinology and Metabolism, 78, pp. 1145-1152
- Wedell, A., Chun, X., Luthman, H., A steroid 21-hydroxylase allele concomitantly carrying four disease-causing mutations is not uncommon in the Swedish population (1994) Human Genetics, 93, pp. 204-206
- White, P.C., New, M.I., Dupont, B., Structure of human steroid 21-hydroxylase genes (1986) Proceedings of the National Academy of Sciences USA, 83, pp. 5111-5115
- Wilson, R.C., Mercado, A.B., Cheng, K.C., New, M.I., Steroid 21-hydroxylase deficiency: Genotype may not predict phenotype (1995) Journal of Clinical Endocrinology and Metabolism, 80, pp. 2322-2329
- Witchel, S.F., Smith, R., Crivellaro, C.E., Della Manna, T., Dichtchekenian, V., Setian, N., Damiani, D., CYP21 mutations in Brazilian patients with 21-hydroxylase deficiency (2000) Human Genetics, 106, pp. 414-419
Citas:
---------- APA ----------
Dain, L.B., Buzzalino, N.D., Oneto, A., Belli, S., Stivel, M., Pasqualini, T., Minutolo, C.,..., Alba, L.G.
(2002)
. Classical and nonclassical 21-hydroxylase deficiency: A molecular study of Argentine patients. Clinical Endocrinology, 56(2), 239-245.
http://dx.doi.org/10.1046/j.0300-0664.2001.01419.x---------- CHICAGO ----------
Dain, L.B., Buzzalino, N.D., Oneto, A., Belli, S., Stivel, M., Pasqualini, T., et al.
"Classical and nonclassical 21-hydroxylase deficiency: A molecular study of Argentine patients"
. Clinical Endocrinology 56, no. 2
(2002) : 239-245.
http://dx.doi.org/10.1046/j.0300-0664.2001.01419.x---------- MLA ----------
Dain, L.B., Buzzalino, N.D., Oneto, A., Belli, S., Stivel, M., Pasqualini, T., et al.
"Classical and nonclassical 21-hydroxylase deficiency: A molecular study of Argentine patients"
. Clinical Endocrinology, vol. 56, no. 2, 2002, pp. 239-245.
http://dx.doi.org/10.1046/j.0300-0664.2001.01419.x---------- VANCOUVER ----------
Dain, L.B., Buzzalino, N.D., Oneto, A., Belli, S., Stivel, M., Pasqualini, T., et al. Classical and nonclassical 21-hydroxylase deficiency: A molecular study of Argentine patients. Clin. Endocrinol. 2002;56(2):239-245.
http://dx.doi.org/10.1046/j.0300-0664.2001.01419.x