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Zhang H, Liu C, Liu Y, Gai Z. Establishment of human induced pluripotent stem cell line SDQLCHi029-A from one Type 1 familial glucocorticoid deficiency patient carrying compound heterozygote mutations in MC2R gene. Stem Cell Res 2024; 76:103368. [PMID: 38430736 DOI: 10.1016/j.scr.2024.103368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/08/2024] [Accepted: 02/25/2024] [Indexed: 03/05/2024] Open
Abstract
Type 1 familial glucocorticoid deficiency (FGD) is a rare autosomal recessive disorder due to variation of the melanocortin-2-receptor (MC2R) gene. Induced pluripotent stem cell (iPSC) line SDQLCHi029-A was successfully generated from peripheral blood mononuclear cells obtained from a 5-day-old girl with MC2R mutations (c.428C > T and c.409C > T). The iPSC line showed genetically stable and matched the donor's PBMCs. displayed a normal karyotype, expressed high pluripotent markers, and exhibited differentiation potential of three germ layers in vitro. The iPSC line could be a good model to study the pathogenesis of FGD type 1 and screen new drugs for the disease.
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Affiliation(s)
- Haiyan Zhang
- Pediatric Research Institute, Children's Hospital Affiliated to Shandong University (Jinan Children's Hospital), Jinan, Shandong 250022, China; Department of Neonatology, Children's Hospital Affiliated to Shandong University (Jinan Children's Hospital), Jinan, Shandong 250022, China
| | - Chen Liu
- Department of Neonatology, Children's Hospital Affiliated to Shandong University (Jinan Children's Hospital), Jinan, Shandong 250022, China; Shandong Provincial Clinical Research Center for Children's Health and Disease, Jinan 250022, China
| | - Yi Liu
- Pediatric Research Institute, Children's Hospital Affiliated to Shandong University (Jinan Children's Hospital), Jinan, Shandong 250022, China; Shandong Provincial Clinical Research Center for Children's Health and Disease, Jinan 250022, China
| | - Zhongtao Gai
- Pediatric Research Institute, Children's Hospital Affiliated to Shandong University (Jinan Children's Hospital), Jinan, Shandong 250022, China; Shandong Provincial Clinical Research Center for Children's Health and Disease, Jinan 250022, China
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Liu S, Zeng T, Luo C, Peng D, Xu X, Liu Q, Wu Q, Lu Q, Huang F. A rare homozygous variant of MC2R gene identified in a Chinese family with familial glucocorticoid deficiency type 1: A case report. Front Endocrinol (Lausanne) 2023; 14:1113234. [PMID: 36909322 PMCID: PMC10003339 DOI: 10.3389/fendo.2023.1113234] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/08/2023] [Indexed: 02/26/2023] Open
Abstract
Background Melanocortin-2 receptor (MC2R), a member of the G protein-coupled receptor family, is selectively activated by adrenocorticotropic hormone (ACTH). variants in MC2R are associated with family glucocorticoid deficiency 1 (FGD1). Case presentation We first reported a Chinese family with two affected siblings with a homozygotic variant of c.712C>T/p.H238Y in MC2R, presenting with skin hyperpigmentation, hyperbilirubinemia, and tall stature. These individuals showed novel clinical features, including congenital heart defects, not been found in other FGD1 patients. Conclusions We reported a Chinese family with affected siblings having a homozygotic variant of c.712C>T/p.H238Y in MC2R.Our report may expand the genetic and clinical spectrum of FGD1.
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Affiliation(s)
- ShuPing Liu
- Department of Children’s Medical Center, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Ting Zeng
- Department of Children's Health Care, Liuzhou Maternity and Child Healthcare Hospital, Liuzhou, Guangxi, China
| | - Cheng Luo
- Department of Children’s Medical Center, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - DanXia Peng
- Department of Children’s Medical Center, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Xuan Xu
- Department of Children’s Medical Center, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Qin Liu
- Department of Children’s Medical Center, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Qiong Wu
- Department of Children’s Medical Center, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Qin Lu
- Department of Applied and Translational Medicine, GeneMind Biosciences Company Limited, Shenzhen, China
| | - FuRong Huang
- Department of Children’s Medical Center, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
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Implication of Melanocortin Receptor Genes in the Familial Comorbidity of Type 2 Diabetes and Depression. Int J Mol Sci 2022; 23:ijms23158350. [PMID: 35955479 PMCID: PMC9369258 DOI: 10.3390/ijms23158350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 12/20/2022] Open
Abstract
The melanocortin receptors are G-protein-coupled receptors, which are essential components of the hypothalamic–pituitary–adrenal axis, and they mediate the actions of melanocortins (melanocyte-stimulating hormones: α-MSH, β-MSH, and γ-MSH) as well as the adrenocorticotropin hormone (ACTH) in skin pigmentation, adrenal steroidogenesis, and stress response. Three melanocortin receptor genes (MC1R, MC2R, and MC5R) contribute to the risk of major depressive disorder (MDD), and one melanocortin receptor gene (MC4R) contributes to the risk of type 2 diabetes (T2D). MDD increases T2D risk in drug-naïve patients; thus, MDD and T2D commonly coexist. The five melanocortin receptor genes might confer risk for both disorders. However, they have never been investigated jointly to evaluate their potential contributing roles in the MDD-T2D comorbidity, specifically within families. In 212 Italian families with T2D and MDD, we tested 11 single nucleotide polymorphisms (SNPs) in the MC1R gene, 9 SNPs in MC2R, 3 SNPs in MC3R, 4 SNPs in MC4R, and 2 SNPs in MC5R. The testing used 2-point parametric linkage and linkage disequilibrium (LD) (i.e., association) analysis with four models (dominant with complete penetrance (D1), dominant with incomplete penetrance (D2), recessive with complete penetrance (R1), and recessive with incomplete penetrance (R2)). We detected significant (p ≤ 0.05) linkage and/or LD (i.e., association) to/with MDD for one SNP in MC2R (rs111734014) and one SNP in MC5R (rs2236700), and to/with T2D for three SNPs in MC1R (rs1805007 and rs201192930, and rs2228479), one SNP in MC2R (rs104894660), two SNPs in MC3R (rs3746619 and rs3827103), and one SNP in MC4R genes (Chr18-60372302). The linkage/LD/association was significant across different linkage patterns and different modes of inheritance. All reported variants are novel in MDD and T2D. This is the first study to report risk variants in MC1R, MC2R, and MC3R genes in T2D. MC2R and MC5R genes are replicated in MDD, with one novel variant each. Within our dataset, only the MC2R gene appears to confer risk for both MDD and T2D, albeit with different risk variants. To further clarity the role of the melanocortin receptor genes in MDD-T2D, these findings should be sought among other ethnicities as well.
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Alsaedi A, Kamal NM, Bakkar A, Althobaiti E, Naeem M, Kamal M. Novel Melano-Cortin-2-Receptor Gene Mutation Presenting With Infantile Cholestasis: A Case Report. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2022; 15:11795476221091387. [PMID: 35418791 PMCID: PMC8998368 DOI: 10.1177/11795476221091387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/09/2022] [Indexed: 11/29/2022]
Abstract
Introduction: For many years, congenital panhypopituitarism has been recognized to cause infantile cholestasis. However, the isolated cortisol deficiency as a cause of cholestasis and liver failure was rarely reported. Case description: A 32-days old male infant presented to the hepatology clinic with infantile cholestasis. His initial workup revealed alanine transaminase (ALT) level of 138 U/L, aspartate transaminase level of 76 U/L, total bilirubin (T.Bil) of 103 mmol/L, direct bilirubin of (D.Bil) 83 mmol/L, gamma-glutamyl transpeptidase (GGT) level of 28 U/L with normal prothrombin time (PT) of 13 seconds. One week later, the patient developed severe bronchiolitis necessitating mechanical ventilation associated with acute liver failure and worsening cholestasis. His ALT increased to 303.5 U/L and direct bilirubin increased to 204 mmol/L with prolongation of PT to 18.9 seconds reflecting derangement in synthetic liver functions. There was associated hypoglycemia, hyponatremia and high normal potassium level with a picture of adrenal insufficiency. Hormonal workup and genetic testing revealed isolated cortisol deficiency with a novel homozygous mutation c.763_764delAT (p. Met255ValfsX17) in Melanocortin 2 receptor gene (MC2R) and the patient was diagnosed as familial primary glucocorticoid deficiency. The patient was maintained on cortisol replacement therapy with the resolution of cholestasis and normalization of liver functions. Conclusions: Patients presenting with infantile cholestasis associated with documented hypoglycemia should alert pediatricians about the possibility of familial glucocorticoid deficiency and prompt investigation of adrenal function should be considered. Cortisol replacement therapy leads to the resolution of cholestasis.
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Affiliation(s)
- Abdulaziz Alsaedi
- Consultant Pediatric Endocrinologist, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | - Naglaa M Kamal
- Professor of Pediatrics and Pediatric Hepatology, Faculty of Medicine, Cairo University, Egypt
| | - Ayman Bakkar
- Consultant Pediatric Endocrinologist, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | - Enad Althobaiti
- Pediatric Endocrinology Senior Registrar, Alhada Military Hospital, Taif, Saudi Arabia
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Özbek MN, Demiral M, Unal E, Karaşin ND, Baran RT, Demirbilek H. A rare and preventable aetiology of neurodevelopmental delay and epilepsy: familial glucocorticoid deficiency. J Pediatr Endocrinol Metab 2021; 34:1463-1468. [PMID: 34271604 DOI: 10.1515/jpem-2021-0150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/20/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Familial glucocorticoid deficiency (FGD) is a rare autosomal recessive disorder characterised by isolated glucocorticoid deficiency. Melanocortin receptor 2 (MC2R) mediates the functions of adrenocorticotropic hormone (ACTH) in the adrenal cortex. MC2R accessory protein (MRAP) is a transmembrane protein involved in the trafficking of MC2R to the cell surface. Mutations in MC2R and MRAP genes cause FGD type 1 and 2. In the present case series, we evaluate the clinical characteristics and long-term follow-up of six cases with FGD due to mutations in MC2R and MRAP. CASE PRESENTATION Data of six cases with FGD (five with mutations in MC2R and one with a mutation in MRAP) who were being followed at our paediatric endocrine centre was evaluated. Diagnosis of FGD was considered in case of elevated ACTH and inappropriately low cortisol level, and exclusion of other aetiologies. The main presenting complaints were hyperpigmentation and hypoglycaemic convulsion in all cases. During a follow-up period of 26-115 months, one patient with homozygous 560delT mutation in MC2R, one female with G226R mutation in MC2R and one female with IVS3ds+1delG mutation in MRAP had a neurodevelopmental delay (NDD), while the other three patients had normal neurodevelopment. CONCLUSIONS FGD patients due to MC2R and MRAP mutations with early diagnosis and compliance to the hydrocortisone therapy had normal neurodevelopment, while delay in diagnosis and poor compliance was associated with severe hypoglycaemic convulsions and subsequent complications NDD.
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Affiliation(s)
- Mehmet Nuri Özbek
- Department of Paediatric Endocrinology, Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Meliha Demiral
- Department of Paediatric Endocrinology, Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Edip Unal
- Department of Paediatric Endocrinology, Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Nezahat Doğan Karaşin
- Department of Paediatrics, Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Rıza Taner Baran
- Department of Paediatric Endocrinology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Huseyin Demirbilek
- Department of Paediatric Endocrinology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Tang L, Xiang Q, Xiang J, Li J, Chen D. A variant in the 3'-untranslated region of the MC2R gene decreases the risk of schizophrenia in a female Han Chinese population. J Int Med Res 2021; 49:3000605211029504. [PMID: 34266338 PMCID: PMC8287359 DOI: 10.1177/03000605211029504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective Schizophrenia is a complex mental disorder with high heritability. The
hypothalamic–pituitary–adrenal (HPA) axis, which is the stress system of the
neuroendocrine system, is considered to impact psychotic disorders. We
hypothesized that polymorphisms of HPA axis genes might be involved in the
development of schizophrenia. Methods A case–control study comprising 234 patients with schizophrenia and 399
matched healthy controls was conducted to investigate the association
between the human melanocortin 2 receptor (MC2R) gene and schizophrenia
risk. Seven tag single nucleotide polymorphisms (SNPs) (rs16941303,
rs16941314, rs2186944, rs28926188, rs7230126, rs948322, and rs948331) of
MC2R were genotyped by direct sequencing. Results No significant associations were observed between any of the alleles,
genotypes, or haplotypes examined within the MC2R gene and the risk of
schizophrenia in the total group or in subgroups stratified by smoking or
alcoholism. However, a subgroup analysis stratified by sex revealed that
under the additive model, the C allele of the MC2R rs948331 SNP
significantly decreased the risk of schizophrenia in females (odds
ratio=0.18). Conclusion The C allele of the MC2R rs948331 locus may be a protective factor, reducing
the risk of schizophrenia in the female Han Chinese population.
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Affiliation(s)
- Liang Tang
- Department of Basic Biology, Changsha Medical College, Changsha, China.,Department of Basic Biology, Wuzhou Medical College, Wuzhou, China.,Center for Neuroscience and Behavior, Changsha Medical College, Changsha, China.,Academic Work Station, Changsha Medical College, Changsha, China
| | - Qin Xiang
- Department of Basic Biology, Changsha Medical College, Changsha, China.,Center for Neuroscience and Behavior, Changsha Medical College, Changsha, China.,Academic Work Station, Changsha Medical College, Changsha, China
| | - Ju Xiang
- Department of Basic Biology, Changsha Medical College, Changsha, China.,Center for Neuroscience and Behavior, Changsha Medical College, Changsha, China.,Academic Work Station, Changsha Medical College, Changsha, China
| | - Jianming Li
- Department of Basic Biology, Changsha Medical College, Changsha, China.,Center for Neuroscience and Behavior, Changsha Medical College, Changsha, China.,Academic Work Station, Changsha Medical College, Changsha, China.,Department of Rehabilitation, Xiangya Boai Rehabilitation Hospital, Changsha, China
| | - Danna Chen
- Department of Basic Biology, Changsha Medical College, Changsha, China.,Center for Neuroscience and Behavior, Changsha Medical College, Changsha, China.,Academic Work Station, Changsha Medical College, Changsha, China
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Çamtosun E, Dündar İ, Akıncı A, Kayaş L, Çiftçi N. Pediatric Primary Adrenal Insufficiency: A 21-year Single Center Experience. J Clin Res Pediatr Endocrinol 2021; 13:88-99. [PMID: 32938577 PMCID: PMC7947721 DOI: 10.4274/jcrpe.galenos.2020.2020.0132] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Primary adrenal insufficiency (PAI) is a rare but potentially life-threatening condition. In childhood, PAI is usually caused by monogenic diseases. Although congenital adrenal hyperplasia (CAH) is the most common cause of childhood PAI, numerous non-CAH genetic causes have also been identified. METHODS Patients aged 0-18 years and diagnosed with PAI between 1998 and 2019 in a tertiary care hospital were retrospectively evaluated. After the etiologic distribution was determined, non-CAH PAI patients were evaluated in detail. RESULTS Seventy-three PAI patients were identified. The most common etiology was CAH (69.9%, n=51). Non-CAH etiologies accounted for 30.1% (n=22) and included adrenoleukodystrophy (ALD; n=8), familial glucocorticoid deficiency (n=3), Triple A syndrome (n=5), autoimmune adrenalitis (n=1), adrenal hypoplasia congenital (n=1), IMAGe syndrome (n=1), and other unknown etiologies (n=3). The median age at the time of AI diagnosis for non-CAH etiologies was 3.52 (0.03-15.17) years. The most frequent symptoms/clinical findings at onset were hyperpigmentation of skin (81.8%), symptoms of hypoglycemia (40.9%), and weakness/fatigue (31.8%). Hypoglycemia (50.0%), hyponatremia (36.4%) and hyperkalemia (22.7%) were prominent biochemical findings. Diagnosis of specific etiologies were proven genetically in 13 of 22 patients. A novel p.Q301* hemizygous frameshift mutation of the DAX1 gene was identified in one patient. CONCLUSION Etiology was determined in 86.3% of children with non-CAH PAI through specific clinical and laboratory findings with/ without molecular analysis of candidate genes. ALD was the most common etiology. Currently, advanced molecular analysis can be utilized to establish a specific genetic diagnosis for PAI in patients who have no specific diagnostic features.
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Affiliation(s)
- Emine Çamtosun
- İnönü University Faculty of Medicine, Department of Pediatric Endocrinology, Malatya, Turkey,* Address for Correspondence: İnönü University Faculty of Medicine, Department of Pediatric Endocrinology, Malatya, Turkey Phone: +90 505 254 17 95 E-mail:
| | - İsmail Dündar
- Malatya Training and Research Hospital, Clinic of Pediatric Endocrinology, Malatya, Turkey
| | - Ayşehan Akıncı
- İnönü University Faculty of Medicine, Department of Pediatric Endocrinology, Malatya, Turkey
| | - Leman Kayaş
- İnönü University Faculty of Medicine, Department of Pediatric Endocrinology, Malatya, Turkey
| | - Nurdan Çiftçi
- İnönü University Faculty of Medicine, Department of Pediatric Endocrinology, Malatya, Turkey
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Abuduxikuer K, Li ZD, Xie XB, Li YC, Zhao J, Wang JS. Novel Melanocortin 2 Receptor Variant in a Chinese Infant With Familial Glucocorticoid Deficiency Type 1, Case Report and Review of Literature. Front Endocrinol (Lausanne) 2019; 10:359. [PMID: 31244773 PMCID: PMC6563654 DOI: 10.3389/fendo.2019.00359] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 05/21/2019] [Indexed: 11/20/2022] Open
Abstract
Familial glucocorticoid deficiency type 1 (FGD1) is an autosomal recessive disorder caused by mutations in the melanocortin 2 receptor (MC2R) gene, characterized by a low or undetectable serum cortisol level and a high adrenocorticotropic hormone (ACTH) level. Clinical manifestations include hypoglycemia, seizure, skin hyperpigmentation, hyperbilirubinemia, cholestasis, and a tall stature. Some dysmorphic features such as, a prominent forehead, hypertelorism, a broad nasal bridge, and small tapering fingers, have been reported. Children with FGD1 may have other isolated endocrine abnormalities. To date, no patient with FGD1 has been reported in mainland China. Here we report on a Chinese patient with FGD1 having a novel MC2R gene variant, a mild transverse palm crease, hypertelorism, and subtle/transient endocrine abnormalities relating to all three zones of the adrenal cortex and thyroid gland. We also reviewed cases with dysmorphic features or additional endocrine abnormalities.
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