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Castets S, Thomas-Teinturier C, Villanueva C, Amsellem J, Barat P, Brun G, Quoc EB, Carel JC, De Filippo GP, Kipnis C, Martinerie L, Vergier J, Saveanu A, Teissier N, Coutant R, Léger J, Reynaud R. Diagnosis and management of congenital hypopituitarism in children. Arch Pediatr 2024; 31:165-171. [PMID: 38538470 DOI: 10.1016/j.arcped.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/02/2024] [Accepted: 01/18/2024] [Indexed: 04/07/2024]
Abstract
Hypopituitarism (or pituitary deficiency) is a rare disease with an estimated prevalence of between 1/16,000 and 1/26,000 individuals, defined by insufficient production of one or several anterior pituitary hormones (growth hormone [GH], thyroid-stimulating hormone [TSH], adrenocorticotropic hormone [ACTH], luteinizing hormone [LH], follicle-stimulating hormone [FSH], prolactin), in association or not with diabetes insipidus (antidiuretic hormone [ADH] deficiency). While in adults hypopituitarism is mostly an acquired disease (tumors, irradiation), in children it is most often a congenital condition, due to abnormal pituitary development. Clinical symptoms vary considerably from isolated to combined deficiencies and between syndromic and non-syndromic forms. Early signs are non-specific but should not be overlooked. Diagnosis is based on a combination of clinical, laboratory (testing of all hormonal axes), imaging (brain magnetic resonance imaging [MRI] with thin slices centered on the hypothalamic-pituitary region), and genetic (next-generation sequencing of genes involved in pituitary development, array-based comparative genomic hybridization, and/or genomic analysis) findings. Early brain MRI is crucial in neonates or in cases of severe hormone deficiency for differential diagnosis and to inform syndrome workup. This article presents recommendations for hormone replacement therapy for each of the respective deficient axes. Lifelong follow-up with an endocrinologist is required, including in adulthood, with multidisciplinary management for patients with syndromic forms or comorbidities. Treatment objectives include alleviating symptoms, preventing comorbidities and acute complications, and optimal social and educational integration.
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Affiliation(s)
- Sarah Castets
- Assistance Publique Hôpitaux de Marseille, Hôpital la Timone, service de pédiatrie multidisciplinaire, Centre de Référence des Maladies Rares d'Origine Hypophysaire HYPO, Marseille, France.
| | - Cécile Thomas-Teinturier
- Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, Hôpital Bicêtre, service d'Endocrinologie et diabète de l'enfant, Le Kremlin Bicêtre, France; INSERM UMR 1018, Equipe d'épidémiologie des radiations, CESP, 94800 Villejuif, France
| | - Carine Villanueva
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service d'Endocrinologie Pédiatrique, Bron, France
| | - Jessica Amsellem
- CHU Angers, Service d'endocrinologie diabétologie pédiatrique, Angers, France
| | - Pascal Barat
- Centre hospitalier universitaire de Bordeaux, unite d'endocrinologie pédiatrique, Bordeaux, France
| | - Gilles Brun
- Hôpital Européen, neuroradiologie, Marseille, France
| | - Emmanuel Bui Quoc
- Assistance Publique-Hôpitaux de Paris, Hôpital universitaire Robert Debré, service d'ophtalmologie, Paris, France
| | - Jean-Claude Carel
- Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Hôpital universitaire Robert Debré, service d'Endocrinologie et Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes de la Croissance et du Développement, Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1141, Paris, France
| | - Gian Paolo De Filippo
- Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Hôpital universitaire Robert Debré, service d'Endocrinologie et Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes de la Croissance et du Développement, Paris, France
| | - Clara Kipnis
- Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Hôpital universitaire Robert Debré, service d'Endocrinologie et Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes de la Croissance et du Développement, Paris, France
| | - Laetitia Martinerie
- Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Hôpital universitaire Robert Debré, service d'Endocrinologie et Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes de la Croissance et du Développement, Paris, France
| | - Julia Vergier
- Assistance Publique Hôpitaux de Marseille, Hôpital la Timone, service de pédiatrie multidisciplinaire, Centre de Référence des Maladies Rares d'Origine Hypophysaire HYPO, Marseille, France
| | - Alexandru Saveanu
- Assistance Publique Hôpitaux de Marseille, Hôpital Conception, laboratoire de bioloie moléculaire, Centre de Référence des Maladies Rares d'Origine Hypophysaire HYPO, Marseille, France; Aix Marseille Université, INSERM, MMG, U 1251, Marseille, France
| | - Natacha Teissier
- Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Hôpital universitaire Robert Debré, service de Chirurgie ORL et cervico-faciale pédiatrique, Paris, France
| | - Régis Coutant
- CHU Angers, Service d'endocrinologie diabétologie pédiatrique, Angers, France
| | - Juliane Léger
- Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Hôpital universitaire Robert Debré, service d'Endocrinologie et Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes de la Croissance et du Développement, Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1141, Paris, France
| | - Rachel Reynaud
- Assistance Publique Hôpitaux de Marseille, Hôpital la Timone, service de pédiatrie multidisciplinaire, Centre de Référence des Maladies Rares d'Origine Hypophysaire HYPO, Marseille, France; Aix Marseille Université, INSERM, MMG, U 1251, Marseille, France
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Castets S, Albarel F, Bachelot A, Brun G, Bouligand J, Briet C, Bui Quoc E, Cazabat C, Chabbert-Buffet C, Christin-Maitre S, Courtillot C, Cuny T, De Filippo G, Donadille B, Illouz F, Pellegrini I, Reznik Y, Saveanu A, Teissier N, Touraine P, Vantyghem MC, Vergier J, Léger J, Brue T, Reynaud R. Position statement on the diagnosis and management of congenital pituitary deficiency in adults: the French National Diagnosis and Treatment Protocol (NDTP). Ann Endocrinol (Paris) 2024:S0003-4266(24)00035-0. [PMID: 38452869 DOI: 10.1016/j.ando.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Pituitary deficiency, or hypopituitarism, is a rare chronic disease. It is defined by insufficient synthesis of one or more pituitary hormones (growth hormone, TSH, ACTH, LH-FSH, prolactin), whether or not associated with arginine vasopressin deficiency (formerly known as diabetes insipidus). In adult patients, it is usually acquired (notably during childhood), but can also be congenital, due to abnormal pituitary development. The present study focuses on congenital pituitary deficiency in adults, from diagnosis to follow-up, including special situations such as pregnancy or the elderly. The clinical presentation is highly variable, ranging from isolated deficit to multiple deficits, which may be part of a syndromic form or not. Diagnosis is based on a combination of clinical, biological (assessment of all hormonal axes), radiological (brain and hypothalamic-pituitary MRI) and genetic factors. Treatment consists in hormonal replacement therapy, adapted according to the period of life and the deficits, which may be progressive. Comorbidities, risk of complications and acute decompensation, and the impact on fertility and quality of life all require adaptative multidisciplinary care and long-term monitoring.
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Affiliation(s)
- S Castets
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France.
| | - F Albarel
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service d'Endocrinologie, Hôpital de la Conception, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - A Bachelot
- AP-HP, IE3M, hôpital Pitié-Salpêtrière, department of endocrinology and reproductive medicine and Centre de référence des maladies endocriniennes rares de la croissance, center de référence des pathologies gynécologiques Rares, ICAN, Paris, France; Sorbonne Université, Paris, France
| | - G Brun
- Aix Marseille University, CNRS, CRMBM, Marseille, France
| | - J Bouligand
- Molecular Genetic, Pharmacogenetic and Hormonology, Paris-Saclay University, Kremlin Bicetre Hospital APHP, Le Kremlin Bicetre, France
| | - C Briet
- Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l'Hypophyse, F-94275 Le Kremlin Bicêtre, France; Institut MITOVASC, INSERM U1083, Université d'Angers, Département d'Endocrinologie, Diabétologie et Nutrition, Centre Hospitalier Universitaire d'Angers, F-49933 Angers, France
| | - E Bui Quoc
- Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Ophthalmology Department, Paris, France
| | - C Cazabat
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - C Chabbert-Buffet
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - S Christin-Maitre
- Sorbonne University, Department of Endocrinology, Diabetology and Reproductive Medicine, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Centre de référence des maladies endocriniennes rares de la croissance et du développement (CMERC) Centre de compétence HYPO 184 rue du faubourg St Antoine, 75012 Paris, France
| | - C Courtillot
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - T Cuny
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - G De Filippo
- Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Hôpital universitaire Robert Debré, Service d'Endocrinologie et Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes de la Croissance et du Développement, Paris, France
| | - B Donadille
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - F Illouz
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - I Pellegrini
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - Y Reznik
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - A Saveanu
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - N Teissier
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - P Touraine
- Service d'endocrinologie et médecine de la reproduction, Sorbonne Université Médecine-Hôpital Pitié Salpêtrière; Centre de maladies endocrinennes rares de la croissance et du développement, Paris, France
| | - M C Vantyghem
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - J Vergier
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - J Léger
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - T Brue
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France; Aix Marseille Univ, APHM, INSERM, MMG, Laboratory of Molecular Biology Hospital La Conception, Marseille, France
| | - R Reynaud
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France; Aix Marseille Univ, APHM, INSERM, MMG, Laboratory of Molecular Biology Hospital La Conception, Marseille, France
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Mac TT, Castinetti F, Bar C, Julia S, Pasquet M, Romanet P, Saveanu A, Mougel G, Fauquier T, Jullien N, Barlier A, Reynaud R, Brue T. Deficient anterior pituitary with common variable immune deficiency (DAVID syndrome): a new case and literature reports. J Neuroendocrinol 2023; 35:e13287. [PMID: 37322808 DOI: 10.1111/jne.13287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/29/2023] [Accepted: 04/28/2023] [Indexed: 06/17/2023]
Abstract
Deficient anterior pituitary with common variable immune deficiency (DAVID) syndrome is a rare condition characterized by adrenocorticotropic hormone (ACTH) deficiency and primary hypogammaglobulinemia. It is due to heterozygous mutations of the nuclear factor kappa-B subunit 2 (NFKB2) gene. Only a few isolated cases have been reported since its first description by our team. Through the international multicenter GENHYPOPIT network, we identified a new case of DAVID syndrome. We then conducted an extensive review of the DAVID syndrome cases published from 2012 to 2022. A 7-year-old boy was diagnosed with symptomatic hypoglycemia revealing ACTH deficiency. Laboratory tests showed asymptomatic hypogammaglobulinemia. He harbored a heterozygous point mutation in NFKB2 gene (c.2600C > T, p.Ala867Val). His management included hydrocortisone replacement treatment, and he also received subcutaneous immunoglobulins during the Covid-19 pandemic. We analyzed 28 cases of DAVID syndrome with ACTH deficiency. ACTH deficiency was the only hormone deficiency in 79% of patients, but some patients harbored growth hormone (GH) and thyroid stimulating hormone (TSH) deficiencies. The first presenting symptoms were sinus/pulmonary infections (82%, mean age of 3 years) and alopecia (mean age of 4.7 years). ACTH deficiency was the third presenting condition (mean age at diagnosis of 8.6 years). All patients had hypogammaglobulinemia (decreased IgA and IgM levels), and 57% of patients had at least one autoimmune manifestation. Heterozygous mutations at the 3'end of the NFKB2 gene, coding for the C-terminal domain of the protein, were identified in all cases. Better knowledge of DAVID syndrome will help clinicians make an early diagnosis to avoid life-threatening complications.
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Affiliation(s)
- Thi Thom Mac
- Aix Marseille University, UMR1251, MMG - Marseille Medical Genetics - MarMaRa Institute, Faculty of Medicine, Marseille, France
- Endocrinology Department, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Frederic Castinetti
- Aix Marseille University, UMR1251, MMG - Marseille Medical Genetics - MarMaRa Institute, Faculty of Medicine, Marseille, France
- Endocrinology Department, Conception Hospital - APHM, Marseille, France
| | - Céline Bar
- Department of Endocrinology and Metabolic Diseases, Children's Hospital, Toulouse Cedex 9, France
| | - Sophie Julia
- Department of Medical Genetics, Purpan Hospital, Pavillon Lefèbvre, Place du Docteur Baylac, Toulouse Cedex 9, France
| | - Marlene Pasquet
- Department of Hematology Oncology Immunology, Children's Hospital, Toulouse Cedex 9, France
| | - Pauline Romanet
- Aix Marseille University, UMR1251, MMG - Marseille Medical Genetics - MarMaRa Institute, Faculty of Medicine, Marseille, France
- Department of Molecular Biology, Conception Hospital - APHM, Marseille, France
| | - Alexandru Saveanu
- Aix Marseille University, UMR1251, MMG - Marseille Medical Genetics - MarMaRa Institute, Faculty of Medicine, Marseille, France
- Department of Molecular Biology, Conception Hospital - APHM, Marseille, France
| | - Gregory Mougel
- Aix Marseille University, UMR1251, MMG - Marseille Medical Genetics - MarMaRa Institute, Faculty of Medicine, Marseille, France
- Department of Molecular Biology, Conception Hospital - APHM, Marseille, France
| | - Teddy Fauquier
- Aix Marseille University, UMR1251, MMG - Marseille Medical Genetics - MarMaRa Institute, Faculty of Medicine, Marseille, France
| | - Nicolas Jullien
- INP - Institute of Neurophysiopathology, UMR 7051, Faculty of Medicine, Marseille, France
| | - Anne Barlier
- Aix Marseille University, UMR1251, MMG - Marseille Medical Genetics - MarMaRa Institute, Faculty of Medicine, Marseille, France
- Department of Molecular Biology, Conception Hospital - APHM, Marseille, France
| | - Rachel Reynaud
- Aix Marseille University, UMR1251, MMG - Marseille Medical Genetics - MarMaRa Institute, Faculty of Medicine, Marseille, France
- Multidisciplinary Pediatrics Department, Timone Hospital, Marseille, France
| | - Thierry Brue
- Aix Marseille University, UMR1251, MMG - Marseille Medical Genetics - MarMaRa Institute, Faculty of Medicine, Marseille, France
- Endocrinology Department, Conception Hospital - APHM, Marseille, France
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Le Collen L, Delemer B, Poitou C, Vaxillaire M, Toussaint B, Dechaume A, Badreddine A, Boissel M, Derhourhi M, Clément K, Petit JM, Mau-Them FT, Bruel AL, Thauvin-Robinet C, Saveanu A, Cherifi BG, Le Beyec-Le Bihan J, Froguel P, Bonnefond A. Heterozygous pathogenic variants in POMC are not responsible for monogenic obesity: implication for MC4R agonist use. Genet Med 2023:100857. [PMID: 37092539 DOI: 10.1016/j.gim.2023.100857] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/15/2023] [Accepted: 04/16/2023] [Indexed: 04/25/2023] Open
Abstract
PURPOSE Recessive deficiency for proopiomelanocortin (POMC) causes childhood-onset severe obesity. Cases can now benefit from the MC4R agonist setmelanotide. Furthermore, a phase 3 clinical trialis evaluating setmelanotide in heterozygotes for POMC. We performed a large-scale genetic analysis assessing the effect of heterozygous, pathogenic POMC variants on obesity. METHODS A genetic analysis was performed in a family including two cousins with childhood-onset obesity. We analyzed the obesity status of heterozygotes for pathogenic POMC variants in the Human Gene Mutation Database (HGMD). The association between heterozygous, pathogenic POMC variants and obesity risk was assessed using 190,000 exome samples from UK Biobank. RESULTS The two cousins carried a compound heterozygous, pathogenic variant in POMC. Six siblings were heterozygotes; only one of them had obesity. In HGMD, we identified 60 heterozygotes for pathogenic POMC variants, of whom 14 had obesity. In UK Biobank, heterozygous, pathogenic POMC variants were not associated with obesity risk, but modestly increased body mass index levels. CONCLUSIONS Heterozygous, pathogenic POMC variants do not contribute to monogenic obesity, but slightly increase BMI. Setmelanotide use in patients with obesity which would only be based on the presence of a heterozygous POMC variant can be questioned.
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Affiliation(s)
- Lauriane Le Collen
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, Lille, France;; Department of Endocrinology Diabetology, University Hospital Center of Reims, Reims, France;; Department of Clinical Genetic, University Hospital Center of Reims, Reims, France;; University of Lille, Lille, France;.
| | - Brigitte Delemer
- Department of Endocrinology Diabetology, University Hospital Center of Reims, Reims, France
| | - Christine Poitou
- Assistance Publique Hôpitaux de Paris, Nutrition Department, Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Université, INSERM, Nutrition and Obesities: systemic approaches Research Unit (NutriOmics), Paris, France
| | - Martine Vaxillaire
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, Lille, France;; University of Lille, Lille, France
| | - Bénédicte Toussaint
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, Lille, France;; University of Lille, Lille, France
| | - Aurélie Dechaume
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, Lille, France;; University of Lille, Lille, France
| | - Alaa Badreddine
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, Lille, France;; University of Lille, Lille, France
| | - Mathilde Boissel
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, Lille, France;; University of Lille, Lille, France
| | - Mehdi Derhourhi
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, Lille, France;; University of Lille, Lille, France
| | - Karine Clément
- Assistance Publique Hôpitaux de Paris, Nutrition Department, Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Université, INSERM, Nutrition and Obesities: systemic approaches Research Unit (NutriOmics), Paris, France
| | - Jean Michel Petit
- Department of Endocrinology Diabetology, University Hospital Central of F.Mitterrand Dijon-Bourgogne
| | - Frédéric Tran Mau-Them
- Unité Fonctionnelle Innovation en Diagnostic Génomique des maladies rares, CHU Dijon Bourgogne, Dijon, France;; INSERM UMR1231 GAD, F-21000, Dijon, France
| | - Ange-Line Bruel
- Unité Fonctionnelle Innovation en Diagnostic Génomique des maladies rares, CHU Dijon Bourgogne, Dijon, France;; INSERM UMR1231 GAD, F-21000, Dijon, France
| | - Christel Thauvin-Robinet
- Unité Fonctionnelle Innovation en Diagnostic Génomique des maladies rares, CHU Dijon Bourgogne, Dijon, France;; INSERM UMR1231 GAD, F-21000, Dijon, France;; Centre de Référence Maladies Rares "Anomalies du développement et syndromes malformatifs", Centre de Génétique, FHU TRANSLAD et Institut GIMI, CHU Dijon Bourgogne, Dijon, France
| | - Alexandru Saveanu
- Aix-Marseille University, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France;; Assistance Publique-Hôpitaux de Marseille (AP-HM), Reference Center for Rare Pituitary Diseases HYPO, Marseille, France;; Assistance-Publique des Hôpitaux de Marseille (AP-HM), Laboratory of Molecular Biology, Conception Hospital, Marseille, France
| | - Blandine Gatta Cherifi
- CHU Bordeaux, Endocrinology, Diabetology & Nutrition, F-33000, Bordeaux, France;; University of Bordeaux, F-33000, Bordeaux, France;; INSERMU1215 Neurocentre Magendie, University of Bordeaux, Bordeaux, France
| | - Johanne Le Beyec-Le Bihan
- Assistance Publique-Hôpitaux de Paris (AP-HP), Endocrine and Oncological Biochemistry Department, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France;; INSERMU1149, Centre de recherche sur l'inflammation, Paris, France
| | - Philippe Froguel
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, Lille, France;; University of Lille, Lille, France;; Department of Metabolism, Imperial College London, London, United Kingdom
| | - Amélie Bonnefond
- Inserm/CNRS UMR 1283/8199, Pasteur Institute of Lille, EGID, Lille, France;; University of Lille, Lille, France;; Department of Metabolism, Imperial College London, London, United Kingdom.
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Fourneaux R, Reynaud R, Mougel G, Castets S, Bretones P, Dauriat B, Edouard T, Raverot G, Barlier A, Brue T, Castinetti F, Saveanu A. IGSF1 mutations are the most frequent genetic aetiology of thyrotropin deficiency. Eur J Endocrinol 2022; 187:787-795. [PMID: 36201163 DOI: 10.1530/eje-22-0520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/05/2022] [Indexed: 11/08/2022]
Abstract
DESIGN Thyroid-stimulating hormone deficiency (TSHD) is a rare disease. It may be isolated, secondary to abnormalities of genes involved in TSH biosynthesis, or associated with other pituitary deficits or abnormalities of genes involved in pituitary ontogenesis. Several genes are involved in thyrotroph development and function. OBJECTIVE Our aim was to determine the genetic causes of TSHD, either isolated (ITSHD) or associated with somatotroph deficiency (TSHD-GHD), in the cohort of patients from the GENHYPOPIT network. METHODS Next-generation sequencing (NGS) analyses were performed as a panel of genes on a cohort of patients with non-syndromic ITSHD or TSHGHD. The variants were classified according to the American College of Medical Genetics classification reviewed by the NGS-Diag network and correlated with the phenotype. Class 3, 4, and 5 single-nucleotide variants were checked by Sanger sequencing and copy number variants by multiplex ligation-dependent probe amplification (MLPA). RESULTS A total of 64 index cases (22 ITSHD and 42 TSHD-GHD) were included in this cohort. A genetic cause was identified in 26.5% of patients, with 36.3% in the ITSHD group (variants in TSHβ and IGSF1) and 21.4% in TSHD-GHD (variants in IGSF1, TSHβ, TRHR, GH1, POU1F1, and PROP1). Among the pathogenic and likely pathogenic variants identified, 42% were in IGSF1, including six not previously reported. CONCLUSION Our results show that IGSF1 variants represent the most frequent aetiology of TSH deficiency. Despite a systematic NGS approach and the identification of new variants, most patients remain without a molecular diagnosis. Larger scale studies, such as exome or genome studies, should be considered in the future.
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Affiliation(s)
- Rachel Fourneaux
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Faculté des Sciences Médicales et Paramédicales, Institut Marseille Maladies Rares (MarMaRa), Marseille, France
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Department of Endocrinology, Hôpital de la Conception, Centre de Référence des Maladies Rares de l'hypophyse HYPO, Marseille, France
- Centre de Référence des Maladies Rares de l'Hypophyse, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
| | - Rachel Reynaud
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Faculté des Sciences Médicales et Paramédicales, Institut Marseille Maladies Rares (MarMaRa), Marseille, France
- Centre de Référence des Maladies Rares de l'Hypophyse, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
- Department of Paediatrics, Paediatric Endocrinology Unit, CHU Timone Enfants, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
| | - Gregory Mougel
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Faculté des Sciences Médicales et Paramédicales, Institut Marseille Maladies Rares (MarMaRa), Marseille, France
- Centre de Référence des Maladies Rares de l'Hypophyse, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
- Laboratory of Molecular Biology, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
| | - Sarah Castets
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Faculté des Sciences Médicales et Paramédicales, Institut Marseille Maladies Rares (MarMaRa), Marseille, France
- Centre de Référence des Maladies Rares de l'Hypophyse, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
- Department of Paediatrics, Paediatric Endocrinology Unit, CHU Timone Enfants, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
| | | | - Benjamin Dauriat
- Department of Cytogenetics and Genetics, CHU Limoges, Limoges, France
| | - Thomas Edouard
- Department of Pediatric Endocrinology, CHU Toulouse, Toulouse, France
| | | | - Anne Barlier
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Faculté des Sciences Médicales et Paramédicales, Institut Marseille Maladies Rares (MarMaRa), Marseille, France
- Centre de Référence des Maladies Rares de l'Hypophyse, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
- Laboratory of Molecular Biology, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
| | - Thierry Brue
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Faculté des Sciences Médicales et Paramédicales, Institut Marseille Maladies Rares (MarMaRa), Marseille, France
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Department of Endocrinology, Hôpital de la Conception, Centre de Référence des Maladies Rares de l'hypophyse HYPO, Marseille, France
- Centre de Référence des Maladies Rares de l'Hypophyse, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
| | - Frederic Castinetti
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Faculté des Sciences Médicales et Paramédicales, Institut Marseille Maladies Rares (MarMaRa), Marseille, France
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Department of Endocrinology, Hôpital de la Conception, Centre de Référence des Maladies Rares de l'hypophyse HYPO, Marseille, France
- Centre de Référence des Maladies Rares de l'Hypophyse, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
| | - Alexandru Saveanu
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Faculté des Sciences Médicales et Paramédicales, Institut Marseille Maladies Rares (MarMaRa), Marseille, France
- Centre de Référence des Maladies Rares de l'Hypophyse, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
- Laboratory of Molecular Biology, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
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Bando H, Brinkmeier ML, Castinetti F, Fang Q, Lee MS, Saveanu A, Albarel F, Dupuis C, Brue T, Camper SA. Heterozygous variants in SIX3 and POU1F1 cause pituitary hormone deficiency in mouse and man. Hum Mol Genet 2022; 32:367-385. [PMID: 35951005 PMCID: PMC9851746 DOI: 10.1093/hmg/ddac192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/22/2022] [Accepted: 08/09/2022] [Indexed: 01/24/2023] Open
Abstract
Congenital hypopituitarism is a genetically heterogeneous condition that is part of a spectrum disorder that can include holoprosencephaly. Heterozygous mutations in SIX3 cause variable holoprosencephaly in humans and mice. We identified two children with neonatal hypopituitarism and thin pituitary stalk who were doubly heterozygous for rare, likely deleterious variants in the transcription factors SIX3 and POU1F1. We used genetically engineered mice to understand the disease pathophysiology. Pou1f1 loss-of-function heterozygotes are unaffected; Six3 heterozygotes have pituitary gland dysmorphology and incompletely ossified palate; and the Six3+/-; Pou1f1+/dw double heterozygote mice have a pronounced phenotype, including pituitary growth through the palate. The interaction of Pou1f1 and Six3 in mice supports the possibility of digenic pituitary disease in children. Disruption of Six3 expression in the oral ectoderm completely ablated anterior pituitary development, and deletion of Six3 in the neural ectoderm blocked the development of the pituitary stalk and both anterior and posterior pituitary lobes. Six3 is required in both oral and neural ectodermal tissues for the activation of signaling pathways and transcription factors necessary for pituitary cell fate. These studies clarify the mechanism of SIX3 action in pituitary development and provide support for a digenic basis for hypopituitarism.
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Affiliation(s)
| | | | - Frederic Castinetti
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Department of Endocrinology, Hôpital de la Conception, Centre de Référence des Maladies Rares de l’hypophyse HYPO, Marseille, France,Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Institut Marseille, Maladies Rares (MarMaRa), Marseille, France
| | - Qing Fang
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Mi-Sun Lee
- Michigan Neuroscience Institute, Department of Biological Chemistry, University of Michigan, Ann Arbor, MI, USA
| | - Alexandru Saveanu
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Department of Endocrinology, Hôpital de la Conception, Centre de Référence des Maladies Rares de l’hypophyse HYPO, Marseille, France,Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Institut Marseille, Maladies Rares (MarMaRa), Marseille, France
| | - Frédérique Albarel
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Department of Endocrinology, Hôpital de la Conception, Centre de Référence des Maladies Rares de l’hypophyse HYPO, Marseille, France,Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Institut Marseille, Maladies Rares (MarMaRa), Marseille, France
| | - Clémentine Dupuis
- Department of Pediatrics, Centre Hospitalier Universitaire de Grenoble-Alpes, site Nord, Hôpital Couple Enfants, Grenoble, France
| | - Thierry Brue
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Department of Endocrinology, Hôpital de la Conception, Centre de Référence des Maladies Rares de l’hypophyse HYPO, Marseille, France,Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Institut Marseille, Maladies Rares (MarMaRa), Marseille, France
| | - Sally A Camper
- To whom correspondence should be addressed at: Department of Human Genetics, University of Michigan Medical School, 5704 Medical Science Building II, 1241 Catherine St., Ann Arbor, MI 48109, USA. Tel: +1-734-763-0682; Fax: +1-734-763-3784;
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7
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Fourneaux R, Castets S, Godefroy A, Grelet M, Abeillon-du Payrat J, Saveanu A, Castinetti F, Reynaud R. Congenital Central Hypothyroidism Caused by a Novel IGSF1 Variant Identified in a French Family. Horm Res Paediatr 2022; 95:296-303. [PMID: 35350016 DOI: 10.1159/000524233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/15/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Congenital central hypothyroidism (CCH) is a rare disorder that can be caused by X-linked mutations in the immunoglobulin superfamily member 1 (IGSF1) gene. Here, we describe four familial cases with a variable presentation due to a novel IGSF1 pathogenic variant. CASE PRESENTATION In the index case, an investigation at birth of a suspected brain-lung-thyroid syndrome surprisingly revealed a central hypothyroidism. Next-generation sequencing uncovered a novel IGSF1 pathogenic variant: a hemizygous single base duplication (G) resulting in a premature stop codon (NM_001555.4: c.2485dup, p.Ala829Glyfs*15). Further family investigations revealed missed neonatal CCH for the older brother who presented with prolonged jaundice (thyroid stimulating hormone 3.06 mUI/L, FT4 9.4 pmol/L, FT3 4.2 pmol/L). It also led to the diagnosis of CCH at 11 months of age for the younger brother, whose thyroid function was considered normal at birth. Neuropsychological evaluations showed no cognitive impairment for the eldest two brothers, but a slightly reduced processing-speed index compared with the other parameters for the oldest. Furthermore, a maternal uncle was diagnosed with biochemical CCH at 34 years of age, despite having few symptoms, and a complete workup revealed prolactin deficiency and macroorchidism. DISCUSSION This report of a rare case of neonatal CCH caused by IGSF1 deficiency highlights the importance of recognizing the neonatal signs of hypothyroidism to diagnose CCH as early as possible. Our results also show the importance of performing family genetic screening if a pathogenic variant is identified, to properly monitor carriers as CCH may develop over time. We suggest that these families should be followed up in the long term to better understand the natural history of this syndrome and evaluate the need for hormone substitution.
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Affiliation(s)
- Rachel Fourneaux
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Institut Marseille Maladies Rares (MarMaRa), Aix-Marseille Université, Marseille, France.,Assistance Publique-Hôpitaux de Marseille (APHM), Department of Endocrinology, Hôpital de la Conception, Centre de Référence des Maladies Rares de l'hypophyse HYPO, Marseille, France
| | - Sarah Castets
- Department of Multidisciplinary Peadiatrics, Centre de Référence des Maladies Rares d'origine hypophysaire HYPO, Hôpital Timone-Enfants, APHM, Marseille, France
| | - Alice Godefroy
- Department of General Peadiatrics, Hôpital Saint Joseph, Marseille, France
| | - Maude Grelet
- Department of Genetics, Centre Hospitalier Sainte Musse, Toulon, France
| | | | - Alexandru Saveanu
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Institut Marseille Maladies Rares (MarMaRa), Aix-Marseille Université, Marseille, France.,Laboratory of Molecular Biology, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
| | - Frederic Castinetti
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Institut Marseille Maladies Rares (MarMaRa), Aix-Marseille Université, Marseille, France.,Assistance Publique-Hôpitaux de Marseille (APHM), Department of Endocrinology, Hôpital de la Conception, Centre de Référence des Maladies Rares de l'hypophyse HYPO, Marseille, France
| | - Rachel Reynaud
- Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Institut Marseille Maladies Rares (MarMaRa), Aix-Marseille Université, Marseille, France.,Department of Multidisciplinary Peadiatrics, Centre de Référence des Maladies Rares d'origine hypophysaire HYPO, Hôpital Timone-Enfants, APHM, Marseille, France
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8
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Castets S, Villanueva C, Vergier J, Brue T, Saveanu A, Reynaud R. Clinical, radiological, and molecular diagnosis of congenital pituitary diseases causing short stature. Arch Pediatr 2022; 28:8S33-8S38. [PMID: 37870532 DOI: 10.1016/s0929-693x(22)00041-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Short stature in children can be caused by congenital pituitary disorders involving at least one form of growth hormone deficiency. Clinical and radiological evaluations of the index case and family history assessments are essential to guide genetic diagnostic testing and interpret results. The first-line approach is panel testing of genes involved in pituitary development with variants known to be pathogenic in this context. It identifies a genetic cause in less than 10% of cases, however. Whole-exome and whole-genome sequencing techniques may provide original information but also raise new questions regarding the pathophysiological role of identified variants. These new tools can make genetic counselling more complex. The role of clinicians in these interpretations is therefore important. © 2022 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.
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Affiliation(s)
- S Castets
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, Marseille, France; Centre de Référence des Maladies Rares de l'Hypophyse HYPO, Marseille, France.
| | - C Villanueva
- Hospices Civils de Lyon (HCL), Hôpital Femme Mère Enfant (HFME), Service d'Endocrinologie pédiatrique, Bron, France; Centre de Référence des Maladies Rares de l'Hypophyse HYPO, Marseille, France
| | - J Vergier
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, Marseille, France; Centre de Référence des Maladies Rares de l'Hypophyse HYPO, Marseille, France
| | - T Brue
- Hospices Civils de Lyon (HCL), Hôpital Femme Mère Enfant (HFME), Service d'Endocrinologie pédiatrique, Bron, France; Centre de Référence des Maladies Rares de l'Hypophyse HYPO, Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Service d'Endocrinologie, Hôpital de la Conception, Marseille, France; Institut Marseille Maladies Rares (MarMaRa), Marseille, France
| | - A Saveanu
- Centre de Référence des Maladies Rares de l'Hypophyse HYPO, Marseille, France; Aix Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Marseille Medical Genetics (MMG), U 1251, Marseille, France; Institut Marseille Maladies Rares (MarMaRa), Marseille, France; Assistance Publique-Hôpitaux de Marseille (AP-HM), Laboratoire de Biologie Moléculaire, Hôpital de la Conception, Marseille, France
| | - R Reynaud
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, Marseille, France; Centre de Référence des Maladies Rares de l'Hypophyse HYPO, Marseille, France; Aix Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Marseille Medical Genetics (MMG), U 1251, Marseille, France; Institut Marseille Maladies Rares (MarMaRa), Marseille, France
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Charnay T, Mougel G, Amouroux C, Gueorguieva I, Joubert F, Pertuit M, Reynaud R, Barlier A, Brue T, Saveanu A. A novel TBX19 gene mutation in patients with isolated ACTH deficiency from distinct families with a common geographical origin. Front Endocrinol (Lausanne) 2022; 13:1080649. [PMID: 36890856 PMCID: PMC9987334 DOI: 10.3389/fendo.2022.1080649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/28/2022] [Indexed: 02/22/2023] Open
Abstract
Isolated ACTH deficiency (IAD) is a life-threatening condition, particularly in the neonatal period, while a main consequence of undiagnosed isolated ACTH deficiency in survivors is cognitive impairment. TBX19 is involved in the differentiation and proliferation of corticotropic cells and TBX19 mutations are responsible for more than 60% of neonatal cases of IAD. We describe a new variant of the main TBX19 transcript (NM 005149.3, c.840del (p.(Glu280Asp fs*27)), classified as pathogenic, whose pathogenicity is assumed to be due to nonsense mediated decay leading to non-expression of T-box transcription factor TBX19. Moreover we summarize the TBX19 mutations published as individual cases since our last large cohort. Interestingly, this pathogenic variant was identified in four patients from three apparently unrelated families. Two of these families were consanguineous, and after investigations all of three were discovered to have roots in the same mountainous region of northern Morocco, suggesting a founder effect. Early diagnosis, timely treatment (hydrocortisone therapy) and preventive education allowed normal development, growth and quality of life in all patients.
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Affiliation(s)
- Théo Charnay
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1251, Marseille Medical Genetics (MMG), Institut Marseille Maladies Rares (MarMaRa), Aix-Marseille Université, Marseille, France
- Laboratory of Molecular Biology, Centre Hospitalier Universitaire Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Gregory Mougel
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1251, Marseille Medical Genetics (MMG), Institut Marseille Maladies Rares (MarMaRa), Aix-Marseille Université, Marseille, France
- Laboratory of Molecular Biology, Centre Hospitalier Universitaire Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Cyril Amouroux
- Paediatric Department, Endocrinology Unit, Arnaud de Villeneuve Hospital, Montpellier University Hospital, Montpellier, France
| | - Iva Gueorguieva
- Paediatric Department, Endocrinology Unit, Children’s Center, Jeanne-de-Flandre Hospital, Lille University Hospital, Lille, France
| | - Florence Joubert
- Department of Pediatrics, Centre Hospitalier d’Avignon, Avignon, France
| | - Morgane Pertuit
- Laboratory of Molecular Biology, Centre Hospitalier Universitaire Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Rachel Reynaud
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1251, Marseille Medical Genetics (MMG), Institut Marseille Maladies Rares (MarMaRa), Aix-Marseille Université, Marseille, France
- Department of Multidisciplinary Peadiatrics, Centre de Référence des Maladies Rares d’origine hypophysaire HYPO, Hôpital Timone-Enfants, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Anne Barlier
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1251, Marseille Medical Genetics (MMG), Institut Marseille Maladies Rares (MarMaRa), Aix-Marseille Université, Marseille, France
- Laboratory of Molecular Biology, Centre Hospitalier Universitaire Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Thierry Brue
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1251, Marseille Medical Genetics (MMG), Institut Marseille Maladies Rares (MarMaRa), Aix-Marseille Université, Marseille, France
- Department of Endocrinology, Centre de Référence des Maladies Rares de l’hypophyse HYPO, Hôpital de la Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Alexandru Saveanu
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1251, Marseille Medical Genetics (MMG), Institut Marseille Maladies Rares (MarMaRa), Aix-Marseille Université, Marseille, France
- Laboratory of Molecular Biology, Centre Hospitalier Universitaire Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
- *Correspondence: Alexandru Saveanu,
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Gergics P, Smith C, Bando H, Jorge AAL, Rockstroh-Lippold D, Vishnopolska SA, Castinetti F, Maksutova M, Carvalho LRS, Hoppmann J, Martínez Mayer J, Albarel F, Braslavsky D, Keselman A, Bergadá I, Martí MA, Saveanu A, Barlier A, Abou Jamra R, Guo MH, Dauber A, Nakaguma M, Mendonca BB, Jayakody SN, Ozel AB, Fang Q, Ma Q, Li JZ, Brue T, Pérez Millán MI, Arnhold IJP, Pfaeffle R, Kitzman JO, Camper SA. High-throughput splicing assays identify missense and silent splice-disruptive POU1F1 variants underlying pituitary hormone deficiency. Am J Hum Genet 2021; 108:1526-1539. [PMID: 34270938 DOI: 10.1016/j.ajhg.2021.06.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 06/18/2021] [Indexed: 12/13/2022] Open
Abstract
Pituitary hormone deficiency occurs in ∼1:4,000 live births. Approximately 3% of the cases are due to mutations in the alpha isoform of POU1F1, a pituitary-specific transcriptional activator. We found four separate heterozygous missense variants in unrelated individuals with hypopituitarism that were predicted to affect a minor isoform, POU1F1 beta, which can act as a transcriptional repressor. These variants retain repressor activity, but they shift splicing to favor the expression of the beta isoform, resulting in dominant-negative loss of function. Using a high-throughput splicing reporter assay, we tested 1,070 single-nucleotide variants in POU1F1. We identified 96 splice-disruptive variants, including 14 synonymous variants. In separate cohorts, we found two additional synonymous variants nominated by this screen that co-segregate with hypopituitarism. This study underlines the importance of evaluating the impact of variants on splicing and provides a catalog for interpretation of variants of unknown significance in POU1F1.
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Affiliation(s)
- Peter Gergics
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109-5618, USA
| | - Cathy Smith
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109-5618, USA; Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI 48109-2218, USA
| | - Hironori Bando
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109-5618, USA
| | - Alexander A L Jorge
- Genetic Endocrinology Unit (LIM25), Division of Endocrinology, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903, Brazil
| | - Denise Rockstroh-Lippold
- Department of Women's and Child Health, Division of Pediatric Endocrinology, University Hospital Leipzig, Leipzig 04103, Germany
| | - Sebastian A Vishnopolska
- Instituto de Biociencias, Biotecnología y Biología Traslacional, Departamento de Fisiología, Biología Molecular y Celular, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad de Buenos Aires, CABA CE1428EHA, Argentina
| | - Frederic Castinetti
- Aix Marseille University, AP-HM, INSERM, Marseille Medical Genetics, Marmara Institute, La Conception Hospital, Department of Endocrinology, Marseille 13005, France
| | - Mariam Maksutova
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109-5618, USA
| | - Luciani Renata Silveira Carvalho
- Developmental Endocrinology Unit, Laboratory of Hormones and Molecular Genetics LIM/42, Division of Endocrinology, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil
| | - Julia Hoppmann
- Department of Women's and Child Health, Division of Pediatric Endocrinology, University Hospital Leipzig, Leipzig 04103, Germany
| | - Julián Martínez Mayer
- Instituto de Biociencias, Biotecnología y Biología Traslacional, Departamento de Fisiología, Biología Molecular y Celular, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad de Buenos Aires, CABA CE1428EHA, Argentina
| | - Frédérique Albarel
- Aix Marseille University, AP-HM, INSERM, Marseille Medical Genetics, Marmara Institute, La Conception Hospital, Department of Endocrinology, Marseille 13005, France
| | - Debora Braslavsky
- Centro de Investigaciones Endocrinológicas "Dr. César Bergadá," FEI - CONICET - División de Endocrinología, Hospital de Niños Ricardo Gutiérrez, Ciudad de Buenos Aires, CABA CE1428EHA, Argentina
| | - Ana Keselman
- Centro de Investigaciones Endocrinológicas "Dr. César Bergadá," FEI - CONICET - División de Endocrinología, Hospital de Niños Ricardo Gutiérrez, Ciudad de Buenos Aires, CABA CE1428EHA, Argentina
| | - Ignacio Bergadá
- Centro de Investigaciones Endocrinológicas "Dr. César Bergadá," FEI - CONICET - División de Endocrinología, Hospital de Niños Ricardo Gutiérrez, Ciudad de Buenos Aires, CABA CE1428EHA, Argentina
| | - Marcelo A Martí
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires e Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales CONICET, Pabellòn 2 de Ciudad Universitaria, Ciudad de Buenos Aires, CABA C1428EHA, Argentina
| | - Alexandru Saveanu
- Aix Marseille University, AP-HM, INSERM, Marseille Medical Genetics, Marmara Institute, La Conception Hospital, Laboratory of Molecular Biology, Marseille 13385, France
| | - Anne Barlier
- Aix Marseille University, AP-HM, INSERM, Marseille Medical Genetics, Marmara Institute, La Conception Hospital, Laboratory of Molecular Biology, Marseille 13385, France
| | - Rami Abou Jamra
- Institute of Human Genetics, University of Leipzig Medical Center, Leipzig 04103, Germany
| | - Michael H Guo
- Division of Endocrinology, Boston Children's Hospital and Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - Andrew Dauber
- Cincinnati Center for Growth Disorders, Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Marilena Nakaguma
- Developmental Endocrinology Unit, Laboratory of Hormones and Molecular Genetics LIM/42, Division of Endocrinology, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil
| | - Berenice B Mendonca
- Developmental Endocrinology Unit, Laboratory of Hormones and Molecular Genetics LIM/42, Division of Endocrinology, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil
| | - Sajini N Jayakody
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109-5618, USA
| | - A Bilge Ozel
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109-5618, USA
| | - Qing Fang
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109-5618, USA
| | - Qianyi Ma
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109-5618, USA
| | - Jun Z Li
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109-5618, USA
| | - Thierry Brue
- Aix Marseille University, AP-HM, INSERM, Marseille Medical Genetics, Marmara Institute, La Conception Hospital, Department of Endocrinology, Marseille 13005, France
| | - María Ines Pérez Millán
- Instituto de Biociencias, Biotecnología y Biología Traslacional, Departamento de Fisiología, Biología Molecular y Celular, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad de Buenos Aires, CABA CE1428EHA, Argentina
| | - Ivo J P Arnhold
- Developmental Endocrinology Unit, Laboratory of Hormones and Molecular Genetics LIM/42, Division of Endocrinology, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil
| | - Roland Pfaeffle
- Department of Women's and Child Health, Division of Pediatric Endocrinology, University Hospital Leipzig, Leipzig 04103, Germany; Institute of Human Genetics, University of Leipzig Medical Center, Leipzig 04103, Germany
| | - Jacob O Kitzman
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109-5618, USA; Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI 48109-2218, USA.
| | - Sally A Camper
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109-5618, USA.
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Cuny T, Graillon T, Defilles C, Datta R, Zhang S, Figarella-Branger D, Dufour H, Mougel G, Brue T, Landsman T, Halem HA, Culler MD, Barlier A, Saveanu A. Characterization of the ability of a, second-generation SST-DA chimeric molecule, TBR-065, to suppress GH secretion from human GH-secreting adenoma cells. Pituitary 2021; 24:351-358. [PMID: 33433890 DOI: 10.1007/s11102-020-01113-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/17/2020] [Indexed: 12/19/2022]
Abstract
CONTEXT Somatostatin (SST) and dopamine (DA) inhibit growth hormone (GH) secretion and proliferation of GH-secreting pituitary adenomas (GHomas) through binding to SSTR2 and D2R receptors. Chimeric SST-DA compounds (Dopastatins) display increased potency in inhibiting GH secretion, as compared with individual SST or DA analogs (alone or combined). OBJECTIVE To assess the efficacy of a second-generation dopastatin, TBR-065, in suppressing GH secretion from human GH- and GH/prolactin(PRL)-omas. DESIGN We compared the ability of TBR-065 to inhibit GH secretion from primary cultures of human GH- or GH/PRLoma cells to that of the first generation dopastatin, TBR-760 (formerly BIM-23A760), octreotide (OCT) and cabergoline (CAB), the later either alone or combined. We investigated whether there was any impact of BIM-133, the metabolite of TBR-065, on the ability of TBR-065 to inhibit GH in these cultures. METHODS 17 GH- and GH/PRLomas were included in this study. Inhibition of GH secretion by TBR-065, TBR-760, OCT and CAB (0.1 pM to 0.1 µM) was assessed over a period of 8 h. RESULTS All tumors expressed SSTR2 and D2R mRNAs. GH suppression was higher with TBR-065 as compared with TBR-760 (Emax = 57 ± 5.6% vs. 41.1 ± 12.5%, respectively, p < 0.001) or with OCT + CAB (Emax = 56.8 ± 7.2% vs. 44.4 ± 9.4%, p < 0.001). BIM-133 did not have any impact on the activity of TBR-065. CONCLUSION TBR-065 has significantly improved efficacy in suppressing GH secretion as compared to current available therapies and may represent a new promising option for the treatment of acromegaly.
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Affiliation(s)
- Thomas Cuny
- Service d'Endocrinologie, Aix Marseille University, APHM, Marseille Medical Genetics, Inserm U1251, Hôpital de la Conception, 147 Boulevard Baille, 13005, Marseille, France.
| | - Thomas Graillon
- Service de Neurochirurgie, Aix Marseille University, APHM, Marseille Medical Genetics, Inserm U1251, Hôpital de la Timone, Marseille, France
| | - Célines Defilles
- Aix Marseille University, APHM, Marseille Medical Genetics, Inserm U1251, Marseille, France
| | - Rakesh Datta
- Ipsen Bioscience (Formers Employees), Cambridge, MA, USA
| | - Shengwen Zhang
- Ipsen Bioscience (Formers Employees), Cambridge, MA, USA
| | | | - Henry Dufour
- Service de Neurochirurgie, Aix Marseille University, APHM, Marseille Medical Genetics, Inserm U1251, Hôpital de la Timone, Marseille, France
| | - Grégory Mougel
- Laboratoire de Biologie Moléculaire et Biochimie, Aix Marseille University, APHM, Marseille Medical Genetics, Inserm U1251, Hôpital de la Conception, Marseille, France
| | - Thierry Brue
- Service d'Endocrinologie, Aix Marseille University, APHM, Marseille Medical Genetics, Inserm U1251, Hôpital de la Conception, 147 Boulevard Baille, 13005, Marseille, France
| | - Tanya Landsman
- Ipsen Bioscience (Formers Employees), Cambridge, MA, USA
| | | | | | - Anne Barlier
- Laboratoire de Biologie Moléculaire et Biochimie, Aix Marseille University, APHM, Marseille Medical Genetics, Inserm U1251, Hôpital de la Conception, Marseille, France
| | - Alexandru Saveanu
- Laboratoire de Biologie Moléculaire et Biochimie, Aix Marseille University, APHM, Marseille Medical Genetics, Inserm U1251, Hôpital de la Conception, Marseille, France
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12
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Castets S, Roucher-Boulez F, Saveanu A, Mallet-Motak D, Chabre O, Amati-Bonneau P, Bonneau D, Girardin C, Morel Y, Villanueva C, Brue T, Reynaud R, Nicolino M. Hypopituitarism in Patients with Blepharophimosis and FOXL2 Mutations. Horm Res Paediatr 2021; 93:30-39. [PMID: 32454486 DOI: 10.1159/000507249] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/15/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND FOXL2 is the gene involved in blepharophimosis, ptosis, and epicanthus inversus syndrome (BPES). There have been few single case reports of growth hormone deficiency (GHD) with this syndrome, and Foxl2 is known to be involved in pituitary development in mice. Our aim was to analyze the prevalence of FOXL2 gene alteration in a series of patients with congenital hypopituitarism and eyelid anomalies. METHODS FOXL2 was analyzed in 10 patients with hypopituitarism (ranging from isolated GHD to complete pituitary hormone deficiency) and eyelid anomalies (typical BPES in 4 patients and milder anomalies in 6 patients). In patients with an FOXL2 mutation, we ruled out other possible molecular explanations by analyzing a panel of 20 genes known to be associated with hypopituitarism, and a candidate gene approach was used for patients without an FOXL2mutation. RESULTS Three patients had an FOXL2mutation. All 3 had typical BPES. Their pituitary phenotype varied from GHD to complete pituitary hormone deficiency and their pituitary morphology ranged from normal to an interrupted pituitary stalk. No mutations were found in genes previously associated with hypopituitarism. CONCLUSION Our study shows that some patients with BPES have hypopituitarism with no molecular explanation other than FOXL2 mutation. This points toward an involvement of FOXL2 in human pituitary development.
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Affiliation(s)
- Sarah Castets
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service d'Endocrinologie Pédiatrique, Bron, France, .,Aix-Marseille Université, AP-HM, Centre de Référence des Maladies Rares D'origine Hypophysaire HYPO, Marseille, France,
| | - Florence Roucher-Boulez
- Hospices Civils de Lyon, Groupement Hospitalier Est, Laboratoire de Biochimie et Biologie Moléculaire Grand Est, UM Pathologies Endocriniennes Rénales Musculaires et Mucoviscidose, Bron, France.,Centre de Référence du Développement Génital: du Fœtus à l'Adulte, Filière Maladies Rares Endocriniennes, Bron, France.,Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Alexandru Saveanu
- Aix-Marseille Université, AP-HM, Centre de Référence des Maladies Rares D'origine Hypophysaire HYPO, Marseille, France.,Aix Marseille Université, INSERM, MMG, U 1251, Marseille, France
| | - Delphine Mallet-Motak
- Hospices Civils de Lyon, Groupement Hospitalier Est, Laboratoire de Biochimie et Biologie Moléculaire Grand Est, UM Pathologies Endocriniennes Rénales Musculaires et Mucoviscidose, Bron, France.,Centre de Référence du Développement Génital: du Fœtus à l'Adulte, Filière Maladies Rares Endocriniennes, Bron, France
| | - Olivier Chabre
- CHU de Grenoble Alpes et Université Grenoble Alpes, CS 10217 38043, Service d'Endocrinologie, Grenoble, France
| | - Patrizia Amati-Bonneau
- MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, Université et Hôpital d'Angers, Angers, France.,Département de Biochimie et Génétique, Université et Hôpital d'Angers, Angers, France
| | - Dominique Bonneau
- MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, Université et Hôpital d'Angers, Angers, France.,Département de Biochimie et Génétique, Université et Hôpital d'Angers, Angers, France
| | - Celine Girardin
- Hôpitaux Universitaires de Genève, Endocrinologie Pédiatrique, Genève, Switzerland
| | - Yves Morel
- Hospices Civils de Lyon, Groupement Hospitalier Est, Laboratoire de Biochimie et Biologie Moléculaire Grand Est, UM Pathologies Endocriniennes Rénales Musculaires et Mucoviscidose, Bron, France.,Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Carine Villanueva
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service d'Endocrinologie Pédiatrique, Bron, France.,Centre de Référence du Développement Génital: du Fœtus à l'Adulte, Filière Maladies Rares Endocriniennes, Bron, France
| | - Thierry Brue
- Aix-Marseille Université, AP-HM, Centre de Référence des Maladies Rares D'origine Hypophysaire HYPO, Marseille, France.,Aix Marseille Université, INSERM, MMG, U 1251, Marseille, France
| | - Rachel Reynaud
- Aix-Marseille Université, AP-HM, Centre de Référence des Maladies Rares D'origine Hypophysaire HYPO, Marseille, France.,Aix Marseille Université, INSERM, MMG, U 1251, Marseille, France
| | - Marc Nicolino
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service d'Endocrinologie Pédiatrique, Bron, France.,Centre de Référence du Développement Génital: du Fœtus à l'Adulte, Filière Maladies Rares Endocriniennes, Bron, France.,Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France
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13
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Jullien N, Saveanu A, Vergier J, Marquant E, Quentien MH, Castinetti F, Galon-Faure N, Brauner R, Marrakchi Turki Z, Tauber M, El Kholy M, Linglart A, Rodien P, Fedala NS, Bergada I, Cortet-Rudelli C, Polak M, Nicolino M, Stuckens C, Barlier A, Brue T, Reynaud R. Clinical lessons learned in constitutional hypopituitarism from two decades of experience in a large international cohort. Clin Endocrinol (Oxf) 2021; 94:277-289. [PMID: 33098107 DOI: 10.1111/cen.14355] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 01/05/2023]
Abstract
CONTEXT The international GENHYPOPIT network collects phenotypical data and screens genetic causes of non-acquired hypopituitarism. AIMS To describe main phenotype patterns and their evolution through life. DESIGN Patients were screened according to their phenotype for coding sequence variations in 8 genes: HESX1, LHX3, LHX4, PROP1, POU1F1, TBX19, OTX2 and PROKR2. RESULTS Among 1213 patients (1143 index cases), the age of diagnosis of hypopituitarism was congenital (24%), in childhood (28%), at puberty (32%), in adulthood (7.2%) or not available (8.8%). Noteworthy, pituitary hormonal deficiencies kept on evolving during adulthood in 49 of patients. Growth Hormone deficiency (GHD) affected 85.8% of patients and was often the first diagnosed deficiency. AdrenoCorticoTropic Hormone deficiency rarely preceded GHD, but usually followed it by over 10 years. Pituitary Magnetic Resonance Imaging (MRI) abnormalities were common (79.7%), with 39.4% pituitary stalk interruption syndrome (PSIS). The most frequently associated extrapituitary malformations were ophthalmological abnormalities (16.1%). Prevalence of identified mutations was 7.3% of index cases (84/1143) and 29.5% in familial cases (n = 146). Genetic analysis in 449 patients without extrapituitary phenotype revealed 36 PROP1, 2 POU1F1 and 17 TBX19 mutations. CONCLUSION This large international cohort highlights atypical phenotypic presentation of constitutional hypopituitarism, such as post pubertal presentation or adult progression of hormonal deficiencies. These results justify long-term follow-up, and the need for systematic evaluation of associated abnormalities. Genetic defects were rarely identified, mainly PROP1 mutations in pure endocrine phenotypes.
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Affiliation(s)
- Nicolas Jullien
- Aix-Marseille Univ, CNRS, INP, Inst Neurophysiopathol, Marseille, France
| | - Alexandru Saveanu
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Faculté des Sciences médicales et paramédicales, Institut Marseille Maladies Rares (MarMaRa), Marseille, France
- Department of Endocrinology, Centre de Référence des Maladies Rares de l'hypophyse HYPO, Hôpital de la Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
- Centre de Référence des Maladies Rares de l'Hypophyse, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
- Laboratory of Molecular Biology, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
| | - Julia Vergier
- Paediatric Endocrinology Unit, Department of Paediatrics, CHU Timone Enfants, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
| | - Emeline Marquant
- Paediatric Endocrinology Unit, Department of Paediatrics, CHU Timone Enfants, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
| | - Marie Helene Quentien
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Faculté des Sciences médicales et paramédicales, Institut Marseille Maladies Rares (MarMaRa), Marseille, France
| | - Frederic Castinetti
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Faculté des Sciences médicales et paramédicales, Institut Marseille Maladies Rares (MarMaRa), Marseille, France
- Department of Endocrinology, Centre de Référence des Maladies Rares de l'hypophyse HYPO, Hôpital de la Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
- Centre de Référence des Maladies Rares de l'Hypophyse, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
| | - Noémie Galon-Faure
- Department of Paediatrics, Centre Hospitalier du Pays d'Aix, Aix-En-Provence, France
| | - Raja Brauner
- Fondation Ophtalmologique Adolphe de Rothschild and Université Paris Descartes, Paris, France
| | | | - Maité Tauber
- Paediatric Endocrinology Unit, Department of Paediatrics, Children Hospital, Toulouse University Hospital, Toulouse, France
| | | | - Agnès Linglart
- Paediatric Endocrinology Unit, Department of Paediatrics, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
| | - Patrice Rodien
- Endocrinology Department, Angers University Hospital, Angers, France
| | | | - Ignacio Bergada
- Children Hospital "Ricardo Gutierrez", Bueno-Aires, Argentina
| | | | - Michel Polak
- Paediatric Endocrinology Unit, Department of Paediatrics, Hôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), INSERM U1016, Institut IMAGINE, Paris, France
| | - Marc Nicolino
- Paediatric Endocrinology Unit, Department of Paediatrics, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon (HCL), Bron, France
| | - Chantal Stuckens
- Department of Paediatrics, Hôpital Jeanne de Flandre, Lille University Hospital, Lille, France
| | - Anne Barlier
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Faculté des Sciences médicales et paramédicales, Institut Marseille Maladies Rares (MarMaRa), Marseille, France
- Department of Endocrinology, Centre de Référence des Maladies Rares de l'hypophyse HYPO, Hôpital de la Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
- Centre de Référence des Maladies Rares de l'Hypophyse, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
- Laboratory of Molecular Biology, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
| | - Thierry Brue
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Faculté des Sciences médicales et paramédicales, Institut Marseille Maladies Rares (MarMaRa), Marseille, France
- Department of Endocrinology, Centre de Référence des Maladies Rares de l'hypophyse HYPO, Hôpital de la Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
- Centre de Référence des Maladies Rares de l'Hypophyse, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
| | - Rachel Reynaud
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Faculté des Sciences médicales et paramédicales, Institut Marseille Maladies Rares (MarMaRa), Marseille, France
- Centre de Référence des Maladies Rares de l'Hypophyse, CHU Conception, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
- Paediatric Endocrinology Unit, Department of Paediatrics, CHU Timone Enfants, Assistance Publique-Hôpitaux de Marseille (APHM), Marseille, France
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14
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Mougel G, Lagarde A, Albarel F, Essamet W, Luigi P, Mouly C, Vialon M, Cuny T, Castinetti F, Saveanu A, Brue T, Barlier A, Romanet P. Germinal defects of SDHx genes in patients with isolated pituitary adenoma. Eur J Endocrinol 2020; 183:369-379. [PMID: 32621582 DOI: 10.1530/eje-20-0054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 07/02/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND The '3PAs' syndrome, associating pituitary adenoma (PA) and pheochromocytoma/paraganglioma (PPGL), is sometimes associated with mutations in PPGL-predisposing genes, such as SDHx or MAX. In '3PAs' syndrome, PAs can occur before PPGL, suggesting a new gateway into SDHx/MAX-related diseases. OBJECTIVE To determine the SDHx/MAX mutation prevalence in patients with isolated PAs and characterize PAs of patients with SDHx/MAX mutations. DESIGN Genes involved in PAs (AIP/MEN1/CDKN1B) or PPGLs (SDHx/MAX) were sequenced in patients with isolated PAs. We then conducted a review of cases of PA in the setting of '3PAs' syndrome. RESULTS A total of 263 patients were recruited. Seven (likely) pathogenic variants were found in AIP, two in MEN1, two in SDHA, and one in SDHC. The prevalence of SDHx mutations reached 1.1% (3/263). Of 31 reported patients with PAs harboring SDHx/MAX mutations (28 published cases and 3 cases reported here), 6/31 (19%) developed PA before PPGL and 8/31 (26%) had isolated PA. The age of onset was later than in patients with AIP/MEN1 mutations. PAs were mainly macroprolactinomas and showed intracytoplasmic vacuoles seen on histopathology. CONCLUSIONS We discovered SDHx mutations in patients bearing PA who had no familial or personal history of PPGL. However, the question of incidental association remains unresolved and data to determine the benefit of SDHx/MAX screening in these patients are lacking. We recommend that patients with isolated PA should be carefully examined for a family history of PPGLs. A family history of PPGL, as well as the presence of intracytoplasmic vacuoles in PA, requires SDHx/MAX genetic testing of patients.
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Affiliation(s)
- Grégory Mougel
- Aix Marseille Univ, APHM, INSERM, MMG, Hospital La Conception, Laboratory of Molecular Biology, Marseille, France
| | - Arnaud Lagarde
- Aix Marseille Univ, APHM, INSERM, MMG, Hospital La Conception, Laboratory of Molecular Biology, Marseille, France
| | - Frédérique Albarel
- Department of Endocrinology, Hospital La Conception, APHM, Marseille, France
| | - Wassim Essamet
- Department of Pathology, Hospital La Timone, APHM, Marseille, France
| | - Perrine Luigi
- Department of Endocrinology, Hospital Lapeyronie, CHU Montpellier, Montpellier, France
| | - Céline Mouly
- Department of Endocrinology, Hospital Larrey, CHU Toulouse, Toulouse, France
| | - Magaly Vialon
- Department of Endocrinology, Hospital Larrey, CHU Toulouse, Toulouse, France
| | - Thomas Cuny
- Aix Marseille University, APHM, INSERM, MMG, Hospital La Conception, Department of Endocrinology, Marseille, France
| | - Frédéric Castinetti
- Aix Marseille University, APHM, INSERM, MMG, Hospital La Conception, Department of Endocrinology, Marseille, France
| | - Alexandru Saveanu
- Aix Marseille Univ, APHM, INSERM, MMG, Hospital La Conception, Laboratory of Molecular Biology, Marseille, France
| | - Thierry Brue
- Aix Marseille University, APHM, INSERM, MMG, Hospital La Conception, Department of Endocrinology, Marseille, France
| | - Anne Barlier
- Aix Marseille Univ, APHM, INSERM, MMG, Hospital La Conception, Laboratory of Molecular Biology, Marseille, France
| | - Pauline Romanet
- Aix Marseille Univ, APHM, INSERM, MMG, Hospital La Conception, Laboratory of Molecular Biology, Marseille, France
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15
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Vergier J, Castinetti F, Saveanu A, Girard N, Brue T, Reynaud R. DIAGNOSIS OF ENDOCRINE DISEASE: Pituitary stalk interruption syndrome: etiology and clinical manifestations. Eur J Endocrinol 2019; 181:R199-R209. [PMID: 31480013 DOI: 10.1530/eje-19-0168] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 09/02/2019] [Indexed: 11/08/2022]
Abstract
Pituitary stalk interruption syndrome (PSIS) is a congenital pituitary anatomical defect. This syndrome is an antenatal developmental defect belonging to the holoprosencephaly phenotype spectrum. It is heterogeneous regarding clinical, biological and radiological presentation and is characterized by the following triad: thin (<1 mm) or interrupted pituitary stalk connecting the hypothalamus to the pituitary gland, no eutopic posterior lobe, and hypoplasia or aplasia of the anterior lobe. This review reports current knowledge about the composite pathogenesis, for which underlying mechanisms remain unclear. Current data suggest genetic origins involving early developmental gene mutations with complex inheritance patterns and environmental influence, placing PSIS at the crossroads between Mendelian and multifactorial diseases. The phenotype associated with PSIS is highly heterogeneous with a high incidence of various combinations of hormonal deficiencies, sometimes associated with extra-pituitary birth defects. The age at onset is variable, but typical presentation is evolutive combined anterior pituitary hormone deficiencies at pediatric age, which progress even during adulthood to panhypopituitarism. Therefore, patients' follow-up throughout life is essential for adequate management.
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Affiliation(s)
- Julia Vergier
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Centre de Référence des Maladies Rares de l'hypophyse HYPO, Marseille, France
- Assistance-Publique des Hôpitaux de Marseille (AP-HM), Department of Pediatrics, Hôpital de la Timone Enfants, Marseille, France
| | - Frederic Castinetti
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Centre de Référence des Maladies Rares de l'hypophyse HYPO, Marseille, France
- Assistance-Publique des Hôpitaux de Marseille (AP-HM), Department of Endocrinology, Hôpital de la Conception, Marseille, France
| | - Alexandru Saveanu
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Centre de Référence des Maladies Rares de l'hypophyse HYPO, Marseille, France
- Assistance-Publique des Hôpitaux de Marseille (AP-HM), Laboratory of Molecular Biology, Hôpital de la Conception, Marseille, France
| | - Nadine Girard
- Aix-Marseille Université, UMR CNRS 7339, Marseille, France
- Assistance-Publique des Hôpitaux de Marseille (AP-HM), Department of Neuroradiology, Hôpital de la Timone Adultes, Marseille, France
| | - Thierry Brue
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Centre de Référence des Maladies Rares de l'hypophyse HYPO, Marseille, France
- Assistance-Publique des Hôpitaux de Marseille (AP-HM), Department of Endocrinology, Hôpital de la Conception, Marseille, France
| | - Rachel Reynaud
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Centre de Référence des Maladies Rares de l'hypophyse HYPO, Marseille, France
- Assistance-Publique des Hôpitaux de Marseille (AP-HM), Department of Pediatrics, Hôpital de la Timone Enfants, Marseille, France
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Bajuk Studen K, Stefanija MA, Saveanu A, Barlier A, Brue T, Pfeifer M. Genetic analysis of adult Slovenian patients with combined pituitary hormone deficiency. Endocrine 2019; 65:379-385. [PMID: 31093944 DOI: 10.1007/s12020-019-01949-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 05/04/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE Among genetic causes of combined pituitary hormone deficiency (CPHD), mutations of genes coding for transcription factors involved in pituitary development have been implicated. Congenital CPHD is a rare disease; therefore, it is important to expand the knowledge about incidence and regional distribution of specific mutations. The aim of this paper is to report results of genetic analyses of adult Slovenian patients with CPHD. METHODS Twenty-three adult Slovenian patients with early childhood onset CPHD were included in the study. Blood samples were collected through the GENHYPOPIT network to assess possible mutations of six genes (PROP1/HESX1/LHX4/LHX3/POU1F1) involved in the pituitary development following an established algorithm. RESULTS In seven out of 23 patients (30%) a specific mutation in genes encoding pituitary transcription factors was discovered. In five patients, two different mutations of the PROP1 gene (c.150delA and c.301-302delAG) were identified. One patient was heterozygous for a missense variant in the LHX4 gene. Additionally, one patient was positive for a mutation in the gene coding for prokineticin receptor-2. CONCLUSIONS Our study confirms that the two most common mutations of the PROP1 gene globally are also the most frequent mutations in the cohort of adult Slovenian patients with CHPD. Other mutations of pituitary transcription factor genes are extremely rare.
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Affiliation(s)
- Katica Bajuk Studen
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Zaloška 7, 1000, Ljubljana, Slovenia.
| | - Magdalena Avbelj Stefanija
- Department of Pediatric Endocrinology, Diabetes and Metabolism, University Children's Hospital, University Medical Centre Ljubljana, Bohoriceva 20, 1000, Ljubljana, Slovenia
| | - Alexandru Saveanu
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Laboratory of Molecular Biology, Hôpital de la Conception, 13005, Marseille, France
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France
| | - Anne Barlier
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Laboratory of Molecular Biology, Hôpital de la Conception, 13005, Marseille, France
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Centre de Référence des Maladies Rares de l'hypophyse HYPO, Department of Endocrinology, Hôpital de la Conception, 13005, Marseille, France
| | - Thierry Brue
- Aix-Marseille Université, Institut National de la Santé et de la Recherche Médicale (INSERM), U1251, Marseille Medical Genetics (MMG), Marseille, France
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Centre de Référence des Maladies Rares de l'hypophyse HYPO, Department of Endocrinology, Hôpital de la Conception, 13005, Marseille, France
| | - Marija Pfeifer
- Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia
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Romanet P, Odou MF, North MO, Saveanu A, Coppin L, Pasmant E, Mohamed A, Goudet P, Borson-Chazot F, Calender A, Béroud C, Lévy N, Giraud S, Barlier A. Proposition of adjustments to the ACMG-AMP framework for the interpretation of MEN1 missense variants. Hum Mutat 2019; 40:661-674. [PMID: 30869828 DOI: 10.1002/humu.23746] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 03/07/2019] [Accepted: 03/13/2019] [Indexed: 01/09/2023]
Abstract
In 2015, the ACMG-AMP guidelines provided a general procedure for the objective and reproducible classification of genomic variants. While the benefits of this framework are of major importance, its adaptation for locus-specific use is needed. Multiple Endocrine Neoplasia type 1 (MEN1) occurs due to inactivating mutations in the tumour suppressor gene MEN1, including 20% of missense variants. The classification of these variants may be extremely challenging. Here, we compared the interpretation of the 122 MEN1 missense variants, identified in the French population over the past 15 years by the TENGEN network (French oncogenetics network of neuroendocrine tumors) versus by using the ACMG-AMP guidelines, and analyzed the causes of discordance. A total of 59.8% of missense variants were termed as (likely)-pathogenic variants by TENGEN versus only 28.7% using ACMG-AMP guidelines. Actually, 53.4% (39/73) of TENGEN (likely)-pathogenic variants were declassified in variant of uncertain significance (VUS) by using ACMG-AMP guidelines, thereby affecting the clinical management of patients and their families. Twenty of these ACMG-AMP VUS were found in patients with a clinically authentic MEN1 disease. Here, TENGEN proposes adjustments to the ACMG-AMP framework for the interpretation of MEN1 missense variants. These propositions merge both the classification systems, and are particularly interesting, as MEN1 is included in the ACMG secondary findings list for reporting in clinical genomic sequencing.
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Affiliation(s)
- Pauline Romanet
- Aix Marseille Univ, APHM, INSERM, MMG, Laboratory of Molecular Biology Hospital La Conception, Marseille, France
| | - Marie-Françoise Odou
- CHU Lille, Service de Biochimie et Biologie moléculaire "Hormonologie, Métabolisme-Nutrition, Oncologie", F-59037 Lille, France
| | - Marie-Odile North
- Service de Génétique et Biologie Moléculaires, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, 27 Rue du Faubourg Saint Jacques, Paris, France
| | - Alexandru Saveanu
- Aix Marseille Univ, APHM, INSERM, MMG, Laboratory of Molecular Biology Hospital La Conception, Marseille, France
| | - Lucie Coppin
- Univ. Lille, Inserm, CHU Lille, UMR-S 1172 - JPARC - Jean-Pierre Aubert Research Center, F-59000 Lille, France
| | - Eric Pasmant
- Service de Génétique et Biologie Moléculaires, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, 27 Rue du Faubourg Saint Jacques, Paris, France
| | - Amira Mohamed
- Laboratory of Molecular Biology, Hospital La Conception, Marseille, France
| | - Pierre Goudet
- Department of Endocrine Surgery, University Hospital of Dijon, and INSERM, U866, Epidemiology and Clinical Research in Digestive Oncology Team, and INSERM, CIC1432, Clinical Epidemiology Unit, University Hospital of Dijon, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, Dijon, France
| | - Françoise Borson-Chazot
- Hospices Civils de Lyon, Fédération d'Endocrinologie, Université Claude Bernard Lyon 1, HESPER EA 7425, F-69008, Lyon, France
| | - Alain Calender
- Genetics Department, Hospices Civils de LYON (HCL), University Hospital, East Pathology Center, B-A3, 59 Bld Pinel, 69677, Bron Cedex, France
| | - Christophe Béroud
- Aix Marseille Univ, APHM, INSERM, MMG, Département de Génétique CHU La Timone Enfants, Marseille, France
| | - Nicolas Lévy
- Aix Marseille Univ, APHM, INSERM, MMG, Département de Génétique CHU La Timone Enfants, Marseille, France
| | - Sophie Giraud
- Genetics Department, Hospices Civils de LYON (HCL), University Hospital, East Pathology Center, B-A3, 59 Bld Pinel, 69677, Bron Cedex, France
| | - Anne Barlier
- Aix Marseille Univ, APHM, INSERM, MMG, Laboratory of Molecular Biology Hospital La Conception, Marseille, France
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Jullien N, Romanet P, Philippon M, Quentien MH, Beck-Peccoz P, Bergada I, Odent S, Reynaud R, Barlier A, Saveanu A, Brue T, Castinetti F. Heterozygous LHX3 mutations may lead to a mild phenotype of combined pituitary hormone deficiency. Eur J Hum Genet 2018; 27:216-225. [PMID: 30262920 DOI: 10.1038/s41431-018-0264-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 07/03/2018] [Accepted: 08/09/2018] [Indexed: 12/31/2022] Open
Abstract
LHX3 is an LIM domain transcription factor involved in the early steps of pituitary ontogenesis. We report here functional studies of three allelic variants, including the first heterozygous variant of LHX3 NM_178138.5(LHX3):c.587T>C (p.(Leu196Pro)) that may be responsible for a milder phenotype of hypopituitarism. Our functional studies showed that NM_178138.5(LHX3):c.587T>C (p.(Leu196Pro)) was not able to activate target promoters in vitro, as it did not bind DNA, and likely affected LHX3 function via a mechanism of haplo-insufficiency. Our study demonstrates the possibility that patients with a heterozygous variant of LHX3 may have pituitary deficiencies, with a milder phenotype than patients with homozygous variants. It is thus of vital to propose an optimal follow-up of such patients, who, until now, were considered as not being at risk of presenting pituitary deficiency. The second variant NM_178138.5(LHX3):c.622C>G (p.(Arg208Gly)), present in a homozygous state, displayed decreased transactivating ability without loss of binding capacity in vitro, concordant with in silico analysis; it should thus be considered to affect LHX3 function. In contrast, the NM_178138.5(LHX3):c.929G>C (p.(Arg310Pro)) variant, in a heterozygous state, also predicted as deleterious in silico, proved functionally active in vitro, and should thus still be classified as a variant of unknown significance. Our study emphasizes the need for functional studies due to the limits of software-based predictions of new variants, and the possible association of a pituitary phenotype to heterozygous LHX3 variants.
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Affiliation(s)
| | - Pauline Romanet
- Aix Marseille Univ, APHM, INSERM, MMG, Hôpital de la Conception, Laboratory of Molecular Biology, Marseille, France
| | - Mélanie Philippon
- Aix Marseille Univ, APHM, INSERM, MMG, Hôpital de la Conception, Department of Endocrinology, Marseille, France
| | | | - Paolo Beck-Peccoz
- Institute of Endocrine Sciences, Ospedale Maggiore IRCCS, University of Milan, Milan, Italy
| | - Ignacio Bergada
- Centro de Investigaciones Endocrinologicas (CEDIE) « Dr. César Bergada » Division de Endocrinologia, Hospital de Ninos Ricardo Guttierrez, Buenos Aires, Argentina
| | - Sylvie Odent
- Service de Génétique Clinique, Centre de référence "Maladies Rares" CLAD-Ouest, université de Rennes 1, CNRS UMR6290, Hôpital SUD, Rennes, France
| | - Rachel Reynaud
- Aix Marseille Univ, APHM, INSERM, MMG, Hôpital la Timone Enfants, Department of Pediatrics, Marseille, France
| | - Anne Barlier
- Aix Marseille Univ, APHM, INSERM, MMG, Hôpital de la Conception, Laboratory of Molecular Biology, Marseille, France
| | - Alexandru Saveanu
- Aix Marseille Univ, INSERM, MMG, UMR1251 Faculté de Médecine, Marseille, France
| | - Thierry Brue
- Aix Marseille Univ, APHM, INSERM, MMG, Hôpital de la Conception, Department of Endocrinology, Marseille, France
| | - Frederic Castinetti
- Aix Marseille Univ, APHM, INSERM, MMG, Hôpital de la Conception, Department of Endocrinology, Marseille, France.
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Graillon T, Romano D, Defilles C, Lisbonis C, Saveanu A, Figarella-Branger D, Roche PH, Fuentes S, Chinot O, Dufour H, Barlier A. Pasireotide is more effective than octreotide, alone or combined with everolimus on human meningioma in vitro. Oncotarget 2017; 8:55361-55373. [PMID: 28903425 PMCID: PMC5589664 DOI: 10.18632/oncotarget.19517] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 07/12/2017] [Indexed: 12/18/2022] Open
Abstract
Pasireotide is a somatostatin analog (SSA) that targets somatostatin receptor subtype 1 (SST1), SST2, SST3, and SST5 with a high affinity. Pasireotide has a better antisecretory effect in acromegaly, Cushing's disease, and neuroendocrine tumors than octreotide. In this study, we compared the effects of pasireotide to those of octreotide in vitro on meningioma primary cell cultures, both alone and in combination with the mTOR inhibitor everolimus. Significant mRNA expression levels of SST1, SST2, and SST5 were observed in 40.5%, 100%, and 35% of meningioma samples, respectively. Pasireotide had a significantly stronger inhibitory effect on cell proliferation than octreotide. The effect of pasireotide, but not of octreotide, was significantly stronger in the group expressing the highest level of SST1 mRNA. Combined treatment with pasireotide and everolimus induced a higher reduction in cell viability than that with octreotide plus everolimus. Moreover, pasireotide decreased Akt phosphorylation and reversed everolimus-induced Akt hyperphosphorylation to a higher degree than octreotide. Using 4E-BP1 siRNA (si4E-BP), we demonstrated that 4E-BP1 protein silencing significantly reversed the response to everolimus, both alone and in combination with SSAs. Moreover, si4E-BP completely reversed the inhibition of cyclin D1 expression level and the increase in p27kip1 induced by SSAs, both alone and in combination with everolimus. Our results strongly support the need for further studies on the combination of pasireotide and everolimus in medical therapy for meningiomas.
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Affiliation(s)
- Thomas Graillon
- Aix Marseille Univ, CNRS CRN2M UMR7286, Marseille, France.,APHM, La Timone Hospital, Department of Neurosurgery, Marseille, France
| | - David Romano
- Aix Marseille Univ, CNRS CRN2M UMR7286, Marseille, France
| | | | | | - Alexandru Saveanu
- Aix Marseille Univ, CNRS CRN2M UMR7286, Marseille, France.,APHM, La Conception Hospital, Molecular Biology Laboratory, Marseille, France
| | - Dominique Figarella-Branger
- APHM, La Timone Hospital, Department of Anatomopathology and Neuropathology, Marseille, France.,Aix Marseille Univ, INSERM, CRO2 UMR911, Marseille, France
| | | | - Stéphane Fuentes
- APHM, La Timone Hospital, Department of Neurosurgery, Marseille, France
| | - Olivier Chinot
- Aix Marseille Univ, INSERM, CRO2 UMR911, Marseille, France.,APHM, La Timone Hospital, Department of Neuro-oncology, Marseille, France
| | - Henry Dufour
- Aix Marseille Univ, CNRS CRN2M UMR7286, Marseille, France.,APHM, La Timone Hospital, Department of Neurosurgery, Marseille, France
| | - Anne Barlier
- Aix Marseille Univ, CNRS CRN2M UMR7286, Marseille, France.,APHM, La Conception Hospital, Molecular Biology Laboratory, Marseille, France
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Brue T, Saveanu A, Jullien N, Fauquier T, Castinetti F, Enjalbert A, Barlier A, Reynaud R. Lessons from monogenic causes of growth hormone deficiency. Annales d'Endocrinologie 2017; 78:77-79. [DOI: 10.1016/j.ando.2017.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mohamed A, Romano D, Saveanu A, Roche C, Albertelli M, Barbieri F, Brue T, Niccoli P, Delpero JR, Garcia S, Ferone D, Florio T, Moutardier V, Poizat F, Barlier A, Gerard C. Anti-proliferative and anti-secretory effects of everolimus on human pancreatic neuroendocrine tumors primary cultures: is there any benefit from combination with somatostatin analogs? Oncotarget 2017; 8:41044-41063. [PMID: 28454119 PMCID: PMC5522327 DOI: 10.18632/oncotarget.17008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 03/22/2017] [Indexed: 11/25/2022] Open
Abstract
Therapeutic management of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) is challenging. The mammalian target of rapamycin (mTOR) inhibitor everolimus recently obtained approval from the Food and Drug Administration for the treatment of patients with advanced pancreatic neuroendocrine tumors (pNETs). Despite its promising antitumor efficacy observed in cell lines, clinical benefit for patients is unsatisfactory. The limited therapeutic potential of everolimus in cancer cells has been attributed to Akt activation due to feedback loops relief following mTOR inhibition. Combined inhibition of Akt might then improve everolimus antitumoral effect. In this regard, the somatostatin analog (SSA) octreotide has been shown to repress the PI3K/Akt pathway in some tumor cell lines. Moreover, SSAs are well tolerated and routinely used to reduce symptoms caused by peptide release in patients carrying functional GEP-NETs. We have recently established and characterized primary cultures of human pNETs and demonstrated the anti-proliferative effects of both octreotide and pasireotide. In this study, we aim at determining the antitumor efficacy of everolimus alone or in combination with the SSAs octreotide and pasireotide in primary cultures of pNETs. Everolimus reduced both Chromogranin A secretion and cell viability and upregulated Akt activity in single treatment. Its anti-proliferative and anti-secretory efficacy was not improved combined with the SSAs. Both SSAs did not overcome everolimus-induced Akt upregulation. Furthermore, caspase-dependent apoptosis induced by SSAs was lost in combined treatments. These molecular events provide the first evidence supporting the lack of marked benefit in patients co-treated with everolimus and SSA.
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Affiliation(s)
- Amira Mohamed
- Aix Marseille Univ, CNRS, CRN2M, Marseille, France
- APHM, Conception Hospital, Molecular Biology Laboratory, Marseille, France
| | - David Romano
- Aix Marseille Univ, CNRS, CRN2M, Marseille, France
| | - Alexandru Saveanu
- Aix Marseille Univ, CNRS, CRN2M, Marseille, France
- APHM, Conception Hospital, Molecular Biology Laboratory, Marseille, France
| | - Catherine Roche
- APHM, Conception Hospital, Molecular Biology Laboratory, Marseille, France
| | - Manuela Albertelli
- Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genova, Genova, Italy
| | - Federica Barbieri
- Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genova, Genova, Italy
| | - Thierry Brue
- Aix Marseille Univ, CNRS, CRN2M, Marseille, France
- APHM, Conception Hospital, Endocrinology Department, Marseille, France
| | - Patricia Niccoli
- Paoli Calmettes Cancer Institute, Oncology Department, IPC CoE-ENETS, Marseille, France
| | - Jean-Robert Delpero
- Paoli Calmettes Cancer Institute, Surgery Department, IPC CoE-ENETS, Marseille, France
| | - Stephane Garcia
- APHM, North Hospital, Pathology Laboratory, Marseille, France
| | - Diego Ferone
- Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genova, Genova, Italy
| | - Tullio Florio
- Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genova, Genova, Italy
| | | | - Flora Poizat
- Paoli Calmettes Cancer Institute, Biopathology Department, IPC CoE-ENETS, Marseille, France
| | - Anne Barlier
- Aix Marseille Univ, CNRS, CRN2M, Marseille, France
- APHM, Conception Hospital, Molecular Biology Laboratory, Marseille, France
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Graillon T, Romano D, Defilles C, Saveanu A, Mohamed A, Figarella-Branger D, Roche PH, Fuentes S, Chinot O, Dufour H, Barlier A. Octreotide therapy in meningiomas: in vitro study, clinical correlation, and literature review. J Neurosurg 2016; 127:660-669. [PMID: 27982767 DOI: 10.3171/2016.8.jns16995] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Meningiomas express somatostatin receptor subtype 2 (SST2), which is targeted by the somatostatin analog octreotide. However, to date, using somatostatin analog therapy for the treatment of these tumors in clinical practice has been debated. This study aims to clarify the in vitro effects of octreotide on meningiomas for precise clinical applications. METHODS The effects of octreotide were analyzed in a large series of 80 meningiomas, including 31 World Health Organization (WHO) Grade II and 4 WHO Grade III tumors, using fresh primary cell cultures to study the impact on cell viability, apoptosis, and signal transduction pathways. RESULTS SST2 mRNA was detected in 100% of the tested meningiomas at levels similar to those observed in other SST2-expressing tumors, neuroendocrine tumors, or pituitary adenomas. Octreotide significantly decreased cell proliferation in 88% of meningiomas but did not induce cell death. On average, cell proliferation was more inhibited in the meningioma group expressing a high level of SST2 than in the low-SST2 group. Moreover, octreotide response was positively correlated to the level of merlin protein and inversely correlated to the level of phosphorylated p70-S6 kinase, a downstream effector of the PI3K/Akt/mammalian target of rapamycin (mTOR) pathway. Octreotide inhibited Akt phosphorylation and activated tyrosine phosphatase without impacting the extracellular regulated kinase (ERK) pathway. CONCLUSIONS Octreotide acts exclusively as an antiproliferative agent and does not promote apoptosis in meningioma in vitro. Therefore, in vivo, octreotide is likely to limit tumor growth rather than induce tumor shrinkage. A meta-analysis of the literature reveals an interest in octreotide for the treatment of WHO Grade I tumors, particularly those in the skull base for which the 6-month progression-free survival level reached 92%. Moreover, somatostatin analogs, which are well-tolerated drugs, could be of interest for use as co-targeting therapies for aggressive meningiomas.
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Affiliation(s)
- Thomas Graillon
- Aix-Marseille Université, CNRS, CRN2M, UMR 7286.,Departments of 2 Neurosurgery
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Marquant E, Jullien N, Saveanu A, Quentien MH, Castinetti F, Galon-Faure N, Enjalbert A, Barlier A, Brue T, Reynaud R. Réseau GENHYPOPIT : analyse phénotype/génotype des hypopituitarismes congénitaux (1213 patients). Arch Pediatr 2016. [DOI: 10.1016/j.arcped.2016.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Castinetti F, Daly AF, Stratakis CA, Caberg JH, Castermans E, Trivellin G, Rostomyan L, Saveanu A, Jullien N, Reynaud R, Barlier A, Bours V, Brue T, Beckers A. GPR101 Mutations are not a Frequent Cause of Congenital Isolated Growth Hormone Deficiency. Horm Metab Res 2016; 48:389-93. [PMID: 26797872 PMCID: PMC7566854 DOI: 10.1055/s-0042-100733] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Patients with Xq26.3 microduplication present with X-linked acrogigantism (X-LAG) syndrome, an early-childhood form of gigantism due to marked growth hormone (GH) hypersecretion from mixed GH-PRL adenomas and hyperplasia. The microduplication includes GPR101, which is upregulated in patients' tumor tissue. The GPR101 gene codes for an orphan G protein coupled receptor that is normally highly expressed in the hypothalamus. Our aim was to determine whether GPR101 loss of function mutations or deletions could be involved in patients with congenital isolated GH deficiency (GHD). Taking advantage of the cohort of patients from the GENHYPOPIT network, we studied 41 patients with unexplained isolated GHD. All patients had Sanger sequencing of the GPR101 gene and array comparative genome hybridization (aCGH) to look for deletions. Functional studies (cell culture with GH secretion measurements, cAMP response) were performed. One novel GPR101 variant, c.589 G>T (p.V197L), was seen in the heterozygous state in a patient with isolated GHD. In silico analysis suggested that this variant could be deleterious. Functional studies did not show any significant difference in comparison with wild type for GH secretion and cAMP response. No truncating, frameshift, or small insertion-deletion (indel) GPR101 mutations were seen in the 41 patients. No deletion or other copy number variation at chromosome Xq26.3 was found on aCGH. We found a novel GPR101 variant of unknown significance, in a patient with isolated GH deficiency. Our study did not identify GPR101 abnormalities as a frequent cause of GH deficiency.
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Affiliation(s)
- F Castinetti
- CNRS UMR7286, CRN2M, Faculté de médecine, Marseille, France and Reference Center for Rare Pituitary Diseases DEFHY, Assistance Publique Hôpitaux de Marseille, La Conception Hospital, Aix Marseille University, Marseille, France
| | - A F Daly
- Department of Endocrinology, Centre Hospitalier Universitaire de Liège, University of Liège, Domaine Universitaire du Sart-Tilman, Liège, Belgium
| | - C A Stratakis
- Section on Endocrinology and Genetics, Program on Developmental Endocrinology & Genetics (PDEGEN) & Pediatric Endocrinology Inter-institute Training Program, Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), Bethesda, USA
| | - J-H Caberg
- Department of Human Genetics, Centre Hospitalier Universitaire de Liège, University of Liège, Domaine Universitaire du Sart-Tilman, Liège, Belgium
| | - E Castermans
- Department of Human Genetics, Centre Hospitalier Universitaire de Liège, University of Liège, Domaine Universitaire du Sart-Tilman, Liège, Belgium
| | - G Trivellin
- Section on Endocrinology and Genetics, Program on Developmental Endocrinology & Genetics (PDEGEN) & Pediatric Endocrinology Inter-institute Training Program, Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), Bethesda, USA
| | - L Rostomyan
- Department of Endocrinology, Centre Hospitalier Universitaire de Liège, University of Liège, Domaine Universitaire du Sart-Tilman, Liège, Belgium
| | - A Saveanu
- CNRS UMR7286, CRN2M, Faculté de médecine, Marseille, France and Reference Center for Rare Pituitary Diseases DEFHY, Assistance Publique Hôpitaux de Marseille, La Conception Hospital, Aix Marseille University, Marseille, France
| | - N Jullien
- CNRS UMR7286, CRN2M, Faculté de médecine, Marseille, France and Reference Center for Rare Pituitary Diseases DEFHY, Assistance Publique Hôpitaux de Marseille, La Conception Hospital, Aix Marseille University, Marseille, France
| | - R Reynaud
- CNRS UMR7286, CRN2M, Faculté de médecine, Marseille, France and Reference Center for Rare Pituitary Diseases DEFHY, Assistance Publique Hôpitaux de Marseille, La Conception Hospital, Aix Marseille University, Marseille, France
| | - A Barlier
- CNRS UMR7286, CRN2M, Faculté de médecine, Marseille, France and Reference Center for Rare Pituitary Diseases DEFHY, Assistance Publique Hôpitaux de Marseille, La Conception Hospital, Aix Marseille University, Marseille, France
| | - V Bours
- Department of Human Genetics, Centre Hospitalier Universitaire de Liège, University of Liège, Domaine Universitaire du Sart-Tilman, Liège, Belgium
| | - T Brue
- CNRS UMR7286, CRN2M, Faculté de médecine, Marseille, France and Reference Center for Rare Pituitary Diseases DEFHY, Assistance Publique Hôpitaux de Marseille, La Conception Hospital, Aix Marseille University, Marseille, France
| | - A Beckers
- Department of Endocrinology, Centre Hospitalier Universitaire de Liège, University of Liège, Domaine Universitaire du Sart-Tilman, Liège, Belgium
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Castinetti F, Reynaud R, Saveanu A, Jullien N, Quentien MH, Rochette C, Barlier A, Enjalbert A, Brue T. MECHANISMS IN ENDOCRINOLOGY: An update in the genetic aetiologies of combined pituitary hormone deficiency. Eur J Endocrinol 2016; 174:R239-47. [PMID: 26733480 DOI: 10.1530/eje-15-1095] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 01/05/2016] [Indexed: 01/08/2023]
Abstract
Over the last 5 years, new actors involved in the pathogenesis of combined pituitary hormone deficiency in humans have been reported: they included a member of the immunoglobulin superfamily glycoprotein and ciliary G protein-coupled receptors, as well as new transcription factors and signalling molecules. New modes of inheritance for alterations of genes encoding transcription factors have also been described. Finally, actors known to be involved in a very specific phenotype (hypogonadotroph hypogonadism for instance) have been identified in a wider range of phenotypes. These data thus suggest that new mechanisms could explain the low rate of aetiological identification in this heterogeneous group of diseases. Taking into account the fact that several reviews have been published in recent years on classical aetiologies of CPHD such as mutations of POU1F1 or PROP1, we focused the present overview on the data published in the last 5 years, to provide the reader with an updated review on this rapidly evolving field of knowledge.
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Affiliation(s)
- Frederic Castinetti
- Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France
| | - Rachel Reynaud
- Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France
| | - Alexandru Saveanu
- Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d
| | - Nicolas Jullien
- Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France
| | - Marie Helene Quentien
- Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France
| | - Claire Rochette
- Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France
| | - Anne Barlier
- Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d
| | - Alain Enjalbert
- Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France
| | - Thierry Brue
- Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France Aix-Marseille UniversitéCNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, 13344 cedex 15 Marseille, FranceDepartment of EndocrinologyAPHM, Hôpital La Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, 13385 cedex 5 Marseille, FranceCentre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY13385 cedex 15 Marseille, FranceAPHMHôpital Timone Enfants, Service de Pédiatrie Multidisciplinaire, 13385 cedex 5 Marseille, FranceAPHMHôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005 Marseille, France
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Vujovic S, Vujosevic S, Kavaric S, Sopta J, Ivovic M, Saveanu A, Brue T, Korbonits M, Popovic V. Cancerous leptomeningitis and familial congenital hypopituitarism. Endocrine 2016; 52:231-5. [PMID: 26886902 DOI: 10.1007/s12020-016-0868-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 01/12/2016] [Indexed: 12/23/2022]
Abstract
People are at higher risk of cancer as they get older or have a strong family history of cancer. The potential influence of environmental and behavioral factors remains poorly understood. Earlier population and case control studies reported that upper quartile of circulating IGF-I is associated with a higher risk of developing cancer suggesting possible involvement of the growth hormone (GH)/IGF system in initiation or progression of cancer. Since GH therapy increases IGF-1 levels, there have been concerns that GH therapy in hypopituitarism might increase the risk of cancer. We report a 42-year-old female patient who presented with subacute onset of symptoms of meningitis and with the absence of fever which resulted in death 70 days after the onset of symptoms. The patient together with her younger brother was diagnosed at the age of 5 years with familial congenital hypopituitarism, due to homozygous mutation c.150delA in PROP1 gene. Due to evolving hypopituitarism, she was replaced with thyroxine (from age 5), hydrocortisone (from age 13), GH (from age 13 until 17), and sex steroids in adolescence and adulthood. Her consanguineous family has a prominent history of malignant diseases. Six close relatives had malignant disease including her late maternal aunt with breast cancer. BRCA 1 and BRCA 2 mutational analysis in the patient's mother was negative. Histology after autopsy disclosed advanced ovarian cancer with multiple metastases to the brain, leptomeninges, lungs, heart, and adrenals. Low circulating IGF-1 did not seem to protect this patient from cancer initiation and progression in the context of strong family history of malignancies.
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Affiliation(s)
- S Vujovic
- Clinic of Endocrinology, Clinical Center Serbia and Medical Faculty, University of Belgrade, Dr Subotic Str 13, 11000, Belgrade, Serbia
| | - S Vujosevic
- Clinical Center of Montenegro and Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
| | - S Kavaric
- Clinical Center of Montenegro and Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
| | - J Sopta
- Institute of Pathology, Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - M Ivovic
- Clinic of Endocrinology, Clinical Center Serbia and Medical Faculty, University of Belgrade, Dr Subotic Str 13, 11000, Belgrade, Serbia
| | - A Saveanu
- Aix-Marseille Université, CNRS, CRN2M UMR 7286, 13344, Marseille Cedex 15, France
- APHM, Hôpital Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, Centre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY, and Laboratoire de Biologie Moleculaire, GeOneE (Genetique Oncologique et Endocrinienne), 13385, Marseille Cedex 15, France
| | - T Brue
- Aix-Marseille Université, CNRS, CRN2M UMR 7286, 13344, Marseille Cedex 15, France
- APHM, Hôpital Conception, Service d'Endocrinologie, Diabète et Maladies Métaboliques, Centre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY, and Laboratoire de Biologie Moleculaire, GeOneE (Genetique Oncologique et Endocrinienne), 13385, Marseille Cedex 15, France
| | - M Korbonits
- Department of Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - V Popovic
- Clinic of Endocrinology, Clinical Center Serbia and Medical Faculty, University of Belgrade, Dr Subotic Str 13, 11000, Belgrade, Serbia.
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Sarfati J, Saveanu A, Young J. Pituitary stalk interruption and olfactory bulbs aplasia/hypoplasia in a man with Kallmann syndrome and reversible gonadotrope and somatotrope deficiencies. Endocrine 2015; 49:865-6. [PMID: 25381604 DOI: 10.1007/s12020-014-0475-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 11/01/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Julie Sarfati
- Faculté de Médecine Paris-Sud , Univ Paris-Sud, UMR-S693, 94276, Le Kremlin-Bicêtre, France
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Rochette C, Jullien N, Saveanu A, Caldagues E, Bergada I, Braslavsky D, Pfeifer M, Reynaud R, Herman JP, Barlier A, Brue T, Enjalbert A, Castinetti F. Identifying the Deleterious Effect of Rare LHX4 Allelic Variants, a Challenging Issue. PLoS One 2015; 10:e0126648. [PMID: 25955177 PMCID: PMC4425544 DOI: 10.1371/journal.pone.0126648] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 04/06/2015] [Indexed: 11/18/2022] Open
Abstract
LHX4 is a LIM homeodomain transcription factor involved in the early steps of pituitary ontogenesis. To date, 8 heterozygous LHX4 mutations have been reported as responsible of combined pituitary hormone deficiency (CPHD) in Humans. We identified 4 new LHX4 heterozygous allelic variants in patients with congenital hypopituitarism: W204X, delK242, N271S and Q346R. Our objective was to determine the role of LHX4 variants in patients’ phenotypes. Heterologous HEK293T cells were transfected with plasmids encoding for wild-type or mutant LHX4. Protein expression was analysed by Western Blot, and DNA binding by electro-mobility shift assay experiments. Target promoters of LHX4 were cotransfected with wild type or mutant LHX4 to test the transactivating abilities of each variant. Our results show that the W204X mutation was associated with early GH and TSH deficiencies and later onset ACTH deficiency. It led to a truncated protein unable to bind to alpha-Gsu promoter binding consensus sequence. W204X was not able to activate target promoters in vitro. Cotransfection experiments did not favour a dominant negative effect. In contrast, all other mutants were able to bind the promoters and led to an activation similar as that observed with wild type LHX4, suggesting that they were likely polymorphisms. To conclude, our study underlines the need for functional in vitro studies to ascertain the role of rare allelic variants of LHX4 in disease phenotypes. It supports the causative role of the W204X mutation in CPHD and adds up childhood onset ACTH deficiency to the clinical spectrum of the various phenotypes related to LHX4 mutations.
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Affiliation(s)
- Claire Rochette
- Aix Marseille University, CNRS UMR7286, CRN2M, Faculté de médecine, Marseille, France and Reference Center for Rare Pituitary Diseases DEFHY, La Timone Hospital, Marseille, France
| | - Nicolas Jullien
- Aix Marseille University, CNRS UMR7286, CRN2M, Faculté de médecine, Marseille, France and Reference Center for Rare Pituitary Diseases DEFHY, La Timone Hospital, Marseille, France
| | - Alexandru Saveanu
- Aix Marseille University, CNRS UMR7286, CRN2M, Faculté de médecine, Marseille, France and Reference Center for Rare Pituitary Diseases DEFHY, La Timone Hospital, Marseille, France
- Laboratory of Molecular Endocrinology, La Conception Hospital, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | | | - Ignacio Bergada
- Centro de Investigaciones Endocrinologicas (CEDIE) « Dr. César Bergada » Division de Endocrinologia, Hospital de Ninos Ricardo Guttierrez, Buenos Aires, Argentina
| | - Debora Braslavsky
- Centro de Investigaciones Endocrinologicas (CEDIE) « Dr. César Bergada » Division de Endocrinologia, Hospital de Ninos Ricardo Guttierrez, Buenos Aires, Argentina
| | - Marija Pfeifer
- Univ med center Ljubjana, Department Endocrinology, Zaloska 7, Ljubjana, Slovenia
| | - Rachel Reynaud
- Aix Marseille University, CNRS UMR7286, CRN2M, Faculté de médecine, Marseille, France and Reference Center for Rare Pituitary Diseases DEFHY, La Timone Hospital, Marseille, France
| | - Jean-Paul Herman
- Aix Marseille University, CNRS UMR7286, CRN2M, Faculté de médecine, Marseille, France and Reference Center for Rare Pituitary Diseases DEFHY, La Timone Hospital, Marseille, France
| | - Anne Barlier
- Aix Marseille University, CNRS UMR7286, CRN2M, Faculté de médecine, Marseille, France and Reference Center for Rare Pituitary Diseases DEFHY, La Timone Hospital, Marseille, France
- Laboratory of Molecular Endocrinology, La Conception Hospital, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Thierry Brue
- Aix Marseille University, CNRS UMR7286, CRN2M, Faculté de médecine, Marseille, France and Reference Center for Rare Pituitary Diseases DEFHY, La Timone Hospital, Marseille, France
| | - Alain Enjalbert
- Aix Marseille University, CNRS UMR7286, CRN2M, Faculté de médecine, Marseille, France and Reference Center for Rare Pituitary Diseases DEFHY, La Timone Hospital, Marseille, France
- Laboratory of Molecular Endocrinology, La Conception Hospital, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Frederic Castinetti
- Aix Marseille University, CNRS UMR7286, CRN2M, Faculté de médecine, Marseille, France and Reference Center for Rare Pituitary Diseases DEFHY, La Timone Hospital, Marseille, France
- * E-mail:
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Castinetti F, Reynaud R, Quentien MH, Jullien N, Marquant E, Rochette C, Herman JP, Saveanu A, Barlier A, Enjalbert A, Brue T. Combined pituitary hormone deficiency: current and future status. J Endocrinol Invest 2015; 38:1-12. [PMID: 25200994 DOI: 10.1007/s40618-014-0141-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 07/17/2014] [Indexed: 12/20/2022]
Abstract
Over the last two decades, the understanding of the mechanisms involved in pituitary ontogenesis has largely increased. Since the first description of POU1F1 human mutations responsible for a well-defined phenotype without extra-pituitary malformation, several other genetic defects of transcription factors have been reported with variable degrees of phenotype-genotype correlations. However, to date, despite the identification of an increased number of genetic causes of isolated or multiple pituitary deficiencies, the etiology of most (80-90 %) congenital cases of hypopituitarism remains unsolved. Identifying new etiologies is of importance as a post-natal diagnosis to better diagnose and treat the patients (delayed pituitary deficiencies, differential diagnosis of a pituitary mass on MRI, etc.), and as a prenatal diagnosis to decrease the risk of early death (undiagnosed corticotroph deficiency for instance). The aim of this review is to summarize the main etiologies and phenotypes of combined pituitary hormone deficiencies, associated or not with extra-pituitary anomalies, and to suggest how the identification of such etiologies could be improved in the near future.
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Affiliation(s)
- F Castinetti
- Aix-Marseille Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, cedex 15, 13344, Marseille, France.
- APHM, Hôpital Timone Adultes, Service d'Endocrinologie, Diabète et Maladies Métaboliques, cedex 5, 13385, Marseille, France.
- Centre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY, cedex 15, 13385, Marseille, France.
| | - R Reynaud
- Aix-Marseille Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, cedex 15, 13344, Marseille, France
- APHM, Hôpital Timone Enfants, Service de Pédiatrie multidisciplinaire, cedex 5, 13385, Marseille, France
- Centre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY, cedex 15, 13385, Marseille, France
| | - M-H Quentien
- Aix-Marseille Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, cedex 15, 13344, Marseille, France
- APHM, Hôpital Timone Adultes, Service d'Endocrinologie, Diabète et Maladies Métaboliques, cedex 5, 13385, Marseille, France
- Centre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY, cedex 15, 13385, Marseille, France
| | - N Jullien
- Aix-Marseille Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, cedex 15, 13344, Marseille, France
| | - E Marquant
- Aix-Marseille Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, cedex 15, 13344, Marseille, France
- APHM, Hôpital Timone Enfants, Service de Pédiatrie multidisciplinaire, cedex 5, 13385, Marseille, France
- Centre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY, cedex 15, 13385, Marseille, France
| | - C Rochette
- Aix-Marseille Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, cedex 15, 13344, Marseille, France
- APHM, Hôpital Timone Adultes, Service d'Endocrinologie, Diabète et Maladies Métaboliques, cedex 5, 13385, Marseille, France
- Centre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY, cedex 15, 13385, Marseille, France
| | - J-P Herman
- Aix-Marseille Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, cedex 15, 13344, Marseille, France
| | - A Saveanu
- Aix-Marseille Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, cedex 15, 13344, Marseille, France
- APHM, Hôpital Timone Adultes, Service d'Endocrinologie, Diabète et Maladies Métaboliques, cedex 5, 13385, Marseille, France
- APHM, Hôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005, Marseille, France
- Centre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY, cedex 15, 13385, Marseille, France
| | - A Barlier
- Aix-Marseille Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, cedex 15, 13344, Marseille, France
- APHM, Hôpital Timone Adultes, Service d'Endocrinologie, Diabète et Maladies Métaboliques, cedex 5, 13385, Marseille, France
- APHM, Hôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005, Marseille, France
- Centre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY, cedex 15, 13385, Marseille, France
| | - A Enjalbert
- Aix-Marseille Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, cedex 15, 13344, Marseille, France
- APHM, Hôpital de la Conception, Laboratoire de Biologie Moléculaire, 13005, Marseille, France
- Centre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY, cedex 15, 13385, Marseille, France
| | - T Brue
- Aix-Marseille Université, CNRS, Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille CRN2M UMR 7286, cedex 15, 13344, Marseille, France
- APHM, Hôpital Timone Adultes, Service d'Endocrinologie, Diabète et Maladies Métaboliques, cedex 5, 13385, Marseille, France
- Centre de Référence des Maladies Rares d'Origine Hypophysaire DEFHY, cedex 15, 13385, Marseille, France
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30
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Mohamed A, Blanchard MP, Albertelli M, Barbieri F, Brue T, Niccoli P, Delpero JR, Monges G, Garcia S, Ferone D, Florio T, Enjalbert A, Moutardier V, Schonbrunn A, Gerard C, Barlier A, Saveanu A. Pasireotide and octreotide antiproliferative effects and sst2 trafficking in human pancreatic neuroendocrine tumor cultures. Endocr Relat Cancer 2014; 21:691-704. [PMID: 25012983 DOI: 10.1530/erc-14-0086] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) raise difficult therapeutic problems despite the emergence of targeted therapies. Somatostatin analogs (SSA) remain pivotal therapeutic drugs. However, the tachyphylaxis and the limited antitumoral effects observed with the classical somatostatin 2 (sst2) agonists (octreotide and lanreotide) led to the development of new SSA, such as the pan sst receptor agonist pasireotide. Our aim was to compare the effects of pasireotide and octreotide on cell survival, chromogranin A (CgA) secretion, and sst2 phosphorylation/trafficking in pancreatic NET (pNET) primary cells from 15 tumors. We established and characterized the primary cultures of human pancreatic tumors (pNETs) as powerful preclinical models for understanding the biological effects of SSA. At clinically relevant concentrations (1-10 nM), pasireotide was at least as efficient as octreotide in inhibiting CgA secretion and cell viability through caspase-dependent apoptosis during short treatments, irrespective of the expression levels of the different sst receptors or the WHO grade of the parental tumor. Interestingly, unlike octreotide, which induces a rapid and persistent partial internalization of sst2 associated with its phosphorylation on Ser341/343, pasireotide did not phosphorylate sst2 and induced a rapid and transient internalization of the receptor followed by a persistent recycling at the cell surface. These results provide the first evidence, to our knowledge, of striking differences in the dynamics of sst2 trafficking in pNET cells treated with the two SSAs, but with similar efficiency in the control of CgA secretion and cell viability.
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Affiliation(s)
- Amira Mohamed
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USAAix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Marie-Pierre Blanchard
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Manuela Albertelli
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Federica Barbieri
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Thierry Brue
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USAAix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Patricia Niccoli
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Jean-Robert Delpero
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Genevieve Monges
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Stephane Garcia
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Diego Ferone
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Tullio Florio
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Alain Enjalbert
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USAAix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Vincent Moutardier
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Agnes Schonbrunn
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Corinne Gerard
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Anne Barlier
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USAAix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
| | - Alexandru Saveanu
- Aix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USAAix-Marseille UniversitéCNRS, CRN2M-UMR 7286, Faculté de Médecine, Secteur Nord - CS80011, 51, Bd Pierre Dramard, 13344 Marseille Cedex 15, FranceMolecular Biology LaboratoryAP-HM, Conception Hospital, 13385 Marseille, FranceAix-Marseille UniversitéCNRS, Plate-Forme de Recherche en Neurosciences PFRN, 13344 Marseille Cedex 15, FranceDepartment of Internal Medicine and Center of Excellence for Biomedical ResearchUniversity of Genova, Genova, ItalyEndocrinology DepartmentAP-HM, Timone Hospital, 13385 Marseille, FranceOncology DepartmentSurgery DepartmentBiopathology DepartmentPaoli Calmettes Cancer Institute, 13009 Marseille, FrancePathology LaboratorySurgery DepartmentAP-HM, Nord Hospital, 13015 Marseille, FranceDepartment of Integrative Biology and PharmacologyUniversity of Texas, Texas 77225, Houston, USA
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Barbieri F, Albertelli M, Grillo F, Mohamed A, Saveanu A, Barlier A, Ferone D, Florio T. Neuroendocrine tumors: insights into innovative therapeutic options and rational development of targeted therapies. Drug Discov Today 2014; 19:458-68. [DOI: 10.1016/j.drudis.2013.10.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 09/02/2013] [Accepted: 10/21/2013] [Indexed: 02/07/2023]
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Saveanu A, Sebag F, Guillet B, Archange C, Essamet W, Barlier A, Palazzo FF, Taïeb D. Targeting dopamine receptors subtype 2 (D2DR) in pheochromocytomas: head-to-head comparison between in vitro and in vivo findings. J Clin Endocrinol Metab 2013; 98:E1951-5. [PMID: 24009136 DOI: 10.1210/jc.2013-2269] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Dopamine subtype 2 receptors (D2DRs) are overexpressed in pheochromocytomas (PHEOs). D2DR-expressing tumors can be visualized by iodine-123 labeled iodobenzamide (¹²³I-IBZM) single-photon emission computed tomography (SPECT). OBJECTIVE The hypothesis of this study was that D2DR high expression in PHEOs would allow in vivo visualization through ¹²³I-IBZM SPECT. The present prospective pilot study aims to evaluate the performance of ¹²³I-IBZM SPECT in PHEOs and to correlate the tumor uptake with D2DR expression in tumor samples after surgery. SETTING, MATERIALS, AND METHODS: Ten unrelated patients with PHEOs were evaluated, prior to adrenalectomy, with ¹²³I-IBZM SPECT (whole body scan at 4 and 24 h after the injection; and SPECT centered on the abdomen at 24 h). D2DR mRNA and protein expressions were evaluated in all tumors by quantitative real-time RT-PCR and immunohistochemistry, respectively. MAIN OUTCOME MEASURE Intensity of tumoral uptake of ¹²³I-IBZM was measured. RESULTS All PHEOs express D2DR mRNA (ranging from 2.1 to 14.7 copy/copy β-glucuronidase) and protein (immunostaining score: moderate or strong in 9 of 10 cases). However, none of the patients (0%) showed an increased tumor uptake of ¹²³I-IBZM. CONCLUSIONS These results suggest that ¹²³I-IBZM is not a useful radiopharmaceutical in the detection and characterization of PHEOs despite D2DR expression. Our findings and data from the related literature may support different hypotheses to explain the failure of D2DR targeting by ¹²³I-IBZM.
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Affiliation(s)
- Alexandru Saveanu
- Unité Mixte de Recherche 7286, CRN2M, Centre National de la Recherche Scientifique, Aix-Marseille Université, Faculté de Médecine, Secteur Nord, CS80011, 51 Boulevard Pierre Dramard, 13344 Marseille, Cedex 15, France.
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Lamine F, Kanoun F, Chihaoui M, Saveanu A, Menif E, Barlier A, Enjalbert A, Brue T, Slimane H. Unilateral agenesis of internal carotid artery associated with congenital combined pituitary hormone deficiency and pituitary stalk interruption without HESX1, LHX4 or OTX2 mutation: a case report. Pituitary 2012; 15 Suppl 1:S81-6. [PMID: 22797803 DOI: 10.1007/s11102-012-0411-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Agenesis of internal carotid artery (ICA) is an unusual finding in subjects with congenital Combined Pituitary hormone deficiency (CPHD) with only nine cases being reported to date but to our best knowledge none of them was genetically investigated. A 10-years old girl presented with severe growth failure (height 103 cm) with substantial bone age delay (3 years). She had no history of perinatal insults or familial CPHD. There was no evidence of mental retardation or craniofacial dysmorphism or ophtalmological abnormalities. She was first diagnosed with GH and TSH deficiency. Cerebral magnetic resonance imaging (MRI) showed hypoplastic anterior pituitary, flat sella turcica, absent pituitary stalk with ectopic posterior pituitary as well as agenesis of the left ICA and the left carotid canal. Genomic analysis of pituitary transcription factor HESX1, LHX4 and OTX2 showed no mutations. Treatment with GH and thyroxine was started. The patient remained free of neurovascular symptoms for 5 years but she presented at the age of 15 years with delayed puberty related to an evolving gonadotropin deficiency. ICA agenesis associated with CPHD is unusual and is often asymptomatic in children. Since the CPHD with pituitary stalk interruption cannot be due to HESX1, LHX4 or OTX2 mutation in our case, other pathogenetic mechanisms may be responsible for CPHD associated with unilateral ICA agenesis.
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Affiliation(s)
- Faïza Lamine
- Department of Endocrinology and Diabetes, Rabta University Hospital, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia.
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Barlier A, Graillon T, Defilles C, Mohamed A, Saveanu A, Figarella-Branger D, Chinot O, Roche P, Enjalbert A, Dufour H. Strong Additive Effect of Everolimus and Octreotide or Pasireotide on Meningioma Cells in Vitro: A New Therapeutic Strategy for These Tumors. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33003-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Reynaud R, Jayakody SA, Monnier C, Saveanu A, Bouligand J, Guedj AM, Simonin G, Lecomte P, Barlier A, Rondard P, Martinez-Barbera JP, Guiochon-Mantel A, Brue T. PROKR2 variants in multiple hypopituitarism with pituitary stalk interruption. J Clin Endocrinol Metab 2012; 97:E1068-73. [PMID: 22466334 DOI: 10.1210/jc.2011-3056] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
CONTEXT Pituitary stalk interruption represents a frequent feature of congenital hypopituitarism, but only rare cases have been assigned to a known genetic cause. OBJECTIVE Using a candidate gene approach, we tested several genes as potential causes of hypopituitarism with pituitary stalk interruption. We hypothesized that ectopic posterior pituitary may be a consequence of defective neuronal axon projections along the pituitary stalk or defective angiogenesis of hypophyseal portal circulation. Considering the role of the prokineticin 2 pathway in angiogenesis and neuronal migration, we screened PROK2 and PROKR2 genes. DESIGN PROK2 and PROKR2 and all genes previously known to be involved in hypopituitarism with pituitary stalk interruption (LHX4, HESX1, OTX2, and SOX3) were screened in 72 index cases with pituitary stalk interruption syndrome from the GENHYPOPIT database. In vitro studies were performed to assess the functional consequences of allelic variants. RESULTS We identified two heterozygous PROKR2 mutations (p.Leu173Arg and p.Arg85His) previously reported in isolated hypogonadotroph hypogonadism and a novel PROKR2 variant (p.Ala51Thr) that, in contrast with both other mutations, did not impair receptor signaling activity. Three allelic variants of HESX1 were identified: the heterozygous p.Phe156Ser and the homozygous p.Arg109X mutations were functionally deleterious, whereas p.Ser67Thr was found as a rare allelic variant in association with p.Arg85His PROKR2 mutation in the same patient. CONCLUSIONS We report PROKR2 variants in congenital hypopituitarism with pituitary stalk interruption, suggesting a potential role of the prokineticin pathway in pituitary development.
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Affiliation(s)
- Rachel Reynaud
- Centre de Recherche en Neurobiologie et Neurophysiologie de Marseille (CRN2M), Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7286, Aix-Marseille University, France.
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Cuny T, Mohamed A, Graillon T, Roche C, Defilles C, Germanetti AL, Couderc B, Figarella-Branger D, Enjalbert A, Barlier A, Saveanu A. Somatostatin receptor sst2 gene transfer in human prolactinomas in vitro: impact on sensitivity to dopamine, somatostatin and dopastatin, in the control of prolactin secretion. Mol Cell Endocrinol 2012; 355:106-13. [PMID: 22348806 DOI: 10.1016/j.mce.2012.01.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 01/06/2012] [Accepted: 01/31/2012] [Indexed: 01/18/2023]
Abstract
OBJECTIVE As prolactinomas fail to respond to dopamine agonist (DA) in 10-20% of cases, we hypothesized that somatostatin subtype 2 receptor (sst2) overexpression in DA-resistant prolactinomas may enhance suppression of prolactine (PRL) using chimeric agonist (dopastatin) that simultaneously binds sst2 and the dopamine subtype 2 receptor (D2DR). DESIGN AND METHODS PRL suppression by octreotide, sst5 agonist, sst2-D2DR agonist (BIM-23A760 dopastatin) and cabergoline was assessed in primary cultures of seven DA-resistant prolactinomas overexpressing sst2. RESULTS sst2 was effectively overexpressed via adenoviral expression in prolactinomas (38.1±7.4 vs. 0.1±0.1 copy/copy β-Gus) and induced octreotide sst2-mediated PRL suppression that remained lower than that induced by DA. BIM-23A760 inhibited PRL similarly to cabergoline both in the control and sst2-expressing cells. Antagonist experiments confirmed predominant dopaminergic effect in dopastatin activity. CONCLUSION sst2 was successfully overexpressed in prolactinomas. However BIM-23A760 was unable to enhance PRL suppression underlining a predominant dopaminergic contribution in its action.
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Affiliation(s)
- Thomas Cuny
- Aix-Marseille University, CRN2M, UMR 7286-CNRS, 51, Bd Pierre Dramard, 13344 Marseille, France.
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Castinetti F, Reynaud R, Saveanu A, Barlier A, Brue T. Genetic causes of combined pituitary hormone deficiencies in humans. Ann Endocrinol (Paris) 2012; 73:53-5. [PMID: 22521856 DOI: 10.1016/j.ando.2012.03.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Congenital hypopituitarism is a rare disease, usually induced by mutations of genes coding for transcription factors involved in pituitary development. PROP1 mutations represent the first cause of identified congenital hypopituitarism. Current techniques only identify 10-20% of congenital hypopituitarism etiologies, suggesting that new techniques are needed to improve this ratio. This should lead to a better management and follow-up of patients presenting with combined pituitary hormone deficiencies.
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Affiliation(s)
- Frédéric Castinetti
- Unité mixte de recherche, centre de recherche en neurobiologie et neurophysiologie de Marseille, faculté de médecine de Marseille, Aix-Marseille université, France
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Gatto F, Barbieri F, Gatti M, Wurth R, Schulz S, Ravetti JL, Zona G, Culler MD, Saveanu A, Giusti M, Minuto F, Hofland LJ, Ferone D, Florio T. Balance between somatostatin and D2 receptor expression drives TSH-secreting adenoma response to somatostatin analogues and dopastatins. Clin Endocrinol (Oxf) 2012; 76:407-14. [PMID: 21848909 DOI: 10.1111/j.1365-2265.2011.04200.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
CONTEXT First-line therapy for thyrotropin-secreting pituitary adenomas (TSHomas) is neurosurgery, while medical treatment rests mainly on somatostatin analogues. Clinically available sst(2) -preferring analogues, octreotide and lanreotide, induce normalization of hormone levels in approximately 90% of patients and tumour shrinkage in 45%. OBJECTIVE We evaluated somatostatin 1, 2, 3 and 5 and dopamine D2 receptor expression in tumour samples from three TSHomas, and the relationships between receptor expression, in vitro antiproliferative response and clinical data, including octreotide test and three months of therapy with octreotide long-acting repeatable (LAR). TSHoma cell proliferation was tested in vitro using octreotide, cabergoline and two chimeric compounds, BIM-23A760 and BIM-23A387. RESULTS All patients showed significant TSH lowering to acute octreotide test, but a hormonal response to long-term treatment was observed in only two patients, showing a high sst(5) /sst(2) ratio. Patient 2, characterized by high expression of sst(2) and sst(1) and a relative lower expression of sst(5) , experienced tachyphylaxis after prolonged octreotide treatment. In vitro, the somatostatin/dopamine receptor agonist BIM-23A760 caused the highest antiproliferative effect among those tested. Combined treatment with octreotide and cabergoline displayed an additive effect of magnitude comparable to that of the other chimeric compound (BIM-23A387). Octreotide resistance was confirmed in cells isolated from the nonresponder patient, although it could be overcome by treatment with the chimeric compounds. CONCLUSIONS A high sst(5) /sst(2) ratio might be predictive of a positive outcome to long-term treatment with somatostatin analogues in TSHomas. Moreover, combined somatostatin and D(2) receptor targeting might be considered as a potential tool to improve the response rate in octreotide-resistant tumours.
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Affiliation(s)
- Federico Gatto
- Department of Internal Medicine & Center of Excellence for Biomedical Research, University of Genoa, Viale Benedetto XV 2, Genoa, Italy
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Couture C, Saveanu A, Barlier A, Carel JC, Fassnacht M, Flück CE, Houang M, Maes M, Phan-Hug F, Enjalbert A, Drouin J, Brue T, Vallette S. Phenotypic homogeneity and genotypic variability in a large series of congenital isolated ACTH-deficiency patients with TPIT gene mutations. J Clin Endocrinol Metab 2012; 97:E486-95. [PMID: 22170728 DOI: 10.1210/jc.2011-1659] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Congenital isolated ACTH deficiency (IAD) is a rare disease characterized by low plasma ACTH and cortisol levels and preservation of all other pituitary hormones. This condition was poorly defined before we identified TPIT, a T-box transcription factor with a specific role in differentiation of the corticotroph lineage in mice and humans, as its principal molecular cause. OBJECTIVE We have enlarged our series of IAD patients to better characterize the phenotype and the genotype of this rare disease. DESIGN Each exon of the TPIT gene was amplified and sequenced in IAD patients without any identified cause. A functional analysis of each new TPIT mutation was performed. RESULTS We described the largest series of 91 IAD patients and identified three distinct groups: neonatal onset complete or partial IAD or late onset IAD. We did not identify any TPIT mutation in patients with partial or late-onset IAD. However, we found a TPIT mutation in 65% of patients with neonatal-onset complete IAD. These patients are homozygous or compound heterozygous for TPIT mutations, and their parents are healthy heterozygous carriers. We identified nine new mutations: four missense, one one-nucleotide deletion, three splice-site mutations, and one large deletion. TPIT mutations lead to loss of function by different mechanisms, such as non-sense-mediated mRNA decay, abnormal mRNA splicing, loss of TPIT DNA binding or protein-protein interaction defects. CONCLUSION TPIT mutations are responsible for two thirds of neonatal-onset complete IAD but can not be detected in partial or late-onset IAD.
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Affiliation(s)
- C Couture
- Institut de Recherches Cliniques de Montréal, Montréal, Québec, Canada H2L 4M1
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Pekic S, Doknic M, Miljic D, Saveanu A, Reynaud R, Barlier A, Brue T, Popovic V. Case seminar: a young female with acute hyponatremia and a sellar mass. Endocrine 2011; 40:325-31. [PMID: 21863341 DOI: 10.1007/s12020-011-9516-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 07/27/2011] [Indexed: 11/26/2022]
Abstract
In familial cases of combined pituitary hormone deficiency the most common mutations are that of Prophet of Pit 1 (PROP1) gene. PROP1 mutations are associated with deficiencies of growth hormone, thyrotropin, prolactin, and gonadotropins (follicle-stimulating hormone and luteinizing hormone), with evolving adrenocorticotropin (ACTH) deficiency in some cases. On imaging in most patients the pituitary gland is hypoplastic, but occasionally transient pituitary enlargement is found. We report a 22-year-old female initially diagnosed at age 12 with familial hypopituitarism due to PROP1 mutation, who presented with coma and respiratory arrest (acute hyponatremia). She was urgently treated in Intensive Care Unit of Emergency Center with hypertonic saline and stress doses of hydrocortisone, which resulted in the fast increase of plasma osmolality resulting in the osmotic demyelination syndrome. Simultaneously and incidentally on computed tomography scan a large sellar and suprasellar mass were reported as possible Rathke's cleft cyst or craniopharyngioma. Once the patient was stable, ACTH deficiency was documented. She remained replaced with hydrocortisone and subsequently underwent transphenoidal surgery. The removed sellar content revealed no pituitary adenoma or pituitary cells, but only an eosinophilic, colloid-like mass, and necrotic acellular debris. Her sister with hypopituitarism had an empty sella. Genetic testing in both sisters revealed the same homozygous c.150delA mutation in PROP1 gene. Here we report two sisters with the same PROP1 mutation who presented in adulthood with different pituitary morphology, one of them with a large sellar and suprasellar mass, in which transphenoidal surgery provided an extremely rare opportunity for a histopathological analysis of the sellar content. Due to the lack of endocrine care during the transition period hypocortisolism which evolved, a consequence of PROP1 mutation, was not recognized. Empirical use of hydrocortisone in the Intensive Care in our patient with life-threatening acute hyponatremia was appropriate but because glucocorticoid therapy on its own corrects hyponatremia even after stopping hypertonic saline infusion, the risk for over-correction of hyponatremia in ACTH deficiency is high.
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Affiliation(s)
- Sandra Pekic
- Clinic of Endocrinology, Clinical Center Serbia, Belgrade, Serbia
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Nyström HF, Saveanu A, Barbosa EJL, Barlier A, Enjalbert A, Glad C, Palming J, Johannsson G, Brue T. Detection of genetic hypopituitarism in an adult population of idiopathic pituitary insufficiency patients with growth hormone deficiency. Pituitary 2011; 14:208-16. [PMID: 21132537 DOI: 10.1007/s11102-010-0278-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Idiopathic pituitary insufficiency (IPI) is diagnosed in 10% of all hypopituitary patients. There are several known and unknown aetiologies within the IPI group. The aim of this study was to investigate an adult IPI population for genetic cause according a screening schedule. From files of 373 GH deficient (GHD) patients on GH replacement 50 cases with IPI were identified. Of the 39 patients that approved to the study, 25 patients were selected for genetic investigation according to phenotype and 14 patients were not further tested, as sporadic isolated GHD (n = 9) and GHD with diabetes insipidus (n = 5) have low probability for a known genetic cause. Genotyping of all coding exons of HESX1, LHX4, PROP1, POU1F1 and GH1 genes were performed according to a diagnostic algorithm based on clinical, hormonal and neuroradiological phenotype. Among the 25 patients, an overall rate of 8% of mutations was found, and a 50% rate in familial cases. Among two sibling pairs, one pair that presented with complete anterior pituitary insufficiency, had a compound heterozygous PROP1 gene mutation (codons 117 and 120: exon 3 p Phe 117 Ile (c349 T>A) and p Arg 120 Cys (c358 C>T)) with a phenotype of very late onset ACTH-insufficiency. In the other sibling pair and in the sporadic cases no mutation was identified. This study suggests that currently known genetic causes are rare in sporadic adult IPI patients, and that systematic genetic screening is not needed in adult-onset sporadic cases of IPI. Conversely, familial cases are highly suspect for genetic causes.
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Affiliation(s)
- Helena Filipsson Nyström
- Department of Endocrinology, Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 8, 41345, Gothenburg, Sweden.
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Gatto F, Barbieri F, Castelletti L, Arvigo M, Pattarozzi A, Annunziata F, Saveanu A, Minuto F, Castellan L, Zona G, Florio T, Ferone D. In vivo and in vitro response to octreotide LAR in a TSH-secreting adenoma: characterization of somatostatin receptor expression and role of subtype 5. Pituitary 2011; 14:141-7. [PMID: 21086053 DOI: 10.1007/s11102-010-0271-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Thyrotropin-secreting pituitary adenomas (TSHomas) are a rare cause of hyperthyroidism and account for less than 2% of pituitary adenomas. Medical therapy with somatostatin analogues (SSAs) effectively reduces TSH secretion in approximately 80% of patients and induces shrinkage in about 45% of tumors. According with previous data, resistance to SSA treatment might be due to heterogeneity in somatostatin receptors (SSTRs) expression. We report the case of TSHoma in a 41-year-old man treated with octreotide LAR that caused a dramatic decrease of TSH and thyroid hormones and tumor shrinkage already after 3 months of pre-surgical therapy. In search of potential molecular determinants of octreotide effectiveness, we measured, in primary cultures from this tumor, SSTR and dopamine D2 receptor (D2R) expression, and octreotide and/or cabergoline effects on TSH secretion and cell proliferation. SSTR5 and D2R expression was higher than SSTR2. Octreotide significantly inhibited TSH secretion more effectively than cabergoline (P<0.001), whereas the combined treatment was comparable with cabergoline alone. Similarly, octreotide resulted more effective than cabergoline on cell proliferation, while the combination did not show any additive or synergistic effects. In conclusion, the significant antisecretive and antiproliferative effect of octreotide in this patient might be related to the high expression of SSTR5, in the presence of SSTR2. After reviewing the literature, indeed, in line with previous observations, we hypothesize that SSTR5/SSTR2 ratio in TSHomas may represent a useful marker in predicting the outcome of therapy with SSAs. The role of D2R should be further explored considering that the presence of D2R can influence SSTRs functionality.
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Affiliation(s)
- Federico Gatto
- Department of Endocrine and Medical Sciences (DiSEM) & Center of Excellence for Biomedical Research, University of Genova, Viale Benedetto XV, 6, 16132 Genova, Italy
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Cuny T, Gerard C, Saveanu A, Barlier A, Enjalbert A. Physiopathology of somatolactotroph cells: from transduction mechanisms to cotargeting therapy. Ann N Y Acad Sci 2011; 1220:60-70. [PMID: 21388404 DOI: 10.1111/j.1749-6632.2010.05924.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
In pituitary somatolactotroph cells, G protein-coupled receptors and receptor tyrosine kinases binding their specific ligands trigger an enzymatic cascade that converges to MAP kinase activation in the subcellular compartment. Different signaling pathways, such as AC/cAMP/PKA and PI3K/Akt pathways, interact with MAP kinase to regulate key physiological functions, such as hormonal secretion and cell proliferation. Abnormalities affecting these signaling pathways have been identified as preponderant factors of pituitary tumorigenesis. In addition to trans-sphenoidal surgery, somatostatin analogs are used to control hormonal hypersecretion in GH-secreting adenomas. However, a subset of these tumors remains uncontrolled with these treatFments, calling for new therapeutic approaches. In these cases, novel multivalent somatostatin analogs or new somatostatin-dopamine chimeric molecules could be of interest. Another attractive therapeutic approach may be to use one or several inhibitors acting downstream in the signaling pathway, such as mammalian target of rapamycin inhibitor. Cotargeting therapy and gene therapy are promising tools for these problematic pituitary tumors.
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Affiliation(s)
- Thomas Cuny
- Research Center of Neurobiology and Neurophysiology of Marseille, CRN2M, UMR 6231 CNRS, University of Mediterranée, Institut Fédératif Jean Roche, Marseille, France.
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Reynaud R, Castinetti F, Galon-Faure N, Albarel-Loy F, Saveanu A, Quentien MH, Jullien N, Khammar A, Enjalbert A, Barlier A, Brue T. [Genetic aspects of growth hormone deficiency]. Arch Pediatr 2011; 18:696-706. [PMID: 21497494 DOI: 10.1016/j.arcped.2011.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 01/31/2011] [Accepted: 03/07/2011] [Indexed: 11/25/2022]
Abstract
Congenital growth hormone deficiency (GHD) is a rare cause of growth delay. It should be suspected when other causes of hypopituitarism (sellar tumor, postsurgical or radioinduced hypopituitarism, etc.) have been ruled out. GHD can be isolated (IGHD) or associated with at least one other pituitary hormone deficiency (CPHD) including thyrotroph, lactotroph, corticotroph, or gonadotroph deficiencies. CPHD is caused by mutations of genes coding for pituitary transcription factors involved in pituitary ontogenesis or in the hypothalamic-pituitary axis. Clinical presentation varies, depending on the type and severity of GHD, the age at diagnosis, the association with other pituitary hormone deficiencies, or extrapituitary malformations. Clinical, biological, and radiological work-up is very important to determine for which transcription factor the patient should be screened. There is a wide variety of phenotypes depending on the transcription factor involved: PROP1 (somatolactotroph, thyrotroph, gonadotroph, and sometimes corticotroph deficiencies ; pituitary hyper- or hypoplasia), POU1F1 (somatolactotroph and thyrotroph deficiencies, pituitary hypoplasia), HESX1 (variable pituitary deficiencies, septo-optic dysplasia), and less frequently LHX3 (somatolactotroph, thyrotroph, and gonadotroph deficiencies, deafness, and limited head and neck rotation), LHX4 (variable pituitary deficiencies, ectopic neurohypophysis, cerebral abnormalities), and OTX2 (variable pituitary deficiencies, ectopic neurohypophysis, ocular abnormalities). Mutations of PROP1 remain the first identified cause of CPHD, and as a consequence the first to be sought. POU1F1 mutations should be looked for in the postpubertal population presenting with GH/TSH deficiencies and no extrapituitary malformations. Once genetic diagnosis has been concluded, a strict follow-up is necessary because patients can develop new deficiencies (for example, late-onset corticotroph deficiency in patients with PROP1 mutations). Identification of gene defects allows early treatment of pituitary deficiency and prevention of their potentially lethal consequences. If untreated, the main symptoms include short stature, cognitive alterations, or delayed puberty. An appropriate replacement of hormone deficiencies is therefore required. Depending on the type of transmission (recessive transmission for PROP1 and LHX3, dominant for LHX4, autosomal dominant or recessive for POU1F1 and HESX1), genetic counseling might be proposed. Genotyping appears highly beneficial at an individual and familial level.
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Affiliation(s)
- R Reynaud
- Service de pédiatrie multidisciplinaire, hôpital de la Timone enfant, 13385 Marseille cedex 05, France.
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Saveanu A, Muresan M, De Micco C, Taieb D, Germanetti AL, Sebag F, Henry JF, Brunaud L, Enjalbert A, Weryha G, Barlier A. Expression of somatostatin receptors, dopamine D₂ receptors, noradrenaline transporters, and vesicular monoamine transporters in 52 pheochromocytomas and paragangliomas. Endocr Relat Cancer 2011; 18:287-300. [PMID: 21335363 DOI: 10.1530/erc-10-0175] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
While somatostatin receptors (sst), through somatostatin-radiolabeled analogs, are used, mainly in second line, in the diagnosis and treatment of pheochromocytomas (PCC) and paragangliomas (PGL), the clinical significance of dopamine receptor subtype 2 (D₂) in PCC/PGL is unknown. Indeed, radiolabeled dopamine (DA) analogs such as fluorine 18 ((18)F)-DA, used for positron emission tomography in PCC localization, are mainly correlated to the presence of noradrenaline transporter (NAT) and vesicular monoamine transporters (VMAT) but not to D₂. The aim of this study was to quantitate D₂ and sst expression in 52 PCC/PGL and to compare it with that of 35 gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Quantitative RT-PCR of sst(1-3) and sst₅, D₂, NAT, VMAT1/2 was performed in all tumors, while immunohistochemistry analysis of sst₂ and D₂ was performed in seven tumors. D₂ mRNA was expressed in all PCC/PGL. Mean expression was significantly higher in PCC/PGL than in GEP-NETs (4.8 vs 0.5 copy/copy β-glucuronidase (Gus)). sst₂ and sst(1) were expressed in most PCC/PGL, with sst(2)-dominant expression (mean mRNA: 1.6 vs 0.4 copy/copy β-Gus). sst₂ expression level was similar to that of GEP-NETs, whereas sst₅ expression level was significantly lower (0.12 vs 0.78 copy/copy β-Gus). Our study evidenced strong D₂ mRNA expression in PCC and for the first time in PGL. PCC/PGL express sst₂ mRNA at levels similar to those of GEP-NETs. New drugs can target ssts and D₂ more efficiently than current somatostatin analogs. Moreover, transporters like NAT and VMAT1/2, could be co-targeted with sst, as a basis of new radionuclide compounds in the imaging and treatment of these tumors.
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Affiliation(s)
- Alexandru Saveanu
- Laboratory of Biochemistry and Molecular Biology, Centre Hospitalo-Universitaire Conception, 147 Boulevard Baille, 13385 Marseille, France
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Reynaud R, Albarel F, Saveanu A, Kaffel N, Castinetti F, Lecomte P, Brauner R, Simonin G, Gaudart J, Carmona E, Enjalbert A, Barlier A, Brue T. Pituitary stalk interruption syndrome in 83 patients: novel HESX1 mutation and severe hormonal prognosis in malformative forms. Eur J Endocrinol 2011; 164:457-65. [PMID: 21270112 DOI: 10.1530/eje-10-0892] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Pituitary stalk interruption syndrome (PSIS) is a particular entity in the population of patients with hypopituitarism. Only rare cases have a known genetic cause. OBJECTIVES i) To compare subgroups with or without extra-pituitary malformations (EPM) in a cohort of PSIS patients to identify predictive factors of evolution, ii) to determine the incidence of mutations of the known pituitary transcription factor genes in PSIS. Study design We analyzed features of 83 PSIS patients from 80 pedigrees and screened HESX1, LHX4, OTX2, and SOX3 genes. RESULTS PSIS had a male predominance and was rarely familial (5%). Pituitary hypoplasia was observed only in the group with EPM. Multiple hormone deficits were observed significantly more often with versus without EPM (87.5 vs 69.5% respectively). Posterior pituitary location along the stalk was a significant protective factor regarding severity of hormonal phenotype. A novel HESX1 causative mutation was found in a consanguineous family, and two LHX4 mutations were present in familial PSIS. CONCLUSION PSIS patients with EPM had a more severe hormonal disorder and pituitary imaging status, suggesting an antenatal origin. HESX1 or LHX4 mutations accounted for <5% of cases and were found in consanguineous or familial cases.
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Affiliation(s)
- R Reynaud
- Pediatric Endocrinology Unit, Department of Pediatrics Department of Endocrinology, Hôpital de la Timone, France.
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Graillon T, Defilles C, Saveanu A, Germanetti AL, Roche P, Dufour H, Barlier A. Effet de l’octréotide et du SOM 230 sur la viabilité cellulaire de méningiomes in vitro. Neurochirurgie 2010. [DOI: 10.1016/j.neuchi.2010.10.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Durán-Prado M, Saveanu A, Luque RM, Gahete MD, Gracia-Navarro F, Jaquet P, Dufour H, Malagón MM, Culler MD, Barlier A, Castaño JP. A potential inhibitory role for the new truncated variant of somatostatin receptor 5, sst5TMD4, in pituitary adenomas poorly responsive to somatostatin analogs. J Clin Endocrinol Metab 2010; 95:2497-502. [PMID: 20233783 DOI: 10.1210/jc.2009-2247] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
CONTEXT Somatostatin (SST) receptors, specially sst2 and sst5, provide a valuable target to inhibit excessive hormone release and cell growth in pituitary tumors by using SST analogs (SSAs). Unfortunately, an appreciable proportion of tumors fail to respond to SSA despite expressing high levels of one or more ssts. Recently we identified two novel truncated sst5 variants, sst5TMD5, and sst5TMD4, absent in normal pituitary but expressed in pituitary tumors. OBJECTIVE AND DESIGN We aimed at exploring the potential role of sst5TMD5 and sst5TMD4 in the poor response of some tumors to SSA in vivo and in vitro. Specifically, 25 somatotropinomas showing different responses to octreotide in vivo and sst2 (BIM-23197)- and sst5(BIM-23268)-selective compounds in vitro were screened for sst5TMD5/sst5TMD4 expression by real-time PCR. Relationships between ssts expression and in vivo and in vitro secretory response of the corresponding pituitary samples were assessed. RESULTS sst5TMD5 was absent in all samples analyzed. sst5TMD4 was found in 85% of tumors, and its expression was positively correlated to that of sst5 (R(2) = 0.79, P < 0.001). Expression of sst5TMD4 was negatively correlated with the ability of octreotide to reduce GH levels in vivo and partially negatively correlated with inhibition of GH secretion by an sst5 selective agonist (BIM-23268) in vitro. CONCLUSIONS These results indicate that sst5TMD4 is related to the reduced ability of octreotide at normalizing hormone secretion in poorly responsive tumors in vivo. Further studies will help to evaluate the potential use of sst5TMD4 expression in surgically removed pituitary adenomas as a predictor of the subsequent response of different pituitary tumors to SSA therapy.
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Affiliation(s)
- Mario Durán-Prado
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba, E-14014 Córdoba, Spain
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Abstract
Somatostatin receptors (sst1-5) and dopamine receptor 2 (D2DR) are well expressed and co-localized in several human pituitary adenomas, suggesting possible functional interactions in the control of hormonal hypersecretion and tumor cell growth. The present review describes the expression and functionality of these receptors in the different classes of human pituitary adenomas. The sst2 agonists, octreotide and lanreotide, control GH hypersecretion and tumor growth in about 65% of somatotropinomas. The D2DR agonists, bromocriptine and cabergoline, control about 90% of prolactinomas. Such drugs are much less effective in the control of the others pituitary adenomas also expressing ssts and D2DR receptors. The second part summarizes the current knowledge on new chimeric compounds with sst2, sst5, and D2DR affinity. Such ligands bearing distinct ssts and DRD2 pharmacophores may synergistically produce an increased control of secretion and/or of proliferation in the different types of pituitary adenomas. The mechanisms of action of such chimeric molecules through increased binding affinities, prolonged bioavailability, ligand-induced modulation of receptors heterodimerization, are discussed.
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Affiliation(s)
- Alexandru Saveanu
- CRN2M UMR 6231, Centre National de la Recherche Scientifique, Universite de la Mediterranee, Faculté de Médecine Nord, Marseille, France.
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Abstract
Lanreotide is an eight-amino acid peptide, which is an analog of the native somatostatin peptide, physiological inhibitor of growth hormone (GH). The drug shows high binding affinity for somatostatin receptors, SSTR2 and SSTR5, which is the primary mechanism considered to be responsible for decreasing GH secretion and GH cell proliferation in acromegaly. Two different formulations of lanreotide are currently available: lanreotide slow release, which requires intramuscular injection every 7-14 days, and lanreotide autogel, which requires deep subcutaneous injection every 4-8 weeks. Several studies have been published to date on the use of lanreotide in acromegaly. Antisecretory efficacy has been reported in 35%-70% of cases; this huge variability is probably explained by different indications (eg, primary or adjunctive postsurgical treatment), or the fact that some studies were based on patients known to be responders to somatostatin analogs. As a primary treatment, antisecretory efficacy was very similar, confirming the possibility of lanreotide as an option in cases of unsuccessful surgery, contraindication, or surgery refusal. Lanreotide also has antitumoral effects as it induces a decrease in tumor volume of [Symbol: see text]25% in 30%-70% of patients. This could be beneficial before transsphenoidal surgery, as a pretreatment, to decrease tumor volume and ease surgery; however, to date, advantages in terms of final remission or uncured status remain a matter of debate. Side effects are rare; the most frequent being gastrointestinal discomfort and increased risk of gallstone formation, and glucose metabolism modifications. Comparison with the other somatostatin analog, octreotide, tends to show identical levels of efficacy between both drugs. Lanreotide thus seems to be an effective treatment in acromegaly. To date, however, lanreotide is still considered as only suspending GH secretion, thus requiring prolonged and costly treatment.
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Affiliation(s)
- F Castinetti
- Department of Endocrinology, Université de la Méditerranée, France
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