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Perrotta S, Roberti D, Bencivenga D, Corsetto P, O'Brien KA, Caiazza M, Stampone E, Allison L, Fleck RA, Scianguetta S, Tartaglione I, Robbins PA, Casale M, West JA, Franzini-Armstrong C, Griffin JL, Rizzo AM, Sinisi AA, Murray AJ, Borriello A, Formenti F, Della Ragione F. Effects of Germline VHL Deficiency on Growth, Metabolism, and Mitochondria. N Engl J Med 2020; 382:835-844. [PMID: 32101665 DOI: 10.1056/nejmoa1907362] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Mutations in VHL, which encodes von Hippel-Lindau tumor suppressor (VHL), are associated with divergent diseases. We describe a patient with marked erythrocytosis and prominent mitochondrial alterations associated with a severe germline VHL deficiency due to homozygosity for a novel synonymous mutation (c.222C→A, p.V74V). The condition is characterized by early systemic onset and differs from Chuvash polycythemia (c.598C→T) in that it is associated with a strongly reduced growth rate, persistent hypoglycemia, and limited exercise capacity. We report changes in gene expression that reprogram carbohydrate and lipid metabolism, impair muscle mitochondrial respiratory function, and uncouple oxygen consumption from ATP production. Moreover, we identified unusual intermitochondrial connecting ducts. Our findings add unexpected information on the importance of the VHL-hypoxia-inducible factor (HIF) axis to human phenotypes. (Funded by Associazione Italiana Ricerca sul Cancro and others.).
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Affiliation(s)
- Silverio Perrotta
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Domenico Roberti
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Debora Bencivenga
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Paola Corsetto
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Katie A O'Brien
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Martina Caiazza
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Emanuela Stampone
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Leanne Allison
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Roland A Fleck
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Saverio Scianguetta
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Immacolata Tartaglione
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Peter A Robbins
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Maddalena Casale
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - James A West
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Clara Franzini-Armstrong
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Julian L Griffin
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Angela M Rizzo
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Antonio A Sinisi
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Andrew J Murray
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Adriana Borriello
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Federico Formenti
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
| | - Fulvio Della Ragione
- From the Departments of Woman, Child, and General and Specialized Surgery (S.P., D.R., M. Caiazza, S.S., I.T., M. Casale), Precision Medicine (D.B., E.S., A.B., F.D.R.), and Advanced Medical and Surgical Sciences (A.A.S.), University of Campania Luigi Vanvitelli, Naples, and the Departments of Pharmacology and Biomolecular Science, University of Milan, Milan (P.C., A.M.R.) - both in Italy; the Departments of Physiology, Development, and Neuroscience (K.A.O., A.J.M.) and Biochemistry (J.A.W., J.L.G.), University of Cambridge, Cambridge, the Centre for Ultrastructural Imaging (L.A., R.A.F.) and the Centre for Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine (F.F.), King's College London, London, and the Department of Physiology, Anatomy, and Genetics (P.A.R., F.F.) and Nuffield Division of Anaesthetics (F.F.), University of Oxford, Oxford - all in the United Kingdom; and the Department of Cell and Developmental Biology, University of Pennsylvania, Philadelphia (C.F.-A.)
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Couvé S, Ladroue C, Laine E, Mahtouk K, Guégan J, Gad S, Le Jeune H, Le Gentil M, Nuel G, Kim WY, Lecomte B, Pagès JC, Collin C, Lasne F, Benusiglio PR, Bressac-de Paillerets B, Feunteun J, Lazar V, Gimenez-Roqueplo AP, Mazure NM, Dessen P, Tchertanov L, Mole DR, Kaelin W, Ratcliffe P, Richard S, Gardie B. Genetic evidence of a precisely tuned dysregulation in the hypoxia signaling pathway during oncogenesis. Cancer Res 2014; 74:6554-64. [PMID: 25371412 PMCID: PMC5555745 DOI: 10.1158/0008-5472.can-14-1161] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The classic model of tumor suppression implies that malignant transformation requires full "two-hit" inactivation of a tumor-suppressor gene. However, more recent work in mice has led to the proposal of a "continuum" model that involves more fluid concepts such as gene dosage-sensitivity and tissue specificity. Mutations in the tumor-suppressor gene von Hippel-Lindau (VHL) are associated with a complex spectrum of conditions. Homozygotes or compound heterozygotes for the R200W germline mutation in VHL have Chuvash polycythemia, whereas heterozygous carriers are free of disease. Individuals with classic, heterozygous VHL mutations have VHL disease and are at high risk of multiple tumors (e.g., CNS hemangioblastomas, pheochromocytoma, and renal cell carcinoma). We report here an atypical family bearing two VHL gene mutations in cis (R200W and R161Q), together with phenotypic analysis, structural modeling, functional, and transcriptomic studies of these mutants in comparison with classical mutants involved in the different VHL phenotypes. We demonstrate that the complex pattern of disease manifestations observed in VHL syndrome is perfectly correlated with a gradient of VHL protein (pVHL) dysfunction in hypoxia signaling pathways. Thus, by studying naturally occurring familial mutations, our work validates in humans the "continuum" model of tumor suppression.
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Affiliation(s)
- Sophie Couvé
- Laboratoire de Génétique Oncologique de l'Ecole Pratique des Hautes Etudes (EPHE), Villejuif, France. Institut National de la Santé et de la Recherche Medicale (INSERM) U753, Gustave Roussy Cancer Campus, Villejuif, France. Centre Expert National Cancers Rares INCa "PREDIR" and Réseau National INCa "Maladie de VHL et prédispositions au cancer du rein," Service d'Urologie, Assistance publique, Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Charline Ladroue
- Laboratoire de Génétique Oncologique de l'Ecole Pratique des Hautes Etudes (EPHE), Villejuif, France. Institut National de la Santé et de la Recherche Medicale (INSERM) U753, Gustave Roussy Cancer Campus, Villejuif, France
| | - Elodie Laine
- Laboratoire de Biologie et de Pharmacologie Appliquée (LBPA), CNRS-ENS de Cachan, LabEx LERMIT, Cachan, France. Equipe de Génomique Analytique, Laboratoire de Biologie Computationnelle et Quantitative, CNRS-UPMC, UMR 7238, Paris, France
| | - Karène Mahtouk
- Laboratoire de Génétique Oncologique de l'Ecole Pratique des Hautes Etudes (EPHE), Villejuif, France. Institut National de la Santé et de la Recherche Medicale (INSERM) U753, Gustave Roussy Cancer Campus, Villejuif, France
| | - Justine Guégan
- Plate-forme de Génomique, Gustave Roussy Cancer Campus, Villejuif, France
| | - Sophie Gad
- Laboratoire de Génétique Oncologique de l'Ecole Pratique des Hautes Etudes (EPHE), Villejuif, France. Institut National de la Santé et de la Recherche Medicale (INSERM) U753, Gustave Roussy Cancer Campus, Villejuif, France. Centre Expert National Cancers Rares INCa "PREDIR" and Réseau National INCa "Maladie de VHL et prédispositions au cancer du rein," Service d'Urologie, Assistance publique, Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Hélène Le Jeune
- Laboratoire de Génétique Oncologique de l'Ecole Pratique des Hautes Etudes (EPHE), Villejuif, France. Institut National de la Santé et de la Recherche Medicale (INSERM) U753, Gustave Roussy Cancer Campus, Villejuif, France
| | - Marion Le Gentil
- Plate-forme de Génomique, Gustave Roussy Cancer Campus, Villejuif, France
| | - Gregory Nuel
- Mathématiques Appliquées à Paris 5 (MAP5), UMR CNRS 8145, Université Paris Descartes, Paris, France
| | - William Y Kim
- Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | - Jean-Christophe Pagès
- INSERM U966, Université François Rabelais de Tours, Faculté de Médecine, Tours, France
| | - Christine Collin
- INSERM U966, Université François Rabelais de Tours, Faculté de Médecine, Tours, France
| | - Françoise Lasne
- Département des analyses, Agence Française de Lutte contre le Dopage (AFLD), Chatenay-Malabry, France
| | - Patrick R Benusiglio
- Département de Médecine Oncologique, Gustave Roussy Cancer Campus, Villejuif, France. Centre Expert National Cancers Rares INCa "PREDIR" and Réseau National INCa "Maladie de VHL et prédispositions au cancer du rein," Service d'Urologie, Assistance publique, Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Brigitte Bressac-de Paillerets
- Centre Expert National Cancers Rares INCa "PREDIR" and Réseau National INCa "Maladie de VHL et prédispositions au cancer du rein," Service d'Urologie, Assistance publique, Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France. Service de Génétique, Gustave Roussy Cancer Campus, Villejuif, France
| | - Jean Feunteun
- Laboratoire Stabilité génétique et Oncogénèse, UMR CNRS 8200, Gustave Roussy Cancer Campus, Villejuif, France
| | - Vladimir Lazar
- Plate-forme de Génomique, Gustave Roussy Cancer Campus, Villejuif, France
| | - Anne-Paule Gimenez-Roqueplo
- Centre Expert National Cancers Rares INCa "PREDIR" and Réseau National INCa "Maladie de VHL et prédispositions au cancer du rein," Service d'Urologie, Assistance publique, Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France. Assistance Publique, Hôpitaux de Paris, Hôpital européen Georges Pompidou, Service de Génétique, Paris, France. INSERM UMR970, Paris-Cardiovascular Research Center at HEGP, Paris, France. Université Paris Descartes, Faculté de Médecine, Paris, France
| | - Nathalie M Mazure
- Institute for Research on Cancer and Ageing of Nice (IRCAN), UMR CNRS 7284, INSERM U1081, UNS, Nice, France
| | - Philippe Dessen
- Plate-forme de Génomique, Gustave Roussy Cancer Campus, Villejuif, France
| | - Luba Tchertanov
- Laboratoire de Biologie et de Pharmacologie Appliquée (LBPA), CNRS-ENS de Cachan, LabEx LERMIT, Cachan, France
| | - David R Mole
- Henry Wellcome Building for Molecular Physiology, University of Oxford, Oxford, United Kingdom
| | | | - Peter Ratcliffe
- Henry Wellcome Building for Molecular Physiology, University of Oxford, Oxford, United Kingdom
| | - Stéphane Richard
- Laboratoire de Génétique Oncologique de l'Ecole Pratique des Hautes Etudes (EPHE), Villejuif, France. Institut National de la Santé et de la Recherche Medicale (INSERM) U753, Gustave Roussy Cancer Campus, Villejuif, France. Centre Expert National Cancers Rares INCa "PREDIR" and Réseau National INCa "Maladie de VHL et prédispositions au cancer du rein," Service d'Urologie, Assistance publique, Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France. Faculté de Médecine Paris-Sud, Le Kremlin-Bicêtre, Paris, France.
| | - Betty Gardie
- Laboratoire de Génétique Oncologique de l'Ecole Pratique des Hautes Etudes (EPHE), Villejuif, France. Unité Mixte de Recherche (UMR) INSERM U892, CNRS 6299, Centre de Recherche en Cancérologie Nantes/Angers (CRCNA), Université de Nantes, Nantes, France.
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