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Olivieri C, Wang Y, Walker C, Subrahmanian MV, Ha KN, Bernlohr D, Gao J, Camilloni C, Vendruscolo M, Taylor SS, Veglia G. The αC-β4 loop controls the allosteric cooperativity between nucleotide and substrate in the catalytic subunit of protein kinase A. eLife 2024; 12:RP91506. [PMID: 38913408 PMCID: PMC11196109 DOI: 10.7554/elife.91506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024] Open
Abstract
Allosteric cooperativity between ATP and substrates is a prominent characteristic of the cAMP-dependent catalytic subunit of protein kinase A (PKA-C). This long-range synergistic action is involved in substrate recognition and fidelity, and it may also regulate PKA's association with regulatory subunits and other binding partners. To date, a complete understanding of this intramolecular mechanism is still lacking. Here, we integrated NMR(Nuclear Magnetic Resonance)-restrained molecular dynamics simulations and a Markov State Model to characterize the free energy landscape and conformational transitions of PKA-C. We found that the apoenzyme populates a broad free energy basin featuring a conformational ensemble of the active state of PKA-C (ground state) and other basins with lower populations (excited states). The first excited state corresponds to a previously characterized inactive state of PKA-C with the αC helix swinging outward. The second excited state displays a disrupted hydrophobic packing around the regulatory (R) spine, with a flipped configuration of the F100 and F102 residues at the αC-β4 loop. We validated the second excited state by analyzing the F100A mutant of PKA-C, assessing its structural response to ATP and substrate binding. While PKA-CF100A preserves its catalytic efficiency with Kemptide, this mutation rearranges the αC-β4 loop conformation, interrupting the coupling of the two lobes and abolishing the allosteric binding cooperativity. The highly conserved αC-β4 loop emerges as a pivotal element to control the synergistic binding of nucleotide and substrate, explaining how mutations or insertions near or within this motif affect the function and drug sensitivity in homologous kinases.
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Affiliation(s)
- Cristina Olivieri
- Department of Biochemistry, Molecular Biology, and Biophysics, University of MinnesotaMinneapolisUnited States
| | - Yingjie Wang
- Department of Biochemistry, Molecular Biology, and Biophysics, University of MinnesotaMinneapolisUnited States
- Department of Chemistry and Supercomputing Institute, University of MinnesotaMinneapolisUnited States
| | - Caitlin Walker
- Department of Biochemistry, Molecular Biology, and Biophysics, University of MinnesotaMinneapolisUnited States
| | | | - Kim N Ha
- Department of Chemistry and Biochemistry, St. Catherine UniversityMinneapolisUnited States
| | - David Bernlohr
- Department of Biochemistry, Molecular Biology, and Biophysics, University of MinnesotaMinneapolisUnited States
| | - Jiali Gao
- Department of Chemistry and Supercomputing Institute, University of MinnesotaMinneapolisUnited States
| | - Carlo Camilloni
- Department of Chemistry, University of CambridgeCambridgeUnited Kingdom
| | | | - Susan S Taylor
- Department of Pharmacology, University of California at San DiegoSan DiegoUnited States
- Department of Chemistry and Biochemistry, University of California at San DiegoSan DiegoUnited States
| | - Gianluigi Veglia
- Department of Biochemistry, Molecular Biology, and Biophysics, University of MinnesotaMinneapolisUnited States
- Department of Chemistry and Supercomputing Institute, University of MinnesotaMinneapolisUnited States
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2
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Glebov-McCloud AGP, Saide WS, Gaine ME, Strack S. Protein Kinase A in neurological disorders. J Neurodev Disord 2024; 16:9. [PMID: 38481146 PMCID: PMC10936040 DOI: 10.1186/s11689-024-09525-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/29/2024] [Indexed: 03/17/2024] Open
Abstract
Cyclic adenosine 3', 5' monophosphate (cAMP)-dependent Protein Kinase A (PKA) is a multi-functional serine/threonine kinase that regulates a wide variety of physiological processes including gene transcription, metabolism, and synaptic plasticity. Genomic sequencing studies have identified both germline and somatic variants of the catalytic and regulatory subunits of PKA in patients with metabolic and neurodevelopmental disorders. In this review we discuss the classical cAMP/PKA signaling pathway and the disease phenotypes that result from PKA variants. This review highlights distinct isoform-specific cognitive deficits that occur in both PKA catalytic and regulatory subunits, and how tissue-specific distribution of these isoforms may contribute to neurodevelopmental disorders in comparison to more generalized endocrine dysfunction.
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Affiliation(s)
- Alexander G P Glebov-McCloud
- Department of Neuroscience and Pharmacology, Bowen Science Building, University of Iowa, Carver College of Medicine, 51 Newton Road, Iowa City, IA, 52242, USA
| | - Walter S Saide
- Department of Neuroscience and Pharmacology, Bowen Science Building, University of Iowa, Carver College of Medicine, 51 Newton Road, Iowa City, IA, 52242, USA
| | - Marie E Gaine
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy Building, College of Pharmacy, University of Iowa, 180 S. Grand Ave, Iowa City, IA, 52242, USA
- Iowa Neuroscience Institute, Intellectual and Developmental Disabilities Research Center, Iowa City, IA, USA
| | - Stefan Strack
- Department of Neuroscience and Pharmacology, Bowen Science Building, University of Iowa, Carver College of Medicine, 51 Newton Road, Iowa City, IA, 52242, USA.
- Iowa Neuroscience Institute, Intellectual and Developmental Disabilities Research Center, Iowa City, IA, USA.
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3
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Olivieri C, Wang Y, Walker C, Subrahmanian MV, Ha KN, Bernlohr DA, Gao J, Camilloni C, Vendruscolo M, Taylor SS, Veglia G. The αC-β4 loop controls the allosteric cooperativity between nucleotide and substrate in the catalytic subunit of protein kinase A. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.12.557419. [PMID: 37745542 PMCID: PMC10515842 DOI: 10.1101/2023.09.12.557419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Allosteric cooperativity between ATP and substrates is a prominent characteristic of the cAMP-dependent catalytic (C) subunit of protein kinase A (PKA). Not only this long-range synergistic action is involved in substrate recognition and fidelity, but it is likely to regulate PKA association with regulatory subunits and other binding partners. To date, a complete understanding of the molecular determinants for this intramolecular mechanism is still lacking. Here, we used an integrated NMR-restrained molecular dynamics simulations and a Markov Model to characterize the free energy landscape and conformational transitions of the catalytic subunit of protein kinase A (PKA-C). We found that the apo-enzyme populates a broad free energy basin featuring a conformational ensemble of the active state of PKA-C (ground state) and other basins with lower populations (excited states). The first excited state corresponds to a previously characterized inactive state of PKA-C with the αC helix swinging outward. The second excited state displays a disrupted hydrophobic packing around the regulatory (R) spine, with a flipped configuration of the F100 and F102 residues at the tip of the αC-β4 loop. To experimentally validate the second excited state, we mutated F100 into alanine and used NMR spectroscopy to characterize the binding thermodynamics and structural response of ATP and a prototypical peptide substrate. While the activity of PKA-CF100A toward a prototypical peptide substrate is unaltered and the enzyme retains its affinity for ATP and substrate, this mutation rearranges the αC-β4 loop conformation interrupting the allosteric coupling between nucleotide and substrate. The highly conserved αC-β4 loop emerges as a pivotal element able to modulate the synergistic binding between nucleotide and substrate and may affect PKA signalosome. These results may explain how insertion mutations within this motif affect drug sensitivity in other homologous kinases.
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Affiliation(s)
- Cristina Olivieri
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, MN 55455, USA
| | - Yingjie Wang
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, MN 55455, USA
- Department of Chemistry and Supercomputing Institute, University of Minnesota, MN 55455, USA
| | - Caitlin Walker
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, MN 55455, USA
| | - Manu V. Subrahmanian
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, MN 55455, USA
| | - Kim N. Ha
- Departmenf of Chemistry and Biochemistry, St. Catherine University, MN 55105, USA
| | - David A. Bernlohr
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, MN 55455, USA
| | - Jiali Gao
- Department of Chemistry and Supercomputing Institute, University of Minnesota, MN 55455, USA
| | - Carlo Camilloni
- Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | | | - Susan S. Taylor
- Department of Pharmacology, University of California at San Diego, CA 92093, USA
- Department of Chemistry and Biochemistry, University of California at San Diego, CA 92093, USA
| | - Gianluigi Veglia
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, MN 55455, USA
- Department of Chemistry and Supercomputing Institute, University of Minnesota, MN 55455, USA
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4
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Omar MH, Kihiu M, Byrne DP, Lee KS, Lakey TM, Butcher E, Eyers PA, Scott JD. Classification of Cushing's syndrome PKAc mutants based upon their ability to bind PKI. Biochem J 2023; 480:875-890. [PMID: 37306403 PMCID: PMC11136536 DOI: 10.1042/bcj20230183] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/02/2023] [Accepted: 06/12/2023] [Indexed: 06/13/2023]
Abstract
Cushing's syndrome is an endocrine disorder caused by excess production of the stress hormone cortisol. Precision medicine strategies have identified single allele mutations within the PRKACA gene that drive adrenal Cushing's syndrome. These mutations promote perturbations in the catalytic core of protein kinase A (PKAc) that impair autoinhibition by regulatory subunits and compartmentalization via recruitment into AKAP signaling islands. PKAcL205R is found in ∼45% of patients, whereas PKAcE31V, PKAcW196R, and L198insW and C199insV insertion mutants are less prevalent. Mass spectrometry, cellular, and biochemical data indicate that Cushing's PKAc variants fall into two categories: those that interact with the heat-stable protein kinase inhibitor PKI, and those that do not. In vitro activity measurements show that wild-type PKAc and W196R activities are strongly inhibited by PKI (IC50 < 1 nM). In contrast, PKAcL205R activity is not blocked by the inhibitor. Immunofluorescent analyses show that the PKI-binding variants wild-type PKAc, E31V, and W196R are excluded from the nucleus and protected against proteolytic processing. Thermal stability measurements reveal that upon co-incubation with PKI and metal-bound nucleotide, the W196R variant tolerates melting temperatures 10°C higher than PKAcL205. Structural modeling maps PKI-interfering mutations to a ∼20 Å diameter area at the active site of the catalytic domain that interfaces with the pseudosubstrate of PKI. Thus, Cushing's kinases are individually controlled, compartmentalized, and processed through their differential association with PKI.
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Affiliation(s)
- Mitchell H. Omar
- Department of Pharmacology, University of Washington, Seattle, WA 98195, U.S.A
| | - Maryanne Kihiu
- Department of Pharmacology, University of Washington, Seattle, WA 98195, U.S.A
| | - Dominic P. Byrne
- Department of Biochemistry, Cell and Systems Biology, University of Liverpool, Liverpool L69 7ZB, U.K
| | - Kyung-Soon Lee
- Department of Pharmacology, University of Washington, Seattle, WA 98195, U.S.A
| | - Tyler M. Lakey
- Department of Pharmacology, University of Washington, Seattle, WA 98195, U.S.A
| | - Erik Butcher
- Department of Pharmacology, University of Washington, Seattle, WA 98195, U.S.A
| | - Patrick A. Eyers
- Department of Biochemistry, Cell and Systems Biology, University of Liverpool, Liverpool L69 7ZB, U.K
| | - John D. Scott
- Department of Pharmacology, University of Washington, Seattle, WA 98195, U.S.A
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5
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Calibration-free, high-precision, and robust terahertz ultrafast metasurfaces for monitoring gastric cancers. Proc Natl Acad Sci U S A 2022; 119:e2209218119. [PMID: 36252031 PMCID: PMC9618089 DOI: 10.1073/pnas.2209218119] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Optical sensors, with great potential to convert invisible bioanalytical response into readable information, have been envisioned as a powerful platform for biological analysis and early diagnosis of diseases. However, the current extraction of sensing data is basically processed via a series of complicated and time-consuming calibrations between samples and reference, which inevitably introduce extra measurement errors and potentially annihilate small intrinsic responses. Here, we have proposed and experimentally demonstrated a calibration-free sensor for achieving high-precision biosensing detection, based on an optically controlled terahertz (THz) ultrafast metasurface. Photoexcitation of the silicon bridge enables the resonant frequency shifting from 1.385 to 0.825 THz and reaches the maximal phase variation up to 50° at 1.11 THz. The typical environmental measurement errors are completely eliminated in theory by normalizing the Fourier-transformed transmission spectra between ultrashort time delays of 37 ps, resulting in an extremely robust sensing device for monitoring the cancerous process of gastric cells. We believe that our calibration-free sensors with high precision and robust advantages can extend their implementation to study ultrafast biological dynamics and may inspire considerable innovations in the field of medical devices with nondestructive detection.
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6
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Unni P, Friend J, Weinberg J, Okur V, Hochscherf J, Dominguez I. Predictive functional, statistical and structural analysis of CSNK2A1 and CSNK2B variants linked to neurodevelopmental diseases. Front Mol Biosci 2022; 9:851547. [PMID: 36310603 PMCID: PMC9608649 DOI: 10.3389/fmolb.2022.851547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 06/29/2022] [Indexed: 12/02/2022] Open
Abstract
Okur-Chung Neurodevelopmental Syndrome (OCNDS) and Poirier-Bienvenu Neurodevelopmental Syndrome (POBINDS) were recently identified as rare neurodevelopmental disorders. OCNDS and POBINDS are associated with heterozygous mutations in the CSNK2A1 and CSNK2B genes which encode CK2α, a serine/threonine protein kinase, and CK2β, a regulatory protein, respectively, which together can form a tetrameric enzyme called protein kinase CK2. A challenge in OCNDS and POBINDS is to understand the genetic basis of these diseases and the effect of the various CK2⍺ and CK2β mutations. In this study we have collected all variants available to date in CSNK2A1 and CSNK2B, and identified hotspots. We have investigated CK2⍺ and CK2β missense mutations through prediction programs which consider the evolutionary conservation, functionality and structure or these two proteins, compared these results with published experimental data on CK2α and CK2β mutants, and suggested prediction programs that could help predict changes in functionality of CK2α mutants. We also investigated the potential effect of CK2α and CK2β mutations on the 3D structure of the proteins and in their binding to each other. These results indicate that there are functional and structural consequences of mutation of CK2α and CK2β, and provide a rationale for further study of OCNDS and POBINDS-associated mutations. These data contribute to understanding the genetic and functional basis of these diseases, which is needed to identify their underlying mechanisms.
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Affiliation(s)
- Prasida Unni
- Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston University, Boston, MA, United States
| | - Jack Friend
- Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston University, Boston, MA, United States
| | - Janice Weinberg
- Department of Biostatistics, Boston University School of Public Health, Boston University, Boston, MA, United States
| | - Volkan Okur
- New York Genome Center, New York, NY, United States
| | - Jennifer Hochscherf
- Department of Chemistry, Institute of Biochemistry, University of Cologne, Cologne, Germany
| | - Isabel Dominguez
- Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston University, Boston, MA, United States
- *Correspondence: Isabel Dominguez,
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7
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Kodama T, Oki K, Otagaki Y, Baba R, Okada A, Itcho K, Kobuke K, Nagano G, Ohno H, Hinata N, Arihiro K, Gomez-Sanchez CE, Yoneda M, Hattori N. Association of DNA methylation with steroidogenic enzymes in Cushing's adenoma. Endocr Relat Cancer 2022; 29:495-502. [PMID: 35675123 PMCID: PMC9339517 DOI: 10.1530/erc-22-0115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 06/08/2022] [Indexed: 12/25/2022]
Abstract
DNA methylation and demethylation regulate the transcription of genes. DNA methylation-associated gene expression of adrenal steroidogenic enzymes may regulate cortisol production in cortisol-producing adenoma (CPA). We aimed to determine the DNA methylation levels of all genes encoding steroidogenic enzymes involved in CPA. Additionally, the aims were to clarify the DNA methylation-associated gene expression and evaluate the difference of CPA genotype from others using DNA methylation data. Twenty-five adrenal CPA and six nonfunctioning adrenocortical adenoma (NFA) samples were analyzed. RNA sequencing and DNA methylation array were performed. The methylation levels at 118 methylation sites of the genes were investigated, and their methylation and mRNA levels were subsequently integrated. Among all the steroidogenic enzyme genes studied, CYP17A1 gene was mainly found to be hypomethylated in CPA compared to that in NFA, and the Benjamini-Hochberg procedure demonstrated that methylation levels at two sites in the CYP17A1 gene body were statistically significant. PRKACA mutant CPAs predominantly exhibited hypomethylation of CYP17A1 gene compared with the GNAS mutant CPAs. Inverse associations between CYP17A1 methylation in three regions of the gene body and its mRNA levels were observed in the NFAs and CPAs. In applying clustering analysis using CYP17A1 methylation and mRNA levels, CPAs with PRKACA mutation were differentiated from NFAs and CPAs with a GNAS mutation. We demonstrated that CPAs exhibited hypomethylation of the CYP17A1 gene body in CPA, especially in the PRKACA mutant CPAs. Methylation of CYP17A1 gene may influence its transcription levels.
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Affiliation(s)
- Takaya Kodama
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kenji Oki
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yu Otagaki
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryuta Baba
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akira Okada
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kiyotaka Itcho
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiro Kobuke
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Gaku Nagano
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Haruya Ohno
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuyuki Hinata
- Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima, University, Hiroshima, Japan
| | - Koji Arihiro
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Celso E. Gomez-Sanchez
- Division of Endocrinology, G.V. (Sonny) Montgomery VA Medical Center and University of Mississippi Medical Center, Jackson, MS, USA
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Masayasu Yoneda
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Noboru Hattori
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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8
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Motomura N, Yamazaki Y, Koga D, Harashima S, Gao X, Tezuka Y, Omata K, Ono Y, Morimoto R, Satoh F, Nakamura Y, Kwon GE, Choi MH, Ito A, Sasano H. The Association of Cholesterol Uptake and Synthesis with Histology and Genotype in Cortisol-Producing Adenoma (CPA). Int J Mol Sci 2022; 23:ijms23042174. [PMID: 35216289 PMCID: PMC8875534 DOI: 10.3390/ijms23042174] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/09/2022] [Accepted: 02/14/2022] [Indexed: 11/16/2022] Open
Abstract
Cortisol-producing adenoma (CPA) is composed of clear and compact cells. Clear cells are lipid abundant, and compact ones lipid poor but associated with higher production of steroid hormones. PRKACA mutation (PRKACA mt) in CPA patients was reported to be associated with more pronounced clinical manifestation of Cushing's syndrome. In this study, we examined the association of histological features and genotypes with cholesterol uptake receptors and synthetic enzymes in 40 CPA cases, and with the quantitative results obtained by gas chromatography-mass spectrometry (GC-MS) analysis in 33 cases to explore their biological and clinical significance. Both cholesterol uptake receptors and synthetic enzymes were more abundant in compact cells. GC-MS analysis demonstrated that the percentage of compact cells was inversely correlated with the concentrations of cholesterol and cholesterol esters, and positively with the activity of cholesterol biosynthesis from cholesterol esters. In addition, hormone-sensitive lipase (HSL), which catalyzes cholesterol biosynthesis from cholesterol esters, tended to be more abundant in compact cells of PRKACA mt CPAs. These results demonstrated that both cholesterol uptake and biosynthesis were more pronounced in compact cells in CPA. In addition, more pronounced HSL expression in compact cells of PRKACA mt CPA could contribute to their more pronounced clinical manifestation.
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Affiliation(s)
- Naoki Motomura
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; (N.M.); (D.K.); (S.H.); (X.G.); (H.S.)
| | - Yuto Yamazaki
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; (N.M.); (D.K.); (S.H.); (X.G.); (H.S.)
- Correspondence:
| | - Daiki Koga
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; (N.M.); (D.K.); (S.H.); (X.G.); (H.S.)
| | - Shogo Harashima
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; (N.M.); (D.K.); (S.H.); (X.G.); (H.S.)
| | - Xin Gao
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; (N.M.); (D.K.); (S.H.); (X.G.); (H.S.)
| | - Yuta Tezuka
- Division of Clinical Hypertension, Endocrinology and Metabolism, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; (Y.T.); (K.O.); (Y.O.); (F.S.)
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai 980-8574, Japan;
| | - Kei Omata
- Division of Clinical Hypertension, Endocrinology and Metabolism, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; (Y.T.); (K.O.); (Y.O.); (F.S.)
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai 980-8574, Japan;
| | - Yoshikiyo Ono
- Division of Clinical Hypertension, Endocrinology and Metabolism, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; (Y.T.); (K.O.); (Y.O.); (F.S.)
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai 980-8574, Japan;
| | - Ryo Morimoto
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai 980-8574, Japan;
| | - Fumitoshi Satoh
- Division of Clinical Hypertension, Endocrinology and Metabolism, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; (Y.T.); (K.O.); (Y.O.); (F.S.)
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai 980-8574, Japan;
| | - Yasuhiro Nakamura
- Division of Pathology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai 981-8558, Japan;
| | - Go Eun Kwon
- Molecular Recognition Research Center, Korea Institute of Science and Technology, Seoul 02792, Korea; (G.E.K.); (M.H.C.)
| | - Man Ho Choi
- Molecular Recognition Research Center, Korea Institute of Science and Technology, Seoul 02792, Korea; (G.E.K.); (M.H.C.)
| | - Akihiro Ito
- Department of Urology, Tohoku University School of Medicine, Sendai 980-8574, Japan;
| | - Hironobu Sasano
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; (N.M.); (D.K.); (S.H.); (X.G.); (H.S.)
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9
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Jang I, Kim SJ, Song RY, Kim K, Choi S, Lee JS, Gwon MK, Seong MW, Lee KE, Kim JH. Clinical and Molecular Characteristics of PRKACA L206R Mutant Cortisol-Producing Adenomas in Korean Patients. Endocrinol Metab (Seoul) 2021; 36:1287-1297. [PMID: 34852451 PMCID: PMC8743585 DOI: 10.3803/enm.2021.1217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/14/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND An activating mutation (c.617A>C/p.Lys206Arg, L206R) in protein kinase cAMP-activated catalytic subunit alpha (PRKACA) has been reported in 35% to 65% of cases of cortisol-producing adenomas (CPAs). We aimed to compare the clinical characteristics and transcriptome analysis between PRKACA L206R mutants and wild-type CPAs in Korea. METHODS We included 57 subjects with CPAs who underwent adrenalectomy at Seoul National University Hospital. Sanger sequencing for PRKACA was conducted in 57 CPA tumor tissues. RNA sequencing was performed in 13 fresh-frozen tumor tissues. RESULTS The prevalence of the PRKACA L206R mutation was 51% (29/57). The mean age of the study subjects was 42±12 years, and 87.7% (50/57) of the patients were female. Subjects with PRKACA L206R mutant CPAs showed smaller adenoma size (3.3±0.7 cm vs. 3.8±1.2 cm, P=0.059) and lower dehydroepiandrosterone sulfate levels (218±180 ng/mL vs. 1,511±3,307 ng/mL, P=0.001) than those with PRKACA wild-type CPAs. Transcriptome profiling identified 244 differentially expressed genes (DEGs) between PRKACA L206R mutant (n=8) and wild-type CPAs (n=5), including five upregulated and 239 downregulated genes in PRKACA L206R mutant CPAs (|fold change| ≥2, P<0.05). Among the upstream regulators of DEGs, CTNNB1 was the most significant transcription regulator. In several pathway analyses, the Wnt signaling pathway was downregulated and the steroid biosynthesis pathway was upregulated in PRKACA mutants. Protein-protein interaction analysis also showed that PRKACA downregulates Wnt signaling and upregulates steroid biosynthesis. CONCLUSION The PRKACA L206R mutation in CPAs causes high hormonal activity with a limited proliferative capacity, as supported by transcriptome profiling.
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Affiliation(s)
- Insoon Jang
- Translational Research Institute, Biomedical Research Institute, Seoul National University Hospital, Seoul,
Korea
- Corresponding authors: Kyu Eun Lee, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea, Tel: +82-2-2072-2081, Fax: +82-2-766-3975, E-mail:
| | - Su-jin Kim
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul,
Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul,
Korea
- Division of Surgery, Thyroid Center, Seoul National University Cancer Hospital, Seoul,
Korea
- Corresponding authors: Kyu Eun Lee, Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea, Tel: +82-2-2072-2081, Fax: +82-2-766-3975, E-mail:
| | - Ra-Young Song
- Department of Surgery, Chung-Ang University Hospital, Seoul,
Korea
| | - Kwangsoo Kim
- Translational Research Institute, Biomedical Research Institute, Seoul National University Hospital, Seoul,
Korea
| | - Seongmin Choi
- Translational Research Institute, Biomedical Research Institute, Seoul National University Hospital, Seoul,
Korea
| | - Jang-Seok Lee
- Translational Research Institute, Biomedical Research Institute, Seoul National University Hospital, Seoul,
Korea
| | - Min-Kyeong Gwon
- Translational Research Institute, Biomedical Research Institute, Seoul National University Hospital, Seoul,
Korea
| | - Moon Woo Seong
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul,
Korea
| | - Kyu Eun Lee
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul,
Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul,
Korea
- Division of Surgery, Thyroid Center, Seoul National University Cancer Hospital, Seoul,
Korea
| | - Jung Hee Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul,
Korea
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10
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Baba R, Oki K, Gomez-Sanchez CE, Otagaki Y, Itcho K, Kobuke K, Kodama T, Nagano G, Ohno H, Yoneda M, Hattori N. Genotype-specific cortisol production associated with Cushing's syndrome adenoma with PRKACA mutations. Mol Cell Endocrinol 2021; 538:111456. [PMID: 34520814 PMCID: PMC8551059 DOI: 10.1016/j.mce.2021.111456] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 12/24/2022]
Abstract
The intracellular molecular mechanisms underlying the genotype of cortisol-producing adenoma (CPA) have not been fully determined. We analyzed gene expressions in CPA and the human adrenocortical cell line (HAC15 cells) with PRKACA mutation. Clustering analysis using a gene set associated with responses to cAMP revealed the possible differences between PRKACA mutant CPAs and GNAS and CTNNB1 mutant CPAs. The levels of STAR, CYP11A1, CYP17A1, CYP21A2, and FDX1 transcripts and cortisol levels per unit area in PRKACA mutant CPAs were significantly higher than those in GNAS mutant CPAs. PRKACA mutations led to an increase in steroidogenic enzyme expression and cortisol production in HAC15 cells. Transcriptome analysis revealed differences between PRKACA mutant CPAs and GNAS and CTNNB1 mutant CPAs. Cortisol production in PRKACA mutant CPAs is increased by the cAMP-PKA signaling pathway-mediated upregulation of steroidogenic enzymes transcription. The intracellular molecular mechanisms underlying these processes would be notably important in PRKACA mutant CPAs.
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Affiliation(s)
- Ryuta Baba
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kenji Oki
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Celso E Gomez-Sanchez
- Division of Endocrinology, G.V. (Sonny) Montgomery VA Medical Center and University of Mississippi Medical Center, Jackson, MS, USA; Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Yu Otagaki
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kiyotaka Itcho
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiro Kobuke
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takaya Kodama
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Gaku Nagano
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Haruya Ohno
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masayasu Yoneda
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Noboru Hattori
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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11
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Jiang Y, Zhu L, Wu D, Ni Y, Huang C, Ye H, Yang Y, Liu R, Li Y. Type IIB PKA is highly expressed in β cells and controls cell proliferation via regulating Cyclin D1 expression. FEBS J 2021; 289:2865-2876. [PMID: 34839588 DOI: 10.1111/febs.16302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/09/2021] [Accepted: 11/26/2021] [Indexed: 12/01/2022]
Abstract
β cell number is maintained mainly by cell proliferation and cell apoptosis. Protein kinase A (PKA) pathway is an important intracellular signalling-mediating β cell proliferation. However, the precise roles of PKA isoforms are not well-defined. We found that the RIIB subunit of PKA is expressed specifically by β cells of mouse and human islets. Sixty percent pancreatectomy caused increased β cell proliferation. Deletion of type IIB PKA by disruption of RIIB expression further promoted β cell proliferation, leading to enhanced β cell mass expansion. RIIB KO mice also showed increased insulin levels and improved glucose tolerance. Mechanistically, activation of type IIB PKA decreased Cyclin D1 levels and inhibition of RIIB expression increased Cyclin D1 levels. Consistently, activation of type IIB PKA inhibited cell cycle entry. These results suggest that type IIB PKA plays a pivotal role in β cell proliferation via regulating Cyclin D1 expression.
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Affiliation(s)
- Yaojing Jiang
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Lu Zhu
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Di Wu
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Yunzhi Ni
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Chuxin Huang
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Hongying Ye
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Yehong Yang
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Rui Liu
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Yiming Li
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
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12
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Ramms DJ, Raimondi F, Arang N, Herberg FW, Taylor SS, Gutkind JS. G αs-Protein Kinase A (PKA) Pathway Signalopathies: The Emerging Genetic Landscape and Therapeutic Potential of Human Diseases Driven by Aberrant G αs-PKA Signaling. Pharmacol Rev 2021; 73:155-197. [PMID: 34663687 PMCID: PMC11060502 DOI: 10.1124/pharmrev.120.000269] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Many of the fundamental concepts of signal transduction and kinase activity are attributed to the discovery and crystallization of cAMP-dependent protein kinase, or protein kinase A. PKA is one of the best-studied kinases in human biology, with emphasis in biochemistry and biophysics, all the way to metabolism, hormone action, and gene expression regulation. It is surprising, however, that our understanding of PKA's role in disease is largely underappreciated. Although genetic mutations in the PKA holoenzyme are known to cause diseases such as Carney complex, Cushing syndrome, and acrodysostosis, the story largely stops there. With the recent explosion of genomic medicine, we can finally appreciate the broader role of the Gαs-PKA pathway in disease, with contributions from aberrant functioning G proteins and G protein-coupled receptors, as well as multiple alterations in other pathway components and negative regulators. Together, these represent a broad family of diseases we term the Gαs-PKA pathway signalopathies. The Gαs-PKA pathway signalopathies encompass diseases caused by germline, postzygotic, and somatic mutations in the Gαs-PKA pathway, with largely endocrine and neoplastic phenotypes. Here, we present a signaling-centric review of Gαs-PKA-driven pathophysiology and integrate computational and structural analysis to identify mutational themes commonly exploited by the Gαs-PKA pathway signalopathies. Major mutational themes include hotspot activating mutations in Gαs, encoded by GNAS, and mutations that destabilize the PKA holoenzyme. With this review, we hope to incite further study and ultimately the development of new therapeutic strategies in the treatment of a wide range of human diseases. SIGNIFICANCE STATEMENT: Little recognition is given to the causative role of Gαs-PKA pathway dysregulation in disease, with effects ranging from infectious disease, endocrine syndromes, and many cancers, yet these disparate diseases can all be understood by common genetic themes and biochemical signaling connections. By highlighting these common pathogenic mechanisms and bridging multiple disciplines, important progress can be made toward therapeutic advances in treating Gαs-PKA pathway-driven disease.
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Affiliation(s)
- Dana J Ramms
- Department of Pharmacology (D.J.R., N.A., J.S.G.), Department of Chemistry and Biochemistry (S.S.T.), and Moores Cancer Center (D.J.R., N.A., J.S.G.), University of California, San Diego, La Jolla, California; Laboratorio di Biologia Bio@SNS, Scuola Normale Superiore, Pisa, Italy (F.R.); and Department of Biochemistry, University of Kassel, Kassel, Germany (F.W.H.)
| | - Francesco Raimondi
- Department of Pharmacology (D.J.R., N.A., J.S.G.), Department of Chemistry and Biochemistry (S.S.T.), and Moores Cancer Center (D.J.R., N.A., J.S.G.), University of California, San Diego, La Jolla, California; Laboratorio di Biologia Bio@SNS, Scuola Normale Superiore, Pisa, Italy (F.R.); and Department of Biochemistry, University of Kassel, Kassel, Germany (F.W.H.)
| | - Nadia Arang
- Department of Pharmacology (D.J.R., N.A., J.S.G.), Department of Chemistry and Biochemistry (S.S.T.), and Moores Cancer Center (D.J.R., N.A., J.S.G.), University of California, San Diego, La Jolla, California; Laboratorio di Biologia Bio@SNS, Scuola Normale Superiore, Pisa, Italy (F.R.); and Department of Biochemistry, University of Kassel, Kassel, Germany (F.W.H.)
| | - Friedrich W Herberg
- Department of Pharmacology (D.J.R., N.A., J.S.G.), Department of Chemistry and Biochemistry (S.S.T.), and Moores Cancer Center (D.J.R., N.A., J.S.G.), University of California, San Diego, La Jolla, California; Laboratorio di Biologia Bio@SNS, Scuola Normale Superiore, Pisa, Italy (F.R.); and Department of Biochemistry, University of Kassel, Kassel, Germany (F.W.H.)
| | - Susan S Taylor
- Department of Pharmacology (D.J.R., N.A., J.S.G.), Department of Chemistry and Biochemistry (S.S.T.), and Moores Cancer Center (D.J.R., N.A., J.S.G.), University of California, San Diego, La Jolla, California; Laboratorio di Biologia Bio@SNS, Scuola Normale Superiore, Pisa, Italy (F.R.); and Department of Biochemistry, University of Kassel, Kassel, Germany (F.W.H.)
| | - J Silvio Gutkind
- Department of Pharmacology (D.J.R., N.A., J.S.G.), Department of Chemistry and Biochemistry (S.S.T.), and Moores Cancer Center (D.J.R., N.A., J.S.G.), University of California, San Diego, La Jolla, California; Laboratorio di Biologia Bio@SNS, Scuola Normale Superiore, Pisa, Italy (F.R.); and Department of Biochemistry, University of Kassel, Kassel, Germany (F.W.H.)
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13
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Walker C, Wang Y, Olivieri C, V S M, Gao J, Bernlohr DA, Calebiro D, Taylor SS, Veglia G. Is Disrupted Nucleotide-Substrate Cooperativity a Common Trait for Cushing's Syndrome Driving Mutations of Protein Kinase A? J Mol Biol 2021; 433:167123. [PMID: 34224748 DOI: 10.1016/j.jmb.2021.167123] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/24/2021] [Accepted: 06/27/2021] [Indexed: 12/14/2022]
Abstract
Somatic mutations in the PRKACA gene encoding the catalytic α subunit of protein kinase A (PKA-C) are responsible for cortisol-producing adrenocortical adenomas. These benign neoplasms contribute to the development of Cushing's syndrome. The majority of these mutations occur at the interface between the two lobes of PKA-C and interfere with the enzyme's ability to recognize substrates and regulatory (R) subunits, leading to aberrant phosphorylation patterns and activation. Rarely, patients with similar phenotypes carry an allosteric mutation, E31V, located at the C-terminal end of the αA-helix and adjacent to the αC-helix, but structurally distinct from the PKA-C/R subunit interface mutations. Using a combination of solution NMR, thermodynamics, kinetic assays, and molecular dynamics simulations, we show that the E31V allosteric mutation disrupts central communication nodes between the N- and C- lobes of the enzyme as well as nucleotide-substrate binding cooperativity, a hallmark for kinases' substrate fidelity and regulation. For both orthosteric (L205R and W196R) and allosteric (E31V) Cushing's syndrome mutants, the loss of binding cooperativity is proportional to the density of the intramolecular allosteric network. This structure-activity relationship suggests a possible common mechanism for Cushing's syndrome driving mutations in which decreased nucleotide/substrate binding cooperativity is linked to loss in substrate fidelity and dysfunctional regulation.
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Affiliation(s)
- Caitlin Walker
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Yingjie Wang
- Department of Chemistry, University of Minnesota, Minneapolis, MN 55455, USA; Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen 518055, China
| | - Cristina Olivieri
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Manu V S
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Jiali Gao
- Department of Chemistry, University of Minnesota, Minneapolis, MN 55455, USA; Institute of Systems and Physical Biology, Shenzhen Bay Laboratory, Shenzhen 518055, China
| | - David A Bernlohr
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Davide Calebiro
- Institute of Metabolism and Systems Research, University of Birmingham, B15 2TT Birmingham, UK; Centre of Membrane Proteins and Receptors, Universities of Birmingham and Nottingham, B15 2TT Birmingham, UK
| | - Susan S Taylor
- Department of Chemistry and Biochemistry, University of California at San Diego, La Jolla, CA 92093, USA; Department of Pharmacology, University of California at San Diego, La Jolla, CA 92093, USA
| | - Gianluigi Veglia
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA; Department of Chemistry, University of Minnesota, Minneapolis, MN 55455, USA.
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14
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Arveseth CD, Happ JT, Hedeen DS, Zhu JF, Capener JL, Klatt Shaw D, Deshpande I, Liang J, Xu J, Stubben SL, Nelson IB, Walker MF, Kawakami K, Inoue A, Krogan NJ, Grunwald DJ, Hüttenhain R, Manglik A, Myers BR. Smoothened transduces Hedgehog signals via activity-dependent sequestration of PKA catalytic subunits. PLoS Biol 2021; 19:e3001191. [PMID: 33886552 PMCID: PMC8096101 DOI: 10.1371/journal.pbio.3001191] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 05/04/2021] [Accepted: 03/16/2021] [Indexed: 12/13/2022] Open
Abstract
The Hedgehog (Hh) pathway is essential for organ development, homeostasis, and regeneration. Dysfunction of this cascade drives several cancers. To control expression of pathway target genes, the G protein-coupled receptor (GPCR) Smoothened (SMO) activates glioma-associated (GLI) transcription factors via an unknown mechanism. Here, we show that, rather than conforming to traditional GPCR signaling paradigms, SMO activates GLI by binding and sequestering protein kinase A (PKA) catalytic subunits at the membrane. This sequestration, triggered by GPCR kinase (GRK)-mediated phosphorylation of SMO intracellular domains, prevents PKA from phosphorylating soluble substrates, releasing GLI from PKA-mediated inhibition. Our work provides a mechanism directly linking Hh signal transduction at the membrane to GLI transcription in the nucleus. This process is more fundamentally similar between species than prevailing hypotheses suggest. The mechanism described here may apply broadly to other GPCR- and PKA-containing cascades in diverse areas of biology.
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Affiliation(s)
- Corvin D. Arveseth
- Department of Oncological Sciences, Department of Biochemistry, Department of Bioengineering, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - John T. Happ
- Department of Oncological Sciences, Department of Biochemistry, Department of Bioengineering, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Danielle S. Hedeen
- Department of Oncological Sciences, Department of Biochemistry, Department of Bioengineering, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Ju-Fen Zhu
- Department of Oncological Sciences, Department of Biochemistry, Department of Bioengineering, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Jacob L. Capener
- Department of Oncological Sciences, Department of Biochemistry, Department of Bioengineering, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Dana Klatt Shaw
- Department of Human Genetics, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Ishan Deshpande
- Department of Pharmaceutical Chemistry, Department of Anaesthesia and Perioperative Care, University of California, San Francisco, California, United States of America
| | - Jiahao Liang
- Department of Pharmaceutical Chemistry, Department of Anaesthesia and Perioperative Care, University of California, San Francisco, California, United States of America
| | - Jiewei Xu
- Department of Cellular and Molecular Pharmacology, Quantitative Biosciences Institute, University of California, San Francisco, California, United States of America
- J. David Gladstone Institutes, San Francisco, California, United States of America
| | - Sara L. Stubben
- Department of Oncological Sciences, Department of Biochemistry, Department of Bioengineering, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Isaac B. Nelson
- Department of Oncological Sciences, Department of Biochemistry, Department of Bioengineering, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Madison F. Walker
- Department of Oncological Sciences, Department of Biochemistry, Department of Bioengineering, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Kouki Kawakami
- Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi, Japan
| | - Asuka Inoue
- Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi, Japan
| | - Nevan J. Krogan
- Department of Cellular and Molecular Pharmacology, Quantitative Biosciences Institute, University of California, San Francisco, California, United States of America
- J. David Gladstone Institutes, San Francisco, California, United States of America
| | - David J. Grunwald
- Department of Human Genetics, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Ruth Hüttenhain
- Department of Cellular and Molecular Pharmacology, Quantitative Biosciences Institute, University of California, San Francisco, California, United States of America
- J. David Gladstone Institutes, San Francisco, California, United States of America
| | - Aashish Manglik
- Department of Pharmaceutical Chemistry, Department of Anaesthesia and Perioperative Care, University of California, San Francisco, California, United States of America
| | - Benjamin R. Myers
- Department of Oncological Sciences, Department of Biochemistry, Department of Bioengineering, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
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15
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Weigand I, Ronchi CL, Vanselow JT, Bathon K, Lenz K, Herterich S, Schlosser A, Kroiss M, Fassnacht M, Calebiro D, Sbiera S. PKA Cα subunit mutation triggers caspase-dependent RIIβ subunit degradation via Ser 114 phosphorylation. SCIENCE ADVANCES 2021; 7:7/8/eabd4176. [PMID: 33608270 PMCID: PMC7895437 DOI: 10.1126/sciadv.abd4176] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
Mutations in the PRKACA gene are the most frequent cause of cortisol-producing adrenocortical adenomas leading to Cushing's syndrome. PRKACA encodes for the catalytic subunit α of protein kinase A (PKA). We already showed that PRKACA mutations lead to impairment of regulatory (R) subunit binding. Furthermore, PRKACA mutations are associated with reduced RIIβ protein levels; however, the mechanisms leading to reduced RIIβ levels are presently unknown. Here, we investigate the effects of the most frequent PRKACA mutation, L206R, on regulatory subunit stability. We find that Ser114 phosphorylation of RIIβ is required for its degradation, mediated by caspase 16. Last, we show that the resulting reduction in RIIβ protein levels leads to increased cortisol secretion in adrenocortical cells. These findings reveal the molecular mechanisms and pathophysiological relevance of the R subunit degradation caused by PRKACA mutations, adding another dimension to the deregulation of PKA signaling caused by PRKACA mutations in adrenal Cushing's syndrome.
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Affiliation(s)
- Isabel Weigand
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, 97080 Würzburg, Germany
| | - Cristina L Ronchi
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, 97080 Würzburg, Germany
- Institute of Metabolism and System Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Edgbaston, Birmingham B15 2TT, UK
| | - Jens T Vanselow
- Rudolf-Virchow-Center for Integrative and Translational Bioimaging, University of Würzburg, 97080 Würzburg, Germany
- Department of Chemical and Product Safety, German Federal Institute of Risk Assessment (BfR), 10589 Berlin, Germany
| | - Kerstin Bathon
- Institute of Pharmacology and Toxicology and Bio-Imaging Center, University of Würzburg, 97080 Würzburg, Germany
| | - Kerstin Lenz
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, 97080 Würzburg, Germany
| | - Sabine Herterich
- Central Laboratory, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Andreas Schlosser
- Rudolf-Virchow-Center for Integrative and Translational Bioimaging, University of Würzburg, 97080 Würzburg, Germany
| | - Matthias Kroiss
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, 97080 Würzburg, Germany
- Comprehensive Cancer Center Mainfranken, University of Würzburg, 97080 Würzburg, Germany
| | - Martin Fassnacht
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, 97080 Würzburg, Germany.
- Central Laboratory, University Hospital Würzburg, 97080 Würzburg, Germany
- Comprehensive Cancer Center Mainfranken, University of Würzburg, 97080 Würzburg, Germany
| | - Davide Calebiro
- Institute of Metabolism and System Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
- Institute of Pharmacology and Toxicology and Bio-Imaging Center, University of Würzburg, 97080 Würzburg, Germany
- Centre of Membrane Proteins and Receptors (COMPARE), Universities of Nottingham and Birmingham, Birmingham B15 2TT, UK
| | - Silviu Sbiera
- Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Würzburg, 97080 Würzburg, Germany.
- Central Laboratory, University Hospital Würzburg, 97080 Würzburg, Germany
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16
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Omar MH, Scott JD. AKAP Signaling Islands: Venues for Precision Pharmacology. Trends Pharmacol Sci 2020; 41:933-946. [PMID: 33082006 DOI: 10.1016/j.tips.2020.09.007] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/21/2020] [Accepted: 09/24/2020] [Indexed: 12/19/2022]
Abstract
Regulatory enzymes often have different roles in distinct subcellular compartments. Yet, most drugs indiscriminately saturate the cell. Thus, subcellular drug-delivery holds promise as a means to reduce off-target pharmacological effects. A-kinase anchoring proteins (AKAPs) sequester combinations of signaling enzymes within subcellular microdomains. Targeting drugs to these 'signaling islands' offers an opportunity for more precise delivery of therapeutics. Here, we review mechanisms that bestow protein kinase A (PKA) versatility inside the cell, appraise recent advances in exploiting AKAPs as platforms for precision pharmacology, and explore the impact of methodological innovations on AKAP research.
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Affiliation(s)
- Mitchell H Omar
- Department of Pharmacology, University of Washington, Seattle, WA, 98195, USA
| | - John D Scott
- Department of Pharmacology, University of Washington, Seattle, WA, 98195, USA.
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17
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Differential Activation of P-TEFb Complexes in the Development of Cardiomyocyte Hypertrophy following Activation of Distinct G Protein-Coupled Receptors. Mol Cell Biol 2020; 40:MCB.00048-20. [PMID: 32341082 DOI: 10.1128/mcb.00048-20] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/16/2020] [Indexed: 12/19/2022] Open
Abstract
Pathological cardiac hypertrophy is driven by neurohormonal activation of specific G protein-coupled receptors (GPCRs) in cardiomyocytes and is accompanied by large-scale changes in cardiomyocyte gene expression. These transcriptional changes require activity of positive transcription elongation factor b (P-TEFb), which is recruited to target genes by the bromodomain protein Brd4 or the super elongation complex (SEC). Here, we describe GPCR-specific regulation of these P-TEFb complexes and a novel mechanism for activating Brd4 in primary neonatal rat cardiomyocytes. The SEC was required for the hypertrophic response downstream of either the α1-adrenergic receptor (α1-AR) or the endothelin receptor (ETR). In contrast, Brd4 inhibition selectively impaired the α1-AR response. This was corroborated by the finding that the activation of α1-AR, but not ETR, increased Brd4 occupancy at promoters and superenhancers of hypertrophic genes. Transcriptome analysis demonstrated that the activation of both receptors initiated similar gene expression programs, but that Brd4 inhibition attenuated hypertrophic genes more robustly following α1-AR activation. Finally, we show that protein kinase A (PKA) is required for α1-AR stimulation of Brd4 chromatin occupancy. The differential role of the Brd4/P-TEFb complex in response to distinct GPCR pathways has potential clinical implications, as therapies targeting this complex are currently being explored for heart failure.
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18
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Li S, Yang C, Fan J, Yao Y, Lv X, Guo Y, Zhang S. Pregnancy-induced Cushing's syndrome with an adrenocortical adenoma overexpressing LH/hCG receptors: a case report. BMC Endocr Disord 2020; 20:62. [PMID: 32393232 PMCID: PMC7216527 DOI: 10.1186/s12902-020-0539-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/27/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Pregnancy-induced Cushing's syndrome (CS) with an adrenocortical adenoma overexpressing luteinizing hormone (LH)/human choriogonadotropin (hCG) receptors (LHCGR) has been rarely reported in the literatures. This peculiar condition challenges the canonical diagnosis and management of CS. CASE PRESENTATION A 27-year-old woman (G2P0A1) presented at 20 weeks gestational age (GA) with overt Cushingoid clinical features. Adrenocorticotropic hormone (ACTH)-independent CS was diagnosed based on undetectable ACTH and unsuppressed cortisol levels by dexamethasone. Magnetic resonance imaging (MRI) scanning without contrast revealed a left adrenal nodule while pituitary MRI scanning was normal. A conservative treatment strategy of controlling Cushingoid comorbidities was conducted. At 36 weeks GA, a caesarean operation was performed and a live female infant was delivered. At 8 weeks after parturition, our patient achieved normalization of blood pressure, blood glucose, serum potassium, and urinary cortisol level spontaneously. During non-pregnancy period, stimulation testing with exogenous hCG significantly evoked a cortisol increase. The woman underwent resection of the adrenal tumor at 6 months after parturition. Immunohistochemistry (IHC) showed the tumor tissue that stained positive for luteinizing hormone (LH)/human choriogonadotropin (hCG) receptor (LHCGR), whereas negative for both melanocortin 2 receptor (MC2R) and G protein-coupled receptor-1 (GPER-1). CONCLUSIONS Stimulation test with exogenous hCG after parturition is necessary for the diagnosis of pregnancy-induced CS. LHCGR plays an essential role in the pathogenesis of this rare condition.
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Affiliation(s)
- Shaohua Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Chen Yang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Jing Fan
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Yao Yao
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Xiaomei Lv
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Ying Guo
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Shaoling Zhang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China.
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19
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Olivieri C, Wang Y, Li GC, V S M, Kim J, Stultz BR, Neibergall M, Porcelli F, Muretta JM, Thomas DDT, Gao J, Blumenthal DK, Taylor SS, Veglia G. Multi-state recognition pathway of the intrinsically disordered protein kinase inhibitor by protein kinase A. eLife 2020; 9:e55607. [PMID: 32338601 PMCID: PMC7234811 DOI: 10.7554/elife.55607] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/27/2020] [Indexed: 12/17/2022] Open
Abstract
In the nucleus, the spatiotemporal regulation of the catalytic subunit of cAMP-dependent protein kinase A (PKA-C) is orchestrated by an intrinsically disordered protein kinase inhibitor, PKI, which recruits the CRM1/RanGTP nuclear exporting complex. How the PKA-C/PKI complex assembles and recognizes CRM1/RanGTP is not well understood. Using NMR, SAXS, fluorescence, metadynamics, and Markov model analysis, we determined the multi-state recognition pathway for PKI. After a fast binding step in which PKA-C selects PKI's most competent conformations, PKI folds upon binding through a slow conformational rearrangement within the enzyme's binding pocket. The high-affinity and pseudo-substrate regions of PKI become more structured and the transient interactions with the kinase augment the helical content of the nuclear export sequence, which is then poised to recruit the CRM1/RanGTP complex for nuclear translocation. The multistate binding mechanism featured by PKA-C/PKI complex represents a paradigm on how disordered, ancillary proteins (or protein domains) are able to operate multiple functions such as inhibiting the kinase while recruiting other regulatory proteins for nuclear export.
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Affiliation(s)
- Cristina Olivieri
- Department of Biochemistry, Molecular Biology, and Biophysics, University of MinnesotaMinneapolisUnited States
| | - Yingjie Wang
- Department of Chemistry and Supercomputing Institute, University of MinnesotaMinneapolisUnited States
- Shenzhen Bay LaboratoryShenzhenChina
| | - Geoffrey C Li
- Department of Chemistry and Supercomputing Institute, University of MinnesotaMinneapolisUnited States
| | - Manu V S
- Department of Biochemistry, Molecular Biology, and Biophysics, University of MinnesotaMinneapolisUnited States
| | - Jonggul Kim
- Department of Chemistry and Supercomputing Institute, University of MinnesotaMinneapolisUnited States
| | | | | | | | - Joseph M Muretta
- Department of Biochemistry, Molecular Biology, and Biophysics, University of MinnesotaMinneapolisUnited States
| | - David DT Thomas
- Department of Biochemistry, Molecular Biology, and Biophysics, University of MinnesotaMinneapolisUnited States
| | - Jiali Gao
- Department of Chemistry and Supercomputing Institute, University of MinnesotaMinneapolisUnited States
- Laboratory of Computational Chemistry and Drug Design, Peking University Shenzhen Graduate SchoolShenzhenChina
| | - Donald K Blumenthal
- Department of Pharmacology and Toxicology, University of UtahSalt Lake CityUnited States
| | - Susan S Taylor
- Department of Chemistry and Biochemistry and Pharmacology, University of California, San DiegoLa JollaUnited States
| | - Gianluigi Veglia
- Department of Biochemistry, Molecular Biology, and Biophysics, University of MinnesotaMinneapolisUnited States
- Department of Chemistry and Supercomputing Institute, University of MinnesotaMinneapolisUnited States
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20
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Rizk-Rabin M, Chaoui-Ibadioune S, Vaczlavik A, Ribes C, Polak M, Ragazzon B, Bertherat J. Link between steroidogenesis, the cell cycle, and PKA in adrenocortical tumor cells. Mol Cell Endocrinol 2020; 500:110636. [PMID: 31678420 DOI: 10.1016/j.mce.2019.110636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 10/09/2019] [Accepted: 10/26/2019] [Indexed: 02/04/2023]
Abstract
Adrenocortical tumors (ACTs) frequently cause steroid excess and present cell-cycle dysregulation. cAMP/PKA signaling is involved in steroid synthesis and play a role in cell-cycle regulation. We investigated, by cell synchronization in the different phases of the cell-cycle, the control of steroidogenesis and the contribution of PKA in adrenocortical cells (H295R and culture of primary pigmented nodular adrenocortical disease cells). Cells showed increased steroidogenesis and a maximal PKA activity at G2 phase, and a reduction at G1 phase. PRKACA overexpression, or cAMP stimulation, enhanced PKA activity and induced steroidogenesis in all synchronized groups but is not sufficient to drive cell-cycle progression. PRKAR1A inactivation enhanced PKA activity and induced STAR gene expression, only in cells in G1, and triggered cell-cycle progression in all groups. These findings provide evidence for a tight association between steroidogenesis and cell-cycle in ACTs. Moreover, PRKAR1A is essential for mediating the function of PKA activity on both steroidogenesis and cell-cycle progression in adrenocortical cells.
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Affiliation(s)
- Marthe Rizk-Rabin
- Institut Cochin, U1016, CNRS (UMR 8104), Université Paris Descartes, Paris, France.
| | | | - Anna Vaczlavik
- Institut Cochin, U1016, CNRS (UMR 8104), Université Paris Descartes, Paris, France
| | - Christopher Ribes
- Institut Cochin, U1016, CNRS (UMR 8104), Université Paris Descartes, Paris, France
| | - Michel Polak
- Institut Cochin, U1016, CNRS (UMR 8104), Université Paris Descartes, Paris, France; Hopital Necker Enfants Maladies, Department of Endocrinology, Paris, France
| | - Bruno Ragazzon
- Institut Cochin, U1016, CNRS (UMR 8104), Université Paris Descartes, Paris, France
| | - Jerôme Bertherat
- Institut Cochin, U1016, CNRS (UMR 8104), Université Paris Descartes, Paris, France; Hôpital Cochin, Department of Endocrinology. Center for Rare Adrenal Diseases, Paris, France
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21
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Di Dalmazi G, Timmers HJLM, Arnaldi G, Küsters B, Scarpelli M, Bathon K, Calebiro D, Beuschlein F, Hermus A, Reincke M. Somatic PRKACA Mutations: Association With Transition From Pituitary-Dependent to Adrenal-Dependent Cushing Syndrome. J Clin Endocrinol Metab 2019; 104:5651-5657. [PMID: 31276155 DOI: 10.1210/jc.2018-02209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 07/01/2019] [Indexed: 11/19/2022]
Abstract
CONTEXT Prolonged adrenal stimulation by corticotropin, as in long-standing Cushing disease (CD), leads to diffuse to nodular hyperplasia. Adrenal functional autonomy has been described in a subset of patients with CD, leading to the hypothesis of transition from ACTH-dependent to ACTH-independent hypercortisolism. OBJECTIVE With the consideration that the catalytic α subunit of protein kinase A (PKA; PRKACA) somatic mutations are the most common finding in adrenal adenomas associated with ACTH-independent Cushing syndrome, our aim was to analyze PRKACA mutations in adrenals of patients with persistent/long-standing CD. DESIGN Cross-sectional. SETTING University hospital. PATIENTS Two patients with long-standing CD and suspicion of coexistence of autonomous adrenal hyperfunction, according to pre and postoperative evaluations, were selected for this study, following an intensive literature search and patient-chart reviewing. INTERVENTION Clinical data were analyzed. DNA was extracted from adrenal tissue for PRKACA sequencing. PKA activity was assayed. MAIN OUTCOME MEASURE PRKACA somatic mutations. RESULTS Both patients showed mutations of PRKACA in the macronodule in the context of micronodular adrenal hyperplasia. One patient harbored the previously described p.Leu206Arg substitution, whereas a p.Ser213Arg missense variation was detected in the adrenal nodule of the second patient. No mutations were detected in the adjacent adrenal cortex of the second patient. In silico analysis predicts that p.Ser213Arg can interfere with the interaction between the regulatory and catalytic subunits of PKA. CONCLUSIONS Our study shows that PRKACA somatic mutations can be found in adrenal nodules of patients with CD. These genetic alterations could represent a possible mechanism underlying adrenal nodule formation and autonomous cortisol hyperproduction in a subgroup of patients with long-standing CD.
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Affiliation(s)
- Guido Di Dalmazi
- Division of Endocrinology, Department of Medical and Surgical Sciences, Alma Mater University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Henri J L M Timmers
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Giorgio Arnaldi
- Division of Endocrinology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Benno Küsters
- Department of Pathology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Marina Scarpelli
- Section of Pathological Anatomy, Polytechnic University of Marche, Ancona, Italy
| | - Kerstin Bathon
- Institute of Pharmacology and Toxicology and Bio-Imaging Center, University of Würzburg, Würzburg, Germany
| | - Davide Calebiro
- Institute of Pharmacology and Toxicology and Bio-Imaging Center, University of Würzburg, Würzburg, Germany
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
| | - Felix Beuschlein
- Klinik für Endokrinologie Diabetologie und Klinische Ernährung, Universitäts Spital Zürich, Zürich, Switzerland
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
| | - Ad Hermus
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Martin Reincke
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
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23
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Walker C, Wang Y, Olivieri C, Karamafrooz A, Casby J, Bathon K, Calebiro D, Gao J, Bernlohr DA, Taylor SS, Veglia G. Cushing's syndrome driver mutation disrupts protein kinase A allosteric network, altering both regulation and substrate specificity. SCIENCE ADVANCES 2019; 5:eaaw9298. [PMID: 31489371 PMCID: PMC6713507 DOI: 10.1126/sciadv.aaw9298] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 07/16/2019] [Indexed: 05/05/2023]
Abstract
Genetic alterations in the PRKACA gene coding for the catalytic α subunit of the cAMP-dependent protein kinase A (PKA-C) are linked to cortisol-secreting adrenocortical adenomas, resulting in Cushing's syndrome. Among those, a single mutation (L205R) has been found in up to 67% of patients. Because the x-ray structures of the wild-type and mutant kinases are essentially identical, the mechanism explaining aberrant function of this mutant remains under active debate. Using NMR spectroscopy, thermodynamics, kinetic assays, and molecular dynamics simulations, we found that this single mutation causes global changes in the enzyme, disrupting the intramolecular allosteric network and eliciting losses in nucleotide/pseudo-substrate binding cooperativity. Remarkably, by rewiring its internal allosteric network, PKA-CL205R is able to bind and phosphorylate non-canonical substrates, explaining its changes in substrate specificity. Both the lack of regulation and change in substrate specificity reveal the complex role of this mutated kinase in the formation of cortisol-secreting adrenocortical adenomas.
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Affiliation(s)
- Caitlin Walker
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Yingjie Wang
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
- Department of Chemistry, University of Minnesota, Minneapolis, MN 55455, USA
| | - Cristina Olivieri
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Adak Karamafrooz
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Jordan Casby
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Kerstin Bathon
- Institute for Pharmacology and Toxicology, University of Würzburg, 97078 Würzburg, Germany
| | - Davide Calebiro
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK
- Centre of Membrane Proteins and Receptors, University of Birmingham, Birmingham B15 2TT, UK
| | - Jiali Gao
- Department of Chemistry, University of Minnesota, Minneapolis, MN 55455, USA
- Shenzhen Bay Laboratory and Laboratory of Computational Chemistry and Drug Design, Peking University Graduate School, Shenzhen 518055, China
| | - David A. Bernlohr
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Susan S. Taylor
- Departments of Chemistry and Biochemistry and Pharmacology, University of California San Diego, La Jolla, CA 92093, USA
| | - Gianluigi Veglia
- Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA
- Department of Chemistry, University of Minnesota, Minneapolis, MN 55455, USA
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24
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Bathon K, Weigand I, Vanselow JT, Ronchi CL, Sbiera S, Schlosser A, Fassnacht M, Calebiro D. Alterations in Protein Kinase A Substrate Specificity as a Potential Cause of Cushing Syndrome. Endocrinology 2019; 160:447-459. [PMID: 30615103 DOI: 10.1210/en.2018-00775] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/31/2018] [Indexed: 11/19/2022]
Abstract
Cushing syndrome is a severe endocrine disorder of cortisol excess associated with major metabolic and cardiovascular sequelae. We recently identified somatic mutations in PRKACA, the gene encoding the catalytic (C) α subunit of protein kinase A (PKA), as being responsible for cortisol-producing adrenocortical adenomas (CPAs), which are a major cause of Cushing syndrome. In spite of previous studies on the two initially identified mutations (L206R, 199_200insW), the mechanisms of action of the clinically highly relevant PRKACA mutations remain poorly understood. Here, by investigating a large panel of PRKACA mutations, including all those identified so far in Cushing syndrome, we unexpectedly found that not all mutations interfere with the binding of regulatory (R) subunits as previously hypothesized. Because several mutations lie in a region of PKA Cα involved in substrate recognition, we investigated their consequences on substrate specificity by quantitative phosphoproteomics. We found that all three mutations analyzed (L206R, 200_201insV, and d244-248+E249Q) cause major changes in the preference of PKA for its targets, leading to hyperphosphorylation of several PKA substrates, most notably including histone H1.4 at Ser36, which is required for and promotes mitosis. This is reflected by a ninefold hyperphosphorylation of H1.4 in CPAs carrying the L206R mutation. Thus, our findings suggest that in addition to hampering binding to R subunits, PRKACA mutations act by altering PKA substrate specificity. These findings shed light on the molecular events leading to Cushing syndrome and illustrate how mutations altering substrate specificity of a protein kinase may cause human disease.
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Affiliation(s)
- Kerstin Bathon
- Institute of Pharmacology and Toxicology and Bio-Imaging Center, University of Würzburg, Würzburg, Germany
| | - Isabel Weigand
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
| | - Jens T Vanselow
- Rudolf Virchow Center, University of Würzburg, Würzburg, Germany
| | - Cristina L Ronchi
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
| | - Silviu Sbiera
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
| | | | - Martin Fassnacht
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
- Central Laboratory, University Hospital Würzburg, Würzburg, Germany
| | - Davide Calebiro
- Institute of Pharmacology and Toxicology and Bio-Imaging Center, University of Würzburg, Würzburg, Germany
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
- Centre of Membrane Proteins and Receptors, University of Birmingham, Birmingham, United Kingdom
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25
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Weigand I. Pathogenesis of benign unilateral adrenocortical tumors: focus on cAMP/PKA pathway. MINERVA ENDOCRINOL 2018; 44:25-32. [PMID: 29963826 DOI: 10.23736/s0391-1977.18.02874-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Somatic mutations affecting genes in the cAMP/PKA (protein kinase A) signaling pathway have been described as causative for the pathogenesis of benign unilateral adrenocortical adenomas associated with cortisol over secretion. These include predominantly somatic mutations in the PRKACA gene which encodes the catalytic subunit α of PKA. In addition, mutations in the GNAS gene, coding for the stimulatory G protein α, have been observed in approximately 10% of cortisol producing adenomas (CPA). The mutations render PKA signaling constitutively active and are therefore involved in cortisol over secretion of these tumors. Despite the prominent role of the cAMP/PKA pathway in the pathogenesis of unilateral CPA, also mutations in the CTNNB1 gene, encoding β-catenin, were identified in CPA. However, mutations in β-catenin are not limited to CPA and are not associated with cortisol secretion since they were predominantly found in endocrine-inactive adenomas (EIA) and might hence contribute to tumorigenesis in adrenocortical tissues. In this review, recent findings in the pathogenesis of benign adrenocortical tumors with a particular focus on the cAMP/PKA signaling pathway are summarized.
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Affiliation(s)
- Isabel Weigand
- Unit of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of Wuerzburg, Wuerzburg, Germany -
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26
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Espiard S, Knape MJ, Bathon K, Assié G, Rizk-Rabin M, Faillot S, Luscap-Rondof W, Abid D, Guignat L, Calebiro D, Herberg FW, Stratakis CA, Bertherat J. Activating PRKACB somatic mutation in cortisol-producing adenomas. JCI Insight 2018; 3:98296. [PMID: 29669941 DOI: 10.1172/jci.insight.98296] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 03/20/2018] [Indexed: 12/13/2022] Open
Abstract
Mutations in the gene encoding the protein kinase A (PKA) catalytic subunit α have been found to be responsible for cortisol-producing adenomas (CPAs). In this study, we identified by whole-exome sequencing the somatic mutation p.S54L in the PRKACB gene, encoding the catalytic subunit β (Cβ) of PKA, in a CPA from a patient with severe Cushing syndrome. Bioluminescence resonance energy transfer and surface plasmon resonance assays revealed that the mutation hampers formation of type I holoenzymes and that these holoenzymes were highly sensitive to cAMP. PKA activity, measured both in cell lysates and with recombinant proteins, based on phosphorylation of a synthetic substrate, was higher under basal conditions for the mutant enzyme compared with the WT, while maximal activity was lower. These data suggest that at baseline the PRKACB p.S54L mutant drove the adenoma cells to higher cAMP signaling activity, probably contributing to their autonomous growth. Although the role of PRKACB in tumorigenesis has been suggested, we demonstrated for the first time to our knowledge that a PRKACB mutation can lead to an adrenal tumor. Moreover, this observation describes another mechanism of PKA pathway activation in CPAs and highlights the particular role of residue Ser54 for the function of PKA.
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Affiliation(s)
- Stéphanie Espiard
- Cochin Institute, Paris Descartes University, CNRS (UMR 8104)/Inserm (U1016), Paris, France.,Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland, USA
| | - Matthias J Knape
- University of Kassel, Department of Biochemistry, Kassel, Germany
| | - Kerstin Bathon
- Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center, University of Würzburg, Würzburg, Germany
| | - Guillaume Assié
- Cochin Institute, Paris Descartes University, CNRS (UMR 8104)/Inserm (U1016), Paris, France.,Center for Rare Adrenal Diseases, Endocrinology Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Marthe Rizk-Rabin
- Cochin Institute, Paris Descartes University, CNRS (UMR 8104)/Inserm (U1016), Paris, France
| | - Simon Faillot
- Cochin Institute, Paris Descartes University, CNRS (UMR 8104)/Inserm (U1016), Paris, France
| | - Windy Luscap-Rondof
- Cochin Institute, Paris Descartes University, CNRS (UMR 8104)/Inserm (U1016), Paris, France
| | - Daniel Abid
- University of Kassel, Department of Biochemistry, Kassel, Germany
| | - Laurence Guignat
- Center for Rare Adrenal Diseases, Endocrinology Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Davide Calebiro
- Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center, University of Würzburg, Würzburg, Germany.,Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom.,Centre of Membrane Proteins and Receptors (COMPARE), Universities of Birmingham and Nottingham, United Kingdom
| | | | - Constantine A Stratakis
- Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland, USA
| | - Jérôme Bertherat
- Cochin Institute, Paris Descartes University, CNRS (UMR 8104)/Inserm (U1016), Paris, France.,Center for Rare Adrenal Diseases, Endocrinology Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
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27
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Luzi NM, Lyons CE, Peterson DL, Ellis KC. Kinetics and inhibition studies of the L205R mutant of cAMP-dependent protein kinase involved in Cushing's syndrome. FEBS Open Bio 2018; 8:606-613. [PMID: 29632813 PMCID: PMC5881547 DOI: 10.1002/2211-5463.12396] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 01/18/2018] [Accepted: 01/20/2018] [Indexed: 12/03/2022] Open
Abstract
Overproduction of cortisol by the hypothalamus–pituitary–adrenal hormone system results in the clinical disorder known as Cushing's syndrome. Genomics studies have identified a key mutation (L205R) in the α‐isoform of the catalytic subunit of cAMP‐dependent protein kinase (PKACα) in adrenal adenomas of patients with adrenocorticotropic hormone‐independent Cushing's syndrome. Here, we conducted kinetics and inhibition studies on the L205R‐PKACα mutant. We have found that the L205R mutation affects the kinetics of both Kemptide and ATP as substrates, decreasing the catalytic efficiency (kcat/KM) for each substrate by 12‐fold and 4.5‐fold, respectively. We have also determined the IC50 and Ki for the peptide substrate‐competitive inhibitor PKI(5–24) and the ATP‐competitive inhibitor H89. The L205R mutation had no effect on the potency of H89, but causes a > 250‐fold loss in potency for PKI(5–24). Collectively, these data provide insights for the development of L205R‐PKACα inhibitors as potential therapeutics.
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Affiliation(s)
- Nicole M Luzi
- Department of Medicinal Chemistry School of Pharmacy Virginia Commonwealth University Richmond VA USA
| | - Charles E Lyons
- Massey Cancer Center Virginia Commonwealth University Richmond VA USA
| | - Darrell L Peterson
- Massey Cancer Center Virginia Commonwealth University Richmond VA USA.,Department of Biochemistry and Molecular Biology School of Medicine Virginia Commonwealth University Richmond VA USA.,Institute for Structural Biology, Drug Discovery, and Development Virginia Commonwealth University Richmond VA USA
| | - Keith C Ellis
- Department of Medicinal Chemistry School of Pharmacy Virginia Commonwealth University Richmond VA USA.,Massey Cancer Center Virginia Commonwealth University Richmond VA USA.,Institute for Structural Biology, Drug Discovery, and Development Virginia Commonwealth University Richmond VA USA
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28
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Bonnet-Serrano F, Bertherat J. Genetics of tumors of the adrenal cortex. Endocr Relat Cancer 2018; 25:R131-R152. [PMID: 29233839 DOI: 10.1530/erc-17-0361] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 12/12/2017] [Indexed: 01/23/2023]
Abstract
This review describes the molecular alterations observed in the various types of tumors of the adrenal cortex, excluding Conn adenomas, especially the alterations identified by genomic approaches these last five years. Two main forms of bilateral adrenocortical tumors can be distinguished according to size and aspect of the nodules: primary pigmented nodular adrenal disease (PPNAD), which can be sporadic or part of Carney complex and primary bilateral macro nodular adrenal hyperplasia (PBMAH). The bilateral nature of the tumors suggests the existence of an underlying genetic predisposition. PPNAD and Carney complex are mainly due to germline-inactivating mutations of PRKAR1A, coding for a regulatory subunit of PKA, whereas PBMAH genetic seems more complex. However, genome-wide approaches allowed the identification of a new tumor suppressor gene, ARMC5, whose germline alteration could be responsible for at least 25% of PBMAH cases. Unilateral adrenocortical tumors are more frequent, mostly adenomas. The Wnt/beta-catenin pathway can be activated in both benign and malignant tumors by CTNNB1 mutations and by ZNRF3 inactivation in adrenal cancer (ACC). Some other signaling pathways are more specific of the tumor dignity. Thus, somatic mutations of cAMP/PKA pathway genes, mainly PRKACA, coding for the catalytic alpha-subunit of PKA, are found in cortisol-secreting adenomas, whereas IGF-II overexpression and alterations of p53 signaling pathway are observed in ACC. Genome-wide approaches including transcriptome, SNP, methylome and miRome analysis have identified new genetic and epigenetic alterations and the further clustering of ACC in subgroups associated with different prognosis, allowing the development of new prognosis markers.
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Affiliation(s)
- Fidéline Bonnet-Serrano
- Institut CochinINSERM U1016, CNRS UMR8104, Paris Descartes University, Paris, France
- Hormonal Biology LaboratoryAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Jérôme Bertherat
- Institut CochinINSERM U1016, CNRS UMR8104, Paris Descartes University, Paris, France
- Department of EndocrinologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
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29
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Calebiro D, Sungkaworn T. Single-Molecule Imaging of GPCR Interactions. Trends Pharmacol Sci 2018; 39:109-122. [DOI: 10.1016/j.tips.2017.10.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/23/2017] [Accepted: 10/25/2017] [Indexed: 02/07/2023]
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30
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Tseng IC, Huang WJ, Jhuang YL, Chang YY, Hsu HP, Jeng YM. Microinsertions in PRKACA cause activation of the protein kinase A pathway in cardiac myxoma. J Pathol 2017; 242:134-139. [PMID: 28369983 DOI: 10.1002/path.4899] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 03/16/2017] [Accepted: 03/21/2017] [Indexed: 11/07/2022]
Abstract
Cardiac myxoma is the most common cardiac tumour. Most lesions occur sporadically, but occasional lesions develop in patients with Carney complex, a syndrome characterized by cardiac myxoma, spotty pigmentation, and endocrine overactivity. Two-thirds of patients with Carney complex harbour germline mutations in PRKAR1A, which encodes the type I regulatory subunit of protein kinase A (PKA). Most studies have not found a mutation in PRKAR1A in sporadic cardiac myxoma cases. Recent studies identified frequent mutations in PRKACA, which encodes the catalytic subunit of PKA, in cortisol-secreting adrenocortical adenoma cases. To determine whether the PRKACA mutation is involved in the tumourigenesis of cardiac myxoma, we performed Sanger sequencing of 41 specimens of sporadic cardiac myxoma to test for the presence of mutations in the coding regions and intron-exon boundaries of PRKACA. Mutations were identified in four cases (9.7%). In contrast to the point mutations identified in adrenocortical adenoma, all mutations were in-frame microinsertions of 18-33 bp clustered in exons 7 and 8. The mutated PRKACA proteins lost their ability to bind to PRKAR1A, and thereby lead to constitutive activation of the PKA pathway. Together with previous reports of PRKAR1A mutations in syndromic cardiac myxoma, our study demonstrates the importance of the PKA pathway in the tumourigenesis of cardiac myxoma. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- I-Ching Tseng
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Ju Huang
- Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taiwan, Taiwan.,Department of Oral Hygiene, Hsin-Sheng College of Medical Care and Management, Taoyuan, Taiwan
| | - Yu-Ling Jhuang
- Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taiwan, Taiwan
| | - Ya-Yun Chang
- Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taiwan, Taiwan
| | - Hung-Pin Hsu
- Division of Cardiology, Department of Internal Medicine, Taipei City Hospital, Taipei, Taiwan
| | - Yung-Ming Jeng
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taiwan, Taiwan
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31
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Abstract
Somatic mutations in PRKACA, coding for the catalytic α subunit of protein kinase A (PKA), have been recently identified as the most frequent genetic alteration in cortisol-secreting adrenocortical adenomas, which are responsible for adrenal Cushing's syndrome. The mutations identified so far lie at the interface between the catalytic (C) and regulatory (R) subunit of PKA. Detailed functional studies of the most frequent of these mutations (L206R) as well as of another one in the same region of the C subunit (199_200insW) have revealed that these mutations cause constitutive activation of PKA and lack of regulation by cAMP. This is due to interference with the binding of the R subunit, which keeps the C subunit inactive in the absence of cyclic AMP. Here, we review these recent findings, with a particular focus on the mechanisms of action of PRKACA mutations.
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Affiliation(s)
- D Calebiro
- Institute of Pharmacology and Toxicology, University Hospital, University of Würzburg, Würzburg, Germany
| | - K Bathon
- Institute of Pharmacology and Toxicology, University Hospital, University of Würzburg, Würzburg, Germany
| | - I Weigand
- Department of Medicine I, Endocrine and Diabetes Unit, University Hospital, University of Würzburg, Würzburg, Germany
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32
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Abstract
Untargeted, next generation sequencing approaches have provided deep insights into genetic events that result in unopposed steroidogenesis from the adrenal cortex. In particular, somatic mutations in the gene encoding the catalytic subunit α of protein kinase A (PKA) (PRKACA) were identified independently by several groups as the most frequently altered gene in cortisol-producing adenomas. Detailed functional studies could explore the molecular consequences of these hot-spot mutations and large international cohorts have provided the basis to explore the clinical characteristics associated with this mutation. Thereby, PRKACA mutations are highly specific for cortisol over-secretion, while they are absent or very rare in the context of other adrenal diseases. Patients carrying these somatic mutations are affected by a more severe phenotype and are identified at a younger age. Thus, these genotype/phenotype correlations provide further evidence for the importance of PKA-dependent pathways for adrenal physiology and disease.
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Affiliation(s)
- G D Dalmazi
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, München, Germany
| | - F Beuschlein
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, München, Germany
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33
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Weigand I, Ronchi CL, Rizk-Rabin M, Dalmazi GD, Wild V, Bathon K, Rubin B, Calebiro D, Beuschlein F, Bertherat J, Fassnacht M, Sbiera S. Differential expression of the protein kinase A subunits in normal adrenal glands and adrenocortical adenomas. Sci Rep 2017; 7:49. [PMID: 28250426 PMCID: PMC5427838 DOI: 10.1038/s41598-017-00125-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 02/08/2017] [Indexed: 11/09/2022] Open
Abstract
Somatic mutations in protein kinase A catalytic α subunit (PRKACA) were found to be causative for 30-40% of cortisol-producing adenomas (CPA) of the adrenal gland, rendering PKA signalling constitutively active. In its resting state, PKA is a stable and inactive heterotetramer, consisting of two catalytic and two regulatory subunits with the latter inhibiting PKA activity. The human genome encodes three different PKA catalytic subunits and four different regulatory subunits that are preferentially expressed in different organs. In normal adrenal glands all regulatory subunits are expressed, while CPA exhibit reduced protein levels of the regulatory subunit IIβ. In this study, we linked for the first time the loss of RIIβ protein levels to the PRKACA mutation status and found the down-regulation of RIIβ to arise post-transcriptionally. We further found the PKA subunit expression pattern of different tumours is also present in the zones of the normal adrenal cortex and demonstrate that the different PKA subunits have a differential expression pattern in each zone of the normal adrenal gland, indicating potential specific roles of these subunits in the regulation of different hormones secretion.
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Affiliation(s)
- Isabel Weigand
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, Wuerzburg, Germany
| | - Cristina L Ronchi
- Comprehensive Cancer Center Mainfranken, University of Wuerzburg, Wuerzburg, Germany
| | - Marthe Rizk-Rabin
- Institut Cochin, INSERM U1016, CNRS UMR810, Department of Endocrinology, Reference Center for Rare Adrenal diseases, Assistance Publique Hôpiteaux de Paris, Hôpital Cochin, Descartes University, Paris, France
| | - Guido Di Dalmazi
- Medizinische Klinik and Poliklinik IV, Ludwig-Maximilians University, Munich, Germany
| | - Vanessa Wild
- Institute of Pathology, University of Wuerzburg, Wuerzburg, Germany
| | - Kerstin Bathon
- Institute of Pharmacology and Toxicology and Bioimaging Center, University of Wuerzburg, Wuerzburg, Germany
| | - Beatrice Rubin
- Endocrinology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Davide Calebiro
- Institute of Pharmacology and Toxicology and Bioimaging Center, University of Wuerzburg, Wuerzburg, Germany
| | - Felix Beuschlein
- Medizinische Klinik and Poliklinik IV, Ludwig-Maximilians University, Munich, Germany
| | - Jérôme Bertherat
- Institut Cochin, INSERM U1016, CNRS UMR810, Department of Endocrinology, Reference Center for Rare Adrenal diseases, Assistance Publique Hôpiteaux de Paris, Hôpital Cochin, Descartes University, Paris, France
| | - Martin Fassnacht
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, Wuerzburg, Germany.,Comprehensive Cancer Center Mainfranken, University of Wuerzburg, Wuerzburg, Germany.,Central Laboratory, University Hospital, University of Wuerzburg, Wuerzburg, Germany
| | - Silviu Sbiera
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, Wuerzburg, Germany. .,Comprehensive Cancer Center Mainfranken, University of Wuerzburg, Wuerzburg, Germany.
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34
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Goyal Y, Jindal GA, Pelliccia JL, Yamaya K, Yeung E, Futran AS, Burdine RD, Schüpbach T, Shvartsman SY. Divergent effects of intrinsically active MEK variants on developmental Ras signaling. Nat Genet 2017; 49:465-469. [PMID: 28166211 PMCID: PMC5621734 DOI: 10.1038/ng.3780] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 12/30/2016] [Indexed: 12/16/2022]
Abstract
Germline mutations in Ras pathway components are associated with a large class of human developmental abnormalities, known as RASopathies, that are characterized by a range of structural and functional phenotypes, including cardiac defects and neurocognitive delays. Although it is generally believed that RASopathies are caused by altered levels of pathway activation, the signaling changes in developing tissues remain largely unknown. We used assays with spatiotemporal resolution in Drosophila melanogaster (fruit fly) and Danio rerio (zebrafish) to quantify signaling changes caused by mutations in MAP2K1 (encoding MEK), a core component of the Ras pathway that is mutated in both RASopathies and cancers in humans. Surprisingly, we discovered that intrinsically active MEK variants can both increase and reduce the levels of pathway activation in vivo. The sign of the effect depends on cellular context, implying that some of the emerging phenotypes in RASopathies may be caused by increased, as well as attenuated, levels of Ras signaling.
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Affiliation(s)
- Yogesh Goyal
- Department of Chemical and Biological Engineering, Princeton University, Princeton, NJ 08544
- The Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ 08544
| | - Granton A. Jindal
- Department of Chemical and Biological Engineering, Princeton University, Princeton, NJ 08544
- The Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ 08544
- Department of Molecular Biology, Princeton University, Princeton, NJ 08544
| | - José L. Pelliccia
- Department of Molecular Biology, Princeton University, Princeton, NJ 08544
| | - Kei Yamaya
- The Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ 08544
- Department of Molecular Biology, Princeton University, Princeton, NJ 08544
| | - Eyan Yeung
- The Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ 08544
- Department of Molecular Biology, Princeton University, Princeton, NJ 08544
| | - Alan S. Futran
- Department of Chemical and Biological Engineering, Princeton University, Princeton, NJ 08544
- The Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ 08544
| | - Rebecca D. Burdine
- Department of Molecular Biology, Princeton University, Princeton, NJ 08544
| | - Trudi Schüpbach
- Department of Molecular Biology, Princeton University, Princeton, NJ 08544
| | - Stanislav Y. Shvartsman
- Department of Chemical and Biological Engineering, Princeton University, Princeton, NJ 08544
- The Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ 08544
- Department of Molecular Biology, Princeton University, Princeton, NJ 08544
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35
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Lubner JM, Dodge-Kafka KL, Carlson CR, Church GM, Chou MF, Schwartz D. Cushing's syndrome mutant PKA L205R exhibits altered substrate specificity. FEBS Lett 2017; 591:459-467. [PMID: 28100013 DOI: 10.1002/1873-3468.12562] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/10/2017] [Accepted: 01/12/2017] [Indexed: 12/22/2022]
Abstract
The PKAL205R hotspot mutation has been implicated in Cushing's syndrome through hyperactive gain-of-function PKA signaling; however, its influence on substrate specificity has not been investigated. Here, we employ the Proteomic Peptide Library (ProPeL) approach to create high-resolution models for PKAWT and PKAL205R substrate specificity. We reveal that the L205R mutation reduces canonical hydrophobic preference at the substrate P + 1 position, and increases acidic preference in downstream positions. Using these models, we designed peptide substrates that exhibit altered selectivity for specific PKA variants, and demonstrate the feasibility of selective PKAL205R loss-of-function signaling. Through these results, we suggest that substrate rewiring may contribute to Cushing's syndrome disease etiology, and introduce a powerful new paradigm for investigating mutation-induced kinase substrate rewiring in human disease.
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Affiliation(s)
- Joshua M Lubner
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, CT, USA
| | - Kimberly L Dodge-Kafka
- Pat and Jim Calhoun Center for Cardiology, Department of Cell Biology, University of Connecticut Health Center, Farmington, CT, USA
| | - Cathrine R Carlson
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Norway
| | - George M Church
- Department of Genetics, Harvard Medical School, Boston, MA, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - Michael F Chou
- Department of Genetics, Harvard Medical School, Boston, MA, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - Daniel Schwartz
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, CT, USA
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36
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Ronchi CL, Di Dalmazi G, Faillot S, Sbiera S, Assié G, Weigand I, Calebiro D, Schwarzmayr T, Appenzeller S, Rubin B, Waldmann J, Scaroni C, Bartsch DK, Mantero F, Mannelli M, Kastelan D, Chiodini I, Bertherat J, Reincke M, Strom TM, Fassnacht M, Beuschlein F. Genetic Landscape of Sporadic Unilateral Adrenocortical Adenomas Without PRKACA p.Leu206Arg Mutation. J Clin Endocrinol Metab 2016; 101:3526-38. [PMID: 27389594 DOI: 10.1210/jc.2016-1586] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Adrenocortical adenomas (ACAs) are among the most frequent human neoplasias. Genetic alterations affecting the cAMP/protein kinase A signaling pathway are common in cortisol-producing ACAs, whereas activating mutations in the gene encoding β-catenin (CTNNB1) have been reported in a subset of both benign and malignant adrenocortical tumors. However, the molecular pathogenesis of most ACAs is still largely unclear. OBJECTIVE The aim of the study was to define the genetic landscape of sporadic unilateral ACAs. DESIGN AND SETTING Next-generation whole-exome sequencing was performed on fresh-frozen tumor samples and corresponding normal tissue samples. PATIENTS Ninety-nine patients with ACAs (74 cortisol-producing and 25 endocrine inactive) negative for p.Leu206Arg PRKACA mutation. MAIN OUTCOME MEASURES Identification of known and/or new genetic alterations potentially involved in adrenocortical tumorigenesis and autonomous hormone secretion, genotype-phenotype correlation. RESULTS A total of 706 somatic protein-altering mutations were detected in 88 of 99 tumors (median, six per tumor). We identified several mutations in genes of the cAMP/protein kinase A pathway, including three novel mutations in PRKACA, associated with female sex and Cushing's syndrome. We also found genetic alterations in different genes involved in the Wnt/β-catenin pathway, associated with larger tumors and endocrine inactivity, and notably, in many genes of the Ca(2+)-signaling pathway. Finally, by comparison of our genetic data with those available in the literature, we describe a comprehensive genetic landscape of unilateral ACAs. CONCLUSIONS This study provides the largest sequencing effort on ACAs to date. We thereby identified somatic alterations affecting known and novel pathways potentially involved in adrenal tumorigenesis.
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Affiliation(s)
- Cristina L Ronchi
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Guido Di Dalmazi
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Simon Faillot
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Silviu Sbiera
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Guillaume Assié
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Isabel Weigand
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Davide Calebiro
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Thomas Schwarzmayr
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Silke Appenzeller
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Beatrice Rubin
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Jens Waldmann
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Carla Scaroni
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Detlef K Bartsch
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Franco Mantero
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Massimo Mannelli
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Darko Kastelan
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Iacopo Chiodini
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Jerome Bertherat
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Martin Reincke
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Tim M Strom
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Martin Fassnacht
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
| | - Felix Beuschlein
- Department of Internal Medicine I (C.L.R., I.W., M.F.), Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, 97080 Wuerzburg, Germany; Medizinische Klinik und Poliklinik IV (G.D.D., M.R., F.B.), Klinikum der Universitaet Muenchen, 80337 Munich, Germany; Comprehensive Cancer Center Mainfranken (S.S., S.A., M.F.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institut Cochin, Inserm U1016 (S.F., G.A., J.B.), CNRS UMR8104, Descartes University, 75006 Paris, France; Department of Endocrinology (S.F., G.A., J.B.), Reference Center for Rare Adrenal Diseases, Hôpital Cochin, 75014 Paris, France; Institute of Pharmacology and Toxicology and Bio-Imaging Center/Rudolf Virchow Center (D.C.), University of Wuerzburg, 97080 Wuerzburg, Germany; Institute of Human Genetics (T.S., T.M.S.), Helmholtz Zentrum Munich, 85764 Neuherberg, Germany; Core Unit System Medicine University of Wuerzburg (S.A.), 97080 Wuerzburg, Germany; Endocrinology Unit (B.R., C.S., F.M.), University Hospital of Padua, 35122 Padua, Italy; Department of Visceral, Thoracic, and Vascular Surgery (J.W., D.K.B.), University Hospital Giessen and Marburg, 35043 Marburg, Germany; Endocrinology Unit (M.M.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50121 Florence, Italy; Department of Endocrinology (D.K.), University Hospital Centre Zagreb, 10000 Zagreb, Croatia; Unit of Endocrinology and Metabolic Diseases (I.C.), Fondazione IRCCS Cá Granda-Ospedale Maggiore Policlinico, 20122 Milan, Italy; Institute of Human Genetics (T.M.S.), Technische Universität Munich, 80333 Munich, Germany; and Central Laboratory (M.F.), Research Unit, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
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37
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Rhayem Y, Perez-Rivas LG, Dietz A, Bathon K, Gebhard C, Riester A, Mauracher B, Gomez-Sanchez C, Eisenhofer G, Schwarzmayr T, Calebiro D, Strom TM, Reincke M, Beuschlein F. PRKACA Somatic Mutations Are Rare Findings in Aldosterone-Producing Adenomas. J Clin Endocrinol Metab 2016; 101:3010-7. [PMID: 27270477 DOI: 10.1210/jc.2016-1700] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
CONTEXT Somatic mutations have been found causative for endocrine autonomy in aldosterone-producing adenomas (APAs). Whereas mutations of PRKACA (catalytic subunit of protein kinase A) have been identified in cortisol-producing adenomas, the presence of PRKACA variants in APAs is unknown, especially in those that display cosecretion of cortisol. OBJECTIVE The objective of the study was to investigate PRKACA somatic variants identified in APA cases. DESIGN Identification of PRKACA somatic variants in APAs by whole-exome sequencing followed by in vitro analysis of the enzymatic activity of PRKACA variants and functional characterization by double immunofluorescence of CYP11B2 and CYP11B1 expression in the corresponding tumor tissues. SETTING AND PATIENTS APA tissues were collected from 122 patients who underwent unilateral adrenalectomy for primary aldosteronism between 2005 and 2015 at a single institution. RESULTS PRKACA somatic mutations were identified in two APA cases (1.6%). One APA carried a newly identified p.His88Asp variant, whereas in a second case, a p.Leu206Arg mutation was found, previously described only in cortisol-producing adenomas with overt Cushing's syndrome. Functional analysis showed that the p.His88Asp variant was not associated with gain of function. Although CYP11B2 was strongly expressed in the p.His88Asp-mutated APA, the p.Leu206Arg carrying APA predominantly expressed CYP11B1. Accordingly, biochemical Cushing's syndrome was present only in the patient with the p.Leu206Arg mutation. After adrenalectomy, both patients improved with a reduced number of antihypertensive medications and normalized serum potassium levels. CONCLUSIONS We describe for the first time PRKACA mutations as rare findings associated with unilateral primary aldosteronism. As cortisol cosecretion occurs in a subgroup of APAs, other molecular mechanisms are likely to exist.
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Affiliation(s)
- Yara Rhayem
- Department of Endocrine Research (Y.R., L.G.P.-R., A.D., C.G., A.R., B.M., M.R., F.B.), Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, D-80336 Munich, Germany; Institute of Pharmacology and Toxicology (K.B., D.C.) and Rudolf Virchow Center for Experimental Biomedicine (D.C.), University of Würzburg, D-97070 Würzburg, Germany; Division of Endocrinology (C.G.-S.), G.V. (Sonny) Montgomery Veterans Affairs Medical Center, and Department of Medicine-Endocrinology (C.G.-S.), University of Mississippi Medical Center, Jackson, Mississippi 39216; Institute of Clinical Chemistry and Laboratory Medicine and Department of Medicine III (G.E.) and Institute of Human Genetics (T.S.), Technische Universität Dresden, D-01307 Dresden, Germany; and Institute of Human Genetics (T.S.), Helmholtz Zentrum München, D-85764 Munich, Germany
| | - Luis G Perez-Rivas
- Department of Endocrine Research (Y.R., L.G.P.-R., A.D., C.G., A.R., B.M., M.R., F.B.), Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, D-80336 Munich, Germany; Institute of Pharmacology and Toxicology (K.B., D.C.) and Rudolf Virchow Center for Experimental Biomedicine (D.C.), University of Würzburg, D-97070 Würzburg, Germany; Division of Endocrinology (C.G.-S.), G.V. (Sonny) Montgomery Veterans Affairs Medical Center, and Department of Medicine-Endocrinology (C.G.-S.), University of Mississippi Medical Center, Jackson, Mississippi 39216; Institute of Clinical Chemistry and Laboratory Medicine and Department of Medicine III (G.E.) and Institute of Human Genetics (T.S.), Technische Universität Dresden, D-01307 Dresden, Germany; and Institute of Human Genetics (T.S.), Helmholtz Zentrum München, D-85764 Munich, Germany
| | - Anna Dietz
- Department of Endocrine Research (Y.R., L.G.P.-R., A.D., C.G., A.R., B.M., M.R., F.B.), Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, D-80336 Munich, Germany; Institute of Pharmacology and Toxicology (K.B., D.C.) and Rudolf Virchow Center for Experimental Biomedicine (D.C.), University of Würzburg, D-97070 Würzburg, Germany; Division of Endocrinology (C.G.-S.), G.V. (Sonny) Montgomery Veterans Affairs Medical Center, and Department of Medicine-Endocrinology (C.G.-S.), University of Mississippi Medical Center, Jackson, Mississippi 39216; Institute of Clinical Chemistry and Laboratory Medicine and Department of Medicine III (G.E.) and Institute of Human Genetics (T.S.), Technische Universität Dresden, D-01307 Dresden, Germany; and Institute of Human Genetics (T.S.), Helmholtz Zentrum München, D-85764 Munich, Germany
| | - Kerstin Bathon
- Department of Endocrine Research (Y.R., L.G.P.-R., A.D., C.G., A.R., B.M., M.R., F.B.), Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, D-80336 Munich, Germany; Institute of Pharmacology and Toxicology (K.B., D.C.) and Rudolf Virchow Center for Experimental Biomedicine (D.C.), University of Würzburg, D-97070 Würzburg, Germany; Division of Endocrinology (C.G.-S.), G.V. (Sonny) Montgomery Veterans Affairs Medical Center, and Department of Medicine-Endocrinology (C.G.-S.), University of Mississippi Medical Center, Jackson, Mississippi 39216; Institute of Clinical Chemistry and Laboratory Medicine and Department of Medicine III (G.E.) and Institute of Human Genetics (T.S.), Technische Universität Dresden, D-01307 Dresden, Germany; and Institute of Human Genetics (T.S.), Helmholtz Zentrum München, D-85764 Munich, Germany
| | - Christian Gebhard
- Department of Endocrine Research (Y.R., L.G.P.-R., A.D., C.G., A.R., B.M., M.R., F.B.), Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, D-80336 Munich, Germany; Institute of Pharmacology and Toxicology (K.B., D.C.) and Rudolf Virchow Center for Experimental Biomedicine (D.C.), University of Würzburg, D-97070 Würzburg, Germany; Division of Endocrinology (C.G.-S.), G.V. (Sonny) Montgomery Veterans Affairs Medical Center, and Department of Medicine-Endocrinology (C.G.-S.), University of Mississippi Medical Center, Jackson, Mississippi 39216; Institute of Clinical Chemistry and Laboratory Medicine and Department of Medicine III (G.E.) and Institute of Human Genetics (T.S.), Technische Universität Dresden, D-01307 Dresden, Germany; and Institute of Human Genetics (T.S.), Helmholtz Zentrum München, D-85764 Munich, Germany
| | - Anna Riester
- Department of Endocrine Research (Y.R., L.G.P.-R., A.D., C.G., A.R., B.M., M.R., F.B.), Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, D-80336 Munich, Germany; Institute of Pharmacology and Toxicology (K.B., D.C.) and Rudolf Virchow Center for Experimental Biomedicine (D.C.), University of Würzburg, D-97070 Würzburg, Germany; Division of Endocrinology (C.G.-S.), G.V. (Sonny) Montgomery Veterans Affairs Medical Center, and Department of Medicine-Endocrinology (C.G.-S.), University of Mississippi Medical Center, Jackson, Mississippi 39216; Institute of Clinical Chemistry and Laboratory Medicine and Department of Medicine III (G.E.) and Institute of Human Genetics (T.S.), Technische Universität Dresden, D-01307 Dresden, Germany; and Institute of Human Genetics (T.S.), Helmholtz Zentrum München, D-85764 Munich, Germany
| | - Brigitte Mauracher
- Department of Endocrine Research (Y.R., L.G.P.-R., A.D., C.G., A.R., B.M., M.R., F.B.), Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, D-80336 Munich, Germany; Institute of Pharmacology and Toxicology (K.B., D.C.) and Rudolf Virchow Center for Experimental Biomedicine (D.C.), University of Würzburg, D-97070 Würzburg, Germany; Division of Endocrinology (C.G.-S.), G.V. (Sonny) Montgomery Veterans Affairs Medical Center, and Department of Medicine-Endocrinology (C.G.-S.), University of Mississippi Medical Center, Jackson, Mississippi 39216; Institute of Clinical Chemistry and Laboratory Medicine and Department of Medicine III (G.E.) and Institute of Human Genetics (T.S.), Technische Universität Dresden, D-01307 Dresden, Germany; and Institute of Human Genetics (T.S.), Helmholtz Zentrum München, D-85764 Munich, Germany
| | - Celso Gomez-Sanchez
- Department of Endocrine Research (Y.R., L.G.P.-R., A.D., C.G., A.R., B.M., M.R., F.B.), Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, D-80336 Munich, Germany; Institute of Pharmacology and Toxicology (K.B., D.C.) and Rudolf Virchow Center for Experimental Biomedicine (D.C.), University of Würzburg, D-97070 Würzburg, Germany; Division of Endocrinology (C.G.-S.), G.V. (Sonny) Montgomery Veterans Affairs Medical Center, and Department of Medicine-Endocrinology (C.G.-S.), University of Mississippi Medical Center, Jackson, Mississippi 39216; Institute of Clinical Chemistry and Laboratory Medicine and Department of Medicine III (G.E.) and Institute of Human Genetics (T.S.), Technische Universität Dresden, D-01307 Dresden, Germany; and Institute of Human Genetics (T.S.), Helmholtz Zentrum München, D-85764 Munich, Germany
| | - Graeme Eisenhofer
- Department of Endocrine Research (Y.R., L.G.P.-R., A.D., C.G., A.R., B.M., M.R., F.B.), Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, D-80336 Munich, Germany; Institute of Pharmacology and Toxicology (K.B., D.C.) and Rudolf Virchow Center for Experimental Biomedicine (D.C.), University of Würzburg, D-97070 Würzburg, Germany; Division of Endocrinology (C.G.-S.), G.V. (Sonny) Montgomery Veterans Affairs Medical Center, and Department of Medicine-Endocrinology (C.G.-S.), University of Mississippi Medical Center, Jackson, Mississippi 39216; Institute of Clinical Chemistry and Laboratory Medicine and Department of Medicine III (G.E.) and Institute of Human Genetics (T.S.), Technische Universität Dresden, D-01307 Dresden, Germany; and Institute of Human Genetics (T.S.), Helmholtz Zentrum München, D-85764 Munich, Germany
| | - Thomas Schwarzmayr
- Department of Endocrine Research (Y.R., L.G.P.-R., A.D., C.G., A.R., B.M., M.R., F.B.), Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, D-80336 Munich, Germany; Institute of Pharmacology and Toxicology (K.B., D.C.) and Rudolf Virchow Center for Experimental Biomedicine (D.C.), University of Würzburg, D-97070 Würzburg, Germany; Division of Endocrinology (C.G.-S.), G.V. (Sonny) Montgomery Veterans Affairs Medical Center, and Department of Medicine-Endocrinology (C.G.-S.), University of Mississippi Medical Center, Jackson, Mississippi 39216; Institute of Clinical Chemistry and Laboratory Medicine and Department of Medicine III (G.E.) and Institute of Human Genetics (T.S.), Technische Universität Dresden, D-01307 Dresden, Germany; and Institute of Human Genetics (T.S.), Helmholtz Zentrum München, D-85764 Munich, Germany
| | - Davide Calebiro
- Department of Endocrine Research (Y.R., L.G.P.-R., A.D., C.G., A.R., B.M., M.R., F.B.), Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, D-80336 Munich, Germany; Institute of Pharmacology and Toxicology (K.B., D.C.) and Rudolf Virchow Center for Experimental Biomedicine (D.C.), University of Würzburg, D-97070 Würzburg, Germany; Division of Endocrinology (C.G.-S.), G.V. (Sonny) Montgomery Veterans Affairs Medical Center, and Department of Medicine-Endocrinology (C.G.-S.), University of Mississippi Medical Center, Jackson, Mississippi 39216; Institute of Clinical Chemistry and Laboratory Medicine and Department of Medicine III (G.E.) and Institute of Human Genetics (T.S.), Technische Universität Dresden, D-01307 Dresden, Germany; and Institute of Human Genetics (T.S.), Helmholtz Zentrum München, D-85764 Munich, Germany
| | - Tim M Strom
- Department of Endocrine Research (Y.R., L.G.P.-R., A.D., C.G., A.R., B.M., M.R., F.B.), Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, D-80336 Munich, Germany; Institute of Pharmacology and Toxicology (K.B., D.C.) and Rudolf Virchow Center for Experimental Biomedicine (D.C.), University of Würzburg, D-97070 Würzburg, Germany; Division of Endocrinology (C.G.-S.), G.V. (Sonny) Montgomery Veterans Affairs Medical Center, and Department of Medicine-Endocrinology (C.G.-S.), University of Mississippi Medical Center, Jackson, Mississippi 39216; Institute of Clinical Chemistry and Laboratory Medicine and Department of Medicine III (G.E.) and Institute of Human Genetics (T.S.), Technische Universität Dresden, D-01307 Dresden, Germany; and Institute of Human Genetics (T.S.), Helmholtz Zentrum München, D-85764 Munich, Germany
| | - Martin Reincke
- Department of Endocrine Research (Y.R., L.G.P.-R., A.D., C.G., A.R., B.M., M.R., F.B.), Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, D-80336 Munich, Germany; Institute of Pharmacology and Toxicology (K.B., D.C.) and Rudolf Virchow Center for Experimental Biomedicine (D.C.), University of Würzburg, D-97070 Würzburg, Germany; Division of Endocrinology (C.G.-S.), G.V. (Sonny) Montgomery Veterans Affairs Medical Center, and Department of Medicine-Endocrinology (C.G.-S.), University of Mississippi Medical Center, Jackson, Mississippi 39216; Institute of Clinical Chemistry and Laboratory Medicine and Department of Medicine III (G.E.) and Institute of Human Genetics (T.S.), Technische Universität Dresden, D-01307 Dresden, Germany; and Institute of Human Genetics (T.S.), Helmholtz Zentrum München, D-85764 Munich, Germany
| | - Felix Beuschlein
- Department of Endocrine Research (Y.R., L.G.P.-R., A.D., C.G., A.R., B.M., M.R., F.B.), Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, D-80336 Munich, Germany; Institute of Pharmacology and Toxicology (K.B., D.C.) and Rudolf Virchow Center for Experimental Biomedicine (D.C.), University of Würzburg, D-97070 Würzburg, Germany; Division of Endocrinology (C.G.-S.), G.V. (Sonny) Montgomery Veterans Affairs Medical Center, and Department of Medicine-Endocrinology (C.G.-S.), University of Mississippi Medical Center, Jackson, Mississippi 39216; Institute of Clinical Chemistry and Laboratory Medicine and Department of Medicine III (G.E.) and Institute of Human Genetics (T.S.), Technische Universität Dresden, D-01307 Dresden, Germany; and Institute of Human Genetics (T.S.), Helmholtz Zentrum München, D-85764 Munich, Germany
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38
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Zheng S, Cherniack AD, Dewal N, Moffitt RA, Danilova L, Murray BA, Lerario AM, Else T, Knijnenburg TA, Ciriello G, Kim S, Assie G, Morozova O, Akbani R, Shih J, Hoadley KA, Choueiri TK, Waldmann J, Mete O, Robertson AG, Wu HT, Raphael BJ, Shao L, Meyerson M, Demeure MJ, Beuschlein F, Gill AJ, Sidhu SB, Almeida MQ, Fragoso MCBV, Cope LM, Kebebew E, Habra MA, Whitsett TG, Bussey KJ, Rainey WE, Asa SL, Bertherat J, Fassnacht M, Wheeler DA, Hammer GD, Giordano TJ, Verhaak RGW. Comprehensive Pan-Genomic Characterization of Adrenocortical Carcinoma. Cancer Cell 2016; 29:723-736. [PMID: 27165744 PMCID: PMC4864952 DOI: 10.1016/j.ccell.2016.04.002] [Citation(s) in RCA: 375] [Impact Index Per Article: 46.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 12/08/2015] [Accepted: 04/05/2016] [Indexed: 01/08/2023]
Abstract
We describe a comprehensive genomic characterization of adrenocortical carcinoma (ACC). Using this dataset, we expand the catalogue of known ACC driver genes to include PRKAR1A, RPL22, TERF2, CCNE1, and NF1. Genome wide DNA copy-number analysis revealed frequent occurrence of massive DNA loss followed by whole-genome doubling (WGD), which was associated with aggressive clinical course, suggesting WGD is a hallmark of disease progression. Corroborating this hypothesis were increased TERT expression, decreased telomere length, and activation of cell-cycle programs. Integrated subtype analysis identified three ACC subtypes with distinct clinical outcome and molecular alterations which could be captured by a 68-CpG probe DNA-methylation signature, proposing a strategy for clinical stratification of patients based on molecular markers.
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Affiliation(s)
- Siyuan Zheng
- Departments of Genomic Medicine, Bioinformatics, and Computational Biology, Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Andrew D Cherniack
- The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA 02142, USA; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA
| | - Ninad Dewal
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Richard A Moffitt
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Ludmila Danilova
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD 21287, USA
| | - Bradley A Murray
- The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA 02142, USA; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA
| | - Antonio M Lerario
- Unidade de Suprarrenal, Laboratório de Hormônios e Genética Molecular LIM42, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil; Departments of Cell & Developmental Biology, Pathology, Molecular & Integrative Physiology, Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA; University of Michigan Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA
| | - Tobias Else
- Departments of Cell & Developmental Biology, Pathology, Molecular & Integrative Physiology, Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA; University of Michigan Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA
| | | | - Giovanni Ciriello
- Department of Computational Biology, University of Lausanne, Rue du Bugnon 27, 1005 Lausanne, Switzerland; Computational Biology Center, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Seungchan Kim
- Translational Genomics Research Institute, Phoenix, AZ 85004, USA
| | - Guillaume Assie
- Inserm U1016, CNRS UMR 8104, Institut Cochin, 75014 Paris, France; Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; Department of Endocrinology, Referral Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, 75014 Paris, France; European Network for the Study of Adrenal Tumors, 75014 Paris, France
| | - Olena Morozova
- University of California Santa Cruz Genomics Institute, University California Santa Cruz, Santa Cruz, CA 95064, USA
| | - Rehan Akbani
- Departments of Genomic Medicine, Bioinformatics, and Computational Biology, Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Juliann Shih
- The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA 02142, USA; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA
| | - Katherine A Hoadley
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Toni K Choueiri
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA; Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Jens Waldmann
- European Network for the Study of Adrenal Tumors, 75014 Paris, France; Department of Visceral, Thoracic and Vascular Surgery, University Hospital Giessen and Marburg, Campus Marburg, General Surgery, Endocrine Center, 34501 Marburg, Germany
| | - Ozgur Mete
- Department of Laboratory Medicine and Pathobiology, University Health Network, Toronto, ON M5G 2C4, Canada
| | - A Gordon Robertson
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Agency, Vancouver, BC V5Z 4S6, Canada
| | - Hsin-Ta Wu
- Department of Computer Science, Brown University, Providence, RI 02906, USA
| | - Benjamin J Raphael
- Department of Computer Science, Brown University, Providence, RI 02906, USA
| | - Lina Shao
- Departments of Cell & Developmental Biology, Pathology, Molecular & Integrative Physiology, Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Matthew Meyerson
- The Eli and Edythe L. Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA 02142, USA; Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA; Department of Pathology, Harvard Medical School, Boston, MA 02215, USA
| | | | - Felix Beuschlein
- European Network for the Study of Adrenal Tumors, 75014 Paris, France; Endocrine Research Unit, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, 80336 Munich, Germany
| | - Anthony J Gill
- Cancer Diagnosis and Pathology Group and Cancer Genetics Laboratory, Kolling Institute of Medical Research, University of Sydney, Sydney, NSW 2006, Australia; Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Stan B Sidhu
- Cancer Diagnosis and Pathology Group and Cancer Genetics Laboratory, Kolling Institute of Medical Research, University of Sydney, Sydney, NSW 2006, Australia; Endocrine Surgical Unit, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Madson Q Almeida
- Unidade de Suprarrenal, Laboratório de Hormônios e Genética Molecular LIM42, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil; Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil
| | - Maria C B V Fragoso
- Unidade de Suprarrenal, Laboratório de Hormônios e Genética Molecular LIM42, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil; Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-900, Brazil
| | - Leslie M Cope
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD 21287, USA
| | - Electron Kebebew
- Endocrine Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Mouhammed A Habra
- Departments of Genomic Medicine, Bioinformatics, and Computational Biology, Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | - Kimberly J Bussey
- Translational Genomics Research Institute, Phoenix, AZ 85004, USA; NantOmics, LLC, The Biodesign Institute, Arizona State University, Tempe, AZ 85287-5001, USA
| | - William E Rainey
- Departments of Cell & Developmental Biology, Pathology, Molecular & Integrative Physiology, Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA; University of Michigan Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA
| | - Sylvia L Asa
- Department of Laboratory Medicine and Pathobiology, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Jérôme Bertherat
- Inserm U1016, CNRS UMR 8104, Institut Cochin, 75014 Paris, France; Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; Department of Endocrinology, Referral Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, 75014 Paris, France; European Network for the Study of Adrenal Tumors, 75014 Paris, France
| | - Martin Fassnacht
- European Network for the Study of Adrenal Tumors, 75014 Paris, France; Endocrine and Diabetes Unit, Department of Internal Medicine I, University Hospital Würzburg, 97080 Würzburg, Germany; Comprehensive Cancer Center Mainfranken, University of Würzburg, 97080 Würzburg, Germany
| | - David A Wheeler
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Gary D Hammer
- Departments of Cell & Developmental Biology, Pathology, Molecular & Integrative Physiology, Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA; University of Michigan Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA
| | - Thomas J Giordano
- Departments of Cell & Developmental Biology, Pathology, Molecular & Integrative Physiology, Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA; University of Michigan Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Roel G W Verhaak
- Departments of Genomic Medicine, Bioinformatics, and Computational Biology, Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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Abstract
Primary adrenal Cushing syndrome is the result of cortisol hypersecretion mainly by adenomas and, rarely, by bilateral micronodular or macronodular adrenocortical hyperplasia. cAMP-dependent protein kinase A (PKA) signalling is the major activator of cortisol secretion in the adrenal cortex. Many adenomas and hyperplasias associated with primary hypercortisolism carry somatic or germline mutations in genes that encode constituents of the cAMP-PKA pathway. In this Review, we discuss Cushing syndrome and its linkage to dysregulated cAMP-PKA signalling, with a focus on genetic findings in the past few years. In addition, we discuss the presence of germline inactivating mutations in ARMC5 in patients with primary bilateral macronodular adrenocortical hyperplasia. This finding has implications for genetic counselling of affected patients; hitherto, most patients with this form of adrenal hyperplasia and Cushing syndrome were thought to have a sporadic and not a familial disorder.
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Affiliation(s)
- Maya Lodish
- Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health Clinical Research Center, 10 Center Drive, Building 10, Room 1-3330, MSC1103, Bethesda, Maryland 20892, USA
| | - Constantine A Stratakis
- Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health Clinical Research Center, 31 Center Drive, Building 31, Room 2A46, MSC2425, Bethesda, Maryland 20892 USA
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40
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Lee SR, Sang L, Yue DT. Uncovering Aberrant Mutant PKA Function with Flow Cytometric FRET. Cell Rep 2016; 14:3019-29. [PMID: 26997269 DOI: 10.1016/j.celrep.2016.02.077] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 01/16/2016] [Accepted: 02/21/2016] [Indexed: 10/22/2022] Open
Abstract
Biology has been revolutionized by tools that allow the detection and characterization of protein-protein interactions (PPIs). Förster resonance energy transfer (FRET)-based methods have become particularly attractive as they allow quantitative studies of PPIs within the convenient and relevant context of living cells. We describe here an approach that allows the rapid construction of live-cell FRET-based binding curves using a commercially available flow cytometer. We illustrate a simple method for absolutely calibrating the cytometer, validating our binding assay against the gold standard isothermal calorimetry (ITC), and using flow cytometric FRET to uncover the structural and functional effects of the Cushing-syndrome-causing mutation (L206R) on PKA's catalytic subunit. We discover that this mutation not only differentially affects PKAcat's binding to its multiple partners but also impacts its rate of catalysis. These findings improve our mechanistic understanding of this disease-causing mutation, while illustrating the simplicity, general applicability, and power of flow cytometric FRET.
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Affiliation(s)
- Shin-Rong Lee
- Calcium Signals Laboratory, Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Ross Building, Room 713, 720 Rutland Avenue, Baltimore, MD 21205, USA.
| | - Lingjie Sang
- Calcium Signals Laboratory, Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Ross Building, Room 713, 720 Rutland Avenue, Baltimore, MD 21205, USA
| | - David T Yue
- Calcium Signals Laboratory, Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Ross Building, Room 713, 720 Rutland Avenue, Baltimore, MD 21205, USA; Department of Neuroscience, The Johns Hopkins University School of Medicine, Ross Building, Room 713, 720 Rutland Avenue, Baltimore, MD 21205, USA; Center for Cell Dynamics, The Johns Hopkins University School of Medicine, Ross Building, Room 713, 720 Rutland Avenue, Baltimore, MD 21205, USA
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41
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Ronchi CL, Peverelli E, Herterich S, Weigand I, Mantovani G, Schwarzmayr T, Sbiera S, Allolio B, Honegger J, Appenzeller S, Lania AG, Reincke M, Calebiro D, Spada A, Buchfelder M, Flitsch J, Strom TM, Fassnacht M. Landscape of somatic mutations in sporadic GH-secreting pituitary adenomas. Eur J Endocrinol 2016; 174:363-72. [PMID: 26701869 DOI: 10.1530/eje-15-1064] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 12/22/2015] [Indexed: 12/18/2022]
Abstract
CONTEXT Alterations in the cAMP signaling pathway are common in hormonally active endocrine tumors. Somatic mutations at GNAS are causative in 30-40% of GH-secreting adenomas. Recently, mutations affecting the USP8 and PRKACA gene have been reported in ACTH-secreting pituitary adenomas and cortisol-secreting adrenocortical adenomas respectively. However, the pathogenesis of many GH-secreting adenomas remains unclear. AIM Comprehensive genetic characterization of sporadic GH-secreting adenomas and identification of new driver mutations. DESIGN Screening for somatic mutations was performed in 67 GH-secreting adenomas by targeted sequencing for GNAS, PRKACA, and USP8 mutations (n=31) and next-generation exome sequencing (n=36). RESULTS By targeted sequencing, known activating mutations in GNAS were detected in five cases (16.1%), while no somatic mutations were observed in both PRKACA and USP8. Whole-exome sequencing identified 132 protein-altering somatic mutations in 31/36 tumors with a median of three mutations per sample (range: 1-13). The only recurrent mutations have been observed in GNAS (31.4% of cases). However, seven genes involved in cAMP signaling pathway were affected in 14 of 36 samples and eight samples harbored variants in genes involved in the calcium signaling or metabolism. At the enrichment analysis, several altered genes resulted to be associated with developmental processes. No significant correlation between genetic alterations and the clinical data was observed. CONCLUSION This study provides a comprehensive analysis of somatic mutations in a large series of GH-secreting adenomas. No novel recurrent genetic alterations have been observed, but the data suggest that beside cAMP pathway, calcium signaling might be involved in the pathogenesis of these tumors.
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Affiliation(s)
- Cristina L Ronchi
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany
| | - Erika Peverelli
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany
| | - Sabine Herterich
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany
| | - Isabel Weigand
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany
| | - Giovanna Mantovani
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany
| | - Thomas Schwarzmayr
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany
| | - Silviu Sbiera
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany
| | - Bruno Allolio
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany
| | - Jürgen Honegger
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany
| | - Silke Appenzeller
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, W
| | - Andrea G Lania
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany
| | - Martin Reincke
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany
| | - Davide Calebiro
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany
| | - Anna Spada
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany
| | - Michael Buchfelder
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany
| | - Joerg Flitsch
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany
| | - Tim M Strom
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, W
| | - Martin Fassnacht
- Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, Wuerzburg, GermanyDepartment of NeurosurgeryUniversity Hospital of Erlangen, Erlangen, GermanyNeurosurgeryUniversity Hospital of Hamburg-Eppendorf, Hamburg, GermanyInstitute of Human GeneticsTechnische Universitaet Muenchen, Munich, Germany Department of Internal Medicine IEndocrine and Diabetes Unit, University Hospital, University of Wuerzburg, Oberduerrbacherstrasse 6, 97080 Wuerzburg, GermanyEndocrinology and Diabetology UnitDepartment of Clinical Sciences and Community Health, University of Milan, Milan, ItalyCentral LaboratoryUniversity Hospital, University of Wuerzburg, Wuerzburg, GermanyInstitute of Human GeneticsHelmholtz Zentrum Munich, Neuherberg, GermanyComprehensive Cancer Center MainfrankenUniversity of Wuerzburg, Wuerzburg, GermanyMedizinische Klinik and Poliklinik IVLudwig-Maximilians University, Munich, GermanyCore Unit Systems MedicineUniversity of Wuerzburg, Wuerzburg, GermanyEndocrinology UnitDepartment of Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Rozzano, Milan, ItalyInstitute of Pharmacology and Toxicology and Bioimaging CenterUniversity of Wuerzburg, W
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Seidel E, Scholl UI. Intracellular Molecular Differences in Aldosterone- Compared to Cortisol-Secreting Adrenal Cortical Adenomas. Front Endocrinol (Lausanne) 2016; 7:75. [PMID: 27445978 PMCID: PMC4921773 DOI: 10.3389/fendo.2016.00075] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 06/14/2016] [Indexed: 12/18/2022] Open
Abstract
The adrenal cortex is a major site of steroid hormone production. Two hormones are of particular importance: aldosterone, which is produced in the zona glomerulosa in response to volume depletion and hyperkalemia, and cortisol, which is produced in the zona fasciculata in response to stress. In both cases, acute stimulation leads to increased hormone production, and chronic stimulation causes hyperplasia of the respective zone. Aldosterone- and cortisol-producing adenomas (APAs and CPAs) are benign tumors of the adrenal cortex that cause excess hormone production, leading to primary aldosteronism and Cushing's syndrome, respectively. About 40% of the APAs carry somatic heterozygous gain-of-function mutations in the K(+) channel KCNJ5. These mutations lead to sodium permeability, depolarization, activation of voltage-gated Ca(2+) channels, and Ca(2+) influx. Mutations in the Na(+)/K(+)-ATPase subunit ATP1A1 and the plasma membrane Ca(2+)-ATPase ATP2B3 similarly cause Na(+) or H(+) permeability and depolarization, whereas mutations in the Ca(2+) channel CACNA1D directly lead to increased calcium influx. One in three CPAs carries a recurrent gain-of-function mutation (L206R) in the PRKACA gene, encoding the catalytic subunit of PKA. This mutation causes constitutive PKA activity by abolishing the binding of the inhibitory regulatory subunit to the catalytic subunit. These mutations activate pathways that are relatively specific to the respective cell type (glomerulosa versus fasciculata), and there is little overlap in mutation spectrum between APAs and CPAs, but co-secretion of both hormones can occur. Mutations in CTNNB1 (beta-catenin) and GNAS (Gsα) are exceptions, as they can cause both APAs and CPAs through pathways that are incompletely understood.
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Affiliation(s)
- Eric Seidel
- Department of Nephrology, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - Ute I. Scholl
- Department of Nephrology, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
- *Correspondence: Ute I. Scholl,
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Villares Fragoso MCB, Wanichi IQ, Cavalcante IP, Mariani BMDP. The Role of gsp Mutations on the Development of Adrenocortical Tumors and Adrenal Hyperplasia. Front Endocrinol (Lausanne) 2016; 7:104. [PMID: 27512387 PMCID: PMC4962502 DOI: 10.3389/fendo.2016.00104] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 07/12/2016] [Indexed: 01/18/2023] Open
Abstract
Somatic GNAS point mutations, commonly known as gsp mutations, are involved in the pathogenesis of McCune-Albright syndrome (MAS) and have also been described in autonomous hormone-producing tumors, such as somatotropinoma, corticotrophoma, thyroid cancer, ovarian and testicular Leydig cell tumors, and primary macronodular adrenocortical hyperplasia (PMAH) (1-3). The involvement of gsp mutations in adrenal tumors was first described by Lyons et al. Since then, several studies have detected the presence of gsp mutations in adrenal tumors, but none of them could explain its presence along or the mechanism that leads to tumor formation and hormone hypersecretion. As a result, the molecular pathogenesis of the majority of sporadic adrenocortical tumors remains unclear (3). PMAH has also been reported with gsp somatic mutations in a few cases. Fragoso et al. identified two distinct gsp somatic mutations affecting arginine residues on codon 201 of GNAS in a few patients with PMAH who lacked any features or manifestations of MAS. Followed by this discovery, other studies have continued looking for gsp mutations based on strong prior evidence demonstrating that increased cAMP signaling is sufficient for cell proliferation and cortisol production (2, 4). With consideration for the previously reported findings, we conjecture that although somatic activating mutations in GNAS are a rare molecular event, these mutations could probably be sufficient to induce the development of macronodule hyperplasia and variable cortisol secretion. In this manuscript, we revised the presence of gsp mutations associated with adrenal cortical tumors and hyperplasia.
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Affiliation(s)
- Maria Candida Barisson Villares Fragoso
- Unidade de Suprarrenal, Disciplina de Endocrinologia e Metabologia, Laboratorio de Hormonios e Genetica Molecular LIM/42, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- *Correspondence: Maria Candida Barisson Villares Fragoso,
| | - Ingrid Quevedo Wanichi
- Unidade de Suprarrenal, Disciplina de Endocrinologia e Metabologia, Laboratorio de Hormonios e Genetica Molecular LIM/42, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Isadora Pontes Cavalcante
- Unidade de Suprarrenal, Disciplina de Endocrinologia e Metabologia, Laboratorio de Hormonios e Genetica Molecular LIM/42, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Beatriz Marinho de Paula Mariani
- Unidade de Suprarrenal, Disciplina de Endocrinologia e Metabologia, Laboratorio de Hormonios e Genetica Molecular LIM/42, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
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Kirschner LS, Stratakis CA. 5th International ACC Symposium: The New Genetics of Benign Adrenocortical Neoplasia: Hyperplasias, Adenomas, and Their Implications for Progression into Cancer. Discov Oncol 2015; 7:9-16. [PMID: 26684645 DOI: 10.1007/s12672-015-0246-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 12/01/2015] [Indexed: 11/25/2022] Open
Abstract
Genetic tools for the analysis of human tumors have developed rapidly over the past 20 years. Adrenocortical neoplasms have been subject to multiple analyses using these new genetic tools. Analysis of adrenocortical carcinomas (ACCs) has been complicated by the fact that these tumors tend to exhibit multiple somatic abnormalities, so that identifying driver mutations is complex task. In contrast, benign adrenocortical neoplasms have proven to be a fertile ground for the identification of the genetic causes of adrenocortical adenomas, as well as a variety of adrenocortical hyperplasia. Analysis of cortisol-producing adrenocortical adenomas has revealed alterations leading to enhanced signaling through the cAMP-dependent protein kinase (PKA) pathway. In contrast, macronodular cortisol-producing neoplasias have been shown to result from mutations in the ARMC5 gene, whose function is not yet quite so clear. In contrast, adrenal tumors resulting in excess production of the blood pressure hormone aldosterone almost always result from abnormalities of calcium handling, both in single adenomas and in bilateral hyperplasias. In both cases, there is elevation of a signaling pathway responsible both for hormone secretion and for gland growth and maintenance, thus confirming the linkage of these two output of cellular physiology. The connection between the benign hyperplasia observed in these states and adrenocortical carcinogenesis is not nearly as clear, although genetic studies are beginning to elucidate the relationship between benign and malignant tumors of this gland.
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Affiliation(s)
- Lawrence S Kirschner
- Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, The Ohio State University Wexner Medical Center, 460 W 12th Ave, Rm 510, Columbus, OH, 43210, USA.
| | - Constantine A Stratakis
- National Institute of Child Health and Human Development, National Institutes of Health, 31 Center Dr. Room 2A46 MSC 2425, Bethesda, MD, 20892-2425, USA.
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Calebiro D, Di Dalmazi G, Bathon K, Ronchi CL, Beuschlein F. cAMP signaling in cortisol-producing adrenal adenoma. Eur J Endocrinol 2015; 173:M99-106. [PMID: 26139209 DOI: 10.1530/eje-15-0353] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 06/23/2015] [Indexed: 01/11/2023]
Abstract
The cAMP signaling pathway is one of the major players in the regulation of growth and hormonal secretion in adrenocortical cells. Although its role in the pathogenesis of adrenocortical hyperplasia associated with Cushing's syndrome has been clarified, a clear involvement of the cAMP signaling pathway and of one of its major downstream effectors, the protein kinase A (PKA), in sporadic adrenocortical adenomas remained elusive until recently. During the last year, a report by our group and three additional independent groups showed that somatic mutations of PRKACA, the gene coding for the catalytic subunit α of PKA, are a common genetic alteration in patients with Cushing's syndrome due to adrenal adenomas, occurring in 35-65% of the patients. In vitro studies revealed that those mutations are able to disrupt the association between catalytic and regulatory subunits of PKA, leading to a cAMP-independent activity of the enzyme. Despite somatic PRKACA mutations being a common finding in patients with clinically manifest Cushing's syndrome, the pathogenesis of adrenocortical adenomas associated with subclinical hypercortisolism seems to rely on a different molecular background. In this review, the role of cAMP/PKA signaling in the regulation of adrenocortical cell function and its alterations in cortisol-producing adrenocortical adenomas will be summarized, with particular focus on recent developments.
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Affiliation(s)
- Davide Calebiro
- Institute of Pharmacology and ToxicologyUniversity of Würzburg, Versbacher Str. 9, 97078 Würzburg, GermanyRudolf Virchow CenterJosef-Schneider-Str. 2, 97080 Würzburg, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-Universität München, Ziemssenstraβe 1, 80336 München, GermanyDepartment of Medicine IEndocrine and Diabetes Unit, University Hospital, University of Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, GermanyComprehensive Cancer Center MainfrankenUniversity of Würzburg, Josef-Schneider-Str. 6, 97080 Würzburg, Germany Institute of Pharmacology and ToxicologyUniversity of Würzburg, Versbacher Str. 9, 97078 Würzburg, GermanyRudolf Virchow CenterJosef-Schneider-Str. 2, 97080 Würzburg, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-Universität München, Ziemssenstraβe 1, 80336 München, GermanyDepartment of Medicine IEndocrine and Diabetes Unit, University Hospital, University of Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, GermanyComprehensive Cancer Center MainfrankenUniversity of Würzburg, Josef-Schneider-Str. 6, 97080 Würzburg, Germany
| | - Guido Di Dalmazi
- Institute of Pharmacology and ToxicologyUniversity of Würzburg, Versbacher Str. 9, 97078 Würzburg, GermanyRudolf Virchow CenterJosef-Schneider-Str. 2, 97080 Würzburg, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-Universität München, Ziemssenstraβe 1, 80336 München, GermanyDepartment of Medicine IEndocrine and Diabetes Unit, University Hospital, University of Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, GermanyComprehensive Cancer Center MainfrankenUniversity of Würzburg, Josef-Schneider-Str. 6, 97080 Würzburg, Germany
| | - Kerstin Bathon
- Institute of Pharmacology and ToxicologyUniversity of Würzburg, Versbacher Str. 9, 97078 Würzburg, GermanyRudolf Virchow CenterJosef-Schneider-Str. 2, 97080 Würzburg, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-Universität München, Ziemssenstraβe 1, 80336 München, GermanyDepartment of Medicine IEndocrine and Diabetes Unit, University Hospital, University of Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, GermanyComprehensive Cancer Center MainfrankenUniversity of Würzburg, Josef-Schneider-Str. 6, 97080 Würzburg, Germany Institute of Pharmacology and ToxicologyUniversity of Würzburg, Versbacher Str. 9, 97078 Würzburg, GermanyRudolf Virchow CenterJosef-Schneider-Str. 2, 97080 Würzburg, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-Universität München, Ziemssenstraβe 1, 80336 München, GermanyDepartment of Medicine IEndocrine and Diabetes Unit, University Hospital, University of Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, GermanyComprehensive Cancer Center MainfrankenUniversity of Würzburg, Josef-Schneider-Str. 6, 97080 Würzburg, Germany
| | - Cristina L Ronchi
- Institute of Pharmacology and ToxicologyUniversity of Würzburg, Versbacher Str. 9, 97078 Würzburg, GermanyRudolf Virchow CenterJosef-Schneider-Str. 2, 97080 Würzburg, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-Universität München, Ziemssenstraβe 1, 80336 München, GermanyDepartment of Medicine IEndocrine and Diabetes Unit, University Hospital, University of Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, GermanyComprehensive Cancer Center MainfrankenUniversity of Würzburg, Josef-Schneider-Str. 6, 97080 Würzburg, Germany Institute of Pharmacology and ToxicologyUniversity of Würzburg, Versbacher Str. 9, 97078 Würzburg, GermanyRudolf Virchow CenterJosef-Schneider-Str. 2, 97080 Würzburg, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-Universität München, Ziemssenstraβe 1, 80336 München, GermanyDepartment of Medicine IEndocrine and Diabetes Unit, University Hospital, University of Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, GermanyComprehensive Cancer Center MainfrankenUniversity of Würzburg, Josef-Schneider-Str. 6, 97080 Würzburg, Germany
| | - Felix Beuschlein
- Institute of Pharmacology and ToxicologyUniversity of Würzburg, Versbacher Str. 9, 97078 Würzburg, GermanyRudolf Virchow CenterJosef-Schneider-Str. 2, 97080 Würzburg, GermanyMedizinische Klinik und Poliklinik IVLudwig-Maximilians-Universität München, Ziemssenstraβe 1, 80336 München, GermanyDepartment of Medicine IEndocrine and Diabetes Unit, University Hospital, University of Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, GermanyComprehensive Cancer Center MainfrankenUniversity of Würzburg, Josef-Schneider-Str. 6, 97080 Würzburg, Germany
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Röck R, Mayrhofer JE, Bachmann V, Stefan E. Impact of kinase activating and inactivating patient mutations on binary PKA interactions. Front Pharmacol 2015; 6:170. [PMID: 26347651 PMCID: PMC4539479 DOI: 10.3389/fphar.2015.00170] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 07/30/2015] [Indexed: 11/13/2022] Open
Abstract
The second messenger molecule cAMP links extracellular signals to intracellular responses. The main cellular cAMP effector is the compartmentalized protein kinase A (PKA). Upon receptor initiated cAMP-mobilization, PKA regulatory subunits (R) bind cAMP thereby triggering dissociation and activation of bound PKA catalytic subunits (PKAc). Mutations in PKAc or RIa subunits manipulate PKA dynamics and activities which contribute to specific disease patterns. Mutations activating cAMP/PKA signaling contribute to carcinogenesis or hormone excess, while inactivating mutations cause hormone deficiency or resistance. Here we extended the application spectrum of a Protein-fragment Complementation Assay based on the Renilla Luciferase to determine binary protein:protein interactions (PPIs) of the PKA network. We compared time- and dose-dependent influences of cAMP-elevation on mutually exclusive PPIs of PKAc with the phosphotransferase inhibiting RIIb and RIa subunits and the protein kinase inhibitor peptide (PKI). We analyzed PKA dynamics following integration of patient mutations into PKAc and RIa. We observed that oncogenic modifications of PKAc(L206R) and RIa(Δ184-236) as well as rare disease mutations in RIa(R368X) affect complex formation of PKA and its responsiveness to cAMP elevation. With the cell-based PKA PPI reporter platform we precisely quantified the mechanistic details how inhibitory PKA interactions and defined patient mutations contribute to PKA functions.
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Affiliation(s)
| | | | | | - Eduard Stefan
- Institute of Biochemistry and Center for Molecular Biosciences, University of InnsbruckInnsbruck, Austria
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Röck R, Bachmann V, Bhang HEC, Malleshaiah M, Raffeiner P, Mayrhofer JE, Tschaikner PM, Bister K, Aanstad P, Pomper MG, Michnick SW, Stefan E. In-vivo detection of binary PKA network interactions upon activation of endogenous GPCRs. Sci Rep 2015; 5:11133. [PMID: 26099953 PMCID: PMC4477410 DOI: 10.1038/srep11133] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 05/14/2015] [Indexed: 12/21/2022] Open
Abstract
Membrane receptor-sensed input signals affect and modulate intracellular protein-protein interactions (PPIs). Consequent changes occur to the compositions of protein complexes, protein localization and intermolecular binding affinities. Alterations of compartmentalized PPIs emanating from certain deregulated kinases are implicated in the manifestation of diseases such as cancer. Here we describe the application of a genetically encoded Protein-fragment Complementation Assay (PCA) based on the Renilla Luciferase (Rluc) enzyme to compare binary PPIs of the spatially and temporally controlled protein kinase A (PKA) network in diverse eukaryotic model systems. The simplicity and sensitivity of this cell-based reporter allows for real-time recordings of mutually exclusive PPIs of PKA upon activation of selected endogenous G protein-coupled receptors (GPCRs) in cancer cells, xenografts of mice, budding yeast, and zebrafish embryos. This extends the application spectrum of Rluc PCA for the quantification of PPI-based receptor-effector relationships in physiological and pathological model systems.
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Affiliation(s)
- Ruth Röck
- Institute of Biochemistry and Center for Molecular Biosciences, University of Innsbruck, Innrain 80/82, 6020 Innsbruck, Austria
| | - Verena Bachmann
- Institute of Biochemistry and Center for Molecular Biosciences, University of Innsbruck, Innrain 80/82, 6020 Innsbruck, Austria
| | - Hyo-Eun C Bhang
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical School, Baltimore, MD 21287, USA
| | - Mohan Malleshaiah
- Département de Biochimie, Université de Montréal, H3C 3J7 Montréal, Québec, Canada
| | - Philipp Raffeiner
- Institute of Biochemistry and Center for Molecular Biosciences, University of Innsbruck, Innrain 80/82, 6020 Innsbruck, Austria
| | - Johanna E Mayrhofer
- Institute of Biochemistry and Center for Molecular Biosciences, University of Innsbruck, Innrain 80/82, 6020 Innsbruck, Austria
| | - Philipp M Tschaikner
- Institute of Molecular Biology, University of Innsbruck, Technikerstrasse 25, 6020 Innsbruck, Austria
| | - Klaus Bister
- Institute of Biochemistry and Center for Molecular Biosciences, University of Innsbruck, Innrain 80/82, 6020 Innsbruck, Austria
| | - Pia Aanstad
- Institute of Molecular Biology, University of Innsbruck, Technikerstrasse 25, 6020 Innsbruck, Austria
| | - Martin G Pomper
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical School, Baltimore, MD 21287, USA
| | - Stephen W Michnick
- Département de Biochimie, Université de Montréal, H3C 3J7 Montréal, Québec, Canada
| | - Eduard Stefan
- Institute of Biochemistry and Center for Molecular Biosciences, University of Innsbruck, Innrain 80/82, 6020 Innsbruck, Austria
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Abstract
PURPOSE OF REVIEW Cushing syndrome caused by cortisol-producing adrenal adenomas is a rare condition, associated with high morbidity due to weight gain, diabetes mellitus, osteoporosis, hypertension, muscle weakness, mood disturbance and others. The first gene to be identified as causative of Cushing syndrome was PRKAR1A. We present an update on protein kinase A (PKA) defects and Cushing syndrome. RECENT FINDINGS The cyclic AMP-dependent PKA catalytic subunit alpha (PRKACA) hotspot point mutation (c.617A > C [p.Leu206Arg]), leading to an increase of basal PKA activity, and formation of cortisol-producing adenoma has been frequently shown to cause the most common form of adrenocorticotropic hormone-independent Cushing syndrome. SUMMARY Somatic PRKACA mutations have been found in up to 50% of patients with adrenal adenomas. Germline PRKACA amplification was also seen in bilateral adrenal hyperplasias. PRKACA activation was associated with higher cortisol levels, smaller tumor size and overt Cushing syndrome. This breakthrough is expected to improve our understanding of how PKA defects lead to Cushing syndrome and may spearhead the development of new, molecularly designed therapies.
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Affiliation(s)
- Mihail Zilbermint
- Section on Endocrinology and Genetics, Program on Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
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Drougat L, Omeiri H, Lefèvre L, Ragazzon B. Novel Insights into the Genetics and Pathophysiology of Adrenocortical Tumors. Front Endocrinol (Lausanne) 2015; 6:96. [PMID: 26106367 PMCID: PMC4460803 DOI: 10.3389/fendo.2015.00096] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 05/26/2015] [Indexed: 11/13/2022] Open
Abstract
Adrenocortical tumors (ACTs) are typically unilateral and can be classified as benign adrenocortical adenomas (ACAs) or malignant adrenocortical cancers (ACCs). In rare cases, tumors may occur in both adrenal glands as micronodular hyperplasia (primary pigmented nodular adrenal dysplasia) or as macronodular hyperplasia (primary bilateral macronodular adrenal hyperplasia, PBMAH). The study of certain tumor predisposition syndromes has improved our understanding of sporadic ACTs. Most ACAs are associated with abnormalities of the cAMP signaling pathway, whereas most ACCs are linked to alterations in IGF2, TP53, or the Wnt/βcatenin pathways. Over the past year, single-nucleotide polymorphism array technology and next-generation sequencing have identified novel genetic alterations in ACTs that shed new light on the molecular mechanisms of oncogenesis. Among these are somatic mutations of PKA catalytic subunit alpha gene (PRKACA) in ACA, germline, and somatic mutations of armadillo repeat containing 5 gene (ARMC5) in primary bilateral macronodular adrenal hyperplasia and somatic alterations of the E3 ubiquitin ligase gene ZNRF3 in ACC. This review focuses on the recent discoveries and their diagnostic, prognostic, and therapeutic implications.
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Affiliation(s)
- Ludivine Drougat
- U1016, INSERM, Institut Cochin, Paris, France
- UMR8104, CNRS, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Hanin Omeiri
- U1016, INSERM, Institut Cochin, Paris, France
- UMR8104, CNRS, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Lucile Lefèvre
- U1016, INSERM, Institut Cochin, Paris, France
- UMR8104, CNRS, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Bruno Ragazzon
- U1016, INSERM, Institut Cochin, Paris, France
- UMR8104, CNRS, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- *Correspondence: Bruno Ragazzon, Institut Cochin, 24 rue du Faubourg-Saint-Jacques, Paris 75014, France,
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