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Groussin L, Kirschner LS, Vincent-Dejean C, Perlemoine K, Jullian E, Delemer B, Zacharieva S, Pignatelli D, Carney JA, Luton JP, Bertagna X, Stratakis CA, Bertherat J. Molecular analysis of the cyclic AMP-dependent protein kinase A (PKA) regulatory subunit 1A (PRKAR1A) gene in patients with Carney complex and primary pigmented nodular adrenocortical disease (PPNAD) reveals novel mutations and clues for pathophysiology: augmented PKA signaling is associated with adrenal tumorigenesis in PPNAD. Am J Hum Genet 2002; 71:1433-42. [PMID: 12424709 PMCID: PMC378588 DOI: 10.1086/344579] [Citation(s) in RCA: 143] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2002] [Accepted: 09/03/2002] [Indexed: 11/03/2022] Open
Abstract
We studied 11 new kindreds with primary pigmented nodular adrenocortical disease (PPNAD) or Carney complex (CNC) and found that 82% of the kindreds had PRKAR1A gene defects (including seven novel inactivating mutations), most of which led to nonsense mRNA and, thus, were not expressed in patients' cells. However, a previously undescribed base substitution in intron 6 (exon 6 IVS +1G-->T) led to exon 6 skipping and an expressed shorter PRKAR1A protein. The mutant protein was present in patients' leukocytes and tumors, and in vitro studies indicated that the mutant PRKAR1A activated cAMP-dependent protein kinase A (PKA) signaling at the nuclear level. This is the first demonstration of an inactivating PRKAR1A mutation being expressed at the protein level and leading to stimulation of the PKA pathway in CNC patients. Along with the lack of allelic loss at the PRKAR1A locus in most of the tumors from this kindred, these data suggest that alteration of PRKAR1A function (not only its complete loss) is sufficient for augmenting PKA activity leading to tumorigenesis in tissues affected by CNC.
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Affiliation(s)
- Lionel Groussin
- Departments of Endocrinology, Institut Cochin, INSERM U576, CNRS UMR 8104 IFR116, René Descartes-Paris V University, and Endocrinology, Hôpital Cochin, Paris; Unit on Genetics and Endocrinology, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda; Department of Endocrinology, CHU de Reims, Reims, France; Department of Endocrinology, Clinical Center of Endocrinology and Gerontology, Sofia, Bulgaria; Institute of Histology and Embryology, Faculty of Medicine of Porto, Porto, Portugal; Mayo Clinic, Rochester, MN; and COMETE Network, France
| | - Lawrence S. Kirschner
- Departments of Endocrinology, Institut Cochin, INSERM U576, CNRS UMR 8104 IFR116, René Descartes-Paris V University, and Endocrinology, Hôpital Cochin, Paris; Unit on Genetics and Endocrinology, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda; Department of Endocrinology, CHU de Reims, Reims, France; Department of Endocrinology, Clinical Center of Endocrinology and Gerontology, Sofia, Bulgaria; Institute of Histology and Embryology, Faculty of Medicine of Porto, Porto, Portugal; Mayo Clinic, Rochester, MN; and COMETE Network, France
| | - Caroline Vincent-Dejean
- Departments of Endocrinology, Institut Cochin, INSERM U576, CNRS UMR 8104 IFR116, René Descartes-Paris V University, and Endocrinology, Hôpital Cochin, Paris; Unit on Genetics and Endocrinology, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda; Department of Endocrinology, CHU de Reims, Reims, France; Department of Endocrinology, Clinical Center of Endocrinology and Gerontology, Sofia, Bulgaria; Institute of Histology and Embryology, Faculty of Medicine of Porto, Porto, Portugal; Mayo Clinic, Rochester, MN; and COMETE Network, France
| | - Karine Perlemoine
- Departments of Endocrinology, Institut Cochin, INSERM U576, CNRS UMR 8104 IFR116, René Descartes-Paris V University, and Endocrinology, Hôpital Cochin, Paris; Unit on Genetics and Endocrinology, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda; Department of Endocrinology, CHU de Reims, Reims, France; Department of Endocrinology, Clinical Center of Endocrinology and Gerontology, Sofia, Bulgaria; Institute of Histology and Embryology, Faculty of Medicine of Porto, Porto, Portugal; Mayo Clinic, Rochester, MN; and COMETE Network, France
| | - Eric Jullian
- Departments of Endocrinology, Institut Cochin, INSERM U576, CNRS UMR 8104 IFR116, René Descartes-Paris V University, and Endocrinology, Hôpital Cochin, Paris; Unit on Genetics and Endocrinology, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda; Department of Endocrinology, CHU de Reims, Reims, France; Department of Endocrinology, Clinical Center of Endocrinology and Gerontology, Sofia, Bulgaria; Institute of Histology and Embryology, Faculty of Medicine of Porto, Porto, Portugal; Mayo Clinic, Rochester, MN; and COMETE Network, France
| | - Brigitte Delemer
- Departments of Endocrinology, Institut Cochin, INSERM U576, CNRS UMR 8104 IFR116, René Descartes-Paris V University, and Endocrinology, Hôpital Cochin, Paris; Unit on Genetics and Endocrinology, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda; Department of Endocrinology, CHU de Reims, Reims, France; Department of Endocrinology, Clinical Center of Endocrinology and Gerontology, Sofia, Bulgaria; Institute of Histology and Embryology, Faculty of Medicine of Porto, Porto, Portugal; Mayo Clinic, Rochester, MN; and COMETE Network, France
| | - Sabina Zacharieva
- Departments of Endocrinology, Institut Cochin, INSERM U576, CNRS UMR 8104 IFR116, René Descartes-Paris V University, and Endocrinology, Hôpital Cochin, Paris; Unit on Genetics and Endocrinology, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda; Department of Endocrinology, CHU de Reims, Reims, France; Department of Endocrinology, Clinical Center of Endocrinology and Gerontology, Sofia, Bulgaria; Institute of Histology and Embryology, Faculty of Medicine of Porto, Porto, Portugal; Mayo Clinic, Rochester, MN; and COMETE Network, France
| | - Duarte Pignatelli
- Departments of Endocrinology, Institut Cochin, INSERM U576, CNRS UMR 8104 IFR116, René Descartes-Paris V University, and Endocrinology, Hôpital Cochin, Paris; Unit on Genetics and Endocrinology, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda; Department of Endocrinology, CHU de Reims, Reims, France; Department of Endocrinology, Clinical Center of Endocrinology and Gerontology, Sofia, Bulgaria; Institute of Histology and Embryology, Faculty of Medicine of Porto, Porto, Portugal; Mayo Clinic, Rochester, MN; and COMETE Network, France
| | - J. Aidan Carney
- Departments of Endocrinology, Institut Cochin, INSERM U576, CNRS UMR 8104 IFR116, René Descartes-Paris V University, and Endocrinology, Hôpital Cochin, Paris; Unit on Genetics and Endocrinology, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda; Department of Endocrinology, CHU de Reims, Reims, France; Department of Endocrinology, Clinical Center of Endocrinology and Gerontology, Sofia, Bulgaria; Institute of Histology and Embryology, Faculty of Medicine of Porto, Porto, Portugal; Mayo Clinic, Rochester, MN; and COMETE Network, France
| | - Jean Pierre Luton
- Departments of Endocrinology, Institut Cochin, INSERM U576, CNRS UMR 8104 IFR116, René Descartes-Paris V University, and Endocrinology, Hôpital Cochin, Paris; Unit on Genetics and Endocrinology, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda; Department of Endocrinology, CHU de Reims, Reims, France; Department of Endocrinology, Clinical Center of Endocrinology and Gerontology, Sofia, Bulgaria; Institute of Histology and Embryology, Faculty of Medicine of Porto, Porto, Portugal; Mayo Clinic, Rochester, MN; and COMETE Network, France
| | - Xavier Bertagna
- Departments of Endocrinology, Institut Cochin, INSERM U576, CNRS UMR 8104 IFR116, René Descartes-Paris V University, and Endocrinology, Hôpital Cochin, Paris; Unit on Genetics and Endocrinology, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda; Department of Endocrinology, CHU de Reims, Reims, France; Department of Endocrinology, Clinical Center of Endocrinology and Gerontology, Sofia, Bulgaria; Institute of Histology and Embryology, Faculty of Medicine of Porto, Porto, Portugal; Mayo Clinic, Rochester, MN; and COMETE Network, France
| | - Constantine A. Stratakis
- Departments of Endocrinology, Institut Cochin, INSERM U576, CNRS UMR 8104 IFR116, René Descartes-Paris V University, and Endocrinology, Hôpital Cochin, Paris; Unit on Genetics and Endocrinology, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda; Department of Endocrinology, CHU de Reims, Reims, France; Department of Endocrinology, Clinical Center of Endocrinology and Gerontology, Sofia, Bulgaria; Institute of Histology and Embryology, Faculty of Medicine of Porto, Porto, Portugal; Mayo Clinic, Rochester, MN; and COMETE Network, France
| | - Jérôme Bertherat
- Departments of Endocrinology, Institut Cochin, INSERM U576, CNRS UMR 8104 IFR116, René Descartes-Paris V University, and Endocrinology, Hôpital Cochin, Paris; Unit on Genetics and Endocrinology, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda; Department of Endocrinology, CHU de Reims, Reims, France; Department of Endocrinology, Clinical Center of Endocrinology and Gerontology, Sofia, Bulgaria; Institute of Histology and Embryology, Faculty of Medicine of Porto, Porto, Portugal; Mayo Clinic, Rochester, MN; and COMETE Network, France
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