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Martins CS, de Castro M. Generalized and tissue specific glucocorticoid resistance. Mol Cell Endocrinol 2021; 530:111277. [PMID: 33864884 DOI: 10.1016/j.mce.2021.111277] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 12/20/2022]
Abstract
Glucocorticoids (GCs) are steroid hormones that influence several physiologic functions and are among the most frequently prescribed drugs worldwide. Resistance to GCs has been observed in the context of the familial generalized GC resistance (Chrousos' syndrome) or tissue specific GC resistance in chronic inflammatory states. In this review, we have summarized the major factors that influence individual glucocorticoid sensitivity/resistance. The fine-tuning of GC action is determined in a tissue-specific fashion that includes the combination of different GC receptor promoters, translation initiation sites, splice isoforms, interacting proteins, post-translational modifications, and alternative mechanisms of signal transduction.
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Affiliation(s)
- Clarissa Silva Martins
- Department of Internal Medicine - Ribeirao Preto Medical School - University of Sao Paulo, Ribeirao Preto, SP, Brazil; School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Margaret de Castro
- Department of Internal Medicine - Ribeirao Preto Medical School - University of Sao Paulo, Ribeirao Preto, SP, Brazil.
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Liu H, Li Z, Qiu F, Li C, Lin X, He Y, Qian M, Song Y, Zhang H. Association Between NR3C1 Mutations and Glucocorticoid Resistance in Children With Acute Lymphoblastic Leukemia. Front Pharmacol 2021; 12:634956. [PMID: 33854435 PMCID: PMC8039513 DOI: 10.3389/fphar.2021.634956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 03/01/2021] [Indexed: 11/13/2022] Open
Abstract
Treatment outcomes in children with acute lymphoblastic leukemia (ALL) have been improved substantially, with a cure rate exceeding 80% using conventional therapy. However, the outcome for patients with relapsed/refractory ALL remains unsatisfactory, despite the fact that these patients generally receive more intense therapy. Glucocorticoid (GC) resistance is a leading cause of treatment failure and relapse in ALL. Abnormal NR3C1 transcription and/or translation is strongly associated with GC resistance, but the underlying molecular mechanism and the clinical value of NR3C1 alterations with GC resistance in ALL treatment remain unclear. This study applied panel sequencing to 333 newly diagnosed and 18 relapsed ALL samples to characterize the link between NR3C1 and ALL further. We identified NR3C1 mutations in three patients with newly diagnosed ALL (0.9%) and two patients with relapsed ALL (11.1%). Functional analyses revealed that four of these five NR3C1 mutations (p. R477H, p. Y478C, p. P530fs, and p. H726P) were loss-of-function (LoF) mutations. A drug sensitivity test further showed that LoF NR3C1 mutations influence GC resistance. Saturated mutagenesis of hotspot R477 demonstrated the importance of this residue for NR3C1 function. The dominant-negative effect of p. R477C and p. R477S and the non-dominant negative effect of p. R477H and p. Y478C suggests multiple mechanisms underlying GC resistance. Thus, primary or acquired genomic lesions in NR3C1 may play a critical role in GC resistance and contribute to ALL treatment failure and/or relapse.
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Affiliation(s)
- Haiyan Liu
- Department of Hematology/Oncology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Ziping Li
- Department of Hematology/Oncology, Guangzhou Women and Children's Medical Center, Guangzhou, China.,Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Fei Qiu
- Bioinspired Engineering and Biomechanics Center, Xi'an Jiaotong University, Xi'an, China
| | - Chunjie Li
- Department of Hematology/Oncology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Xiaojing Lin
- Department of Hematology/Oncology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Yingyi He
- Department of Hematology/Oncology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Maoxiang Qian
- Institute of Pediatrics and Department of Hematology and Oncology, Children's Hospital of Fudan University, National Children's Medical Center, the Shanghai Key Laboratory of Medical Epigenetics, International Co-laboratory of Medical Epigenetics and Metabolism, Ministry of Science and Technology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Yuanbin Song
- State Key Laboratory of Oncology in South China, Department of Hematologic Oncology, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Hui Zhang
- Department of Hematology/Oncology, Guangzhou Women and Children's Medical Center, Guangzhou, China
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Tosca L, Giltay JC, Bouvattier C, Klijn AJ, Bouligand J, Lambert AS, Lecerf L, Josso N, Tachdjian G, Picard JY. Persistent Müllerian duct syndrome due to anti-Müllerian hormone receptor 2 microdeletions: a diagnostic challenge. Hum Reprod 2020; 35:999-1003. [PMID: 32187366 DOI: 10.1093/humrep/deaa014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/09/2020] [Indexed: 11/12/2022] Open
Abstract
The persistent Müllerian duct syndrome (PMDS) is defined by the persistence of Müllerian derivatives in an otherwise normally virilized 46,XY male. It is usually caused by mutations in either the anti-Müllerian hormone (AMH) or AMH receptor type 2 (AMHR2) genes. We report the first cases of PMDS resulting from a microdeletion of the chromosomal region 12q13.13, the locus of the gene for AMHR2. One case involved a homozygous microdeletion of five exons of the AMHR2 gene. In the second case, the whole AMHR2 gene was deleted from the maternally inherited chromosome. The patient's paternal allele carried a stop mutation, which was initially thought to be homozygous by Sanger sequencing. Diagnostic methods are discussed, with an emphasis on comparative genomic hybridization and targeted massive parallel sequencing.
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Affiliation(s)
- L Tosca
- Service d'Histologie, Embryologie et Cytogénétique, Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, Hôpital Antoine Béclère, 92140 Clamart, France.,Faculté de Médecine, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - J C Giltay
- Division Laboratories, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, P.O. Box 85090, 3508 AB Utrecht, The Netherlands
| | - C Bouvattier
- Faculté de Médecine, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France.,Service Endocrinologie et Diabète de l'Enfant, Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - A J Klijn
- Department Pediatric Urology Wilhelmina Kinderziekenhuis. University Medical Center Utrecht, P.O. Box 85090, 3508 AB Utrecht, The Netherlands
| | - J Bouligand
- Faculté de Médecine, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France.,Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - A S Lambert
- Faculté de Médecine, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France.,Service Endocrinologie et Diabète de l'Enfant, Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - L Lecerf
- Faculté de Médecine, Institut National de la Santé et de la Recherche Médicale, Université Paris-Est, Unité 955, 94000 Créteil, France
| | - N Josso
- UMR_S938 Centre de Recherche Saint Antoine, Institut National de la Santé et de la Recherche Médicale, Sorbonne Université, 75012 Paris, France
| | - G Tachdjian
- Service d'Histologie, Embryologie et Cytogénétique, Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, Hôpital Antoine Béclère, 92140 Clamart, France.,Faculté de Médecine, Université Paris-Saclay, 94270 Le Kremlin-Bicêtre, France
| | - J Y Picard
- UMR_S938 Centre de Recherche Saint Antoine, Institut National de la Santé et de la Recherche Médicale, Sorbonne Université, 75012 Paris, France
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