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Marti N, Malikova J, Galván JA, Aebischer M, Janner M, Sumnik Z, Obermannova B, Escher G, Perren A, Flück CE. Androgen production in pediatric adrenocortical tumors may occur via both the classic and/or the alternative backdoor pathway. Mol Cell Endocrinol 2017; 452:64-73. [PMID: 28501574 DOI: 10.1016/j.mce.2017.05.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 04/24/2017] [Accepted: 05/09/2017] [Indexed: 11/27/2022]
Abstract
Children with adrenocortical tumors (ACTs) often present with virilization due to high tumoral androgen production, with dihydrotestosterone (DHT) as most potent androgen. Recent work revealed two pathways for DHT biosynthesis, the classic and the backdoor pathway. Usage of alternate routes for DHT production has been reported in castration-resistant prostate cancer, CAH and PCOS. To assess whether the backdoor pathway may contribute to the virilization of pediatric ACTs, we investigated seven children suffering from androgen producing tumors using steroid profiling and immunohistochemical expression studies. All cases produced large amounts of androgens of the classic and/or backdoor pathway. Variable expression of steroid enzymes was observed in carcinomas and adenomas. We found no discriminative pattern. This suggests that enhanced androgen production in pediatric ACTs is the result of deregulated steroidogenesis through multiple steroid pathways. Thus future treatments of ACTs targeting androgen overproduction should consider these novel steroid production pathways.
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Affiliation(s)
- Nesa Marti
- Pediatric Endocrinology and Diabetology, Department of Pediatrics, Switzerland; Department of Clinical Research, Inselspital, Bern University Hospital, University of Bern, Switzerland; Graduate School Bern, University of Bern, Switzerland
| | - Jana Malikova
- Pediatric Endocrinology and Diabetology, Department of Pediatrics, Switzerland; Department of Clinical Research, Inselspital, Bern University Hospital, University of Bern, Switzerland; Department of Pediatrics, 2(nd) Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic
| | - José A Galván
- Institute of Pathology, University of Bern, Switzerland
| | - Maude Aebischer
- Pediatric Endocrinology and Diabetology, Department of Pediatrics, Switzerland
| | - Marco Janner
- Pediatric Endocrinology and Diabetology, Department of Pediatrics, Switzerland
| | - Zdenek Sumnik
- Department of Pediatrics, 2(nd) Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic
| | - Barbora Obermannova
- Department of Pediatrics, 2(nd) Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic
| | - Genevieve Escher
- Department of Clinical Research, Inselspital, Bern University Hospital, University of Bern, Switzerland; Department of Nephrology and Hypertension, Bern University Hospital, University of Bern, Switzerland
| | - Aurel Perren
- Institute of Pathology, University of Bern, Switzerland
| | - Christa E Flück
- Pediatric Endocrinology and Diabetology, Department of Pediatrics, Switzerland; Department of Clinical Research, Inselspital, Bern University Hospital, University of Bern, Switzerland.
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