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Wanichi IQ, de Paula Mariani BM, Frassetto FP, Siqueira SAC, de Castro Musolino NR, Cunha-Neto MBC, Ochman G, Cescato VAS, Machado MC, Trarbach EB, Bronstein MD, Fragoso MCBV. Cushing's disease due to somatic USP8 mutations: a systematic review and meta-analysis. Pituitary 2019; 22:435-442. [PMID: 31273566 DOI: 10.1007/s11102-019-00973-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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] [Indexed: 01/26/2023]
Abstract
PURPOSE Cushing's disease (CD) is a severe illness generally caused by microcorticotropinomas (MICs) and in approximately 7-20% of patients by macrocorticotropinomas (MACs). USP8-mutations have been identified as a major genetic cause of CD (~ 50%). Few studies have reported the distribution between MICs-MACs related to USP8-mutations and their genotype-phenotype correlations. Therefore, we aimed to evaluate USP8-mutations in a cohort of MICs-MACs from a unique center and to perform a systematic review and meta-analysis. METHODS DNA-tumor-tissues from 47 corticotropinomas (16 MICs and 31 MACs) were sequenced. Clinical-biochemical data, radiological imaging data and remission/recurrence rates were evaluated. In addition, we performed a meta-analysis of nine published series (n = 630). RESULTS We identified four different USP8-mutations previously described, in 11 out of 47 (23.4%) corticotropinomas; 8 out of 11 were MACs. The urinary cortisol levels of our patients with corticotrophin USP8-mutated-alleles were lower than those of patients with wild-type (WT) alleles (p ≤ 0.017). The frequency of USP8-mutated-alleles among the series was approximately 30% with a higher prevalence in female-patients (p < 0.1 × 10-4). Among the 5 series, the remission rates were higher in patients with USP8-mutated-alleles than in those with the USP8-WT-alleles (p < 0.1 × 10-4). CONCLUSION Our data, as well as the retrospective review of CD series associated with USP8-mutated alleles, show heterogeneous findings among the series. Several drawbacks included the lack of a systematic protocol to evaluate these patients before surgery and follow-up. Further prospective studies using a systematic protocol will provide more consistent information about the influence of the corticotropinomas with USP8-mutated alleles on the phenotype, responses to treatment and outcome of patients with CD.
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Affiliation(s)
- Ingrid Quevedo Wanichi
- Laboratório de Hormônios e Genética Molecular (LIM/42) do Hospital das Clinicas da Disciplina de Endocrinologia e Metabologia da Faculdade de Medicina da, Universidade de São Paulo, Avenida Dr.Enéas de Carvalho Aguiar, 155 - 2 andar bloco 6, São Paulo, CEP 05403900, Brazil
| | - Beatriz Marinho de Paula Mariani
- Laboratório de Hormônios e Genética Molecular (LIM/42) do Hospital das Clinicas da Disciplina de Endocrinologia e Metabologia da Faculdade de Medicina da, Universidade de São Paulo, Avenida Dr.Enéas de Carvalho Aguiar, 155 - 2 andar bloco 6, São Paulo, CEP 05403900, Brazil
| | - Fernando Pereira Frassetto
- Departamento de Patologia do Hospital das Clinicas da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, Brazil
| | | | - Nina Rosa de Castro Musolino
- Unidade de Neuroendocrinologia da Divisão de Neurocirurgia Funcional, Instituto de Psiquiatria do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Malebranche Berardo Carneiro Cunha-Neto
- Unidade de Neuroendocrinologia da Divisão de Neurocirurgia Funcional, Instituto de Psiquiatria do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Gilberto Ochman
- Unidade de Neuroendocrinologia da Divisão de Neurocirurgia Funcional, Instituto de Psiquiatria do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Valter Angelo Sperling Cescato
- Unidade de Neuroendocrinologia da Divisão de Neurocirurgia Funcional, Instituto de Psiquiatria do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marcio Carlos Machado
- Unidade de Neuroendocrinologia da Disciplina de Endocrinologia e Metabologia da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, Brazil
- Endocrinology Service, AC Camargo Cancer Center, São Paulo, Brazil
- Laboratorio de Endocrinologia Celular e Molecular (LIM/25) do Hospital das Clinicas da Disciplina de Endocrinologia e Metabologia da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, Brazil
| | - Ericka Barbosa Trarbach
- Laboratorio de Endocrinologia Celular e Molecular (LIM/25) do Hospital das Clinicas da Disciplina de Endocrinologia e Metabologia da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, Brazil
| | - Marcello Delano Bronstein
- Unidade de Neuroendocrinologia da Disciplina de Endocrinologia e Metabologia da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, Brazil
- Laboratorio de Endocrinologia Celular e Molecular (LIM/25) do Hospital das Clinicas da Disciplina de Endocrinologia e Metabologia da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, Brazil
| | - Maria Candida Barisson Villares Fragoso
- Laboratório de Hormônios e Genética Molecular (LIM/42) do Hospital das Clinicas da Disciplina de Endocrinologia e Metabologia da Faculdade de Medicina da, Universidade de São Paulo, Avenida Dr.Enéas de Carvalho Aguiar, 155 - 2 andar bloco 6, São Paulo, CEP 05403900, Brazil.
- Unidade de Suprarrenal da Disciplina de Endocrinologia e Metabologia da Faculdade de Medicina da, Universidade de São Paulo, São Paulo, Brazil.
- Clinica de Bases do Instituto do Câncer do Estado de São Paulo, ICESP, São Paulo, Brazil.
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