期刊
NATURE GENETICS
卷 53, 期 9, 页码 1360-+出版社
NATURE PORTFOLIO
DOI: 10.1038/s41588-021-00906-y
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资金
- British Heart Foundation [FS/19/50/34566, FS/14/75/31134]
- National Institute of Health Research (NIHR) [NF-SI-0512-10052]
- NIHR Efficacy and Mechanisms Evaluation Project [14/145/09]
- Barts and the London Charity project [MGU0360]
- INSERM
- Agence Nationale de la Recherche [ANR-15-CE14-0017-03]
- Fondation pour la Recherche Medicale [EQU201903007864]
- NIHR Advanced Fellowship [NIHR3000098]
- Wellcome Trust Investigator Award [106995/Z/15/Z]
- NIHR Oxford Biomedical Research Centre (BRC) Programme
- NIHR BRC at Barts
- The London School of Medicine and Dentistry
- NIHR Cambridge BRC [IS-BRC-1215-20014]
- National Medical Research Council
- BRC of Singapore
- NIHR Barts Cardiovascular BRC [IS-BRC-1215-20022]
- Cambridge BRC
- BRC
- QMUL Research-IT
- National Institutes of Health Research (NIHR) [IS-BRC-1215-20022] Funding Source: National Institutes of Health Research (NIHR)
- Agence Nationale de la Recherche (ANR) [ANR-15-CE14-0017] Funding Source: Agence Nationale de la Recherche (ANR)
The study identified gain-of-function somatic mutations in GNA11 or GNAQ in CTNNB1-mutant aldosterone-producing adenomas. These mutations were often found in patients during puberty, pregnancy, or menopause, with elevated LHCGR expression. While most aldosterone-producing adenomas have gain-of-function somatic mutations, the presence of these mutations in aldosterone-producing cell clusters of normal adrenal glands indicates a necessity for codriver mutations in APAs.
Sequence analysis identifies gain-of-function somatic mutations in GNA11 or GNAQ in CTNNB1-mutant aldosterone-producing adenomas. Most patients with these mutations presented during puberty, pregnancy or menopause, with elevated LHCGR expression. Most aldosterone-producing adenomas (APAs) have gain-of-function somatic mutations of ion channels or transporters. However, their frequency in aldosterone-producing cell clusters of normal adrenal gland suggests a requirement for codriver mutations in APAs. Here we identified gain-of-function mutations in both CTNNB1 and GNA11 by whole-exome sequencing of 3/41 APAs. Further sequencing of known CTNNB1-mutant APAs led to a total of 16 of 27 (59%) with a somatic p.Gln209His, p.Gln209Pro or p.Gln209Leu mutation of GNA11 or GNAQ. Solitary GNA11 mutations were found in hyperplastic zona glomerulosa adjacent to double-mutant APAs. Nine of ten patients in our UK/Irish cohort presented in puberty, pregnancy or menopause. Among multiple transcripts upregulated more than tenfold in double-mutant APAs was LHCGR, the receptor for luteinizing or pregnancy hormone (human chorionic gonadotropin). Transfections of adrenocortical cells demonstrated additive effects of GNA11 and CTNNB1 mutations on aldosterone secretion and expression of genes upregulated in double-mutant APAs. In adrenal cortex, GNA11/Q mutations appear clinically silent without a codriver mutation of CTNNB1.
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