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Steroid 21-hydroxylase gene mutational spectrum in 454 Argentinean patients: genotype-phenotype correlation in a large cohort of patients with congenital adrenal hyperplasia.
Clin Endocrinol (Oxf). 2011 Oct; 75(4):427-35.CE

Abstract

OBJECTIVE

To report genotype-phenotype correlation in a large cohort of patients.

CONTEXT

Study of the CYP21A2 gene in 866 unrelated chromosomes of 21-hydroxylase deficiency in Argentinean patients with classic and nonclassic (NC) forms of congenital adrenal hyperplasia (CAH).

METHODS

Eleven most common mutations were analysed by allele-specific polymerase chain reaction, restriction fragment length polymorphism (RFLP) or southern blot analysis. Gene sequencing was performed when no mutation was detected in one allele or the genotype-phenotype correlation was lacking.

RESULTS

The 11-most-common-mutation screening allowed for the detection of 88·1% of affected alleles (80·3% in the NC and 95·2% in the classic forms). p.V281L, IVS2-13A/C>G (In2) and gene deletions and large gene conversions were the most prevalent mutations. In2 (35·2%) in salt wasting (SW), p.I172N (37·3%) in simple virilizing and p.V281L (54·1%) in NC CAH were the most prevalent mutations within the clinical forms. In 7/15 p.P30L mutation alleles, a chimeric CYP21A1P/CYP21A2 gene [PromCYP21A1P; p.P30L] was detected, while 6/15 represented a single-nucleotide substitution, and in 2/15 linkage with mutations, p.[P30L; V281L] and [p.P30L; IVS2-13A/C > G; p.Q318X] was found. In two SW patients, a novel nonsense mutation, p.Q41X, was observed. In three p.V281L mutation patients, the phenotype was more severe than predicted by genotype. Sequence analysis revealed an intronic alteration in the allele carrying the p.V281L mutation [IVS2 + 5G > A; p.V281L]. An aberrant splicing in this p.V281L mutated allele explains the clinical phenotype.

CONCLUSIONS

A high percentage of CYP21A2 affected alleles is detected by the 11-mutation screening study. Genotype-phenotype correlation was high, but when the phenotype is more severe than predicted by genotype, presence of two alterations in one allele should be ruled out.

Authors+Show Affiliations

Endocrinology Service, Hospital de Pediatria Garrahan, Buenos Aires, Argentina.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21609351

Citation

Marino, Roxana, et al. "Steroid 21-hydroxylase Gene Mutational Spectrum in 454 Argentinean Patients: Genotype-phenotype Correlation in a Large Cohort of Patients With Congenital Adrenal Hyperplasia." Clinical Endocrinology, vol. 75, no. 4, 2011, pp. 427-35.
Marino R, Ramirez P, Galeano J, et al. Steroid 21-hydroxylase gene mutational spectrum in 454 Argentinean patients: genotype-phenotype correlation in a large cohort of patients with congenital adrenal hyperplasia. Clin Endocrinol (Oxf). 2011;75(4):427-35.
Marino, R., Ramirez, P., Galeano, J., Perez Garrido, N., Rocco, C., Ciaccio, M., Warman, D. M., Guercio, G., Chaler, E., Maceiras, M., Bergadá, I., Gryngarten, M., Balbi, V., Pardes, E., Rivarola, M. A., & Belgorosky, A. (2011). Steroid 21-hydroxylase gene mutational spectrum in 454 Argentinean patients: genotype-phenotype correlation in a large cohort of patients with congenital adrenal hyperplasia. Clinical Endocrinology, 75(4), 427-35. https://doi.org/10.1111/j.1365-2265.2011.04123.x
Marino R, et al. Steroid 21-hydroxylase Gene Mutational Spectrum in 454 Argentinean Patients: Genotype-phenotype Correlation in a Large Cohort of Patients With Congenital Adrenal Hyperplasia. Clin Endocrinol (Oxf). 2011;75(4):427-35. PubMed PMID: 21609351.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Steroid 21-hydroxylase gene mutational spectrum in 454 Argentinean patients: genotype-phenotype correlation in a large cohort of patients with congenital adrenal hyperplasia. AU - Marino,Roxana, AU - Ramirez,Pablo, AU - Galeano,Jesica, AU - Perez Garrido,Natalia, AU - Rocco,Carlos, AU - Ciaccio,Marta, AU - Warman,Diana M, AU - Guercio,Gabriela, AU - Chaler,Eduardo, AU - Maceiras,Mercedes, AU - Bergadá,Ignacio, AU - Gryngarten,Mirta, AU - Balbi,Viviana, AU - Pardes,Esther, AU - Rivarola,Marco A, AU - Belgorosky,Alicia, PY - 2011/5/26/entrez PY - 2011/5/26/pubmed PY - 2012/4/25/medline SP - 427 EP - 35 JF - Clinical endocrinology JO - Clin Endocrinol (Oxf) VL - 75 IS - 4 N2 - OBJECTIVE: To report genotype-phenotype correlation in a large cohort of patients. CONTEXT: Study of the CYP21A2 gene in 866 unrelated chromosomes of 21-hydroxylase deficiency in Argentinean patients with classic and nonclassic (NC) forms of congenital adrenal hyperplasia (CAH). METHODS: Eleven most common mutations were analysed by allele-specific polymerase chain reaction, restriction fragment length polymorphism (RFLP) or southern blot analysis. Gene sequencing was performed when no mutation was detected in one allele or the genotype-phenotype correlation was lacking. RESULTS: The 11-most-common-mutation screening allowed for the detection of 88·1% of affected alleles (80·3% in the NC and 95·2% in the classic forms). p.V281L, IVS2-13A/C>G (In2) and gene deletions and large gene conversions were the most prevalent mutations. In2 (35·2%) in salt wasting (SW), p.I172N (37·3%) in simple virilizing and p.V281L (54·1%) in NC CAH were the most prevalent mutations within the clinical forms. In 7/15 p.P30L mutation alleles, a chimeric CYP21A1P/CYP21A2 gene [PromCYP21A1P; p.P30L] was detected, while 6/15 represented a single-nucleotide substitution, and in 2/15 linkage with mutations, p.[P30L; V281L] and [p.P30L; IVS2-13A/C > G; p.Q318X] was found. In two SW patients, a novel nonsense mutation, p.Q41X, was observed. In three p.V281L mutation patients, the phenotype was more severe than predicted by genotype. Sequence analysis revealed an intronic alteration in the allele carrying the p.V281L mutation [IVS2 + 5G > A; p.V281L]. An aberrant splicing in this p.V281L mutated allele explains the clinical phenotype. CONCLUSIONS: A high percentage of CYP21A2 affected alleles is detected by the 11-mutation screening study. Genotype-phenotype correlation was high, but when the phenotype is more severe than predicted by genotype, presence of two alterations in one allele should be ruled out. SN - 1365-2265 UR - https://www.unboundmedicine.com/medline/citation/21609351/Steroid_21_hydroxylase_gene_mutational_spectrum_in_454_Argentinean_patients:_genotype_phenotype_correlation_in_a_large_cohort_of_patients_with_congenital_adrenal_hyperplasia_ L2 - https://doi.org/10.1111/j.1365-2265.2011.04123.x DB - PRIME DP - Unbound Medicine ER -