1. Contribution of LHX4 Mutations to Pituitary Deficits in a Cohort of 417 Unrelated Patients
- Author
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Michel Polak, Enzo Cohen, Sophie Rose, Frédéric Brioude, Nathalie Collot, Daniela Larizza, Marie Legendre, Florence Dastot, Juliane Léger, Anne Marie Bertrand, Philippe Duquesnoy, Marie Laure Sobrier, Philippe Touraine, Mohamad Maghnie, Bruno Copin, Maïté Tauber, Irène Netchine, Serge Amselem, Isabelle Oliver-Petit, Laura González Briceño, Thomas Edouard, Physiopathologie des maladies génétiques d'expression pédiatrique, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Università degli studi di Genova = University of Genoa (UniGe), Service de génétique et embryologie médicales [CHU Trousseau], CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Référence des Maladies Endocriniennes Rares de la Croissance [APHP Robert Debré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7), Service d'endocrinologie, gynécologie et diabétologie pédiatriques [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Digestive et Endocrinienne [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de Diabétologie - Endocrinologie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service d'explorations fonctionnelles [CHU Trousseau], Fondazione IRCCS Policlinico San Matteo [Pavia], Università degli Studi di Pavia = University of Pavia (UNIPV), Couvet, Sandrine, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Pitié-Salpêtrière [AP-HP], and Societe Francaise d'Endocrinologie et Diabetologie PediatriqueFondation pour la Recherche Medicale PLP20131028838
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0301 basic medicine ,Male ,Pituitary gland ,MESH: Sequence Homology, Amino Acid ,Endocrinology, Diabetes and Metabolism ,[SDV]Life Sciences [q-bio] ,Clinical Biochemistry ,Sequence Homology ,Hypopituitarism ,MESH: Amino Acid Sequence ,medicine.disease_cause ,MESH: Hypopituitarism ,Biochemistry ,Cohort Studies ,0302 clinical medicine ,Endocrinology ,MESH: Child ,Child ,MESH: Cohort Studies ,Genetics ,Sanger sequencing ,Mutation ,Blotting ,MESH: Infant, Newborn ,MESH: Transcription Factors ,MESH: Follow-Up Studies ,Prognosis ,MESH: Infant ,Ectopic Posterior Pituitary ,Pedigree ,Diabetes and Metabolism ,[SDV] Life Sciences [q-bio] ,Amino Acid ,medicine.anatomical_structure ,Sella turcica ,Child, Preschool ,symbols ,Female ,Western ,medicine.medical_specialty ,MESH: Mutation ,Adolescent ,MESH: Pedigree ,Blotting, Western ,LIM-Homeodomain Proteins ,030209 endocrinology & metabolism ,Context (language use) ,Biology ,[SDV.GEN.GH] Life Sciences [q-bio]/Genetics/Human genetics ,MESH: Prognosis ,03 medical and health sciences ,symbols.namesake ,Internal medicine ,medicine ,Humans ,Immunoprecipitation ,MESH: Blotting, Western ,Amino Acid Sequence ,Preschool ,Biomarkers ,Follow-Up Studies ,Infant ,Infant, Newborn ,Sequence Homology, Amino Acid ,Transcription Factors ,Biochemistry (medical) ,MESH: Adolescent ,MESH: LIM-Homeodomain Proteins ,MESH: Humans ,MESH: Immunoprecipitation ,MESH: Child, Preschool ,Heterozygote advantage ,medicine.disease ,Newborn ,MESH: Male ,030104 developmental biology ,[SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics ,MESH: Biomarkers ,MESH: Female - Abstract
Context:LHX4 encodes a LIM-homeodomain transcription factor that is implicated in early pituitary development. In humans, only 13 heterozygous LHX4 mutations have been associated with congenital hypopituitarism.Objective:The aims of this study were to evaluate the prevalence of LHX4 mutations in patients with hypopituitarism, to define the associated phenotypes, and to characterize the functional impact of the identified variants and the respective role of the 2 LIM domains of LHX4.Design and Patients:We screened 417 unrelated patients with isolated growth hormone deficiency or combined pituitary hormone deficiency associated with ectopic posterior pituitary and/or sella turcica anomalies for LHX4 mutations (Sanger sequencing). In vitro studies were performed to assess the functional consequences of the identified variants.Results:We identified 7 heterozygous variations, including p.(Tyr131*), p.(Arg48Thrfs*104), c.606+1G>T, p.Arg65Val, p.Thr163Pro, p.Arg221Gln, and p.Arg235Gln), that were associated with variable expressivity; 5 of the 7 were also associated with incomplete penetrance. The p.(Tyr131*), p.(Arg48Thrfs*104), p.Ala65Val, p.Thr163Pro, and p.Arg221Gln LHX4 variants are unable to transactivate the POU1F1 and GH promoters. As suggested by transactivation, subcellular localization, and protein-protein interaction studies, p.Arg235Gln is probably a rare polymorphism. Coimmunoprecipitation studies identified LHX3 as a potential protein partner of LHX4. As revealed by functional studies of LIM-defective recombinant LHX4 proteins, the LIM1 and LIM2 domains are not redundant.Conclusion:This study, performed in the largest cohort of patients screened so far for LHX4 mutations, describes 6 disease-causing mutations that are responsible for congenital hypopituitarism. LHX4 mutations were found to be associated with variable expressivity, and most of them with incomplete penetrance; their contribution to pituitary deficits that are associated with an ectopic posterior pituitary and/or a sella turcica defect is ∼1.4% in the 417 probands tested.
- Published
- 2017
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