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Heterozygous mutation of HESX1 causing hypopituitarism and multiple anatomical malformations without features of septo-optic dysplasia

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Abstract

Isolated GH deficiency or combined pituitary hormone deficiencies have been associated with mutations in transcription factors encoding genes that control organogenesis or cell differentiation. Among these factors, Hesx1 is essential for the development of the optic nerve and regulates some of the earliest stages in pituitary development and is intimately involved in orchestrating the expression of other factors involved in pituitary organogenesis. Mutations in HESX1 are reported in patients with hypopituitarism either with typical septo-optic dysplasia (SOD) or with neuromorphological abnormalities not included in classical SOD. The present report describes clinical features, biochemical parameters, and characterization of a missense mutation (Gln6His) in exon1 of HESX1 in a pre-pubertal child who progressively developed multiple hypopituitarism, firstly GH and, afterwards, TSH and ACTH deficiencies, in a pluri-malformative syndrome characterized by short stature and anatomical malformations not associated with a classical SOD phenotype. This finding further supports the necessity to stay alert in evaluating a gene that plays a minor role in the pathogenesis of sporadic hypopituitarism, such as HESX1 gene even when the phenotype does not fit in with a classical SOD syndrome.

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References

  1. Rosenfeld MG, Briata P, Dasen J, et al. Multipstep signaling and transcriptional requirements for pituitary organogenesis in vivo. Recent Prog Horm Res 2000, 55: 1–14.

    CAS  PubMed  Google Scholar 

  2. Cohen LE, Radovick S. Molecular basis of combined pituitary hormone deficiencies. End Rev 2002, 23: 431–42.

    Article  CAS  Google Scholar 

  3. Hermesz E, Mackem S, Mahon KA. Rpx: a novel anterior-restricted homeobox gene progressively activated in the prechordal plate, anterior neural plate and Rathke’s pouch of the mouse embryo. Development 1996, 122: 41–52.

    CAS  PubMed  Google Scholar 

  4. Gage PJ, Brinkmeier ML, Scarlett LM, Knapp LT, Camper SA, Mahon KA. The Ames dwarf gene, df, is required early in pituitary ontogeny for the extinction of Rpx transcription and initiation of lineage-specific cell proliferation. Mol Endocrinol 1996, 10: 1570–81.

    CAS  PubMed  Google Scholar 

  5. Martinez-Barbera JP, Rodriguez TA, Beddington RS. The homeobox gene Hesx1 is required in the anterior neural forebrain formation. Dev Biol 2000, 223: 422–30.

    Article  CAS  PubMed  Google Scholar 

  6. Dattani MT, Robinson IC. HESX1 and Septo-Optic Dysplasia. Rev Endocr Metab Disord 2002, 3: 289–300.

    Article  PubMed  Google Scholar 

  7. Dattani MT, Martinez-Barbera JP, Thomas PQ, et al. Mutations in the homeobox gene HESX1/Hesx1 associated with septo-optic dysplasia in human and mouse. Nat Genet 1998, 19: 125–33.

    Article  CAS  PubMed  Google Scholar 

  8. Sobrier ML, Netchine I, Heinrichs C, et al. Alu-element insertion in the homeodomain of HESX1 and aplasia of the anterior pituitary. Hum Mutat 2005, 25: 503.

    Article  PubMed  Google Scholar 

  9. Sobrier ML, Maghnie M, Vié-Luton MP, et al. Novel HESX1 mutations associated with a life-threatening neonatal phenotype, pituitary aplasia, but normally located posterior pituitary and no optic nerve abnormalities. J Clin Endocrinol Metab 2006, 91: 4528–36.

    Article  CAS  PubMed  Google Scholar 

  10. Melo ME, Marui S, Carvalho LR, et al. Hormonal, pituitary magnetic resonance, LHX4 and HESX1 evaluation in patients with hypopituitarism and ectopic posterior pituitary lobe. Clin Endocrinol (Oxf) 2007, 66: 95–102.

    CAS  Google Scholar 

  11. Carvalho LR, Woods KS, Mendonca BB, et al. A homozygous mutation in HESX1 is associated with evolving hypopituitarism due to impaired repressor-corepressor interaction. J Clin Invest 2003, 112: 1192–201.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Thomas PQ, Dattani MT, Brickman JM, et al. Heterozygous HESX1 mutations associated with isolated congenital pituitary hypoplasia and septo-optic dysplasia. Hum Mol Gen 2001, 10: 39–45.

    Article  CAS  PubMed  Google Scholar 

  13. Tajima T, Hattorri T, Nakajima T, et al. Sporadic heterozygous frameshift mutation of HESX1 causing pituitary and optic nerve hypoplasia and combined pituitary hormone deficiency in a Japanese patient. J Clin Endocrinol Metab 2003, 88: 45–50.

    Article  CAS  PubMed  Google Scholar 

  14. Cohen RN, Cohen LE, Botero D, et al. Enhanced repression by HESX1 as a cause of hypopituitarism and septooptic dysplasia. J Clin Endocrinol Metab 2003, 88: 4832–9.

    Article  CAS  PubMed  Google Scholar 

  15. Coya R, Vela A, Pérez de Nanclares G, et al; GEDPIT group. Panhypopituitarism: genetic versus acquired etiological factors. J Pediatr Endocrinol Metab 2007, 20: 27–36.

    Article  CAS  PubMed  Google Scholar 

  16. McNay DE, Turton JP, Kelberman D, et al. HESX1 mutations are an uncommon cause of septooptic dysplasia and hypopituitarism. J Clin Endocrinol Metab 2007, 92: 691–7.

    Article  CAS  PubMed  Google Scholar 

  17. Ranke MB, Haber P. Growth hormone stimulation tests. In Functional Endocrinologic Diagnostics in Children and Adolescents, edn 1, pp 61–75. Ed. Ranke MB, J&J Verlag: Mannheim, 1992.

    Google Scholar 

  18. Miller SA, Dykes DD, Polesky HF. A simple salting-out procedure for extracting DNA from human nucleated cells. Nucleic Acids Res 1988, 16: 1215.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Brucker-Davis F, Pointis G, Chevallier D, Fenichel P. Update on cryptorchidism: endocrine, environmental and therapeutic aspects. J Endocrinol Invest 2003, 26: 575–87.

    Article  CAS  PubMed  Google Scholar 

  20. Brickman JM, Clements M, Tyrell R, et al. Molecular effects of novel mutations in Hesx1/HESX1 associated with human pituitary disorders. Development 2001, 128: 5189–99.

    CAS  PubMed  Google Scholar 

  21. Smith ST, Jaynes JB. A conserved region of engrailed, shared among all en-, gsc-, Nk1 -, Nk2- and msh-class homeoproteins, mediates active transcriptional repression in vivo. Development 1996, 122: 3141–50.

    CAS  PubMed Central  PubMed  Google Scholar 

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Correspondence to G. Bona MD.

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Corneli, G., Vivenza, D., Prodam, F. et al. Heterozygous mutation of HESX1 causing hypopituitarism and multiple anatomical malformations without features of septo-optic dysplasia. J Endocrinol Invest 31, 689–693 (2008). https://doi.org/10.1007/BF03346416

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