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Progress in molecular-genetic studies on congenital adrenal hyperplasia due to 11β-hydroxylase deficiency

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Abstract

Background

11β-hydroxylase deficiency is one of the main causes of congenital adrenal hyperplasia (CAH). It is caused by the mutation of the CYP11B1 gene that encodes the enzyme. Researches have shown that mutations of the CYP11B1 gene would result in activity decrease or inactivation of the enzyme in classical 11β-hydroxylase deficiency.

Data sources

Articles on CAH and CYP11B1 gene mutation were retrieved from PubMed and MEDLINE published after 1991.

Results

The prevalence, pathophysiology, and molecular-genetic mechanisms were summarized.

Conclusions

The disease is caused by genetic mutations of CYP11B1, and types of the mutations are varied. In classical 11β-hydroxylase deficiency, genetic mutations of CYP11B1 lead to activity decrease or loss; mutations in unclassical 11β-hydroxylase deficiency are not definite. And the relationship between genotype and phenotype is not established.

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References

  1. Speiser PW, White PC. Congenital adrenal hyperplasia. N Engl J Med 2003;349:776–788.

    Article  PubMed  CAS  Google Scholar 

  2. Hughes I. Congenital adrenal hyperplasia. Medicine 2005;33:25–26.

    Article  Google Scholar 

  3. Nimkarn S, New MI. Steroid 11beta-hydroxylase deficiency congenital adrenal hyperplasia. Trends Endocrinol Metab 2008;19:96–99.

    PubMed  CAS  Google Scholar 

  4. Pasterski V, Hindmarsh P, Geffner M, Brook C, Brain C, Hines M. Increased aggression and activity level in 3-to 11-year-old girls with congenital adrenal hyperplasia (CAH). Horm Behav 2007;52:368–374.

    Article  PubMed  CAS  Google Scholar 

  5. Chemaitilly W, Wilson RC, New MI. Hypertension and Adrenal Disorders. Curr Hypertens Rep 2003;5:498–504.

    Article  PubMed  Google Scholar 

  6. Deng C, Ji J, Zhang L, Zhang X. Diagnosis of congenital adrenal hyperplasia by rapid determination of 17alpha-hydroxyprogesterone in dried blood spots by gas chromatography/mass spectrometry following microwaveassisted silylation. Rapid Commun Mass Spectrom 2005;19:2974–2978.

    Article  PubMed  CAS  Google Scholar 

  7. Krone N, Riepe FG, Götze D, Korsch E, Rister M, Commentz J, et al. Congenital adrenal hyperplasia due to 11-hydroxylase deficiency: functional characterization of two novel point mutations and a three-base pair deletion in the CYP11B1 gene. J Clin Endocrinol Metab 2005;90:3724–3730.

    Article  PubMed  CAS  Google Scholar 

  8. Krone N, Riepe FG, Grötzinger J, Partsch CJ, Sippell WG. Functional characterization of two novel point mutations in the CYP21 gene causing simple virilizing forms of congenital adrenal hyperplasia due to 21-hydroxylase deficiency. J Clin Endocrinol Metab 2005;90:445–454.

    Article  PubMed  CAS  Google Scholar 

  9. Dolzan V, Sólyom J, Fekete G, Kovács J, Rakosnikova V, Votava F, et al. Mutational spectrum of steroid 21-hydroxylase and the genotype-phenotype association in Middle European patients with congenital adrenal hyperplasia. Eur J Endocrinol 2005;153;99–106.

    Article  PubMed  CAS  Google Scholar 

  10. Merke DP, Tajima T, Chhabra A, Barnes K, Mancilla E, Baron J, et al. Novel CYP11B1 mutations in congenital adrenal hyperplasia due to steroid 11 beta-hydroxylase deficiency. J Clin Endocrinol Metab 1998;83:270–273.

    Article  PubMed  CAS  Google Scholar 

  11. Gatelais F, Berthelot J, Beringue F, Descamps P, Bonneau D, Limal JM, et al. Effect of single and multiple courses of prenatal corticosteroids on 17-hydroxyprogesterone levels: implication for neonatal screening of congenital adrenal hyperplasia. Pediatr Res 2004;56:701–705.

    Article  PubMed  CAS  Google Scholar 

  12. Geley S, Kapelari K, Jöhrer K, Peter M, Glatzl J, Vierhapper H, et al. CYP11B1 mutations causing congenital adrenal hyperplasia due to 11 beta-hydroxylase deficiency. J Clin Endocrinol Metab 1996;81:2896–2901.

    Article  PubMed  CAS  Google Scholar 

  13. Wisniewski AB, Migeon CJ, Malouf MA, Gearhart JP. Psychosexual outcome in women affected by congenital adrenal hyperplasia due to 21-hydroxylase deficiency. J Urol 2004;171:2497–2501.

    Article  PubMed  Google Scholar 

  14. Skinner CA, Rumsby G, Honour JW. Single strand conformation polymorphism (SSCP) analysis for the detection of mutations in the CYP11B1 gene. J Clin Endocrinol Metab 1996;81:2389–2393.

    Article  PubMed  CAS  Google Scholar 

  15. Forest MG. Recent advances in the diagnosis and management of congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Hum Reprod Update 2004;10:469–485.

    Article  PubMed  CAS  Google Scholar 

  16. Hampf M, Ngoc Dao NT, Hoan NT, Bernhardt R. Unequal crossing-over between aldosterone synthase and 11β-hydroxylase genes causes congenital adrenal hyperplasia. J Clin Endocrinol Metab 2001;86:4445–4452.

    Article  PubMed  CAS  Google Scholar 

  17. Chabre O, Portrat-Doyen S, Chaffanjon P, Vivier J, Liakos P, Labat-Moleur F, et al. Bilateral laparoscopic adrenalectomy for congenital adrenal hyperplasia with severe hypertension, resulting from two novel mutations in splice donor sites of CYP11B1. J Clin Endocrinol Metab 2000;85:4060–4068.

    Article  PubMed  CAS  Google Scholar 

  18. Olgemöller B, Roscher AA, Liebl B, Fingerhut R. Screening for congenital adrenal hyperplasia: adjustment of 17-hydroxyprogesterone cut-off values to both age and birth weight markedly improves the predictive value. J Clin Endocrinol Metab 2003;88:5790–5794.

    Article  PubMed  CAS  Google Scholar 

  19. Portrat S, Mulatero P, Curnow KM, Chaussain JL, Morel Y, Pascoe L. Deletion hybrid genes, due to unequal crossing over between CYP11B1 (11β-Hydroxylase) and CYP11B2 (aldosterone synthase) cause steroid 11β-hydroxylase deficiency and congenital adrenal hyperplasia. J Clin Endocrinol Metab 2001;86:3197–3201.

    Article  PubMed  CAS  Google Scholar 

  20. Skinner CA, Rumsby G. Steroid 11 beta-hydroxylase deficiency caused by a five base pair duplication in the CYP11B1 gene. Hum Mol Genet 1994;3:377–378.

    Article  PubMed  CAS  Google Scholar 

  21. Muirhead S, Sellers EA, Guyda H. Indicators of adult height outcome in classical 21-hydroxylase deficiency congenital adrenal hyperplasia. J Pediatr 2002;141:247–252.

    Article  PubMed  CAS  Google Scholar 

  22. Cingöz S, Ozkan B, Döneray H, Sakizli M. Familial pericentric inversion chromosome 3 and R448C mutation of CYP11B1 gene in Turkish kindred with 11beta-hydroxylase deficiency. J Endocrinol Invest 2007;30:285–291.

    PubMed  Google Scholar 

  23. Vijayakumar S, Salerno JC. Molecular modeling of the 3-Dstructure of cytochrome P-450scc. Biochim Biophys Acta 1992;1160:281–286.

    PubMed  CAS  Google Scholar 

  24. Rosenfield RL. Serum cortisol and 17-hydroxyprogesterone concentrations in children with classic congenital adrenal hyperplasia. J Clinic Endocrinol Metab 2002;87:2993.

    Article  Google Scholar 

  25. Ravichandran KG, Boddupalli SS, Hasermann CA, Peterson JA, Deisenhofer J. Crystal structure of hemoprotein domain of P450BM-3, a prototype for microsomal P450’s. Science 1993;261:731–736.

    Article  PubMed  CAS  Google Scholar 

  26. Hasemann CA, Ravichandran KG, Peterson JA, Deisenhofer J. Crystal structure and refinement of cytochrome P450terp at 2.3 A solution. J Mol Biol 1994;236:1169–1185.

    Article  PubMed  CAS  Google Scholar 

  27. Nelson DR, Strobel HW. On the membrane topology of vertebrate cytochrome P-450 proteins. J Biol Chem 1988;263:6038–6050.

    PubMed  CAS  Google Scholar 

  28. Tusie-Luna MT, Speiser PW, Dumic M, New MI, White PC. A mutation (Pro-30 to Leu) in CYP21 represents a potential nonclassic steroid 21-hydroxylase deficiency allele. Mol Endocrinol 1991;5:685–692.

    Article  PubMed  CAS  Google Scholar 

  29. Gröschl M, Rauh M, Dörr HG. Cortisol and 17-hydroxyprogesterone kinetics in saliva after oral administration of hydrocortisone in children and young adolescents with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. J Clin Endocrinol Metab 2002;87:1200–1204.

    Article  PubMed  Google Scholar 

  30. Nordenstrom A, Wedell A, Hagenfeldt L, Marcus C, Larsson A. Neonatal screening for congenital adrenal hyperplasia: 17-hydroxyprogesterone levels and CYP21 genotypes in preterm infants. Pediatrics 2001;108:868.

    Article  Google Scholar 

  31. Portrat S, Mulatero P, Curnow KM, Chaussain JL, Morel Y, Pascoe L. Deletion hybrid genes, due to unequal crossing over between CYP11B1 (11beta-hydroxylase) and CYP11B2 (aldosterone synthase) cause steroid 11beta-hydroxylase deficiency and congenital adrenal hyperplasia. J Clin Endocrinol Metab 2001;86:3197–3201.

    Article  PubMed  CAS  Google Scholar 

  32. Curnow KM, Mulatero P, Emeric-Blanchouin N, Aupetit-Faisant B, Corvol P, Pascoe L. The amino acid substitutions Ser288Gly and Val320Ala convert the cortisol producing enzyme, CYP11B1, into an aldosterone producing enzyme. Nat Struct Biol 1997;4:32–35.

    Article  PubMed  CAS  Google Scholar 

  33. Mulatero P, Curnow KM, Aupetit-Faisant B, Foekling M, Gomez-Sanchez C, Veglio F, et al. Recombinant CYP11B genes encode enzymes that can catalyze conversion of 11-deoxycortisol to cortisol, 18-hydroxycortisol, and 18-oxocortisol. J Clin Endocrinol Metab 1998;83:3996–4001.

    Article  PubMed  CAS  Google Scholar 

  34. MacConnachie AA, Kelly KF, McNamara A, Loughlin S, Gates LJ, Inglis GC, et al. Rapid diagnosis and identification of cross-over sites in patients with glucocorticoid remediable aldosteronism. J Clin Endocrinol Metab 1998;83:4328–4331.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Su Han.

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Zhao, LQ., Han, S. & Tian, HM. Progress in molecular-genetic studies on congenital adrenal hyperplasia due to 11β-hydroxylase deficiency. World J Pediatr 4, 85–90 (2008). https://doi.org/10.1007/s12519-008-0016-8

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  • DOI: https://doi.org/10.1007/s12519-008-0016-8

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