title: The first activating TSH receptor mutation in transmembrane domain 1 identified in a family with nonautoimmune hyperthyroidism.
abstract: Sporadic and familial nonautoimmune hyperthyroidism are very rarely occurring diseases. Within the last years constitutively activating TSH receptor mutations were identified as one possible pathomechanism. Except for S281N in the extracellular N-terminal domain, all other germline mutations are located in the transmembrane domains 2, 3, 5, 6, and 7 of the TSH receptor, whereas no mutation was reported in transmembrane domains 1 and 4 to date. Here we report the first family with a constitutively active TSHR mutation in transmembrane domain 1 resulting in a substitution of the conserved Gly(431) for Ser. This mutation was found in the investigated patient, his father, and the paternal grandmother. As known from other familial cases of nonautoimmune hyperthyroidism, the age of onset of the disease was variable, ranging from early childhood in the patient and his father to adolescence in the grandmother. Functional characterization of this mutation showed a constitutive activation of the G(s)/adenylyl cyclase system. Moreover, this germline mutation also activates the G(q/11)/phospholipase C pathway. The importance of Gly(431) for receptor quiescence is supported further by introduction of other mutations at this position, all leading to constitutive receptor activity. Our data show now that constitutively activating mutations can be found in the entire transmembrane domain region of the TSH receptor, indicating the important role of all parts of the transmembrane domain region for maintaining the inactive receptor conformation.
authors.affiliation: Otto Heubner Centrum für Kinderheilkunde und Jugendmedizin, Pädiatrische Endokrinologie, Charité Campus Virchow Klinikum, Humboldt Universität zu Berlin, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Biebermann
authors.forename: T
authors.initials: T
authors.lastname: Schöneberg
authors.forename: C
authors.initials: C
authors.lastname: Hess
authors.forename: J
authors.initials: J
authors.lastname: Germak
authors.forename: T
authors.initials: T
authors.lastname: Gudermann
authors.forename: A
authors.initials: A
authors.lastname: Grüters
mesh_terms: D000262:Adenylyl Cyclases / Q000235:genetics; D000818:Animals; D019556:COS Cells; D002675:Child, Preschool; D000242:Cyclic AMP / Q000378:metabolism; D004247:DNA / Q000235:genetics*; D005260:Female; D019205:GTP-Binding Protein alpha Subunits, Gs / Q000378:metabolism; D016678:Genome; D006801:Humans; D006980:Hyperthyroidism / Q000097:blood / Q000235:genetics*; D008297:Male; D020125:Mutation, Missense / Q000235:genetics*; D010375:Pedigree; D010957:Plasmids / Q000235:genetics; D011989:Receptors, Thyrotropin / Q000235:genetics*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013963:Thyroid Hormones / Q000097:blood; D013972:Thyrotropin / Q000378:metabolism; D010738:Type C Phospholipases / Q000378:metabolism
chemical_list: D011989:Receptors, Thyrotropin; D013963:Thyroid Hormones; D013972:Thyrotropin; D004247:DNA; D000242:Cyclic AMP; D010738:Type C Phospholipases; D019205:GTP-Binding Protein alpha Subunits, Gs; D000262:Adenylyl Cyclases