Steroid 11-beta-hydroxylase deficiency caused by compound heterozygosity for a novel mutation, p.G314R, in one CYP11B1 allele, and a chimeric CYP11B2/CYP11B1 in the other allele.
OBJECTIVE
Steroid 11beta-hydroxylase deficiency (11beta-OHD) is the second most common (5-8%) cause of congenital adrenal hyperplasia (CAH), and results from homozygous or compound heterozygous mutations or deletions of the responsible gene CYP11B1. In order to better understand the molecular basis causing 11beta-OHD, we performed detailed studies of CYP11B1 in a newly described patient diagnosed with the classical signs of 11beta-OHD.


METHODS
CYP11B1 of the patient was investigated by polymerase chain reaction (PCR), sequencing, restriction fragment length polymorphism (RFLP) analysis, Southern blotting, and transient cell expression.


RESULTS
We identified two new mutated alleles in CYP11B1. In one allele CYP11B1 has a g.940G-->C (p.G314R) missense mutation. On the other allele we found a chimeric gene that consists of part of the aldosterone synthase gene (CYP11B2) at exons 1-3 and part of the 11beta-hydroxylase gene (CYP11B1) at exons 4-9. Inin vitro studies, the g.940G-->C (p.G314R) mutation abolished all hydroxylase activity in comparison with the wild-type 11beta-hydroxylase. The chimeric CYP11B2/CYP11B1 protein retained 11beta-hydroxylase enzymatic activity in vitro.


CONCLUSIONS
This case is caused by compound heterozygosity for a nonfunctional missense mutation and a chimeric CYP11B2/CYP11B1 gene with hydroxylase activity that is controlled by the CYP11B2 promoter. The most likely explanation is that the CYP11B2 promoter does not function in the zona fasciculata/reticularis where cortisol is exclusively synthesized.
Kuribayashi
Isao
I
Department of Molecular Genetics, Kochi University Medical School, Nankoku, Kochi, Japan. kuribaya@med.kochi-u.ac.jp
Nomoto
Satoshi
S
Massa
Guy
G
Oostdijk
Wilma
W
Wit
Jan M
JM
Wolffenbuttel
Bruce H R
BH
Shizuta
Yutaka
Y
Honke
Koichi
K
D000312:Adrenal Hyperplasia, Congenital / Q000201:enzymology / Q000235:genetics*; D000483:Alleles; D000595:Amino Acid Sequence; D000818:Animals; D001483:Base Sequence; D019556:COS Cells; D002675:Child, Preschool; D002522:Chlorocebus aethiops; D019405:Cytochrome P-450 CYP11B2 / Q000235:genetics*; D006579:Heterozygote; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D020125:Mutation, Missense; D011993:Recombinant Fusion Proteins / Q000235:genetics; D016415:Sequence Alignment; D013252:Steroid 11-beta-Hydroxylase / Q000096:biosynthesis / Q000235:genetics*; D015383:Zona Fasciculata / Q000201:enzymology
D011993:Recombinant Fusion Proteins; D019405:Cytochrome P-450 CYP11B2; D013252:Steroid 11-beta-Hydroxylase