Gadelha M R, Une K N, Rohde K, Vaisman M, Kineman R D, Frohman L A
Department of Medicine, University of Illinois at Chicago, 60612, USA.
J Clin Endocrinol Metab. 2000 Feb;85(2):707-14. doi: 10.1210/jcem.85.2.6386.
The majority of somatotropinomas are sporadic, although a small number occur with a familial aggregation, either as a component of an endocrine neoplasia complex that includes multiple endocrine neoplasia type 1 (MEN-1) and Carney complex (CNC) or as isolated familial somatotropinomas (IFS). IFS is defined as the occurrence of at least two cases of acromegaly or gigantism in a family that does not exhibit MEN-1 or CNC. This rare disease is associated with loss of heterozygosity (LOH) on chromosome 11q13, the locus of the MEN-1 gene, although the MEN-1 sequence and expression appear normal. These data suggest the presence of another tumor suppressor gene located at 11q13 that is important in the control of somatotrope proliferation. To establish linkage of IFS to 11q13 and to define the candidate interval of the IFS gene, we performed haplotype and allelotype analyses on two families with IFS. Collectively, allelic retention in one tumor and a recombinant haplotype in an affected individual mapped the tumor suppressor gene involved in the pathogenesis of IFS to a region of 8.6 cM between polymorphic microsatellite markers D11S1335 and INT-2 located at chromosome 11q13.1-13.3. Maximum two-point LOD scores for five markers within this region were 3.0 or more at theta = 0.0. As somatotropinomas are the predominant pituitary tumor subtype associated with CNC and arise before 30 yr of age, which is strikingly similar to the age at diagnosis for IFS, we explored the possibility that the putative CNC genes might also contribute to the pathogenesis of IFS. Although the genetic defect responsible for the complex is unknown, CNC has been mapped by linkage analysis to chromosomes 2p15-16 and 17q23-24 in different kindreds. Two-point LOD scores less than -2.0 were obtained using marker D17S949 from chromosome 17q23-24, excluding linkage. However, LOD scores of 2.5 were obtained for markers within 2p16-12; therefore, linkage of IFS to chromosome 2p cannot be excluded. This report establishes linkage of the tumor suppressor gene involved in the pathogenesis of IFS to chromosome 11q13.1-13.3 and identifies a potential second locus at chromosome 2p16-12.
大多数生长激素瘤是散发性的,尽管少数是家族聚集性的,要么是作为内分泌肿瘤综合征的一部分,包括多发性内分泌腺瘤1型(MEN - 1)和卡尼综合征(CNC),要么是孤立性家族性生长激素瘤(IFS)。IFS被定义为在一个不表现出MEN - 1或CNC的家族中至少出现两例肢端肥大症或巨人症病例。这种罕见疾病与11q13染色体上MEN - 1基因位点的杂合性缺失(LOH)有关,尽管MEN - 1的序列和表达看起来正常。这些数据表明在11q13存在另一个肿瘤抑制基因,它在生长激素细胞增殖的控制中起重要作用。为了确定IFS与11q13的连锁关系并定义IFS基因的候选区间,我们对两个IFS家族进行了单倍型和等位基因分型分析。总体而言,一个肿瘤中的等位基因保留和一个受影响个体中的重组单倍型将参与IFS发病机制的肿瘤抑制基因定位到位于11q13.1 - 13.3的多态性微卫星标记D11S1335和INT - 2之间8.6 cM的区域。该区域内五个标记的最大两点LOD分数在θ = 0.0时为3.0或更高。由于生长激素瘤是与CNC相关的主要垂体肿瘤亚型,且发病年龄在30岁之前,这与IFS的诊断年龄惊人地相似,我们探讨了推测的CNC基因也可能参与IFS发病机制的可能性。尽管导致该综合征的基因缺陷尚不清楚,但通过连锁分析已将CNC定位到不同家族的2p15 - 16和17q23 - 24染色体上。使用来自17q23 - 24染色体的标记D17S949获得的两点LOD分数小于 - 2.0,排除了连锁关系。然而,在2p16 - 12内的标记获得了2.5的LOD分数;因此,不能排除IFS与2号染色体的连锁关系。本报告确定了参与IFS发病机制的肿瘤抑制基因与11q13.1 - 13.3染色体的连锁关系,并在2p16 - 12染色体上鉴定出一个潜在的第二个位点。