Department of Medical Genetics, Erciyes University, Kayseri, 38039, Turkey.
Department of Radiology, Mayo Clinic, Rochester, MN, 55905, USA.
Mol Biol Rep. 2019 Aug;46(4):3677-3690. doi: 10.1007/s11033-019-04809-4. Epub 2019 Apr 20.
Congenital adrenal hyperplasia (CAH) is an autosomal recessive genetic disorder due to presence of mutations in the genes involved in the metabolism of steroid hormones in adrenal gland. There are two main forms of CAH, classic form and non-classic form. While classic form stands for the severe form, the non-classic form stands for the moderate and more frequent form of CAH. The enzyme deficiencies such as 21-hydroxylase, 11-beta-hydroxylase, 3-beta-hydroxysteroid dehydrogenase, 17-alpha-hydroxylase deficiencies are associated with CAH. In this study, we aimed to investigate CYP21A2, CYP11B1, HSD3B2 genes which are associated with 21-hydroxylase, 11-beta-hydroxylase and 3-beta-hydroxysteroid dehydrogenase enzyme deficiencies, respectively, in 365 individuals by using Sanger sequencing method. We emphasized the classification of variants according their disease causing potential, and evaluated variants' frequencies including newly discovered novel variants. As a result, 32 variants of CYP21A2 including 10 novel variants, 9 variants of CYP11B1 including 3 novel variants and 6 variants of HSD3B2 including 4 novel variants were identified. The conclusions of our study showed that in Anatolia, discovery of novel variants is quite common on account of tremendous ratios of consanguineous marriages which increases the frequency of CAH. These results will contribute to the understanding of molecular pathology of the disease.
先天性肾上腺皮质增生症(CAH)是一种常染色体隐性遗传疾病,由于肾上腺类固醇激素代谢相关基因发生突变所致。CAH 主要有两种形式,经典型和非经典型。经典型代表严重形式,而非经典型代表 CAH 中较为常见的中度形式。21-羟化酶、11-β羟化酶、3-β羟类固醇脱氢酶等酶缺乏与 CAH 相关。在这项研究中,我们旨在通过桑格测序法对 365 名个体的 CYP21A2、CYP11B1 和 HSD3B2 基因进行研究,这三个基因分别与 21-羟化酶、11-β羟化酶和 3-β羟类固醇脱氢酶缺乏有关。我们根据致病变异的可能性对变异进行分类,并评估包括新发现的罕见变异在内的变异频率。结果发现,CYP21A2 有 32 个变异,包括 10 个新变异;CYP11B1 有 9 个变异,包括 3 个新变异;HSD3B2 有 6 个变异,包括 4 个新变异。本研究的结论表明,由于安纳托利亚地区近亲结婚的比例很高,导致 CAH 的发病率增加,因此新的罕见变异的发现相当普遍。这些结果将有助于理解该疾病的分子病理学。