1. Somatic mutations in ATP1A1 and CACNA1D underlie a common subtype of adrenal hypertension
- Author
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Azizan, E.A., Poulsen, H., Tuluc, P., Zhou, J, Clausen, M.V., Lieb, A., Maniero, C., Garg, S., Bochukova, E.G., Zhao, W., Shaikh, L.H., Brighton, C.A., Teo, A.E., Davenport, A.P., Dekkers, T., Tops, B., Kusters, B., Ceral, J., Yeo, G.S., Neogi, S.G., McFarlane, I., Rosenfeld, N., Marass, F., Hadfield, J., Margas, W., Chaggar, K., Solar, M., Deinum, J., Dolphin, A.C., Farooqi, I.S., Striessnig, J., Nissen, P., Brown, M.J., Azizan, E.A., Poulsen, H., Tuluc, P., Zhou, J, Clausen, M.V., Lieb, A., Maniero, C., Garg, S., Bochukova, E.G., Zhao, W., Shaikh, L.H., Brighton, C.A., Teo, A.E., Davenport, A.P., Dekkers, T., Tops, B., Kusters, B., Ceral, J., Yeo, G.S., Neogi, S.G., McFarlane, I., Rosenfeld, N., Marass, F., Hadfield, J., Margas, W., Chaggar, K., Solar, M., Deinum, J., Dolphin, A.C., Farooqi, I.S., Striessnig, J., Nissen, P., and Brown, M.J.
- Abstract
Item does not contain fulltext, At least 5% of individuals with hypertension have adrenal aldosterone-producing adenomas (APAs). Gain-of-function mutations in KCNJ5 and apparent loss-of-function mutations in ATP1A1 and ATP2A3 were reported to occur in APAs. We find that KCNJ5 mutations are common in APAs resembling cortisol-secreting cells of the adrenal zona fasciculata but are absent in a subset of APAs resembling the aldosterone-secreting cells of the adrenal zona glomerulosa. We performed exome sequencing of ten zona glomerulosa-like APAs and identified nine with somatic mutations in either ATP1A1, encoding the Na(+)/K(+) ATPase alpha1 subunit, or CACNA1D, encoding Cav1.3. The ATP1A1 mutations all caused inward leak currents under physiological conditions, and the CACNA1D mutations induced a shift of voltage-dependent gating to more negative voltages, suppressed inactivation or increased currents. Many APAs with these mutations were <1 cm in diameter and had been overlooked on conventional adrenal imaging. Recognition of the distinct genotype and phenotype for this subset of APAs could facilitate diagnosis.
- Published
- 2013