SFEBES2021 Oral Communications Adrenal and Cardiovascular (6 abstracts)
Somatic mutations of GNA11 and GNAQ in CTNNB1-mutant aldosterone-producing adenomas presenting in puberty, pregnancy or menopause.
Giulia Argentesi 1 , Elena Azizan 2 , Junhua Zhou 1 , Claudia Cabrera 1 , Sam O’Toole 1 , Xilin Wu 1 , Emily Goodchild 1 , Emily Cottrell 1 , Alison Marker 3 , Russell Senanayake 3 , Sumedha Garg 4 , Suzanne Jordan 5 , Dan Berney 5 , Anna Gluck 6 , Kate Lines 6 , Rajesh V Thakker 6 , Antoinette Tuthill 7 , Caroline Joyce 7 , Fiona Karet Frankl 8 , Lou Metherell 1 , Ada Teo 9 , Mark Gurnell 3 , Laila Parvanta 10 , William Drake 10 , Eva Wozniak 1 , Chaz Mein 1 , Veronika Kinsler 11 , Helen Storr 1 & Morris Brown 12
1Queen Mary University of London, London, United Kingdom; 2Department of Medicine, The National University of Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia; 3Addenbrookes Hospital, Cambridge, United Kingdom; 4Metabolic Research Laboratories, Welcome Trust-MRC Institute of Metabolic Science, Cambridge, United Kingdom; 5Royal London Hospital, London, United Kingdom; 6Academic Endocrine Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; 7Clinical Biochemistry, Cork University Hospital, Cork, Ireland; 8Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom; 9Dept of Medicine, Yong Loo Lin School of Medicine, National University of Singapore,, Singapore, Singapore; 10St Bartholomews Hospital, London, United Kingdom; 11Genetics and Genomic Medicine, University College London Great Ormond Street Institute of Child Health, London, United Kingdom; 12Queen Marys University, London, United Kingdom
Most aldosterone-producing adenomas (APAs) have gain-of-function somatic mutations of ion channels or transporters. However, their frequency in aldosterone-producing cell-clusters of normal adrenals could suggest the existence of co-driver mutations which influence the development or phenotype of APAs [1]. Gain-of-function mutations in both CTNNB1 and the G-protein coupled receptor GNA11 were found by whole exome sequencing in 3/10 APAs. Further sequencing of known CTNNB1-mutant APAs from UK/Irish patients led to 10/10 with a somatic p.Gln209His, p.Gln209Pro or p.Gln209Leu mutation of GNA11/Q. Nine out of ten patients presented at times of high LH/HCG (puberty, pregnancy, menopause). Their double-mutant APAs had >10-fold higher expression of multiple transcripts, including LHCGR, than other APAs. Transfections of NCI-H295R cells (an immortalised adrenocortical cell line with S45P mutation of CTNNB1) with GNA11 Q209H, L or P increased aldosterone secretion and CYP11B2 expression (encoding aldosterone synthase) by 2.5-6.1-fold and 8.0-9.8-fold (P = <0.0005) respectively, compared to vector-transfected cells. H295R cells, and one double-mutant APA, did not express LHCGR, and pointed to alternative mediators of the double-mutant phenotype, e.g. TMEM132E. Fresh adrenal adenoma cells harvested post adrenalectomy were transfected with CTNNB1 and GNA11 mutants, alone or together, and compared with cells transfected with vector or wild-type genes. Aldosterone secretion, CYP11B2 expression and LHCGR were increased substantially more by the combination than by single mutant, or wild-type transfections (P = <0.0001). LHCGR expression was also assessed via immunofluorescence, which showed cells harbouring both mutations to stain the most intensely. In conclusion, somatic mutations of the Q209 residue of GNA11/Q appear always to co-exist with exon 3 mutations of CTNNB1 and to cause a unique clinical and APA phenotype. These experiments are part of a larger study, which also compared APAs with single- or double-mutation of CTNNB1, from French and Swedish cohorts [2].
1. Nishimoto et al. Proc Natl Acad Sci 2015.
2. Zhou et al. Nat Gen in press.
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Endocrine Abstracts
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