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Article Dans Une Revue Genetics in Medicine Année : 2022

KDM1A inactivation causes hereditary food-dependent Cushing syndrome

Lucas Bouys
  • Fonction : Auteur
Gaetan Giannone
  • Fonction : Auteur
Annabel Berthon
  • Fonction : Auteur
Bertrand Dousset
Martin Reincke
Eric Pasmant
Bruno Ragazzon
  • Fonction : Auteur

Résumé

PURPOSE: This study aimed to investigate the genetic cause of food-dependent Cushing syndrome (FDCS) observed in patients with primary bilateral macronodular adrenal hyperplasia (PBMAH) and adrenal ectopic expression of the glucose-dependent insulinotropic polypeptide receptor. Germline ARMC5 alterations have been reported in about 25% of PBMAH index cases but are absent in patients with FDCS. METHODS: A multiomics analysis of PBMAH tissues from 36 patients treated by adrenalectomy was performed (RNA sequencing, single-nucleotide variant array, methylome, miRNome, exome sequencing). RESULTS: The integrative analysis revealed 3 molecular groups with different clinical features, namely G1, comprising 16 patients with ARMC5 inactivating variants; G2, comprising 6 patients with FDCS with glucose-dependent insulinotropic polypeptide receptor ectopic expression; and G3, comprising 14 patients with a less severe phenotype. Exome sequencing revealed germline truncating variants of KDM1A in 5 G2 patients, constantly associated with a somatic loss of the KDM1A wild-type allele on 1p, leading to a loss of KDM1A expression both at messenger RNA and protein levels (P = 1.2 × 10(-12) and P < .01, respectively). Subsequently, KDM1A pathogenic variants were identified in 4 of 4 additional index cases with FDCS. CONCLUSION: KDM1A inactivation explains about 90% of FDCS PBMAH. Genetic screening for ARMC5 and KDM1A can now be offered for most PBMAH operated patients and their families, opening the way to earlier diagnosis and improved management.

Dates et versions

hal-03604178 , version 1 (10-03-2022)

Identifiants

Citer

Anna Vaczlavik, Lucas Bouys, Florian Violon, Gaetan Giannone, Anne Jouinot, et al.. KDM1A inactivation causes hereditary food-dependent Cushing syndrome. Genetics in Medicine, 2022, 24 (2), pp.374-383. ⟨10.1016/j.gim.2021.09.018⟩. ⟨hal-03604178⟩
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