Loss-of-Function Variants in TBC1D32 Underlie Syndromic Hypopituitarism.

Abstract

CONTEXT:

Congenital pituitary hormone deficiencies with syndromic phenotypes and/or familial occurrence suggest genetic hypopituitarism; however, in many such patients the underlying molecular basis of the disease remains unknown.

OBJECTIVE:

To describe patients with syndromic hypopituitarism due to biallelic loss-of-function variants in TBC1D32, a gene implicated in Sonic Hedgehog (Shh) signaling.

SETTING:

Referral center.

PATIENTS:

A Finnish family of 2 siblings with panhypopituitarism, absent anterior pituitary, and mild craniofacial dysmorphism, and a Pakistani family with a proband with growth hormone deficiency, anterior pituitary hypoplasia, and developmental delay.

INTERVENTIONS:

The patients were investigated by whole genome sequencing. Expression profiling of TBC1D32 in human fetal brain was performed through in situ hybridization. Stable and dynamic protein-protein interaction partners of TBC1D32 were investigated in HEK cells followed by mass spectrometry analyses.

MAIN OUTCOME MEASURES:

Genetic and phenotypic features of patients with biallelic loss-of-function mutations in TBC1D32.

RESULTS:

The Finnish patients harboured compound heterozygous loss-of-function variants (c.1165_1166dup p.(Gln390Phefs*32) and c.2151del p.(Lys717Asnfs*29)) in TBC1D32; the Pakistani proband carried a known pathogenic homozygous TBC1D32 splice-site variant c.1372 + 1G > A p.(Arg411_Gly458del), as did a fetus with a cleft lip and partial intestinal malrotation from a terminated pregnancy within the same pedigree. TBC1D32 was expressed in the developing hypothalamus, Rathke's pouch, and areas of the hindbrain. TBC1D32 interacted with proteins implicated in cilium assembly, Shh signaling, and brain development.

CONCLUSIONS:

Biallelic TBC1D32 variants underlie syndromic hypopituitarism, and the underlying mechanism may be via disrupted Shh signaling.

• Authors: Johanna Hietamäki, Louise C Gregory, Sandy Ayoub, Anna-Pauliina Iivonen, Kirsi Vaaralahti, Xiaonan Liu, Nina Brandstack, Andrew J Buckton, Tiina Laine, Johanna Känsäkoski, Matti Hero, Päivi J Miettinen, Markku Varjosalo, Emma Wakeling, Mehul T Dattani, Taneli Raivio
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 105 Issue 6 (06 01 2020) ISSN: 1945-7197 [Electronic] United States
• PMID: 32060556 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © Endocrine Society 2020.

Chemical References

• Adaptor Proteins, Signal Transducing
• Biomarkers
• TBC1D32 protein, human

Topics

• Adaptor Proteins, Signal Transducing (genetics)
• Biomarkers (analysis)
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Humans
• Hypopituitarism (etiology, pathology)
• Infant
• Infant, Newborn
• Male
• Mutation
• Pedigree
• Phenotype
• Prognosis
• Signal Transduction