Multi-genic pattern found in rare type of hypopituitarism: a whole-exome sequencing study of Han Chinese with pituitary stalk interruption syndrome

J Cell Mol Med. 2017 Dec;21(12):3626-3632. doi: 10.1111/jcmm.13272. Epub 2017 Jul 14.

Abstract

Pituitary stalk interruption syndrome (PSIS) is a rare type of hypopituitarism manifesting various degrees of pituitary hormone deficiency. Although mutations have been identified in some familial cases, the underpinning mechanisms of sporadic patients with PSIS who are in a vast majority remain elusive, necessitating a comprehensive study using systemic approaches. We postulate that other genetic mechanisms may be responsible for the sporadic PSIS. To test this hypothesis, we conducted a study in 24 patients with PSIS of Han Chinese with no family history using whole-exome sequencing (WES) and bioinformatic analysis. We identified a group of heterozygous mutations in 92% (22 of 24) of the patients, and these genes are mostly associated with Notch, Shh, Wnt signalling pathways. Importantly, 83% (20 of 24) of the patients had more than one mutation in those pathways suggesting synergy of compound mutations underpin the pathogenesis of sporadic PSIS.

Keywords: bioinformatics; pathogenesis; pathway; pituitary stalk interruption syndrome; whole-exome sequencing.

MeSH terms

  • Adolescent
  • Adult
  • Asian People
  • Child
  • Computational Biology
  • Female
  • Gene Expression
  • Genome, Human*
  • Hedgehog Proteins / genetics*
  • Hedgehog Proteins / metabolism
  • Humans
  • Hypopituitarism / ethnology
  • Hypopituitarism / genetics*
  • Hypopituitarism / metabolism
  • Hypopituitarism / pathology
  • Male
  • Mutation*
  • Pituitary Gland / abnormalities
  • Pituitary Gland / metabolism
  • Pituitary Hormones / deficiency
  • Pituitary Hormones / genetics*
  • Receptors, Notch / genetics*
  • Receptors, Notch / metabolism
  • Signal Transduction
  • Syndrome
  • Whole Genome Sequencing
  • Wnt Proteins / genetics*
  • Wnt Proteins / metabolism

Substances

  • Hedgehog Proteins
  • Pituitary Hormones
  • Receptors, Notch
  • SHH protein, human
  • Wnt Proteins