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Published on: March 28, 2017
A Novel Compound Heterozygous CYP17A1 Variant Causes 17α-Hydroxylase/17, 20-Lyase Deficiency
Hong Chen1, Ke Yuan1, Bingtao Zhang2
1Department of Pediatrics, The First Affiliated Hospital, College of Medicine Zhejiang University, Hangzhou, China.
This study identifies novel compound heterozygous variants in the CYP17A1 gene causing 17α-hydroxylase/17,20-lyase deficiency (17-OHD), a form of congenital adrenal hyperplasia. These genetic mutations lead to a complete loss of enzyme activity, impacting cortisol synthesis and patient health.
Area of Science:
- Endocrinology
- Genetics
- Biochemistry
Background:
- Congenital adrenal hyperplasia (CAH) comprises autosomal recessive disorders affecting cortisol synthesis due to enzyme deficiencies.
- 17α-hydroxylase/17,20-lyase deficiency (17-OHD) is a rare CAH subtype linked to mutations in the CYP17A1 gene.
Purpose of the Study:
- To report a novel compound heterozygous CYP17A1 variant.
- To investigate its association with the pathogenesis of 17-OHD.
Main Methods:
- Whole-exome sequencing and Sanger sequencing for mutation identification.
- Functional analysis in HEK-293T cells to assess P450c17 expression and enzymatic activity.
- Liquid chromatography-tandem mass spectrometry (LC-MS/MS) for hormone level quantification.
Main Results:
- A patient presented with 17-OHD, rhabdomyolysis, hypokalemia, and adrenal insufficiency.
- Novel compound heterozygous variants (c.1304T > C/p.Phe435Ser and c.1228delG/p.Asp410Ilefs*9) in the CYP17A1 gene were identified.
- These variants resulted in complete deficiency of 17α-hydroxylase and 17,20-lyase activity, correlating with the patient's hormonal profile.
Conclusions:
- The identified compound heterozygous CYP17A1 variants (c.1304T > C and c.1228delG) cause 17-OHD.
- This research offers new insights into the clinical and molecular aspects of 17-OHD.
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