Horm Metab Res 2020; 52(11): 788-795
DOI: 10.1055/a-1147-1375
Endocrine Care

Identification of Novel Variants in MEN1: A Study Conducted with Four Multiple Endocrine Neoplasia Type 1 Patients

Wen-mu Hu
1   Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
,
Qin Zhang
1   Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
,
Li-hua Huang
1   Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
,
Zhao-hui Mo
1   Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
,
Xiao-dan Long
1   Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
,
You-bo Yang
1   Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
,
Wen-jun Yang
1   Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
,
Jun Liu
1   Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
,
Ping Jin
1   Department of Endocrinology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
› Author Affiliations
Funding: This work was supported by the National Natural Science Foundation of China (81670730, 81100583).

Abstract

Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant inherited endocrine tumor syndrome caused by inactivating variants of the MEN1 gene. The aim of this study is to explore the clinical and genetic characteristics of four MEN1 patients. We isolated genomic deoxyribonucleic acid from lymphocytes, parathyroid, and thymic tumoral tissue specimens from the MEN1 patients. All exons of the MEN1 and CDNK1B genes and adjacent exon-intron sequences were amplified by polymerase chain reaction and subsequently sequenced. Further, the splice alterations were studied by sequencing the amplified RT-PCR products for MEN1 cDNA. We identified four heterozygous MEN1 germline variants: c.564delC, c.1268G>A, IVS5+5delG, and c.1546_1547insC. Both c.564delC and IVS5+5delG were novel variants. The impact of the MEN1 splice variant, IVS5+5delG, was evaluated using bioinformatics and in vitro analyses. The analyses indicated that this variant resulted in skipping of the neighboring exon and was disease-causing. Two novel somatic variants, c.249_252delGTCT and c.313_314insC, were found. Additionally, loss of heterozygosity (LOH) for the MEN1 locus (IVS5+5delG and c.564delC) was found in tumor tissue samples from the MEN1 patients, consistent with Knudson’s two-hit mechanism. We identified four MEN1 germline variants and two novel somatic variants. Early recognition of the phenotype coupled with variant screening of the MEN1 gene is the key to diagnosing and treating MEN1 effectively at an early stage.

Supplementary Material



Publication History

Received: 05 February 2020

Accepted after revision: 18 March 2020

Article published online:
16 April 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Thakker RV, Newey PJ, Walls GV. et al. Clinical Practice Guidelines for Multiple Endocrine Neoplasia Type 1 (MEN1). J Clin Endocrinol Metab 2012; 97: 2990-3011
  • 2 Lemos MC, Thakker RV. Multiple Endocrine Neoplasia Type 1 (MEN1): Analysis of 1336 mutations reported in the first decade following identification of the gene. Hum Mutat 2008; 29: 22-32
  • 3 Matkar S, Thiel A, Hua X. Menin: a scaffold protein that controls gene expression and cell signaling. Trends Biochem Sci 2013; 38: 394-402
  • 4 Kamilaris CDC, Stratakis CA. Multiple Endocrine Neoplasia Type 1 (MEN1): An update and the significance of early genetic and clinical diagnosis. Front Endocrinol (Lausanne) 2019; 10: 339
  • 5 Pannett AA, Thakker RV. Somatic mutations in MEN type 1 tumors, consistent with the Knudson “two-hit” hypothesis. J Clin Endocrinol Metab 2001; 86: 4371-4374
  • 6 Pellegata NS, Quintanilla-Martinez L, Siggelkow H. et al. Germ-line mutations in p27Kip1 cause a multiple endocrine neoplasia syndrome in rats and humans. Proc Natl Acad Sci USA 2006; 17: 15558-15563
  • 7 Lee M, Pellegata NS. Multiple endocrine neoplasia syndromes associated with mutation of p27. J Endocrinol Invest 2013; 36: 781-787
  • 8 Alrezk R, Hannah-Shmouni F, Stratakis CA. MEN4 and mutations: the latest of the MEN syndromes. Endocr Relat Cancer 2017; 24: T195-T208
  • 9 Richards S, Aziz N, Bale S. et al. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Genet Med 2015; 17: 405-424
  • 10 Bergman L, Teh B, Cardinal J. et al. Identification of MEN1 gene mutations in families with MEN 1 and related disorders. Br J Cancer 2000; 83: 1009-1014
  • 11 Huang J, Gurung B, Wan B. et al. The same pocket in menin binds both MLL and JUND but has opposite effects on transcription. Nature 2012; 12: 482 (7386): 542–546
  • 12 Thakker RV. Multiple endocrine neoplasia type 1 (MEN1). Best Pract Res Clin Endocrinol Metab 2010; 24: 355-370
  • 13 Zha BB, Liang W, Liu J. et al. Mutation analysis in a Chinese family with multiple endocrine neoplasia type 1. Chin Med J (Engl) 2010; 123: 569-573
  • 14 Bazzi W, Renon M, Vercherat C. et al. MEN1 missense mutations impair sensitization to apoptosis induced by wild-type menin in endocrine pancreatic tumor cells. Gastroenterology 2008; 135: e2
  • 15 Nozières C, Zhang CX, Buffet A. et al. p.Ala541Thr variant of MEN1 gene: a non deleterious polymorphism or a pathogenic mutation?. Ann. Endocrinol (Paris) 2014; 75: 133-140
  • 16 Giacche M, Panarotto A, Mori L. et al. A novel menin gene deletional mutation in a little series of Italian patients affected by apparently sporadic multiple endocrine neoplasia type 1 syndrome. J Endocrinol Invest 2012; 35: 124-128
  • 17 Lourenço DM, Coutinho FL, Toledo RA. et al. Early-onset, progressive, frequent, extensive, and severe bone mineral and renal complications in multiple endocrine neoplasia type 1-associated primary hyperparathyroidism. J Bone Miner Res 2010; 25: 2382-2391
  • 18 Twigt BA, Scholten A, Valk GD. et al. Differences between sporadic and MEN related primary hyperparathyroidism; clinical expression, preoperative workup, operative strategy and follow-up. Orphanet J Rare Dis 2013; 8: 50
  • 19 Service FJ, McMahon MM, O'Brien PC. et al. Functioning insulinoma–incidence, recurrence, and long-term survival of patients: a 60-year study. Mayo Clin Proc 1991; 66: 711-719
  • 20 Christakis I, Qiu W, Silva Figueroa AM. et al. Clinical features, treatments, and outcomes of patients with thymic carcinoids and multiple endocrine neoplasia type 1 syndrome at MD Anderson Cancer Center. Horm Cancer 2016; 7: 279-287