NO APPARENT MINERALOCORTICOID RECEPTOR DEFECT IN A SERIES OF SPORADIC CASES OF PSEUDOHYPOALDOSTERONISM

作者:ARAI K*; TSIGOS C; SUZUKI Y; LISTWAK S; ZACHMAN K; ZANGENEH F; RAPAPORT R; CHANOINE JP; CHROUSOS GP
来源:Journal of Clinical Endocrinology & Metabolism, 1995, 80(3): 814-817.
DOI:10.1210/jc.80.3.814

摘要

Pseudohypoaldosteronism (PHA) is characterized by congenital resistance of the kidney and/or other mineralocorticoid target tissues to aldosterone, resulting in excessive salt wasting. Although the mineralocorticoid receptor (MR) was suggested as a potential locus of the defect in this disease, no such abnormality was found in 3 recently reported cases, one of whom belongs to this series of 5 patients. Molecular studies of the MR complementary DNA and gene in this series of sporadic cases of pseudohypoaldosteronism are reported. Four of these patients had multiple mineralocorticoid target tissue resistance, whereas 1 had transient isolated resistance in the kidney. A nonconservative homozygous mutation (C-944-->T-944, Ala(241)-->Val(241)) was identified in the complementary DNA of 4 of the patients but was also found in 62 of 100 normal alleles. One of these 4 patients had an additional conservative heterozygous mutation (A(760)-->G(760), Ileu(180)-->Val(180), which was also present in 11 of 100 normal alleles. None of the patients had any abnormalities in the first untranslated exon and 0.9 kilobases of the 5'-regulatory region of the MR gene, which were fully sequenced and compared with the normal sequence. It is concluded that the mutations identified in 4 of these 5 patients with PHA are polymorphisms, which on their own have no apparent pathophysiological significance. It is hypothesized that the defect causing PHA might be in a post-MR step of aldosterone action or in an unsuspected nonclassic receptor for this hormone.

  • 出版日期1995-3

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