Analise molecular do loco C4/CYP21 : impacto da variabilidade alelica provocada por recombinações sobre os metodos de avaliação de mutações / Molecular analysis of C4/CYP21 locus : influence of allelic variability caused by recombinations on current methods of mutation detection

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Congenital adrenal hyperplasia is caused by deficiency of one of the five enzymes responsible for cortisol synthesis in the steroidogenesis. More than 90% of the cases occur due to deficiency of 21-hidroxilase (21-OH). The haploid human genome bears two copies in tandem of 21-OH coding gene, CYP21A2 and CYP21A1P. Although the two copies are approximately 98% homologous, CYP21A1P is a pseudogene, due to some deleterious mutations. They map to the short arm of chromosome 6, as well as RP, C4 and TNX genes which are also duplicated in tandem. This locus is called RCCX module, each letter representing one gene. An expected consequence of such organization is that it favors events of unequal crossing-overs, producing pairs of gametes with different number of complete units. The aim of this investigation was to estimate the variability of CYP21A21P/CYP21A2 chimeric genes based on the region of recombination in the monomodular, bimodular and trimodular alleles in patients with 21-hydroxylase deficiency. Fifty-five patients were included for Southern blot, Multiplex ligationdependent probe amplification (MLPA), Allele-specific PCR (ASO-PCR) and sequencing analyses. Southern blot identified alleles which were: mono (n = 26), bi (n = 26) and trimodular (n = 5) with chimeric genes. A novel monomodular allele was identified that carry C4A [6,4 kb] variant and also bore an unique CYP21A21P/CYP21A2 formation. MLPA technique mapped three main recombination regions in CYP21A21P/CYP21A2 chimerical genes in the three RCCX configurations. Moreover, it indicated possible chimeric C4A and B genes in both mono- and bimodular configurations. Therefore, five mono-, seven bi- and three trimodular haplotypes had been defined. Both ASO-PCR and sequencing techniques for CYP21A21P/CYP21A2 and CYP21A21P analysis had refined the characterization subdividing these haplotypes in ten mono-, fifteen bi- and five trimodular. Considering the high degree of variability observed it was not possible to identify a founder effect of any specific haplotype for the deficiency of 21-hidroxilase. Conversely, a novel haplotype corresponding to about 15% of the monomodular alleles was characterized as carrying the mutations p.P34L and p.H62L and, similarly one haplotype carrying the p.H62L was found among bimodular alleles. SNPs in the 5 UTR, intron 2 and exon 7 were responsible for the main differentiation among chimerical genes within a group as well as upon comparison between different groups. The results presented here indicate that the combination of four different techniques and the study of segregation in the families had been essential for defining the genotypes of the patients. It is also shown that CYP21A21P/CYP21A2 chimeric genes can be related to different clinical forms: salt losing, non-salt losing and non-classical depending on the region where the recombination for its formation occurs

ASSUNTO(S)

gene hibrido cyp21a1p/cyp21a2 conversão genica cyp21a1p/cyp21a2 chimeric gene gene conversion gene deletion deleção genica modulo rccx 21-hydroxylase deficiency rccx module deficiencia de 21 hidroxilase

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