Abstract

Pituitary adenomas are neoplasms of the anterior pituitary lobe and account for 15–20% of all intracranial tumors. Although most pituitary tumors are benign they can cause severe symptoms related to tumor size as well as hypopituitarism and/or hypersecretion of one or more pituitary hormones. Most pituitary adenomas are sporadic, but it has been estimated that 5% of patients have a familial background. Germline mutations of the tumor suppressor gene aryl hydrocarbon receptor-interacting protein (AIP) predispose to hereditary pituitary neoplasia. Recently, it has been demonstrated that AIP mutations predispose to pituitary tumorigenesis through defective inhibitory GTP binding protein (Gαi) signaling. This finding prompted us to examine whether germline loss-of-function mutations in inhibitory guanine nucleotide (GTP) binding protein alpha (GNAI) loci are involved in genetic predisposition of pituitary tumors. To our knowledge, this is the first time GNAI genes are sequenced in order to examine the occurrence of inactivating germline mutations. Thus far, only somatic gain-of-function hot-spot mutations have been studied in these loci. Here, we have analyzed the coding regions of GNAI1 , GNAI2, and GNAI3 in a set of young sporadic somatotropinoma patients (n = 32; mean age of diagnosis 32 years) and familial index cases (n = 14), thus in patients with a disease phenotype similar to that observed in AIP mutation carriers. In addition, expression of Gαi proteins was studied in human growth hormone (GH), prolactin (PRL), adrenocorticotropic hormone (ACTH)-secreting and non-functional pituitary tumors. No pathogenic germline mutations affecting the Gαi proteins were detected. The result suggests that loss-of-function mutations of GNAI loci are rare or nonexistent in familial pituitary adenomas.

Highlights

  • Pituitary adenomas are neoplasms of the anterior pituitary lobe

  • We have recently demonstrated that aryl hydrocarbon receptorinteracting protein (AIP) loss-of-function mutations predispose to pituitary tumorigenesis through defective inhibitory GTP binding protein (Gai) signaling and consequent elevated intracellular cyclic adenosine monophosphate (cAMP) concentrations [29]

  • Weak and speckled cytoplasmic expression of Gai-1 was detected in growth hormone (GH)(mean6SD; 0.860.4) and PRL- (160.8) secreting tumors, whereas nonfunctioning (non-secreting) pituitary adenomas (NFPA) (1.860.5) and adrenocorticotropic hormone (ACTH) (1.760.6) tumors showed weak to moderate cytoplasmic expression (Figure 1)

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Summary

Introduction

Pituitary adenomas are neoplasms of the anterior pituitary lobe. They account for 15–20% of all the intracranial tumors [1] and approximately 16% of all the primary brain and central nervous system tumors [2]. Pituitary adenomas are classified based on the pituitary cell of origin and the type of hormone secreted. Somatotropinomas hypersecrete growth hormone (GH) (20–25%), causing acromegaly with clinical features of enlarged extremities, coarse facial structures and comorbidities such as hypertension, cardiovascular disease and diabetes mellitus [4]. Tumors secreting adrenocorticotropic hormone (ACTH) (10–12%) cause Cushing’s disease, which is characterized by hypercortisolism. Pituitary adenomas cause a heavy clinical burden due to increased morbidity and the treatment modalities involved, i.e neurosurgery, chronic medical therapies and radiotherapy

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