Abstract

Introduction: The McCune-Albright syndrome (MAS) is a genetic disease clinically characterized by the triad: bone fibrous dysplasia cafe-au-lait skin spots and endocrine hyperfunction, such as precocious puberty. MAS is due to activating mutations of GNAS, the gene encoding Gs alpha and mutations analysis of this gene could increase the definitive diagnosis of MAS and atypical and partial. Objectives: To identify the p.R201H and p. R201C GNAS activating mutations in multiple tissues derived from patients with MAS using real time PCR genotyping. Material and methods: Genomic DNA was isolated from blood from 31 patients (28 females) with typical and atypical forms of MAS. Skin, adrenal gland or bone tissue samples were also available from six different patients. Genotyping based on PCR real time assay using TaqMan probes was performed for identification of p.R201H and p. R201C GNAS mutations. Cloning and sequencing were used as assenting techniques. Results: Using real time PCR genotyping, no mutations in GNAS were identified in blood samples of MAS patients, only in bone sample of a patient with a previously identified p.R201H. Cloning and sequencing from blood of this same patient revealed that 5/150 clones harboring the p. R201H. Conclusion: The real time PCR genotyping proved to be efficient for the molecular diagnosis of MAS in affected patient's tissues. Advantages of this technique are rapidity, accuracy, it is generally easy to perform and could be used routinely. Nevertheless, optimization of GNAS detection mutation is still necessary to considerer this technique to earlier diagnosis of non-classical forms of MAS using peripheral blood.

Highlights

  • The McCune-Albright syndrome (MAS) is a genetic disease clinically characterized by the triad: bone fibrous dysplasia café-au-lait skin spots and endocrine hyperfunction, such as precocious puberty

  • Using real time PCR genotyping, no mutations in GNAS were identified in blood samples of MAS patients, only in bone sample of a patient with a previously identified p.R201H

  • Analysis of p.R201C and p.R201H mutations by real time PCR genotyping failure to clearly demonstrate the presence of any correspondent variant allele in blood and/or skin or adrenal samples of 31 MAS patients, with exception of the bone patient's sample used as p.R201H positive control (Figure 1a and b)

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Summary

Introduction

The McCune-Albright syndrome (MAS) is a genetic disease clinically characterized by the triad: bone fibrous dysplasia café-au-lait skin spots and endocrine hyperfunction, such as precocious puberty. All the endocrine glands that are hyperactive in MAS have an autonomous secretion and have in common a response to extracellular signals by the AC-cAMP pathway and constitutionally elevated AC activity Consistent with these findings, activating mutations in GNAS protein have been identified in patients with MAS [5,6]. A low percentage of mutated cells may be present in peripheral blood and could be used in the identification of GNAS-activating mutations leading to earlier diagnosis in patients with partial forms of MAS [8,9,10] This is only realistic if an accurate and sensitive assay for mosaic mutations detection is available.

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