A mutation of the β-domain in POU1F1 causes pituitary deficiency due to dominant PIT-1β expression

in European Journal of Endocrinology
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  • 1 S Suzuki, Department of Pediatrics, Asahikawa Medical University, Asahikawa, 078-8510, Japan
  • 2 K Matsuo, Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
  • 3 Y Ito, Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
  • 4 A Kobayashi, Division of Metabolism and Biosystemic Science, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan
  • 5 T Kokumai, Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
  • 6 A Furuya, Department of Pediatrics, Asahikawa Medical University, Asahikawa, 078-8510, Japan
  • 7 O Ueda, Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
  • 8 T Mukai, Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
  • 9 K Yano, Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
  • 10 K Fujieda, Department of Pediatrics, Asahikawa Medical College, Asahikawa, 0788510, Japan
  • 11 A Okuno, Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
  • 12 Y Tanahashi, Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
  • 13 H Azuma, Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan

Correspondence: Shigeru Suzuki, Email: shige5p@asahikawa-med.ac.jp

Background: POU1F1 encodes both PIT-1α, which plays pivotal roles in pituitary development and GH, PRL and TSHB expression, and the alternatively spliced isoform PIT-1β, which contains an insertion of 26-amino acids (β-domain) in the transactivation domain of PIT-1α due to the use of an alternative splice acceptor at the end of the first intron. PIT-1β is expressed at much lower levels than PIT-1α and represses endogenous PIT-1α transcriptional activity. Although POU1F1 mutations lead to combined pituitary hormone deficiency (CPHD), no patients with β-domain mutations have been reported.

Results: Here, we report that a three-generation family exhibited different degrees of CPHD, including growth hormone deficiency with intrafamilial variability of prolactin/TSH insufficiency and unexpected prolactinoma occurrence. The CPHD was due to a novel POU1F1 heterozygous variant (c.143-69T>G) in intron 1 of PIT-1α (RefSeq number NM_000306) or as c.152T>G (p.Ile51Ser) in exon 2 of PIT-1β (NM_001122757). Gene splicing experiments showed that this mutation yielded the PIT-1β transcript without other transcripts. Lymphocyte PIT-1β mRNA expression was significantly higher in the patients with the heterozygous mutation than a control. A luciferase reporter assay revealed that the PIT-1β-Ile51Ser mutant repressed PIT-1α and abolished transactivation capacity for the rat prolactin promoter in GH3 pituitary cells.

Conclusions: We describe, for the first time, that PIT-1β mutation can cause CPHD through a novel genetic mechanism, such as PIT-1β overexpression, and that POU1F1 mutation might be associated with a prolactinoma. Analysis of new patients and long-term follow-up are needed to clarify the characteristics of PIT-1β mutations.

 

     European Society of Endocrinology