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2016 ; 99
(5
): 1034-1044
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GCM2-Activating Mutations in Familial Isolated Hyperparathyroidism
#MMPMID27745835
Guan B
; Welch JM
; Sapp JC
; Ling H
; Li Y
; Johnston JJ
; Kebebew E
; Biesecker LG
; Simonds WF
; Marx SJ
; Agarwal SK
Am J Hum Genet
2016[Nov]; 99
(5
): 1034-1044
PMID27745835
show ga
Primary hyperparathyroidism (PHPT) is a common endocrine disease characterized by
parathyroid hormone excess and hypercalcemia and caused by hypersecreting
parathyroid glands. Familial PHPT occurs in an isolated nonsyndromal form, termed
familial isolated hyperparathyroidism (FIHP), or as part of a syndrome, such as
multiple endocrine neoplasia type 1 or hyperparathyroidism-jaw tumor syndrome.
The specific genetic or other cause(s) of FIHP are unknown. We performed exome
sequencing on germline DNA of eight index-case individuals from eight unrelated
kindreds with FIHP. Selected rare variants were assessed for co-segregation in
affected family members and screened for in an additional 32 kindreds with FIHP.
In eight kindreds with FIHP, we identified three rare missense variants in GCM2,
a gene encoding a transcription factor required for parathyroid development.
Functional characterization of the GCM2 variants and deletion analyses revealed a
small C-terminal conserved inhibitory domain (CCID) in GCM2. Two of the three
rare variants were recurrent, located in the GCM2 CCID, and found in seven of the
40 (18%) kindreds with FIHP. These two rare variants acted as gain-of-function
mutations that increased the transcriptional activity of GCM2, suggesting that
GCM2 is a parathyroid proto-oncogene. Our results demonstrate that
germline-activating mutations affecting the CCID of GCM2 can cause FIHP.