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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Clin+Endocrinol+Metab
2015 ; 100
(4
): E672-80
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English Wikipedia
PAPSS2 deficiency causes androgen excess via impaired DHEA sulfation--in vitro
and in vivo studies in a family harboring two novel PAPSS2 mutations
#MMPMID25594860
Oostdijk W
; Idkowiak J
; Mueller JW
; House PJ
; Taylor AE
; O'Reilly MW
; Hughes BA
; de Vries MC
; Kant SG
; Santen GW
; Verkerk AJ
; Uitterlinden AG
; Wit JM
; Losekoot M
; Arlt W
J Clin Endocrinol Metab
2015[Apr]; 100
(4
): E672-80
PMID25594860
show ga
CONTEXT: PAPSS2 (PAPS synthase 2) provides the universal sulfate donor PAPS
(3'-phospho-adenosine-5'-phosphosulfate) to all human sulfotransferases,
including SULT2A1, responsible for sulfation of the crucial androgen precursor
dehydroepiandrosterone (DHEA). Impaired DHEA sulfation is thought to increase the
conversion of DHEA toward active androgens, a proposition supported by the
previous report of a girl with inactivating PAPSS2 mutations who presented with
low serum DHEA sulfate and androgen excess, clinically manifesting with premature
pubarche and early-onset polycystic ovary syndrome. PATIENTS AND METHODS: We
investigated a family harboring two novel PAPSS2 mutations, including two
compound heterozygous brothers presenting with disproportionate short stature,
low serum DHEA sulfate, but normal serum androgens. Patients and parents
underwent a DHEA challenge test comprising frequent blood sampling and urine
collection before and after 100 mg DHEA orally, with subsequent analysis of DHEA
sulfation and androgen metabolism by mass spectrometry. The functional impact of
the mutations was investigated in silico and in vitro. RESULTS: We identified a
novel PAPSS2 frameshift mutation, c.1371del, p.W462Cfs*3, resulting in complete
disruption, and a novel missense mutation, c.809G>A, p.G270D, causing partial
disruption of DHEA sulfation. Both patients and their mother, who was
heterozygous for p.W462Cfs*3, showed increased 5?-reductase activity at baseline
and significantly increased production of active androgens after DHEA intake. The
mother had a history of oligomenorrhea and chronic anovulation that required
clomiphene for ovulation induction. CONCLUSIONS: We provide direct in vivo
evidence for the significant functional impact of mutant PAPSS2 on DHEA sulfation
and androgen activation. Heterozygosity for PAPSS2 mutations can be associated
with a phenotype resembling polycystic ovary syndrome.