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Steroid 21-hydroxylase gene mutational spectrum in 50 Tunisian patients: Characterization of three novel polymorphisms
Authors:Ilhem Ben Charfeddine  Felix G Riepe  Eric Clauser  Abdelkarim Ayedi  Saloua Makni  Mohamed Tahar Sfar  Hassen Sboui  Najoua Kahloul  Hechmi Ben Hamouda  Slaheddine Chouchane  Sihem Trimech  Noura Zouari  Samir M'rabet  Fathi Amri  Ali Saad  Paul-Martin Holterhus  Moez Gribaa
Institution:Laboratory of Human Cytogenetics, Molecular Genetics and Reproductive Biology, Farhat Hached University Hospital, Street Ibn El Jazzar, 4000 Sousse, Tunisia.
Abstract:Congenital adrenal hyperplasia (CAH) is an autosomal recessive disease of steroid biosynthesis in humans. More than 90% of all CAH cases are caused by mutations of the 21-hydroxylase gene (CYP21A2), and approximately 75% of the defective CYP21A2 genes are generated through an intergenic recombination with the neighboring CYP21A1P pseudogene. In this study, the CYP21A2 gene was genotyped in 50 patients in Tunisia with the clinical diagnosis of 21-hydroxylase deficiency. CYP21A2 mutations were identified in 87% of the alleles. The most common point mutation in our population was the pseudogene specific variant p.Q318X (26%). Three novel single nucleotide polymorphism (SNP) loci were identified in the CYP21A2 gene which seems to be specific for the Tunisian population. The overall concordance between genotype and phenotype was 98%. With this study the molecular basis of CAH has been characterized, providing useful results for clinicians in terms of prediction of disease severity, genetic and prenatal counseling.
Keywords:CAH  congenital adrenal hyperplasia  CYP21A2  21 hydroxylase enzyme  NC  non classical form  MLPA  multiplex ligation-dependent probe amplification  SNP  single nucleotide polymorphism  SV  simple virilizing form  SW  salt-wasting form  17OHP  17-hydroxyprogesterone  21-OHD  steroid 21-hydroxylase deficiency
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