TMEM127 suppresses tumor development by promoting RET ubiquitination, positioning, and degradation.

The TMEM127 gene encodes a transmembrane protein of poorly known function that is mutated in pheochromocytomas, neural crest-derived tumors of adrenomedullary cells. Here, we report that, at single-nucleus resolution, TMEM127-mutant tumors share precursor cells and transcription regulatory elements with pheochromocytomas carrying mutations of the tyrosine kinase receptor RET. Additionally, TMEM127-mutant pheochromocytomas, human cells, and mouse knockout models of TMEM127 accumulate RET and increase its signaling. TMEM127 contributes to RET cellular positioning, trafficking, and lysosome-mediated degradation. Mechanistically, TMEM127 binds to RET and recruits the NEDD4 E3 ubiquitin ligase for RET ubiquitination and degradation via TMEM127 C-terminal PxxY motifs. Lastly, increased cell proliferation and tumor burden after TMEM127 loss can be reversed by selective RET inhibitors in vitro and in vivo. Our results define TMEM127 as a component of the ubiquitin system and identify aberrant RET stabilization as a likely mechanism through which TMEM127 loss-of-function mutations cause pheochromocytoma.

A RET::GRB2 fusion in pheochromocytoma defies the classic paradigm of RET oncogenic fusions.

The RET kinase receptor is a target of mutations in neural crest tumors, including pheochromocytomas, and of oncogenic fusions in epithelial cancers. We report a RET::GRB2 fusion in a pheochromocytoma in which RET, functioning as the upstream partner, retains its kinase domain but loses critical C-terminal motifs and is fused to GRB2, a physiological RET interacting protein. RET::GRB2 is an oncogenic driver that leads to constitutive, ligand-independent RET signaling; has transforming capability dependent on RET catalytic function; and is sensitive to RET inhibitors. These observations highlight a new driver event in pheochromocytomas potentially amenable for RET-driven therapy.

Ambulatory urodynamics in clinical practice: A single centre experience.

OBJECTIVES: To assess the additional value of ambulatory urodynamics (AUDS) monitoring in the management of patients with unexplained lower urinary tract symptoms. METHODS: A retrospective review of the urodynamic data at a tertiary referral center between January 2006 and December 2018. During this period 12,123 urodynamic studies were conducted; 430 patients were arranged to have AUDS monitoring because their symptoms were not reproduced with either standard or video urodynamics (UDS). RESULTS: A total of 391 patients were included, (360 females, 31 males). Symptoms were reproduced in 74% of cases. The most common AUDS finding was detrusor overactivity with or without incontinence, followed by urodynamic stress incontinence. In 75.7% of the patients, the additional information from AUDS resulted in a change to patient management. CONCLUSIONS: Additional UDS findings were made in the majority of patients who underwent AUDS. This helped in setting a new treatment plan for the bothersome urinary findings. AUDS monitoring is a useful additional diagnostic tool and can help to guide patient management where symptoms are not explained by standard or video UDS.

Mini-review: toxicity of mercury as a consequence of enzyme alteration.

Mercury, in both its elemental and bonded states, is noted for its negative effects on biological organisms. Recent anthropogenic and environmental disasters have spurred numerous comparative studies. These studies attempted to detail the biochemical implications of mercury ingestion, in low, persistent concentrations as well as elevated acute dosages. The studies propose models for mercuric action on healthy cells; which is centered on the element's disruption of key enzymatic processes at deposition sites. Mercury's high affinity for the sulfhydryl moieties of enzyme catalytic sites is a common motif for enzyme inactivation. These permanent covalent modifications inactivate the enzyme, thereby inducing devastating effects on an organism's metabolic functions. Mercury has been shown to be highly nonspecific in its binding to sulfhydryl moieties, and highly varied in terms of how it is encountered by living organisms. This review focuses on mercury's effects on a wide swath of enzymes, with emphasis on how these alterations deleteriously affect several metabolic pathways.