Demonstration by transfection studies that mutations in the adrenocorticotropin receptor gene are one cause of the hereditary syndrome of glucocorticoid deficiency.

The hereditary syndrome of unresponsiveness to ACTH is a rare autosomal recessive disorder characterized by low levels of serum cortisol and high levels of plasma ACTH. There is no cortisol response to exogenous ACTH. Recent cloning of the human ACTH receptor gene has enabled us to study this gene in patients with glucocorticoid deficiency. By using the PCR to amplify the coding sequence of the ACTH receptor gene, we identified three mutations in two unrelated patients. One mutation present in homozygous form converted the negatively charged Asp107, located in the third transmembrane domain, to an uncharged Asn residue. The second patient was a compound heterozygote: the paternal allele contained a one-nucleotide insertion leading to a stop codon within the third extracellular loop, and the maternal allele contained a point mutation converting Cys251 to Phe, also in the third extracellular loop. Normal and mutant ACTH receptor genes were expressed in the M3 cell line, and intracellular cAMP production in response to ACTH was measured. For the mutant receptors, no response to physiological ACTH concentrations was detected, suggesting an impaired binding of ACTH to the receptors and/or an altered coupling to the adenylate cyclase effector.

Stable expression of normal and mutant human ACTH receptor: study of ACTH binding and coupling to adenylate cyclase.

Point mutations of the human ACTH receptor have been reported in some patients with a familial glucocorticoid deficiency syndrome. To demonstrate that these mutations were responsible for the disease, it was necessary to develop a model in which characteristics of normal and mutant receptors could be studied. We have developed a stable expression model in order to characterize the human ACTH receptor by binding studies and functional coupling to adenylate cyclase. After confirmation of the stable integration of receptor constructs, ACTH dose-responses for the production of cAMP were carried out. The EC50 for ACTH were 2.9 +/- 0.2 x 10(-10) M and 2.4 +/- 0.8 x 10(-10) M, respectively, for two different clones stably expressing the normal human ACTH receptor. EC50 calculated for clones expressing either one of the two studied mutant receptors (C251F and D107N) were increased: 4.1 +/- 0.9 x 10(-9) M and 6.4 +/- 1.3 x 10(-9) M respectively. These values were similar to that obtained with M3 parental cells (4.7 +/- 0.8 x 10(-9) M). Binding studies were performed on the same clones. Scatchard analysis showed that clones expressing the normal receptor possessed high affinity binding sites for ACTH, with K(d) = 5.8 +/- 2.4 x 10(-10) M and 6.9 +/- 3.6 x 10(-10) M, respectively, for the two different studied clones. A second type of sites, with low affinity (K(d) around 10(-8) M), was also present. There was no ACTH binding to the high affinity binding sites for the two clones expressing either one of the mutant receptors. An impaired binding of ACTH to its receptors is then responsible for the absence of biological response to ACTH in patients carrying these mutant ACTH receptors.

Characterization of the transcription start site of the ACTH receptor gene: presence of an intronic sequence in the 5'-flanking region.

Corticotropin (ACTH) regulates glucocorticoid production through specific receptors on the adrenal cortex. Analysis of the ACTH receptor mRNA in human adrenal has revealed the presence of five transcripts ranging from 1.8 to 11 kilobases (kb). Characterization of the 5'-untranslated regions (UTRs) of the ACTH receptor mRNA demonstrated the presence of one major initiation site of transcription 177 bp away from the ATG codon. Analysis of this 5' sequence showed a perfect alignment with the previously described genomic sequence until position -128 bp from the ATG. The upstream 49-bp sequence was divergent, suggesting the occurrence of a splicing and indicating the presence of an intronic sequence in the UTRs, as well as the presence of an upstream exon containing this 49-bp sequence and located at least 1.8 kb away from the exon encoding the protein.

[Mutations of ACTH receptor gene and familial syndrome of glucocorticoid deficiency]. / Mutations du gène du récepteur à l'ACTH et syndrome familial de déficit en glucocorticoïdes.

Familial isolated glucocorticoid deficiency syndrome is characterized by low cortisol plasma levels despite high ACTH levels without any stimulation of steroid production after ACTH administration. However, the mineralocorticoid function is well-preserved in this syndrome which indicates a specific resistance to ACTH. Recent cloning of the ACTH receptor allowed to study this receptor in this particular syndrome. After studying sixteen affected families, we have found three mutations in two patients from non-related families. One of these patients was a double heterozygote compound (C251F, G217fs) while the other one was homozygote for another mutation D107N. The mutant receptors were expressed in vitro in transfected M3 cells (S91 Cloudman cells) which represents a working expression system to express the ACTH receptor. Production of intracellular cyclic AMP was calculated in the presence of increasing concentrations of ACTH. The EC50 values were estimated (C251F: 3.5 +/- 0.9 x 10(-9) M, D107N: 3.0 +/- 0.9 x 10(-9) M, G217fs: 4.8 +/- 0.9 x 10(-9) M) and comparison with the value obtained for the wild type ACTH receptor (5.1 +/- 0.9 x 10(-10) M) indicates a clear 6 to 9 shift to the right due to an impaired function of these mutant receptors. Such results were expected for the G217fs mutation, and could be explained by a decrease in ligand affinity or an impaired coupling to adenylate cyclase in the case of amino acid substitutions. A total of twelve mutations has been described in the literature although eight of them have not been tested in vitro until now.

Image analysis of dendritic cells in the human fetal thymus.

The distribution and evolution of thymic dendritic cells (DC) were studied during human ontogeny. Immunochemical techniques were used to detect S100 protein-positive cells on fetal thymus sections, at different post-fecundation (PF) ages; an image analysis of these positive cells was then carried out. Variations in the percentage of these cells in the medulla were determined according to age: the higher percentages were seen at 12 and 16 weeks PF. Dendritic cells were present at an early stage in the thymic rudiment (7 weeks PF), a finding consistent with an origin of these cells in the fetal liver, and with the possible existence of local attraction and/or maturation factors. The expression of the CD54 adhesion molecule revealed the existence of particular interactions between DC and lymphocytes in the medullary area, and at the cortico-medullar junction. Diffuse CD11a (LFA-1) expression on lymphocytes was consistent throughout gestation. The monocyte/macrophage markers (CD11b, CD14) and the reaction of non-specific esterases showed that the distribution pattern of these cells differed from the DC pattern. These ontogenic data are related to the significant role played by DC throughout the different stages of thymopoiesis.

Genomic structure and promoter characterization of the human ACTH receptor gene.

One kb of the 5'-flanking region of the human ACTH receptor gene was isolated and partially characterized. Transient transfections with hGH reporter confirmed the promoter activity in Y1 cells. Putative elements for transcription factors involved in regulation were noted in the sequence. The promoter activity of some of the constructs is responsive to a treatment by forskolin, due to the presence of several CRE-like sequences.

The DNA sequence coding for the 5' untranslated region of herpes simplex virus type 1 ICP22 mRNA mediates a high level of gene expression.

The sequence coding for the 5' untranslated region (UTR) of ICP22 mRNA of herpes simplex virus type 1 has been tested for its ability to regulate gene expression. This sequence was placed in frame with the chloramphenicol acetyltransferase (CAT) coding sequence and under the control of the simian virus 40 early promoter-enhancer. Under these conditions, the sequence coding for the 5'UTR led to an increase of about 13-fold in CAT activity, measured during transient expression. The use of mutants with progressive deletions within the sequence coding for the 5'UTR allowed localization of the sequence responsible for the enhancement of gene expression to the first exon of the ICP22 gene. Precise quantification of hybrid ICP22-CAT mRNA showed that the sequence coding for the 5'UTR induced an increase in the amounts of transcripts, which resulted in a parallel increase in CAT activity. This increase in the level of hybrid ICP22-CAT mRNA is not the result of an increase in mRNA stability, nor is it due to more efficient nucleo-cytoplasmic transport of the transcripts. Moreover, the distribution of hybrid mRNA in the different ribosomal populations indicates that the 5'UTR of ICP22 mRNA does not induce a preferential recruitment of the transcripts by the translational apparatus. Taken together, these results indicate that a cis-acting element located in the sequence coding for the 5'UTR of ICP22 mRNA can mediate a high level of gene expression independently of the viral promoter and of viral trans-acting factors.

Characterization of the human ACTH receptor gene and in vitro expression.

The coding sequence of the human ACTH receptor, cloned in 1992, contains no intron, but the presence of one intron (of about 18 kb) separating the coding exon from an upstream exon has been demonstrated. One major transcription start site was located in this first exon. Northern blot analysis of cultured human adrenocortical cells revealed several transcripts that can be partly explained by the use of different polyadenylation sites. We have isolated a 1 kb fragment of genomic DNA upstream of exon 1 and studied its basal promoter activity. The sequence of this region shows several putative CREs that could be responsible for the stimulation by ACTH of its own receptors as demonstrated on human adrenocortical cells. To functionally characterize the human ACTH receptor, we have prepared cells stably transfected with either the normal receptor or a mutant receptor. This model allows the study of both binding to ACTH and coupling to adenylate cyclase. Two naturally mutated receptors, described in patients with Familial Glucocorticoid Deficiency, have been studied. Both mutations (C251F and D107N) strongly impaired the binding of ACTH to its receptors and are then responsible for the absence of biological response to ACTH.