Abstract
Rare mutations in several genes have a critical role in the control of homeostatic mechanisms such as food-intake, energy balance and glucose metabolism. In this study, we performed a mutational screening in a 58-year-old woman presenting early-onset type 2 diabetes and central obesity. The entire coding regions of MC4R, MC3R, HNF1A, GCK and POMC (pro-opiomelanocortin) genes were analyzed by direct sequencing. A new missense mutation was identified within the POMC gene signal peptide sequence, resulting in a heterozygous substitution of an arginine for a glycine at codon 15 (p.A15G) that was excluded in 300 healthy normal weight controls. The mutation segregated in the family and was associated with overweight, type 2 diabetes, hypertension and coronary heart disease in the carriers. Functional studies demonstrated that POMC protein was not detectable in β-TC3 cells transfected with A15G-POMC vector as well as in their culture media, despite POMC mRNA levels were comparable for amount and stability to those of wild-type-transfected cells. In silico RNA folding prediction indicated that the mutation gives rise to a different RNA secondary structure, suggesting that it might affect translation and protein synthesis. To the best of our knowledge, this is the first report addressing the functional consequences of a mutation in the signal peptide of POMC. These findings further support the hypothesis that POMC-derived peptides might have a role in the control of peripheral glucose metabolism and suggest that disruption of central POMC secretion might represent an additional link between type 2 diabetes and obesity.
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References
Mountjoy KG : Functions for pro-opiomelanocortin-derived peptides in obesity and diabetes. Biochem J 2010; 428: 305–324.
Parton LE, Ye CP, Coppari R et al. Glucose sensing by POMC neurons regulates glucose homeostasis and is impaired in obesity. Nature 2007; 449: 228–232.
Fick LJ, Belsham DD : Nutrient sensing and insulin signaling in neuropeptide-expressing immortalized, hypothalamic neurons: A cellular model of insulin resistance. Cell Cycle 2010; 9: 3186–3193.
Coll AP, Challis BG, Lopez M, Piper S, Yeo GS, O'Rahilly S : Proopiomelanocortin-deficient mice are hypersensitive to the adverse metabolic effects of glucocorticoids. Diabetes 2005; 54: 2269–2276.
Coll AP : Effects of pro-opiomelanocortin (POMC) on food intake and body weight: mechanisms and therapeutic potential? Clin Sci (Lond) 2007; 113: 171–182.
Coll AP, Loraine Tung YC : Pro-opiomelanocortin (POMC)-derived peptides and the regulation of energy homeostasis. Mol Cell Endocrinol 2009; 300: 147–151.
Krude H, Biebermann H, Luck W, Horn R, Brabant G, Gruters A : Severe early-onset obesity, adrenal insufficiency and red hair pigmentation caused by POMC mutations in humans. Nat Genet 1998; 19: 155–157.
Krude H, Biebermann H, Schnabel D et al. Obesity due to proopiomelanocortin deficiency: three new cases and treatment trials with thyroid hormone and ACTH4-10. J Clin Endocrinol Metab 2003; 88: 4633–4640.
Farooqi IS, Drop S, Clements A et al. Heterozygosity for a POMC-null mutation and increased obesity risk in humans. Diabetes 2006; 55: 2549–2553.
Lee YS, Challis BG, Thompson DA et al. A POMC variant implicates beta-melanocyte-stimulating hormone in the control of human energy balance. Cell Metab 2006; 3: 135–140.
Creemers JW, Lee YS, Oliver RL et al. Mutations in the amino-terminal region of proopiomelanocortin (POMC) in patients with early-onset obesity impair POMC sorting to the regulated secretory pathway. J Clin Endocrinol Metab 2008; 93: 4494–4499.
Miraglia del Giudice E, Cirillo G, Santoro N et al. Molecular screening of the proopiomelanocortin (POMC) gene in Italian obese children: report of three new mutations. Int J Obes Relat Metab Disord 2001; 25: 61–67.
Santoro N, del Giudice EM, Cirillo G et al. An insertional polymorphism of the proopiomelanocortin gene is associated with fasting insulin levels in childhood obesity. J Clin Endocrinol Metab 2004; 89: 4846–4849.
Santoro N, Perrone L, Cirillo G et al. Weight loss in obese children carrying the proopiomelanocortin R236G variant. J Endocrinol Invest 2006; 29: 226–230.
Tortorella A, Monteleone P, del Giudice EM et al. Melanocortin-4 receptor molecular scanning and pro-opiomelanocortin R236G variant screening in binge eating disorder. Psychiatr Genet 2005; 15: 161.
Rost B, Liu J : The PredictProtein server. Nucleic Acids Res 2003; 31: 3300–3304.
Zuker M : Mfold web server for nucleic acid folding and hybridization prediction. Nucleic Acids Res 2003; 31: 3406–3415.
Zuker M, Stiegler P : Optimal computer folding of large RNA sequences using thermodynamics and auxiliary information. Nucleic Acids Res 1981; 9: 133–148.
O'Rahilly S : Human genetics illuminates the paths to metabolic disease. Nature 2009; 462: 307–314.
Michailidou Z, Coll AP, Kenyon CJ et al. Peripheral mechanisms contributing to the glucocorticoid hypersensitivity in proopiomelanocortin null mice treated with corticosterone. J Endocrinol 2007; 194: 161–170.
Challis BG, Pritchard LE, Creemers JW et al. A missense mutation disrupting a dibasic prohormone processing site in pro-opiomelanocortin (POMC) increases susceptibility to early-onset obesity through a novel molecular mechanism. Hum Mol Genet 2002; 11: 1997–2004.
Biebermann H, Castaneda TR, van Landeghem F et al. A role for beta-melanocyte-stimulating hormone in human body-weight regulation. Cell Metab 2006; 3: 141–146.
Mohren S, Weiskirchen R : Non-synonymous gene polymorphisms in the secretory signal peptide of human TGF-beta1 affect cellular synthesis but not secretion of TGF-beta1. Biochem Biophys Res Commun 2009; 379: 1015–1020.
Butler AA, Kesterson RA, Khong K et al. A unique metabolic syndrome causes obesity in the melanocortin-3 receptor-deficient mouse. Endocrinology 2000; 141: 3518–3521.
Chen AS, Marsh DJ, Trumbauer ME et al. Inactivation of the mouse melanocortin-3 receptor results in increased fat mass and reduced lean body mass. Nat Genet 2000; 26: 97–102.
Ni XP, Humphreys MH : Abnormal glucose metabolism in hypertensive mice with genetically interrupted gamma-melanocyte stimulating hormone signaling fed a high-sodium diet. Am J Hypertens 2008; 21: 1284–1287.
Fan W, Dinulescu DM, Butler AA, Zhou J, Marks DL, Cone RD : The central melanocortin system can directly regulate serum insulin levels. Endocrinology 2000; 141: 3072–3079.
Huszar D, Lynch CA, Fairchild-Huntress V et al. Targeted disruption of the melanocortin-4 receptor results in obesity in mice. Cell 1997; 88: 131–141.
Banno R, Arima H, Hayashi M et al. Central administration of melanocortin agonist increased insulin sensitivity in diet-induced obese rats. FEBS Lett 2007; 581: 1131–1136.
Obici S, Feng Z, Tan J, Liu L, Karkanias G, Rossetti L : Central melanocortin receptors regulate insulin action. J Clin Invest 2001; 108: 1079–1085.
Barzilai N, She L, Liu L et al. Decreased visceral adiposity accounts for leptin effect on hepatic but not peripheral insulin action. Am J Physiol 1999; 277: E291–E298.
Liu L, Karkanias GB, Morales JC et al. Intracerebroventricular leptin regulates hepatic but not peripheral glucose fluxes. J Biol Chem 1998; 273: 31160–31167.
Stanley S, Pinto S, Segal J et al. Identification of neuronal subpopulations that project from hypothalamus to both liver and adipose tissue polysynaptically. Proc Natl Acad Sci USA 2010; 107: 7024–7029.
Chai B, Li JY, Zhang W, Wang H, Mulholland MW : Melanocortin-4 receptor activation inhibits c-Jun N-terminal kinase activity and promotes insulin signaling. Peptides 2009; 30: 1098–1104.
Minder EI : Afamelanotide an agonistic analog of alpha-melanocyte-stimulating hormone, in dermal phototoxicity of erythropoietic protoporphyria. Expert Opin Investig Drugs 2010; 19: 1591–1602.
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We would like to thank the patient and her relatives for the kind collaboration.
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Mencarelli, M., Zulian, A., Cancello, R. et al. A novel missense mutation in the signal peptide of the human POMC gene: a possible additional link between early-onset type 2 diabetes and obesity. Eur J Hum Genet 20, 1290–1294 (2012). https://doi.org/10.1038/ejhg.2012.103
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DOI: https://doi.org/10.1038/ejhg.2012.103


