Entry
Name
Cushing syndrome - Pteropus alecto (black flying fox)
Description
Cushing syndrome (CS) is a rare disorder resulting from prolonged exposure to excess glucocorticoids via exogenous and endogenous sources. The typical clinical features of CS are related to hypercortisolism and include accumulation of central fat, moon facies, neuromuscular weakness, osteoporosis or bone fractures, metabolic complications, and mood changes. Traditionally, endogenous CS is classified as adrenocorticotropic hormone (ACTH)-dependent (about 80%) or ACTH- independent (about 20%). Among ACTH-dependent forms, pituitary corticotroph adenoma (Cushing's disease) is most common. Most pituitary tumors are sporadic, resulting from monoclonal expansion of a single mutated cell. Recently recurrent activating somatic driver mutations in the ubiquitin-specific protease 8 gene (USP8) were identified in almost half of corticotroph adenoma. Germline mutations in MEN1 (encoding menin), AIP (encoding aryl-hydrocarbon receptor-interacting protein), PRKAR1A (encoding cAMP-dependent protein kinase type I alpha regulatory subunit) and CDKN1B (encoding cyclin-dependent kinase inhibitor 1B; also known as p27 Kip1) have been identified in familial forms of pituitary adenomas. However, the frequency of familial pituitary adenomas is less than 5% in patients with pituitary adenomas. Among ACTH-independent CS, adrenal adenoma is most common. Rare adrenal causes of CS include primary bilateral macronodular adrenal hyperplasia (BMAH) or primary pigmented nodular adrenocortical disease (PPNAD).
Class
Human Diseases; Endocrine and metabolic disease
BRITE hierarchy
Pathway map
Ortholog table
Organism
Pteropus alecto (black flying fox) [GN:
pale ]
Gene
102878226 CRHR1; corticotropin-releasing factor receptor 1 isoform X1 [KO:K04578 ]
102889764 guanine nucleotide-binding protein G(s) subunit alpha isoforms XLas [KO:K04632 ]
102888198 CREB1; cyclic AMP-responsive element-binding protein 1 isoform X1 [KO:K05870 ]
102889014 ATF2; cyclic AMP-dependent transcription factor ATF-2 isoform X1 [KO:K04450 ]
102896553 ATF4; cyclic AMP-dependent transcription factor ATF-4 [KO:K04374 ]
102878515 CREB3L4; cyclic AMP-responsive element-binding protein 3-like protein 4 [KO:K09048 ]
102894633 CREB3L1; cyclic AMP-responsive element-binding protein 3-like protein 1 isoform X1 [KO:K09048 ]
102882888 CREB3L2; cyclic AMP-responsive element-binding protein 3-like protein 2 isoform X1 [KO:K09048 ]
102886510 CREB3; cyclic AMP-responsive element-binding protein 3 isoform X1 [KO:K09048 ]
102879289 CREB3L3; cyclic AMP-responsive element-binding protein 3-like protein 3 [KO:K09048 ]
102884583 CREB5; cyclic AMP-responsive element-binding protein 5 isoform X1 [KO:K09047 ]
102898128 ATF6B; cyclic AMP-dependent transcription factor ATF-6 beta isoform X3 [KO:K09049 ]
102881393 ASH2L; set1/Ash2 histone methyltransferase complex subunit ASH2 isoform X1 [KO:K14964 ]
102896422 LOW QUALITY PROTEIN: cyclin-dependent kinase inhibitor 2A [KO:K06621 ]
102892785 GNAI3; guanine nucleotide-binding protein G(k) subunit alpha [KO:K04630 ]
102885642 GNAI1; guanine nucleotide-binding protein G(i) subunit alpha-1 [KO:K04630 ]
102898665 GNAI2; guanine nucleotide-binding protein G(i) subunit alpha-2 [KO:K04630 ]
102885691 ARNT; aryl hydrocarbon receptor nuclear translocator isoform X1 [KO:K09097 ]
102882682 CACNA1C; voltage-dependent L-type calcium channel subunit alpha-1C isoform X2 [KO:K04850 ]
102888351 CACNA1D; voltage-dependent L-type calcium channel subunit alpha-1D [KO:K04851 ]
102893611 CACNA1F; voltage-dependent L-type calcium channel subunit alpha-1F isoform X1 [KO:K04853 ]
102896136 CACNA1S; voltage-dependent L-type calcium channel subunit alpha-1S [KO:K04857 ]
102888385 CAMK2A; calcium/calmodulin-dependent protein kinase type II subunit alpha isoform X1 [KO:K04515 ] [EC:2.7.11.17 ]
102893743 PDE8B; high affinity cAMP-specific and IBMX-insensitive 3',5'-cyclic phosphodiesterase 8B [KO:K18437 ] [EC:3.1.4.53 ]
102891335 PDE8A; high affinity cAMP-specific and IBMX-insensitive 3',5'-cyclic phosphodiesterase 8A [KO:K18437 ] [EC:3.1.4.53 ]
102881135 STAR; steroidogenic acute regulatory protein, mitochondrial [KO:K16931 ]
102885919 NCEH1; LOW QUALITY PROTEIN: neutral cholesterol ester hydrolase 1 [KO:K14349 ] [EC:3.1.1.-]
102877919 guanine nucleotide-binding protein G(q) subunit alpha [KO:K04634 ]
102888619 GNA11; guanine nucleotide-binding protein subunit alpha-11 [KO:K04635 ]
102885207 PLCB4; 1-phosphatidylinositol 4,5-bisphosphate phosphodiesterase beta-4 isoform X1 [KO:K05858 ] [EC:3.1.4.11 ]
102896356 ITPR2; inositol 1,4,5-trisphosphate receptor type 2 isoform X1 [KO:K04959 ]
102885724 KCNK2; potassium channel subfamily K member 2 isoform X2 [KO:K04913 ]
102889039 CACNA1G; voltage-dependent T-type calcium channel subunit alpha-1G isoform X6 [KO:K04854 ]
102890816 CACNA1H; voltage-dependent T-type calcium channel subunit alpha-1H isoform X2 [KO:K04855 ]
102882076 CACNA1I; LOW QUALITY PROTEIN: voltage-dependent T-type calcium channel subunit alpha-1I [KO:K04856 ]
102883130 ORAI1; calcium release-activated calcium channel protein 1 isoform X1 [KO:K16056 ]
102897170 KCNA4; potassium voltage-gated channel subfamily A member 4 [KO:K04877 ]
102888790 LDLR; LOW QUALITY PROTEIN: low-density lipoprotein receptor [KO:K12473 ]
102895469 DVL3; segment polarity protein dishevelled homolog DVL-3 isoform X1 [KO:K02353 ]
102880039 DVL2; segment polarity protein dishevelled homolog DVL-2 isoform X1 [KO:K02353 ]
102881158 DVL1; segment polarity protein dishevelled homolog DVL-1 isoform X1 [KO:K02353 ]
Compound
C01176 17alpha-Hydroxyprogesterone
C01245 D-myo-Inositol 1,4,5-trisphosphate
C05138 17alpha-Hydroxypregnenolone
C07557 2,3,7,8-Tetrachlorodibenzodioxin
Reference
Authors
Lacroix A, Feelders RA, Stratakis CA, Nieman LK
Title
Cushing's syndrome.
Journal
Reference
Authors
Xiong Q, Ge W
Title
Gene mutations in Cushing's disease.
Journal
Reference
Authors
Fukuoka H, Takahashi Y
Title
The role of genetic and epigenetic changes in pituitary tumorigenesis.
Journal
Reference
Authors
Quereda V, Malumbres M
Title
Cell cycle control of pituitary development and disease.
Journal
Reference
Authors
Caimari F, Korbonits M
Title
Novel Genetic Causes of Pituitary Adenomas.
Journal
Reference
Authors
Lecoq AL, Kamenicky P, Guiochon-Mantel A, Chanson P
Title
Genetic mutations in sporadic pituitary adenomas--what to screen for?
Journal
Reference
Authors
Hannah-Shmouni F, Faucz FR, Stratakis CA
Title
Alterations of Phosphodiesterases in Adrenocortical Tumors.
Journal
Reference
Authors
Melmed S
Title
Pathogenesis of pituitary tumors.
Journal
Reference
Authors
Daly AF, Tichomirowa MA, Beckers A
Title
Genetic, molecular and clinical features of familial isolated pituitary adenomas.
Journal
Reference
Authors
Albani A, Theodoropoulou M, Reincke M
Title
Genetics of Cushing's disease.
Journal
Reference
Authors
Duan K, Hernandez KG, Mete O
Title
Clinicopathological correlates of adrenal Cushing's syndrome.
Journal
Reference
Authors
Drougat L, Espiard S, Bertherat J
Title
Genetics of primary bilateral macronodular adrenal hyperplasia: a model for early diagnosis of Cushing's syndrome?
Journal
Reference
Authors
Stratakis CA, Boikos SA
Title
Genetics of adrenal tumors associated with Cushing's syndrome: a new classification for bilateral adrenocortical hyperplasias.
Journal
Reference
Authors
Refojo D, Holsboer F
Title
CRH signaling. Molecular specificity for drug targeting in the CNS.
Journal
Reference
Authors
Kovalovsky D, Refojo D, Liberman AC, Hochbaum D, Pereda MP, Coso OA, Stalla GK, Holsboer F, Arzt E
Title
Activation and induction of NUR77/NURR1 in corticotrophs by CRH/cAMP: involvement of calcium, protein kinase A, and MAPK pathways.
Journal
Reference
Authors
Lacroix A, Baldacchino V, Bourdeau I, Hamet P, Tremblay J
Title
Cushing's syndrome variants secondary to aberrant hormone receptors.
Journal
Reference
Authors
Reincke M, Sbiera S, Hayakawa A, Theodoropoulou M, Osswald A, Beuschlein F, Meitinger T, Mizuno-Yamasaki E, Kawaguchi K, Saeki Y, Tanaka K, Wieland T, Graf E, Saeger W, Ronchi CL, Allolio B, Buchfelder M, Strom TM, Fassnacht M, Komada M
Title
Mutations in the deubiquitinase gene USP8 cause Cushing's disease.
Journal
Reference
Authors
Kaiser UB
Title
Cushing's disease: towards precision medicine.
Journal
Reference
Authors
Uzilov AV, Cheesman KC, Fink MY, Newman LC, Pandya C, Lalazar Y, Hefti M, Fowkes M, Deikus G, Lau CY, Moe AS, Kinoshita Y, Kasai Y, Zweig M, Gupta A, Starcevic D, Mahajan M, Schadt EE, Post KD, Donovan MJ, Sebra R, Chen R, Geer EB
Title
Identification of a novel RASD1 somatic mutation in a USP8-mutated corticotroph adenoma.
Journal
Reference
Authors
Huang C, Shi Y, Zhao Y
Title
USP8 mutation in Cushing's disease.
Journal
Reference
Authors
Theodoropoulou M, Reincke M, Fassnacht M, Komada M
Title
Decoding the genetic basis of Cushing's disease: USP8 in the spotlight.
Journal
Reference
Authors
Yu L, Zhang J, Guo X, Chen X, He Z, He Q
Title
ARMC5 mutations in familial and sporadic primary bilateral macronodular adrenal hyperplasia.
Journal
Reference
Authors
Wu X, Hua X
Title
Menin, histone h3 methyltransferases, and regulation of cell proliferation: current knowledge and perspective.
Journal
Reference
Authors
Ozfirat Z, Korbonits M
Title
AIP gene and familial isolated pituitary adenomas.
Journal
Related pathway
pale04960 Aldosterone-regulated sodium reabsorption
KO pathway
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