Entry
Name
Cushing syndrome - Theropithecus gelada (gelada)
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
Theropithecus gelada (gelada) [GN:
tge ]
Gene
112609410 CRHR1; corticotropin-releasing factor receptor 1 isoform X1 [KO:K04578 ]
112620033 CRHR2; corticotropin-releasing factor receptor 2 isoform X1 [KO:K04579 ]
112632629 GNAS; guanine nucleotide-binding protein G(s) subunit alpha isoforms XLas isoform X1 [KO:K04632 ]
112636017 CREB1; cyclic AMP-responsive element-binding protein 1 isoform X1 [KO:K05870 ]
112636593 ATF2; cyclic AMP-dependent transcription factor ATF-2 isoform X1 [KO:K04450 ]
112632664 ATF4; cyclic AMP-dependent transcription factor ATF-4 isoform X1 [KO:K04374 ]
112620604 CREB3L2; cyclic AMP-responsive element-binding protein 3-like protein 2 [KO:K09048 ]
112613040 CREB3L3; cyclic AMP-responsive element-binding protein 3-like protein 3 isoform X1 [KO:K09048 ]
112607019 CREB3L1; cyclic AMP-responsive element-binding protein 3-like protein 1 [KO:K09048 ]
112636418 CREB3L4; cyclic AMP-responsive element-binding protein 3-like protein 4 isoform X1 [KO:K09048 ]
112608313 CREB3; cyclic AMP-responsive element-binding protein 3 [KO:K09048 ]
112621312 CREB5; cyclic AMP-responsive element-binding protein 5 isoform X1 [KO:K09047 ]
112622249 ATF6B; cyclic AMP-dependent transcription factor ATF-6 beta isoform X1 [KO:K09049 ]
112630641 ASH2L; set1/Ash2 histone methyltransferase complex subunit ASH2 isoform X1 [KO:K14964 ]
112607789 CDKN2B; cyclin-dependent kinase 4 inhibitor B isoform X1 [KO:K04685 ]
112609305 RASD1; dexamethasone-induced Ras-related protein 1 isoform X1 [KO:K07843 ]
112620903 GNAI1; guanine nucleotide-binding protein G(i) subunit alpha-1 isoform X1 [KO:K04630 ]
112625820 GNAI3; guanine nucleotide-binding protein G(k) subunit alpha [KO:K04630 ]
112618989 GNAI2; guanine nucleotide-binding protein G(i) subunit alpha-2 isoform X1 [KO:K04630 ]
112609244 AIPL1; aryl-hydrocarbon-interacting protein-like 1 isoform X1 [KO:K17767 ]
112620303 ARNT; aryl hydrocarbon receptor nuclear translocator isoform X1 [KO:K09097 ]
112634261 CDKN1B; cyclin-dependent kinase inhibitor 1B isoform X1 [KO:K06624 ]
112623750 CDKN1A; cyclin-dependent kinase inhibitor 1 isoform X1 [KO:K06625 ]
112634000 CACNA1C; voltage-dependent L-type calcium channel subunit alpha-1C isoform X1 [KO:K04850 ]
112618467 CACNA1D; voltage-dependent L-type calcium channel subunit alpha-1D isoform X1 [KO:K04851 ]
112614995 CACNA1F; voltage-dependent L-type calcium channel subunit alpha-1F [KO:K04853 ]
112625837 CACNA1S; voltage-dependent L-type calcium channel subunit alpha-1S [KO:K04857 ]
112621751 CAMK2B; calcium/calmodulin-dependent protein kinase type II subunit beta isoform X1 [KO:K04515 ] [EC:2.7.11.17 ]
112631191 CAMK2G; calcium/calmodulin-dependent protein kinase type II subunit gamma isoform X1 [KO:K04515 ] [EC:2.7.11.17 ]
112624412 CAMK2D; calcium/calmodulin-dependent protein kinase type II subunit delta isoform X1 [KO:K04515 ] [EC:2.7.11.17 ]
112625819 CAMK2A; calcium/calmodulin-dependent protein kinase type II subunit alpha isoform X1 [KO:K04515 ] [EC:2.7.11.17 ]
112612394 MAP2K2; LOW QUALITY PROTEIN: dual specificity mitogen-activated protein kinase kinase 2 [KO:K04369 ] [EC:2.7.12.2 ]
112634399 NR4A1; nuclear receptor subfamily 4 group A member 1 isoform X1 [KO:K04465 ]
112621427 MRAP; melanocortin-2 receptor accessory protein isoform X1 [KO:K22398 ]
112628817 PDE8A; high affinity cAMP-specific and IBMX-insensitive 3',5'-cyclic phosphodiesterase 8A isoform X1 [KO:K18437 ] [EC:3.1.4.53 ]
112625864 PDE8B; high affinity cAMP-specific and IBMX-insensitive 3',5'-cyclic phosphodiesterase 8B isoform X1 [KO:K18437 ] [EC:3.1.4.53 ]
112620982 PBX1; pre-B-cell leukemia transcription factor 1 isoform X1 [KO:K09355 ]
112630644 STAR; steroidogenic acute regulatory protein, mitochondrial [KO:K16931 ]
112619286 NCEH1; neutral cholesterol ester hydrolase 1 isoform X1 [KO:K14349 ] [EC:3.1.1.-]
112614561 ARMC5; armadillo repeat-containing protein 5 isoform X1 [KO:K22499 ]
112607858 GNAQ; guanine nucleotide-binding protein G(q) subunit alpha [KO:K04634 ]
112612879 GNA11; guanine nucleotide-binding protein subunit alpha-11 isoform X1 [KO:K04635 ]
112607332 PLCB3; 1-phosphatidylinositol 4,5-bisphosphate phosphodiesterase beta-3 isoform X1 [KO:K05858 ] [EC:3.1.4.11 ]
112633067 PLCB1; 1-phosphatidylinositol 4,5-bisphosphate phosphodiesterase beta-1 isoform X1 [KO:K05858 ] [EC:3.1.4.11 ]
112633206 PLCB4; 1-phosphatidylinositol 4,5-bisphosphate phosphodiesterase beta-4 isoform X1 [KO:K05858 ] [EC:3.1.4.11 ]
112627584 PLCB2; 1-phosphatidylinositol 4,5-bisphosphate phosphodiesterase beta-2 isoform X1 [KO:K05858 ] [EC:3.1.4.11 ]
112612170 KCNK2; potassium channel subfamily K member 2 isoform X1 [KO:K04913 ]
112608876 CACNA1G; voltage-dependent T-type calcium channel subunit alpha-1G isoform X1 [KO:K04854 ]
112614052 CACNA1H; voltage-dependent T-type calcium channel subunit alpha-1H isoform X1 [KO:K04855 ]
112632965 CACNA1I; voltage-dependent T-type calcium channel subunit alpha-1I [KO:K04856 ]
112634597 ORAI1; calcium release-activated calcium channel protein 1 isoform X1 [KO:K16056 ]
112606619 KCNA4; potassium voltage-gated channel subfamily A member 4 [KO:K04877 ]
112634448 SCARB1; scavenger receptor class B member 1 isoform X1 [KO:K13885 ]
112608975 DVL2; segment polarity protein dishevelled homolog DVL-2 isoform X1 [KO:K02353 ]
112617036 segment polarity protein dishevelled homolog DVL-1-like [KO:K02353 ]
112617045 segment polarity protein dishevelled homolog DVL-1-like [KO:K02353 ]
112618281 DVL3; segment polarity protein dishevelled homolog DVL-3 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
tge04927 Cortisol synthesis and secretion
tge04960 Aldosterone-regulated sodium reabsorption
KO pathway
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