KEGG   PATHWAY: pvp04934
Entry
pvp04934                    Pathway                                
Name
Cushing syndrome - Pteropus vampyrus (large 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
Pathway map
pvp04934  Cushing syndrome
pvp04934

Disease
H01431  Cushing syndrome
Organism
Pteropus vampyrus (large flying fox) [GN:pvp]
Gene
105288383  CDKN1A; cyclin-dependent kinase inhibitor 1 [KO:K06625]
105288744  USP8; ubiquitin carboxyl-terminal hydrolase 8 isoform X1 [KO:K11839] [EC:3.4.19.12]
105288781  PLCB2; 1-phosphatidylinositol 4,5-bisphosphate phosphodiesterase beta-2 [KO:K05858] [EC:3.1.4.11]
105288850  ADCY5; adenylate cyclase type 5 [KO:K08045] [EC:4.6.1.1]
105288866  CAMK2G; calcium/calmodulin-dependent protein kinase type II subunit gamma isoform X2 [KO:K04515] [EC:2.7.11.17]
105289063  PRKACB; cAMP-dependent protein kinase catalytic subunit beta isoform X1 [KO:K04345] [EC:2.7.11.11]
105289200  ORAI1; calcium release-activated calcium channel protein 1 isoform X1 [KO:K16056]
105289326  MAPK1; mitogen-activated protein kinase 1 isoform X2 [KO:K04371] [EC:2.7.11.24]
105289805  KCNK3; potassium channel subfamily K member 3 [KO:K04914]
105289810  POMC; pro-opiomelanocortin [KO:K05228]
105289813  ADCY3; adenylate cyclase type 3 [KO:K08043] [EC:4.6.1.1]
105289998  PDE11A; dual 3',5'-cyclic-AMP and -GMP phosphodiesterase 11A [KO:K13298] [EC:3.1.4.17 3.1.4.35]
105290070  CREB3L1; cyclic AMP-responsive element-binding protein 3-like protein 1 isoform X1 [KO:K09048]
105290156  WNT16; protein Wnt-16 [KO:K01558]
105290195  ATF2; cyclic AMP-dependent transcription factor ATF-2 [KO:K04450]
105290328  CTNNB1; catenin beta-1 [KO:K02105]
105290434  WNT4; protein Wnt-4 [KO:K00408]
105290449  E2F2; transcription factor E2F2 isoform X1 [KO:K09389]
105291051  WNT10A; protein Wnt-10a [KO:K01357]
105291052  WNT6; protein Wnt-6 isoform X2 [KO:K00445]
105291480  TCF7L2; transcription factor 7-like 2 isoform X8 [KO:K04491]
105291512  FZD3; frizzled-3 isoform X1 [KO:K02329]
105291624  CREB3L2; cyclic AMP-responsive element-binding protein 3-like protein 2 [KO:K09048]
105291659  BRAF; serine/threonine-protein kinase B-raf isoform X1 [KO:K04365] [EC:2.7.11.1]
105291733  DVL2; segment polarity protein dishevelled homolog DVL-2 isoform X1 [KO:K02353]
105291983  AIPL1; aryl-hydrocarbon-interacting protein-like 1 [KO:K17767]
105292087  ADCY7; adenylate cyclase type 7 isoform X1 [KO:K08047] [EC:4.6.1.1]
105293004  LEF1; lymphoid enhancer-binding factor 1 isoform X1 [KO:K04492]
105293217  [KO:K09047]
105293567  TCF7; transcription factor 7 isoform X2 [KO:K02620]
105293607  WNT8A; protein Wnt-8a [KO:K00714]
105293715  KCNA4; potassium voltage-gated channel subfamily A member 4 [KO:K04877]
105293891  AHR; aryl hydrocarbon receptor [KO:K09093]
105293923  E2F3; transcription factor E2F3 isoform X1 [KO:K06620]
105294112  ITPR2; inositol 1,4,5-trisphosphate receptor type 2 [KO:K04959]
105294187  FZD4; frizzled-4 [KO:K02354]
105294446  CDK6; cyclin-dependent kinase 6 isoform X1 [KO:K02091] [EC:2.7.11.22]
105294552  FZD1; frizzled-1 [KO:K02432]
105294869  NR5A1; steroidogenic factor 1 isoform X1 [KO:K08560]
105294948  AGTR1; type-1 angiotensin II receptor [KO:K04166]
105294978  WNT7A; protein Wnt-7a [KO:K00572]
105295028  KCNK2; potassium channel subfamily K member 2 isoform X1 [KO:K04913]
105295071  CRH; corticoliberin [KO:K05256]
105295155  GNAI2; guanine nucleotide-binding protein G(i) subunit alpha-2 [KO:K04630]
105295171  ITPR1; inositol 1,4,5-trisphosphate receptor type 1 [KO:K04958]
105295395  CACNA1G; voltage-dependent T-type calcium channel subunit alpha-1G isoform X7 [KO:K04854]
105295478  APC; adenomatous polyposis coli protein isoform X3 [KO:K02085]
105295517  GNAI1; guanine nucleotide-binding protein G(i) subunit alpha-1 [KO:K04630]
105296083  [KO:K04632]
105296358  [KO:K00070] [EC:1.1.1.145 5.3.3.1]
105296460  CREB3L4; cyclic AMP-responsive element-binding protein 3-like protein 4 [KO:K09048]
105296814  WNT2B; protein Wnt-2b isoform X1 [KO:K00182]
105296884  RAP1A; ras-related protein Rap-1A [KO:K04353]
105296936  CACNA1S; voltage-dependent L-type calcium channel subunit alpha-1S [KO:K04857]
105297173  CDKN2C; cyclin-dependent kinase 4 inhibitor C [KO:K06622]
105297202  GNAI3; guanine nucleotide-binding protein G(k) subunit alpha [KO:K04630]
105297256  WNT5B; protein Wnt-5b isoform X1 [KO:K00444]
105297298  CACNA1C; voltage-dependent L-type calcium channel subunit alpha-1C [KO:K04850]
105297518  ADCY6; adenylate cyclase type 6 isoform X1 [KO:K08046] [EC:4.6.1.1]
105297527  WNT10B; protein Wnt-10b [KO:K01357]
105297529  WNT1; proto-oncogene Wnt-1 [KO:K03209]
105297532  KMT2D; histone-lysine N-methyltransferase 2D isoform X1 [KO:K09187] [EC:2.1.1.354]
105297627  WNT11; protein Wnt-11 [KO:K01384]
105297749  AXIN2; axin-2 [KO:K04385]
105297846  PLCB3; 1-phosphatidylinositol 4,5-bisphosphate phosphodiesterase beta-3 [KO:K05858] [EC:3.1.4.11]
105297861  MEN1; menin isoform X2 [KO:K14970]
105298070  ATF4; cyclic AMP-dependent transcription factor ATF-4 [KO:K04374]
105298101  CACNA1I; voltage-dependent T-type calcium channel subunit alpha-1I [KO:K04856]
105298116  FZD7; frizzled-7 [KO:K02432]
105298400  FZD5; frizzled-5 [KO:K02375]
105298404  CREB1; cyclic AMP-responsive element-binding protein 1 isoform X1 [KO:K05870]
105298440  CDKN2B; cyclin-dependent kinase 4 inhibitor B isoform X4 [KO:K04685]
105298541  TCF7L1; transcription factor 7-like 1 isoform X1 [KO:K04490]
105298737  PLCB4; 1-phosphatidylinositol 4,5-bisphosphate phosphodiesterase beta-4 isoform X1 [KO:K05858] [EC:3.1.4.11]
105299042  WDR5B; WD repeat-containing protein 5B isoform X1 [KO:K14963]
105299441  CAMK2A; calcium/calmodulin-dependent protein kinase type II subunit alpha [KO:K04515] [EC:2.7.11.17]
105299444  PLCB1; 1-phosphatidylinositol 4,5-bisphosphate phosphodiesterase beta-1 [KO:K05858] [EC:3.1.4.11]
105299568  FZD10; frizzled-10 [KO:K02842]
105299581  ADCY2; adenylate cyclase type 2 [KO:K08042] [EC:4.6.1.1]
105299684  FZD9; frizzled-9 [KO:K02842]
105299863  WNT5A; protein Wnt-5a isoform X5 [KO:K00444]
105299958  WNT3A; protein Wnt-3a [KO:K00312]
105300002  WNT9A; protein Wnt-9a [KO:K01064]
105300023  RB1; retinoblastoma-associated protein [KO:K06618]
105300190  ASH2L; set1/Ash2 histone methyltransferase complex subunit ASH2 isoform X1 [KO:K14964]
105300196  STAR; steroidogenic acute regulatory protein, mitochondrial [KO:K16931]
105300436  GNA11; guanine nucleotide-binding protein subunit alpha-11 [KO:K04635]
105300673  RBBP5; retinoblastoma-binding protein 5 isoform X1 [KO:K14961]
105300873  FZD6; frizzled-6 isoform X1 [KO:K02376]
105301042  ITPR3; inositol 1,4,5-trisphosphate receptor type 3 [KO:K04960]
105301250  ADCY8; adenylate cyclase type 8 [KO:K08048] [EC:4.6.1.1]
105301269  MRAP; melanocortin-2 receptor accessory protein [KO:K22398]
105301304  GSK3B; glycogen synthase kinase-3 beta isoform X1 [KO:K03083] [EC:2.7.11.26]
105302023  [KO:K00497] [EC:1.14.15.4]
105302044  WNT7B; protein Wnt-7b [KO:K00572]
105302160  RAP1B; ras-related protein Rap-1b [KO:K07836]
105302190  PDE8B; high affinity cAMP-specific and IBMX-insensitive 3',5'-cyclic phosphodiesterase 8B [KO:K18437] [EC:3.1.4.53]
105302259  APC2; adenomatous polyposis coli protein 2 [KO:K02085]
105302452  [KO:K04634]
105302600  CDK2; cyclin-dependent kinase 2 isoform X1 [KO:K02206] [EC:2.7.11.22]
105302655  SP1; transcription factor Sp1 isoform X1 [KO:K04684]
105302767  CAMK2D; calcium/calmodulin-dependent protein kinase type II subunit delta [KO:K04515] [EC:2.7.11.17]
105302792  CDKN1B; cyclin-dependent kinase inhibitor 1B [KO:K06624]
105302891  PDE8A; high affinity cAMP-specific and IBMX-insensitive 3',5'-cyclic phosphodiesterase 8A isoform X1 [KO:K18437] [EC:3.1.4.53]
105302944  [KO:K14963]
105303095  ADCY9; adenylate cyclase type 9 [KO:K08049] [EC:4.6.1.1]
105303252  AXIN1; axin-1 isoform X1 [KO:K02157]
105303376  CACNA1H; voltage-dependent T-type calcium channel subunit alpha-1H [KO:K04855]
105303453  WNT3; proto-oncogene Wnt-3 [KO:K00312]
105303454  WNT9B; protein Wnt-9b [KO:K01064]
105303480  FZD2; frizzled-2 [KO:K02235]
105303517  [KO:K04578]
105303599  DVL1; segment polarity protein dishevelled homolog DVL-1 [KO:K02353]
105303857  ARNT; aryl hydrocarbon receptor nuclear translocator [KO:K09097]
105304277  E2F1; transcription factor E2F1 [KO:K17454]
105304363  CACNA1D; LOW QUALITY PROTEIN: voltage-dependent L-type calcium channel subunit alpha-1D [KO:K04851]
105304498  ARMC5; armadillo repeat-containing protein 5 [KO:K22499]
105304566  MAPK3; mitogen-activated protein kinase 3 isoform X1 [KO:K04371] [EC:2.7.11.24]
105304667  WNT8B; protein Wnt-8b [KO:K00714]
105305286  ATF6B; cyclic AMP-dependent transcription factor ATF-6 beta isoform X1 [KO:K09049]
105305287  [KO:K00513] [EC:1.14.14.16]
105305408  FH; fumarate hydratase, mitochondrial isoform X1 [KO:K01679] [EC:4.2.1.2]
105305615  LDLR; LOW QUALITY PROTEIN: low-density lipoprotein receptor [KO:K12473]
105305713  NCEH1; neutral cholesterol ester hydrolase 1 isoform X1 [KO:K14349] [EC:3.1.1.-]
105306022  AGT; angiotensinogen [KO:K09821]
105306027  PBX1; pre-B-cell leukemia transcription factor 1 isoform X1 [KO:K09355]
105306141  [KO:K04361] [EC:2.7.10.1]
105306370  MC2R; adrenocorticotropic hormone receptor [KO:K04200]
105306466  CREB3; cyclic AMP-responsive element-binding protein 3 isoform X1 [KO:K09048]
105306555  AIP; AH receptor-interacting protein isoform X1 [KO:K17767]
105306721  SCARB1; scavenger receptor class B member 1 [KO:K13885]
105306744  MAP2K2; dual specificity mitogen-activated protein kinase kinase 2 [KO:K04369] [EC:2.7.12.2]
105306745  CREB3L3; cyclic AMP-responsive element-binding protein 3-like protein 3 [KO:K09048]
105306828  [KO:K00498] [EC:1.14.15.6]
105307011  NR4A1; nuclear receptor subfamily 4 group A member 1 [KO:K04465]
105307126  DVL3; segment polarity protein dishevelled homolog DVL-3 isoform X1 [KO:K02353]
105307128  [KO:K04503]
105307149  FZD8; frizzled-8 [KO:K02375]
105307393  CDK4; cyclin-dependent kinase 4 isoform X2 [KO:K02089] [EC:2.7.11.22]
105308299  [KO:K08041] [EC:4.6.1.1]
105308466  WNT2; protein Wnt-2 [KO:K00182]
105308501  PRKACA; cAMP-dependent protein kinase catalytic subunit alpha [KO:K04345] [EC:2.7.11.11]
105308616  CRHR2; corticotropin-releasing factor receptor 2 [KO:K04579]
105308762  CAMK2B; calcium/calmodulin-dependent protein kinase type II subunit beta [KO:K04515] [EC:2.7.11.17]
105308799  CCNE2; G1/S-specific cyclin-E2 isoform X1 [KO:K06626]
105309056  CACNA1F; voltage-dependent L-type calcium channel subunit alpha-1F isoform X1 [KO:K04853]
105309400  ADCY4; adenylate cyclase type 4 [KO:K08044] [EC:4.6.1.1]
105309652  [KO:K00512] [EC:1.14.14.19 1.14.14.32]
105309827  MAP2K1; dual specificity mitogen-activated protein kinase kinase 1 isoform X1 [KO:K04368] [EC:2.7.12.2]
105310134  [KO:K00497] [EC:1.14.15.4]
105310154  [KO:K14963]
105310196  KMT2A; histone-lysine N-methyltransferase 2A isoform X1 [KO:K09186] [EC:2.1.1.354]
105311044  [KO:K07843]
105311216  [KO:K04685]
Compound
C00020  AMP
C00076  Calcium cation
C00187  Cholesterol
C00238  Potassium cation
C00410  Progesterone
C00575  3',5'-Cyclic AMP
C00735  Cortisol
C01176  17alpha-Hydroxyprogesterone
C01245  D-myo-Inositol 1,4,5-trisphosphate
C01953  Pregnenolone
C05138  17alpha-Hydroxypregnenolone
C05488  11-Deoxycortisol
C07557  2,3,7,8-Tetrachlorodibenzodioxin
Reference
  Authors
Lacroix A, Feelders RA, Stratakis CA, Nieman LK
  Title
Cushing's syndrome.
  Journal
Lancet 386:913-27 (2015)
DOI:10.1016/S0140-6736(14)61375-1
Reference
  Authors
Xiong Q, Ge W
  Title
Gene mutations in Cushing's disease.
  Journal
Biomed Rep 5:277-282 (2016)
DOI:10.3892/br.2016.729
Reference
  Authors
Fukuoka H, Takahashi Y
  Title
The role of genetic and epigenetic changes in pituitary tumorigenesis.
  Journal
Neurol Med Chir (Tokyo) 54 Suppl 3:943-57 (2014)
DOI:10.2176/nmc.suppl.2014-3
Reference
  Authors
Quereda V, Malumbres M
  Title
Cell cycle control of pituitary development and disease.
  Journal
J Mol Endocrinol 42:75-86 (2009)
DOI:10.1677/JME-08-0146
Reference
  Authors
Caimari F, Korbonits M
  Title
Novel Genetic Causes of Pituitary Adenomas.
  Journal
Clin Cancer Res 22:5030-5042 (2016)
DOI:10.1158/1078-0432.CCR-16-0452
Reference
  Authors
Lecoq AL, Kamenicky P, Guiochon-Mantel A, Chanson P
  Title
Genetic mutations in sporadic pituitary adenomas--what to screen for?
  Journal
Nat Rev Endocrinol 11:43-54 (2015)
DOI:10.1038/nrendo.2014.181
Reference
  Authors
Hannah-Shmouni F, Faucz FR, Stratakis CA
  Title
Alterations of Phosphodiesterases in Adrenocortical Tumors.
  Journal
Front Endocrinol (Lausanne) 7:111 (2016)
DOI:10.3389/fendo.2016.00111
Reference
  Authors
Melmed S
  Title
Pathogenesis of pituitary tumors.
  Journal
Nat Rev Endocrinol 7:257-66 (2011)
DOI:10.1038/nrendo.2011.40
Reference
  Authors
Daly AF, Tichomirowa MA, Beckers A
  Title
Genetic, molecular and clinical features of familial isolated pituitary adenomas.
  Journal
Horm Res 71 Suppl 2:116-22 (2009)
DOI:10.1159/000192448
Reference
  Authors
Albani A, Theodoropoulou M, Reincke M
  Title
Genetics of Cushing's disease.
  Journal
Clin Endocrinol (Oxf) 88:3-12 (2018)
DOI:10.1111/cen.13457
Reference
  Authors
Duan K, Hernandez KG, Mete O
  Title
Clinicopathological correlates of adrenal Cushing's syndrome.
  Journal
Postgrad Med J 91:331-42 (2015)
DOI:10.1136/postgradmedj-2014-202612rep
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
Eur J Endocrinol 173:M121-31 (2015)
DOI:10.1530/EJE-15-0532
Reference
  Authors
Stratakis CA, Boikos SA
  Title
Genetics of adrenal tumors associated with Cushing's syndrome: a new classification for bilateral adrenocortical hyperplasias.
  Journal
Nat Clin Pract Endocrinol Metab 3:748-57 (2007)
DOI:10.1038/ncpendmet0648
Reference
  Authors
Refojo D, Holsboer F
  Title
CRH signaling. Molecular specificity for drug targeting in the CNS.
  Journal
Ann N Y Acad Sci 1179:106-19 (2009)
DOI:10.1111/j.1749-6632.2009.04983.x
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
Mol Endocrinol 16:1638-51 (2002)
DOI:10.1210/mend.16.7.0863
Reference
  Authors
Lacroix A, Baldacchino V, Bourdeau I, Hamet P, Tremblay J
  Title
Cushing's syndrome variants secondary to aberrant hormone receptors.
  Journal
Trends Endocrinol Metab 15:375-82 (2004)
DOI:10.1016/j.tem.2004.08.007
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
Nat Genet 47:31-8 (2015)
DOI:10.1038/ng.3166
Reference
  Authors
Kaiser UB
  Title
Cushing's disease: towards precision medicine.
  Journal
Cell Res 25:649-50 (2015)
DOI:10.1038/cr.2015.53
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
Cold Spring Harb Mol Case Stud 3:a001602 (2017)
DOI:10.1101/mcs.a001602
Reference
  Authors
Huang C, Shi Y, Zhao Y
  Title
USP8 mutation in Cushing's disease.
  Journal
Oncotarget 6:18240-1 (2015)
DOI:10.18632/oncotarget.4856
Reference
  Authors
Theodoropoulou M, Reincke M, Fassnacht M, Komada M
  Title
Decoding the genetic basis of Cushing's disease: USP8 in the spotlight.
  Journal
Eur J Endocrinol 173:M73-83 (2015)
DOI:10.1530/EJE-15-0320
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
PLoS One 13:e0191602 (2018)
DOI:10.1371/journal.pone.0191602
Reference
  Authors
Wu X, Hua X
  Title
Menin, histone h3 methyltransferases, and regulation of cell proliferation: current knowledge and perspective.
  Journal
Curr Mol Med 8:805-15 (2008)
DOI:10.2174/156652408786733702
Reference
  Authors
Ozfirat Z, Korbonits M
  Title
AIP gene and familial isolated pituitary adenomas.
  Journal
Mol Cell Endocrinol 326:71-9 (2010)
DOI:10.1016/j.mce.2010.05.001
Related
pathway
pvp00020  Citrate cycle (TCA cycle)
pvp00140  Steroid hormone biosynthesis
pvp04020  Calcium signaling pathway
pvp04024  cAMP signaling pathway
pvp04110  Cell cycle
pvp04310  Wnt signaling pathway
pvp04927  Cortisol synthesis and secretion
pvp04960  Aldosterone-regulated sodium reabsorption
KO pathway
ko04934   

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