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Bibliografia
1- Neumann HP, Bausch B, McWhinney SR et al. Germ-line mutations in nonsyndromic pheochromocytoma. N Engl J Med 2002; 346: 1459-1466.
2- Latif F, Tory K, Gnarra J et al. Identification of the Von Hippel-Lindau disease tumor suppressor gene. Science 1993; 260: 1317-1320.
3- Walther MM, Reiter R, Keiser HR et al. Clinical and genetic characterization of pheochromocytoma in von Hippel-Lindau families: comparison with sporadic pheochromocytoma give insight into natural history of pheochromocytoma. J Urol 1999; 162: 659-664.
4- Eng C. The RET proto-oncogene in multiple endocrine neoplasia type 2 and Hirschprung’s disease. N Engl J Med 1996; 335: 943-951.
5- Neumann HPH, Berger DP, Sigmund G et al. Pheochromocytomas,multiple endocrine neoplasia type 2 and von Hippel-Lindau disease. N Engl J Med 1993; 329: 1531-1538.
6- Eng C, Smith DP, Mulligan LM et al. Point mutation within the tyrosine kinase domain of the RET proto-oncogene in multiple endocrine neoplasia type 2B and related sporadic tumours. Hum mol Genet 1994; 3: 237-241.
7- White R, O'Connell P. Identification and characterization of the gene for neurofibromatosis type 1. Curr Opin Genet Dev 1991; 1: 15-19.
8- Astuti D, Latif F, Dallol A et al. Gene mutations in the succinate dehydrogenase subunit SDHB cause susceptibility to familial pheochromocytoma and to familial paraganglioma. Am J Genet 2001; 69:49-54.
9- Niemann S, Mueller U. Mutations in SDHC cause autosomal dominant paraganglioma, type 3. Nat Genet 2000; 26: 268-270.
10- Baysal BE, Ferrell RE, Willett-Brozick JE et al. Mutations in SDHD, a mitochondrial complex II gene, in hereditary paraganglioma. Science 2000; 287: 848-851.
11- Astuti D, Douglas F, Lennard TWJ et al. Germline SDHD mutations in familial pheochromocytoma. Lancet 2001; 357: 1181-1182.
12- Hirawake H, Taniwaki M, Tamura A, Kojima S, Kita K Cytochrome b in human complex II (succinate-ubiquinone oxidoreductase): cDNA cloning of the components in liver mitochondria and chromosome assignment of the genes for the large (SDHC) and small (SDHD) subunits to 1q21 and 11q23. Cytogenet Cell Genet 1997; 79:132-138
13- Hirawake H, Taniwaki M, Tamura A, Amino H, Tomitsuka E, Kita K. Characterization of the human SDHD gene encoding the small subunit of cytochrome b (cybS) in mitochondrial succinate-ubiquinone oxidoreductase. Biochim Biophys Acta 1999; 1412: 295-300.
14- Bourgeron T, Rustin P, Chretien D et al. Mutation of a nuclear succinate dehydrogenase gene results in mitochondrial respiratory chain deficiency Nat Genet 1995 ; 11 : 144-149.
15- Lancaster CRD, editor. Special issue in bioenergetics. Biochem Biophys Acta 2002, 1553: 1-176.
16- Gerald D et al. JunD reduces tumor angiogenesis by protecting cells from oxidative stress. Cell 2004, 118: 781-794
17- Moeller BJ, CaoY, Li CY et al. Radiation activates HIF-1 to regulate vascular radiosensitivity in tumors: role of reoxygenation, free radicals and stress granules. Cancer Cell 2004, 5. 429-441.
18- Selak MA, Armour SM, MacKenzie ED, et al. Succinate links TCA cycle disfunction to oncogenesis by inhibiting HIF-a prolyl hydroxylase. Cancer Cell 2005, 7: 77-85.
19- Lee S, et al. Neuronal apoptosis linked to EglN3 prolyl hydroxylase and familial pheochromocytoma genes: developmental culling and cancer. Cancer Cell. 2005, 8:155-67.
20- Maxwell PH. A common pathway for genetic events leading to pheochromocytoma.
Cancer Cell. 2005, 8:91-3.
21- Maxwell PH, Wiesener MS, Chang G-W et al. The tumour suppressor protein VHL targets hypoxia-inducible factors for oxygen-dependent proteolysis. Nature 1999, 399: 271-275.
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24- Cascon A, Riuz-Llorente S, Rodrigues-Perales S et al. A novel candidate region linked to development of both pheochromocytoma and head/neck paragangliomas. Genes Chromosomes Cancer2005, 42:260-268.
25- Van der Mey AG, Maaswinkel-Mooy PD, Cornelisse CJ et al. Genomic imprinting in hereditary glomus tumours: evidence for new genetic theory. Lancet 1989, 2: 1291-1294.
26- Baysal BE, Farr JE, Rubinstein WS et al. Fine mapping of an imprinted gene for familial nonchromaffin paragangliomas, on chromosome 11q23. Am J Hum Genet 1997, 60:121-132.
27- Baysal BE, Ferrell RE, Willett-Brozick JE et al. Mutations in SDHD, a mitochondrial complex II gene, in hereditary paraganglioma. Science 2000; 287: 848-851.
28- Dannenberg H, Krijger RR, Zhao J et al. Differential loss of chromosome 11q in familial and spoardic parasympathetic paragangliomas detected by comparative genomic hybridization. Am J Pathol 2001; 158: 1937-1942.
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Keywords
PARAGANGLIOMAS, PHEOCHROMOCYTOMAS, SUCCINATE DEHYDROGENASE, FOUNDER EFFECT, ALLELIC LOSS, GENE SILENCING, RECETTORI ALLA SOMATOSTATINA

Genetics, biology and clinics of paragangliomas: mitochondrial succinate-dehydrogenase mutations as a model for studying transmission, growth, variability and treatment of neural crest-derived tumors.

Università degli Studi di Firenze
Abstract
Paragangliomas (PGLs) and pheochromocytomas (Pheos) are neural crest-derived (NCD) tumors which can be sporadic or familial. Genes responsible for the familial forms encompasse the VHL RET, NF1 genes and the genes encoding succinate dehydrogenase subunit B (SDHB), C (SDHC) and D (SDHD). Mutations of SDHD, B and C genes have been associated with familial head and neck (H/N) paragangliomas syndromes named PGL1, PGL4 and PGL3 respectively.
There are still several unresolved issues in the pathogenesis and clinical presentation of PGL syndromes: 1) Mechanisms responsible for tumor formation; 2) Genetic transmission; 3) Clinical presentation, clinical progression and treatment of PGL syndromes.
As in the last two years each of the three Research Units has collected a large number of families affected by SDH mutations, it is now possible to propose a program with the following aims:
1) To improve the genetic screening procedures in patients affected by non-syndromic Pheos/PGLs.
The search of large deletions in DNA of patients affected by non-syndromic Pheos/PGLs will inform us on whether the percentage of germline mutations is higher that that established to date.
In fact, recent studies demonstrate that, in addition to point mutations and small deletions and insertions, deletions of entire exons, escaping detection with the commonly used methods, may affect the susceptibility genes.
Moreover, we will analyse whether mutations in the EGLN3 >>>

Principal Investigator
Massimo Mannelli Università degli Studi di FIRENZE
Research Objectives
This research program has several aims:

1) To improve the genetic screening procedures in patients affected by non-syndromic Pheos/PGLs.
It is now widely accepted that about 25% of patients with non-syndromic Pheos/PGLs have a germline mutation in one of the susceptibility genes. Nevertheless, some patients suspected for syndromic Pheos/PGLs (bilateral , multiple or recurrent tumors) do not show any mutation in the susceptibility genes as evaluated by the traditional genetic screening procedure. Indeed, recent studies demonstrate that, in addition to point mutations and small deletions and insertions, deletions of entire exons, escaping detection with the commonly used methods, may affect the susceptibility genes. Therefore, some negative results may depend on methodological problems. The search of large deletions in DNA of patients affected by non-syndromic Pheos/PGLs will inform us on whether the percentage of germline mutations is higher that that established to date.
Moreover, according to Lee et al., mutations in VHL, RET, NF1 and SDHx may all cause the development of Pheos/PGLs through a single common pathway, namely by decreasing the activity of a 2-oxoglutarate-dependent oxigenase, EGLN3, resulting in reduced apoptosis of neural crest cells during development. Therefore, it will be of great interest to analyse whether mutations in this gene might be responsible for some of the non-syndromic Pheos/PGLs.

2) To propose a >>>

Timescale
24 months
National and international background
Paragangliomas (PGLs) and pheochromocytomas (Pheos) are neural crest-derived (NCD) tumors which can be sporadic or familial. Estimated yearly incidence of Pheos and PGLs is about 1 in 300000. In the last years the percentage of the familial forms is rapidly increased, due to the demonstration that about 25% of the apparently sporadic cases are indeed due to a germline mutation in one of the susceptibility genes (1). ). The group of these genes encompasses, among the others, the tumor-suppressor gene VHL (2, 3), the proto-oncogene RET (4, 5, 6), the tumor-suppressor gene NF1 (7) and the more recently discovered genes encoding succinate dehydrogenase subunit B (SDHB) (8), C (SDHC) (9) and D (SDHD) (10, 11). Germline mutations in these genes are responsible for the classic syndromes , namely von Hippel-Lindau disease (VHL), multiple endocrine neoplasia type 2 (MEN2), neurofibromatosis type 1 (NF1) and the paraganglioma syndromes (PGL).
SDH genes are located in 1p36.13 for SDHB, in 1q21.23 for SDHC and 11q23 for SDHD (12, 13).
These three genes encode proteins of the succinate dehydrogenase complex within the mitochondrial respiratory chain (14). The complex contains four nuclear-encoded subunits represented by two hydrophilic proteins (the flavoprotein SDHA and the iron-sulfur protein SDHB) which form the enzymatic core of the complex and two hydrophobic integral membrane proteins (SDHC and SDHD) which anchor the complex to the inner mitochondrial membrane (15). >>>