Mutations of the Growth Hormone Receptor in Children with Idiopathic Short Stature
Audrey D. Goddard, Ph.D., Robin Covello, M.Sc., Shiuh-Ming Luoh, M.Sc., Tim Clackson, Ph.D., Kenneth M. Attie, M.D., Neil Gesundheit, M.D., Amy Chen Rundle, M.Sc., James A. Wells, Ph.D., Lena M.S. Carlsson, M.D., Ph.D., for The Growth Hormone Insensitivity Study Group
Background Short stature in children who are not deficient ingrowth hormone (GH) is probably caused by a variety of defects.Some children with idiopathic short stature have low serum concentrationsof GH-binding protein, which is derived from the GH receptor.The possibility that low serum concentrations of GH-bindingprotein might indicate partial insensitivity to GH led us toinvestigate possible defects in the gene for the GH receptorin children with idiopathic short stature and low serum concentrationsof GH-binding protein.
Methods We studied 14 children with idiopathic short staturewho were selected on the basis of normal GH secretion and lowserum concentrations of GH-binding protein. Analysis of single-strandconformation polymorphisms and DNA sequencing were both usedto identify mutations in the GH-receptor gene.
Results Mutations in the region of the GH-receptor gene thatcodes for the extracellular domain of the receptor were foundin 4 of the 14 children, but in none of 24 normal subjects.One of the four children with mutations was a compound heterozygote,with one mutation that reduced the affinity of the receptorfor GH and a second mutation that may affect a function otherthan ligand binding. The remaining three children had singlemutations in one allele of the gene. One mutation introduceda premature termination codon, and two caused substitutionsof single amino acids in a structurally conserved domain ofthe receptor.
Conclusions Some children with idiopathic short stature mayhave partial insensitivity to GH due to mutations in the GH-receptorgene.
Source Information
From the Departments of Molecular Biology (A.D.G., S.-M.L.), Endocrine Research (R.C.), Protein Engineering (T.C., J.A.W.), and Medical Affairs (K.M.A., N.G., A.C.R.), Genentech, Inc., South San Francisco, Calif.; and the Research Center for Endocrinology and Metabolism, Department of Internal Medicine, University of Göteborg, Göteborg, Sweden (L.M.S.C.).
Address reprint requests to Dr. Goddard at the Department of Molecular Biology, Genentech, Inc., 460 Point San Bruno Blvd., South San Francisco, CA 94080.
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