Disruption of HNF1α binding site causes inherited severe unconjugated hyperbilirubinemia

Autor: Vincent A. van der Mark, Isabel Mayayo-Peralta, Piter J. Bosma, Ulrich Beuers, Sem J. Aronson, Nevin Oruc, Rob J. de Knegt, Remco van Dijk, Anja A. Kattentidt-Mouravieva
Přispěvatelé: Graduate School, Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism, Obstetrics & Gynecology, Gastroenterology & Hepatology
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Zdroj: Journal of hepatology, 63(6), 1525-1529. Elsevier
Journal of Hepatology, 63(6), 1525-1529. Elsevier
ISSN: 0168-8278
DOI: 10.1016/j.jhep.2015.07.027
Popis: Crigler-Najjar syndrome presents as severe unconjugated hyper-bilirubinemia and is characteristically caused by a mutation in the UGT1A1 gene, encoding the enzyme responsible for bilirubin glucuronidation. Here we present a patient with Crigler-Najjar syndrome with a completely normal UGT1A1 coding region. Instead, a homozygous 3 nucleotide insertion in the UGT1A1 promoter was identified that interrupts the HNF1 alpha binding site. This mutation results in almost complete abolishment of UGT1A1 promoter activity and prevents the induction of UGT1A1 expression by the liver nuclear receptors CAR and PXR, explaining the lack of a phenobarbital response in this patient. Although animal studies have revealed the importance of HNF1 alpha for normal liver function, this case provides the first clinical proof that mutations in its binding site indeed result in severe liver pathology stressing the importance of promoter sequence analysis. (C) 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Databáze: OpenAIRE