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Analysis of the P3 Promoter of the Human Parathyroid Hormone (PTH)/PTH-Related Peptide Receptor Gene in Pseudohypoparathyroidism Type 1b¹

Department of Pediatrics, Chiba University School of Medicine (M.M., T.W., Y.K., T.Y.), Inohana, Chuo-ku, Chiba 260-8670, Japan; Division of Endocrinology and Metabolism, Saitama Children’s Medical Center (H.M.), Iwatsuki, Saitama 339-8551, Japan; Department of Physiology, McGill University (G.N.H., D.G., J.H.W.), Montréal, Québec, Canada H3G 1Y6; and Department of Medicine and Calcium Research Laboratory, McGill University (G.N.H., D.G.), and Royal Victoria Hospital, Montreal, Québec, Canada H3A 1A1

Address all correspondence and requests for reprints to: Toshiyuki Yasuda, M.D., Department of Pediatrics, Chiba University School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. E-mail: toshi{at}med.m.chiba-u.ac.jp

Abstract

Hypocalcemia and hyperphosphatemia caused by PTH resistance are the only discernible abnormalities in pseudohypoparathyroidism type 1b (PHP-1b). Because of the selective resistance toward PTH, inactivating mutations in its receptor, the PTH/PTH-related peptide receptor (PTHR1), were thought to be responsible for PHP-1b. However, gene abnormalities responsible for PHP-1b have not been identified in the coding region and well conserved promoters (P1 and P2) of the PTHR1 gene. The purpose of the present study was to analyze the structure of the P3 promoter, the main promoter of the human PTHR1 gene in kidney, in patients with PHP-1b. Southern analysis of genomic DNA from lymphoblastoid cell lines of eight nonfamilial patients with PHP-1b revealed neither gross rearrangements nor methylation abnormalities in the P3 promoter region of the PTHR1 gene. Sequencing revealed no abnormalities in the P3 promoter region, although one patient was homozygous for an (AAAG)n polymorphic variant.

In conclusion, despite the selective resistance toward PTH in the kidney, which mainly uses the PTHR1 P3 promoter, PHP-1b in eight cases is not associated with structural abnormalities in this promoter. This study also indicates that inactivation of the P3 promoter is not achieved by methylation as tested in patients’ genomic DNA from lymphoblastoid cell lines. The influence of alterations in the polymorphic A-rich repeat sequence on promoter activity warrants further study.

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