Mutations in the protein kinase A R1α regulatory subunit cause familial cardiac myxomas and Carney complex
Mairead Casey, … , Cynthia C. Morton, Craig T. Basson
Mairead Casey, … , Cynthia C. Morton, Craig T. Basson
Published September 1, 2000
Citation Information: J Clin Invest. 2000;106(5):R31-R38. https://doi.org/10.1172/JCI10841.
View: Text | PDF | Corrigendum
Rapid Publication

Mutations in the protein kinase A R1α regulatory subunit cause familial cardiac myxomas and Carney complex

Abstract

Cardiac myxomas are benign mesenchymal tumors that can present as components of the human autosomal dominant disorder Carney complex. Syndromic cardiac myxomas are associated with spotty pigmentation of the skin and endocrinopathy. Our linkage analysis mapped a Carney complex gene defect to chromosome 17q24. We now demonstrate that the PRKAR1α gene encoding the R1α regulatory subunit of cAMP-dependent protein kinase A (PKA) maps to this chromosome 17q24 locus. Furthermore, we show that PRKAR1α frameshift mutations in three unrelated families result in haploinsufficiency of R1α and cause Carney complex. We did not detect any truncated R1α protein encoded by mutant PRKAR1α. Although cardiac tumorigenesis may require a second somatic mutation, DNA and protein analyses of an atrial myxoma resected from a Carney complex patient with a PRKAR1α deletion revealed that the myxoma cells retain both the wild-type and the mutant PRKAR1α alleles and that wild-type R1α protein is stably expressed. However, in this atrial myxoma, we did observe a reversal of the ratio of R1α to R2β regulatory subunit protein, which may contribute to tumorigenesis. Further investigation will elucidate the cell-specific effects of PRKAR1α haploinsufficiency on PKA activity and the role of PKA in cardiac growth and differentiation.

Authors

Mairead Casey, Carl J. Vaughan, Jie He, Cathy J. Hatcher, Jordan M. Winter, Stanislawa Weremowicz, Kate Montgomery, Raju Kucherlapati, Cynthia C. Morton, Craig T. Basson

×

Figure 4

Options: View larger image (or click on image) Download as PowerPoint
Mutational analysis of PRKAR1α in Carney complex families YA, YB, and YF...
Mutational analysis of PRKAR1α in Carney complex families YA, YB, and YF. Automated sequence analyses of wild-type and mutant exons 7, 8, and 5 amplified from normal and affected individuals in families YA, YB, and YF, respectively, are shown. Sequence of the sense strand is shown for family YA, and the antisense strand for families YB and YF. A heterozygous 1-bp deletion is noted in family YA, and 2-bp deletions in families YB and YF (arrows; deleted bases are underlined). These mutations all result in a frameshift with consequent premature stop codons.