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Comparative Study
. 2000 Nov;26(3):332-5.
doi: 10.1038/81642.

Mutant WD-repeat protein in triple-A syndrome

A Tullio-Pelet  1 , R Salomon, S Hadj-Rabia, C Mugnier, M H de Laet, B Chaouachi, F Bakiri, P Brottier, L Cattolico, C Penet, M Bégeot, D Naville, M Nicolino, J L Chaussain, J Weissenbach, A Munnich, S Lyonnet
Affiliations
Comparative Study

Mutant WD-repeat protein in triple-A syndrome

A Tullio-Pelet et al. Nat Genet. 2000 Nov.

Abstract

Triple-A syndrome (MIM 231550; also known as Allgrove syndrome) is an autosomal recessive disorder characterized by adrenocorticotropin hormone (ACTH)-resistant adrenal insufficiency, achalasia of the oesophageal cardia and alacrima. Whereas several lines of evidence indicate that triple-A syndrome results from the abnormal development of the autonomic nervous system, late-onset progressive neurological symptoms (including cerebellar ataxia, peripheral neuropathy and mild dementia) suggest that the central nervous system may be involved in the disease as well. Using fine-mapping based on linkage disequilibrium in North African inbred families, we identified a short ancestral haplotype on chromosome 12q13 (<1 cM), sequenced a BAC contig encompassing the triple-A minimal region and identified a novel gene (AAAS) encoding a protein of 547 amino acids that is mutant in affected individuals. We found five homozygous truncating mutations in unrelated patients and ascribed the founder effect in North African families to a single splice-donor site mutation that occurred more than 2,400 years ago. The predicted product of AAAS, ALADIN (for alacrima-achalasia-adrenal insufficiency neurologic disorder), belongs to the WD-repeat family of regulatory proteins, indicating a new disease mechanism involved in triple-A syndrome. The expression of the gene in both neuroendocrine and cerebral structures points to a role in the normal development of the peripheral and central nervous systems.

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