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Abstract
Recent advances in the molecular and cell biology of the steroid hydroxylase genes
have begun to provide an explanation for the molecular basis of the steroid hydroxylase
deficiencies. 21-Hydroxylase deficiency is one of the most frequent genetic diseases.
Sequence data for the human 21-hydroxylase gene show that duplication of the 21-hydroxylase
gene with creation of a pseudogene has occurred. Frequent recombination between the
two genes may provide an “engine” for the continual generation of new mutant forms.
21-hydroxylase deficiency may result from deletions, alterations of primary sequence
resulting in no protein product or a protein with altered properties, or alterations
in upstream regulatory elements. A specific hypothesis considered here is that changes
in the coding region of the gene may produce a protein with an unusually short half-life
due to greater sensitivity to nonproductive cycling in the presence of steroid pseudosubstrates.
Pseudosubstrate effects that have been studied in cultured adrenocortical cells are
reviewed. Altered regulatory regions of the 21-hydroxylase gene could also selectively
affect the enzyme in one region of the cortex if there were a mutation in a cyclic
AMP-responsive sequence without an alteration in a putative C-kinase responsive sequence.
Key Words
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© 1988 Springer-Verlag New York Inc. Published by Elsevier Inc. All rights reserved.