A Novel Homozygous Missense Mutation of Melanocortin-4 Receptor (MC4R) in a Japanese Woman With Severe Obesity

  1. Hiromasa Kobayashi1,
  2. Yoshihiro Ogawa2,
  3. Mitsuyo Shintani2,
  4. Ken Ebihara2,
  5. Makiko Shimodahira1,
  6. Toshio Iwakura1,
  7. Megumu Hino3,
  8. Takashi Ishihara1,
  9. Katsuji Ikekubo3,
  10. Hiroyuki Kurahachi1 and
  11. Kazuwa Nakao2
  1. 1Department of Endocrinology, Kobe City General Hospital, Kobe, Japan
  2. 2Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, Kyoto, Japan
  3. 3Department of Nuclear Medicine, Kobe City General Hospital, Kobe, Japan

    Abstract

    The melanocortin-4 receptor (MC4R) is a member of the seven membrane–spanning G protein–coupled receptor superfamily and signals through the activation of adenylyl cyclase. The MC4R mutations are the most common known monogenic cause of human obesity. However, no such mutations have been found in Japanese obese subjects. Here we report a novel homozygous missense mutation of MC4R (G98R) in a nondiabetic Japanese woman with severe early-onset obesity, which is located in its second transmembrane domain. Her birth weight was 3,360 g, and she gained weight progressively from 10 months of age. At 40 years of age, her weight reached 160 kg and a BMI of 62 kg/m2. Her parents, who are heterozygous for the mutation, have BMIs of 26 and 27 kg/m2. In vitro transient transfection assays revealed no discernable agonist ligand binding and cAMP production in HEK293 cells expressing the mutant receptor, indicating a severe loss-of-function mutation. This study represents the first demonstration of a pathogenic mutation of MC4R in Japan and will provide further insight into the pathophysiologic role of the hypothalamic melanocortin system in human obesity.

    Footnotes

    • Address correspondence and reprint requests to Hiromasa Kobayashi, MD, Department of Endocrinology, Kobe City General Hospital, Minatojimanakamachi, Chuo-ku, Kobe 650-0046, Japan. E-mail: hiromasa_kobayashi{at}medical.general.hp.city.kobe.jp or Yoshihiro Ogawa, MD, PhD, Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku Kyoto 606-8507, Japan. E-mail: ogawa{at}kuhp.kyoto-u.ac.jp

      Received for publication 23 August 2001 and accepted in revised form 4 October 2001.

      MC4R, melanocortin-4 receptor; α-MSH, α-melanocyte-stimulating hormone; PCR, polymerase chain reaction; POMC, proopiomelanocortin; RFLP, restriction fragment–length polymorphism; TCA, trichloroacetic acid.

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