Reduced steroidogenesis in patients with PCDH19-female limited epilepsy

Marina Trivisano, Chiara Lucchi, Cecilia Rustichelli, Alessandra Terracciano, Raffaella Cusmai, Grazia Maria Ubertini, Germana Giannone, Enrico Silvio Bertini, Federico Vigevano, Jozef Gecz, Giuseppe Biagini, Nicola Specchio

Research output: Contribution to journalArticle

Abstract

Patients affected by protocadherin 19 (PCDH19)–female limited epilepsy (PCDH19-FE) present a remarkable reduction in allopregnanolone blood levels. However, no information is available on other neuroactive steroids and the steroidogenic response to hormonal stimulation. For this reason, we evaluated allopregnanolone, pregnanolone, and pregnenolone sulfate by liquid chromatographic procedures coupled with electrospray tandem mass spectrometry in 12 unrelated patients and 15 age-matched controls. We also tested cortisol, estradiol, progesterone, and 17OH-progesterone using standard immunoassays. Apart from estradiol and progesterone, all the considered hormones were evaluated in basal condition and after stimulation with adrenocorticotropic hormone (ACTH). A generalized decrease in blood levels of almost all measured neuroactive steroids was found. When considering sexual development, cortisol and pregnenolone sulfate basal levels were significantly reduced in postpubertal girls affected by PCDH19-FE. Of interest, ACTH administration did not recover pregnenolone sulfate serum levels but restored cortisol to control levels. In prepubertal girls with PCDH19-FE, by challenging adrenal function with ACTH we disclosed defects in the production of cortisol, pregnenolone sulfate, and 17OH-progesterone, which were not apparent in basal condition. These findings point to multiple defects in peripheral steroidogenesis associated with and potentially relevant to PCDH19-FE. Some of these defects could be addressed by stimulating adrenocortical activity.

Original languageEnglish
Pages (from-to)e91-e95
JournalEpilepsia
Volume58
Issue number6
DOIs
Publication statusPublished - Jun 1 2017

Fingerprint

Pregnanolone
Progesterone
Epilepsy
Adrenocorticotropic Hormone
Hydrocortisone
Estradiol
Steroids
Sexual Development
Tandem Mass Spectrometry
Immunoassay
Hormones
pregnenolone sulfate
Serum
cortisol 21-sulfate

Keywords

  • Adrenocorticotropic hormone
  • Allopregnanolone
  • Cortisol
  • Female-limited epilepsy
  • PCDH19
  • Pregnenolone sulfate

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Reduced steroidogenesis in patients with PCDH19-female limited epilepsy. / Trivisano, Marina; Lucchi, Chiara; Rustichelli, Cecilia; Terracciano, Alessandra; Cusmai, Raffaella; Ubertini, Grazia Maria; Giannone, Germana; Bertini, Enrico Silvio; Vigevano, Federico; Gecz, Jozef; Biagini, Giuseppe; Specchio, Nicola.

In: Epilepsia, Vol. 58, No. 6, 01.06.2017, p. e91-e95.

Research output: Contribution to journalArticle

Trivisano, Marina ; Lucchi, Chiara ; Rustichelli, Cecilia ; Terracciano, Alessandra ; Cusmai, Raffaella ; Ubertini, Grazia Maria ; Giannone, Germana ; Bertini, Enrico Silvio ; Vigevano, Federico ; Gecz, Jozef ; Biagini, Giuseppe ; Specchio, Nicola. / Reduced steroidogenesis in patients with PCDH19-female limited epilepsy. In: Epilepsia. 2017 ; Vol. 58, No. 6. pp. e91-e95.
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