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      CAG polymorphism in the androgen receptor gene in women may be associated with nodulocystic acne

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          Abstract

          Introduction

          Acne vulgaris (AV) is a multifactorial, inflammatory disease of the pilosebaceous unit. Hormones play a major role in the pathogenesis of acne. In cases of hyperandrogenism; hirsutism, acne, seborrhoea and alopecia appear in women. However, severe acne can also be seen without evidence of hyperandrogenism. In this case, hypersensitivity of the androgen receptor gene (ARG) encoded in the X chromosome, which is the only receptor for androgens, can be considered. ARG contains a polymorphic CAG triple loop encoding the polyglutamine pathway at the 5’end of exon 1.

          Aim

          To investigate CAG repeat polymorphism in the ARG in nodulocystic acne patients in Turkish population.

          Material and methods

          This prospective clinical study was conducted between 2016 and 2017 in accordance with the tenets of the Declaration of Helsinki. DNA isolation from blood was performed using the RTA ® Genomic DNA Isolation Kit. The fragment lengths obtained from the device to determine CAG repeat numbers were analysed based on –288 bp length 22 CAG repeat content.

          Results

          A total of 199 subjects; 100 patients (51 males, 49 females) and 99 controls (49 males, 50 females) were included in the study. The mean allele length in the patient group was 19.34; and 19.7 in the control group. There was a statistically significant difference between female patients and the control group, when the patients and control groups were compared by gender ( p = 0.0059).

          Conclusions

          The CAG trinucleotide repeat count in the ARG may be associated with acne, without hirsutism findings.

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          Most cited references22

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          The length and location of CAG trinucleotide repeats in the androgen receptor N-terminal domain affect transactivation function.

          Some transcription factors contain stretches of polyglutamine encoded by repeats of the trinucleotide CAG. Expansion of the CAG repeat in the androgen receptor (AR) has been correlated with the incidence and severity of X-linked spinal and bulbar muscular atrophy (Kennedy's disease). In order to understand the relationship of this mutation to AR function, we constructed ARs that varied in the position and size of the polyglutamine tract, and assayed for the abilities of these mutant receptors to bind androgen and to activate transcription of several different AR-responsive reporter genes. Elimination of the tract in both human and rat AR resulted in elevated transcriptional activation activity, strongly suggesting that the presence of the polyglutamine tract is inhibitory to transactivation. Progressive expansion of the CAG repeat in human AR caused a linear decrease of transactivation function. Importantly, expansion of the tract did not completely eliminate AR activity. We postulate that this residual AR activity may be sufficient for development of male primary and secondary sex characteristics, but may fall below a threshold level of activity necessary for normal maintenance of motor neuron function. This functional abnormality may be representative of other genetic diseases that are associated with CAG expansion mutations in open reading frames, such as spinocerebellar ataxia type I and Huntington's disease.
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            Androgen receptor defects: historical, clinical, and molecular perspectives.

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              Evidence for a repressive function of the long polyglutamine tract in the human androgen receptor: possible pathogenetic relevance for the (CAG)n-expanded neuronopathies.

              We have reported that polyglutamine (polyGln)-expanded human androgen receptors (hAR) have reduced transactivational competence in transfected cells. We presumed that maximal hAR transactivation requires a normal-size polyGln tract. Here we report, however, that hAR transactivity and polyGln-tract length are related inversely: n = 0 > 12 > 20 > 40 > 50. Thus, a normal-size polyGln tract represses the transactivational competence of a polyGln-free hAR, and polyGln expansion increases that negative effect. This observation has pathogenetic implications for X-linked spinobular muscular atrophy (Kennedy syndrome), and possibly for the autosomal dominant central neuronopathies associated with (CAG)n expansion in the translated portion of four different genes.
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                Author and article information

                Journal
                Postepy Dermatol Alergol
                Postepy Dermatol Alergol
                PDIA
                Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii
                Termedia Publishing House
                1642-395X
                2299-0046
                14 May 2019
                April 2019
                : 36
                : 2
                : 173-176
                Affiliations
                [1 ]Department of Dermatology and Venereology, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
                [2 ]Department of Medical Genetics, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
                Author notes
                Address for correspondence: Serkan Demirkan MD, Department of Dermatology and Venereology, Faculty of Medicine, Kirikkale University, Yenisehir District, Tahsin Duru Avenue No. 14, Yahsihan, Kirikkale, Turkey. phone: +90 553 771 71 68, fax: +90 318 2444697. e-mail: serkan.demirkan@ 123456yahoo.com.tr
                Article
                84592
                10.5114/ada.2019.84592
                6627258
                1171d266-2088-4ca8-8f17-3686b19165b2
                Copyright: © 2019 Termedia Sp. z o. o.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

                History
                : 21 February 2018
                : 20 May 2018
                Categories
                Original Paper

                acne,polymorphism,androgen receptor gene,cag
                acne, polymorphism, androgen receptor gene, cag

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