Essential Endocrinology and Diabetes. Richard I. G. Holt

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representation of a gene, transcription and translation. In this example, the gene comprises three exons with enhancer elements in the 5′ and 3′ flanking regions and a silencer element upstream of the promoter. UTR, untranslated region; Met, methionine (encoded by the start codon).

      There is another layer of complexity governing how genes are expressed. Epigenetics is the study of how gene expression is regulated by mechanisms beyond the precise DNA sequence. Methylation of DNA around genes tends to silence expression. Modification to histones, such as acetylation or methylation, alters the chromatin structure to make enhancers and promoters either accessible or inaccessible to transcription factors. Acetylation tends to open up the chromatin structure, facilitating gene expression, whereas methylation tends to close it down and silence transcription. Genomic imprinting is an epigenetic phenomenon involving DNA methylation and modifications to histones such that gene expression varies according to which parent the particular chromosome came from.

      RNA contains ribose sugar moieties rather than deoxyribose. RNA polymerase attaches ribonucleotides together to generate a single strand of mRNA that correlates to the DNA code of the gene, except that in place of thymidine, a very similar nucleoside, uridine, is incorporated. The initial mRNA strand (pre‐mRNA) is processed so that intronic gene regions are removed and only the exonic sequences are ‘spliced’ together. Not all exonic regions encode protein; stretches at either end constitute the 5′ and 3′ untranslated regions (UTRs) (Figure 2.2). Within the 3′ UTR, mRNA transcription is terminated by a specific motif, the polyadenylation signal, ∼20 base pairs upstream of where the mRNA gains a stretch of adenosine residues. This polyA tail provides stability as the mRNA is moved from the nucleus to the cytoplasm for translation into protein.

      Translation into protein

Schematic illustrations of (a) Peptide hormone-synthesizing and (b) steroid hormone-synthesizing cells. In (b), cholesterol enters the cell via the low-density lipoprotein receptor which is internalized.

       Abnormalities in DNA (genetic)

       Base substitution – swapping different nucleotides

       Insertion or deletion – alters frame if exonic and not a multiple of three

       Chromosomal abnormalities (genomic)

       Numerical – loss of an X chromosome as in Turner syndrome (45,XO)

       Structural:Inversion – region of a chromosome is turned upside downTranslocation – regions swapped between chromosomesDuplication – region of a chromosome is present twiceDeletion – region of a chromosome is excised and lost

       Imprinting abnormalities (epigenetic)

       Methylation – altered methylation changing local gene expression, such as Beckwith–Wiedemann syndrome with neonatal hypoglycaemia or transient neonatal diabetes mellitus associated with over‐expression of the gene called PLAGL1

       Structural chromosomal abnormalities (above) can also cause imprinting errors

      Post‐translational modification of peptides

      Some polypeptides can function as hormones after little more than removal of the starting methionine, e.g. thyrotrophin‐releasing hormone (TRH), which comprises only three amino acids. Larger peptides can fold into three‐dimensional structures, which may contain helical or pleated domains. These shapes provide stability and affect how one protein interacts with another (e.g. how a hormone might bind to its receptor).

Schematic illustration of the potential post-translational modifications of peptide hormones. Four types are shown. (a) Simple changes such as removal of the amino-terminal pro- extension prior to secretion or the addition of intra-chain disulphide bonds. (b) Multiple processing of a polyprotein into a number of different peptide hormones. (c) Synthesis of insulin requires folding of the peptide and the formation of disulphide bonds. The active molecule is created by hydrolytic removal of a connecting (C)-peptide so that proinsulin gives rise to insulin plus C-peptide in equimolar proportion. (d) Synthesis of larger protein hormones from two separate peptides that complex together.

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