RT Journal Article T1 Molecular Basis of CYP19A1 Deficiency in a 46,XX Patient With R550W Mutation in POR: Expanding the PORD Phenotype. A1 Parween, Shaheena A1 Fernández-Cancio, Mónica A1 Benito-Sanz, Sara A1 Camats, Núria A1 Rojas Velazquez, Maria Natalia A1 López-Siguero, Juan-Pedro A1 Udhane, Sameer S A1 Kagawa, Norio A1 Flück, Christa E A1 Audí, Laura A1 Pandey, Amit V K1 CY19A1 K1 CYP17A1 K1 CYP21A2 K1 POR K1 PORD K1 congenital adrenal hyperplasia AB Mutations in cytochrome P450 oxidoreductase (POR) cause a form of congenital adrenal hyperplasia (CAH). We report a novel R550W mutation in POR identified in a 46,XX patient with signs of aromatase deficiency. Analysis of aromatase deficiency from the R550W mutation in POR. Both the child and the mother had signs of virilization. Ultrasound revealed the presence of uterus and ovaries. No defects in CYP19A1 were found, but further analysis with a targeted Disorders of Sexual Development NGS panel (DSDSeq.V1, 111 genes) on a NextSeq (Illumina) platform in Madrid and Barcelona, Spain, revealed compound heterozygous mutations c.73_74delCT/p.L25FfsTer93 and c.1648C > T/p.R550W in POR. Wild-type and R550W POR were produced as recombinant proteins and tested with multiple cytochrome P450 enzymes at University Children's Hospital, Bern, Switzerland. POR-R550W showed 41% of the WT activity in cytochrome c and 7.7% activity for reduction of MTT. Assays of CYP19A1 showed a severe loss of activity, and CYP17A1 as well as CYP21A2 activities were also lost by more than 95%. Loss of CYP2C9, CYP2C19, and CYP3A4 activities was observed for the R550W-POR. Predicted adverse effect on aromatase activity as well as a reduction in binding of NADPH was confirmed. Pathological effects due to POR-R550W were identified, expanding the knowledge of molecular pathways associated with aromatase deficiency. Screening of the POR gene may provide a diagnosis in CAH without defects in genes for steroid metabolizing enzymes. YR 2020 FD 2020 LK http://hdl.handle.net/10668/15112 UL http://hdl.handle.net/10668/15112 LA en DS RISalud RD Apr 6, 2025