SDHA

At least 15 mutations in the SDHA gene have been found in people with a gastrointestinal stromal tumor (GIST), which is a type of tumor that occurs in the gastrointestinal tract. Mutations in this gene cause SDH-deficient GIST, which accounts for less than 10 percent of GIST cases. SDH-deficient GISTs usually occur in childhood or early adulthood and are almost always found in the stomach. Individuals with an SDH-deficient GIST have a high risk of developing other types of tumors, particularly noncancerous tumors in the nervous system called paragangliomas (described below) and noncancerous lung tumors called pulmonary chondromas. SDHA gene mutations are particularly associated with the development of all three tumor types, which is a condition known as Carney triad, although people with these mutations may develop one type of tumor or a different combination of tumors. The combination of GIST and pulmonary chondroma is known as incomplete Carney triad; and the combination of GIST and paraganglioma is known as known as Carney-Stratakis syndrome.

An inherited (germline) mutation in the SDHA gene increases the risk that an individual will develop a GIST. However, an additional mutation that alters or deletes the normal copy of the gene is needed to cause tumor formation. This second mutation, called a somatic mutation, is acquired during a person's lifetime and is present only in tumor cells. SDHA gene mutations associated with GIST prevent the production of functional SDHA protein. Without this subunit, the SDH enzyme either cannot form or is unstable and broken down quickly. As a result, there is little or no SDH enzyme activity. Without the SDH enzyme, succinate is not converted to fumarate, and succinate builds up in the cell. The excess succinate abnormally stabilizes the HIF protein, which also builds up in cells. Excess HIF protein stimulates cells to divide and triggers the production of blood vessels when they are not needed. Rapid and uncontrolled cell division, along with the formation of new blood vessels, can lead to the development of tumors.

At least 30 mutations in the SDHA gene have been identified in people with paraganglioma or pheochromocytoma (a type of paraganglioma), which are noncancerous (benign) tumors associated with the nervous system. SDHA gene mutations are seen most commonly in people with paraganglioma, but they have been found in people with pheochromocytoma. Specifically, SDHA gene mutations are associated with nonsyndromic paraganglioma or pheochromocytoma, which means the tumors are not part of an inherited syndrome.

A single mutation in the SDHA gene increases the risk that an individual will develop a paraganglioma. However, an additional, somatic mutation that deletes the normal copy of the gene is needed to cause tumor formation. 

The SDHA gene mutations associated with nonsyndromic paraganglioma or pheochromocytoma change single protein building blocks (amino acids) in the SDHA protein sequence or result in a shortened protein. Because of the abnormal subunit, the SDH enzyme cannot form or is broken down. With little SDH enzyme activity, succinate accumulates in the cell. The excess succinate abnormally stabilizes the HIF protein, which also builds up in cells. Excess HIF protein stimulates cells to divide and triggers the production of blood vessels when they are not needed. Rapid and uncontrolled cell division, along with the formation of new blood vessels, can lead to the development of tumors.

MedlinePlus Genetics provides information about Hereditary paraganglioma-pheochromocytoma

Mutations in the SDHA gene have been identified in a small number of people with Leigh syndrome, a progressive brain disorder that typically appears in infancy or early childhood. Affected children may experience vomiting, seizures, delayed development, muscle weakness, and problems with movement. Heart disease, kidney problems, and difficulty breathing can also occur in people with this disorder.

The SDHA gene mutations responsible for Leigh syndrome change single amino acids in the SDHA protein or result in an abnormally short protein. These genetic changes disrupt the activity of the SDH enzyme, impairing the ability of mitochondria to produce energy. It is not known, however, how mutations in the SDHA gene are related to the specific features of Leigh syndrome.