ARMC5 Gene: Structure, Function, and Clinical Significance in Primary Bilateral Macronodular Adrenal Hyperplasia

A comprehensive overview of the ARMC5 gene, its protein product, associated diseases, expression patterns, and mutational landscape.

Gene Information Card

Symbol ARMC5
Full Name Armadillo repeat containing 5
Gene Type Protein coding
Chromosomal Location 16p11.2
NCBI Gene ID 79798 ncbi.nlm.nih.gov/gene/79798
Ensembl ID ENSG00000140678
UniProt ID Q8N9Z9
OMIM ID 615923
HGNC ID 25789
Aliases FLJ20241, MGC126851, MGC126853

Description

The ARMC5 gene encodes a protein containing armadillo repeats, which are involved in protein-protein interactions. ARMC5 is a putative tumor suppressor gene, most notably associated with primary bilateral macronodular adrenal hyperplasia (PBMAH), a condition characterized by bilateral adrenal enlargement and cortisol excess. Somatic and germline mutations in ARMC5 are frequently found in PBMAH, leading to loss of function and dysregulation of adrenal cell proliferation and steroidogenesis. The protein is localized in the cytoplasm and may play a role in apoptosis and cell cycle regulation.

Disease Associations

Disease category Pathophysiological mechanism Genomic evidence
Primary bilateral macronodular adrenal hyperplasia (PBMAH) Inactivating mutations (germline and somatic) lead to loss of tumor suppressor function, causing adrenal hyperplasia and cortisol overproduction. Multiple studies, including those in OMIM (615923) and ClinVar, report ARMC5 mutations in 20-50% of PBMAH cases.
Adrenocortical adenoma Somatic ARMC5 mutations contribute to tumorigenesis in a subset of sporadic adrenocortical adenomas, though less frequent than in PBMAH. COSMIC database lists ARMC5 mutations in adrenal tumors; ClinVar also includes pathogenic variants.
Cushing syndrome ARMC5 mutations cause ACTH-independent Cushing syndrome due to bilateral adrenal hyperplasia and cortisol hypersecretion. Clinical evidence from case reports and cohort studies, as referenced in OMIM and PubMed.

Expression Profile

Tissue Expression
Tissue nTPM level
Adrenal gland High High expression in adrenal cortex, consistent with its role in adrenal function.
Thyroid Medium Moderate expression; relevance not fully characterized.
Kidney Medium Moderate expression; possible role in renal tissues.
Liver Low Low expression; minimal functional data.
Brain Low Low expression; not well studied.
Cell Line Expression
Cell Line nTPM Notes
H295R (adrenocortical carcinoma) High Adrenal cell line; used for functional studies of ARMC5.
SW13 (adrenal carcinoma) Medium Adrenal origin; expression lower than H295R.
HeLa (cervical cancer) Low Non-adrenal; low expression.
HEK293 (embryonic kidney) Low Common lab cell line; low endogenous expression.
Data source:Human Protein Atlas(proteinatlas.org)

Mutations & Variants

Hotspot Mutations
Variant Type Frequency Functional Description
c.1540C>T (p.Arg514Ter) Nonsense Reported in PBMAH; loss of function Pathogenic; truncating mutation leading to protein loss.
c.1960C>T (p.Arg654Ter) Nonsense Reported in PBMAH; loss of function Pathogenic; truncating mutation.
c.2578C>T (p.Arg860Ter) Nonsense Reported in PBMAH; loss of function Pathogenic; truncating mutation.
c.1061G>A (p.Trp354Ter) Nonsense Reported in PBMAH; loss of function Pathogenic; truncating mutation.
c.2266C>T (p.Arg756Cys) Missense Reported in PBMAH; likely loss of function Uncertain significance; functional studies suggest impaired activity.
Mutation functional classification

Loss of Function (LOF)

Most ARMC5 mutations are inactivating (nonsense, frameshift, splice-site) leading to haploinsufficiency or complete loss of protein function, consistent with tumor suppressor activity.

Gain of Function (GOF)

No evidence of gain-of-function mutations; ARMC5 acts as a tumor suppressor.

Dominant Negative (DN)

Some missense mutations may exert dominant-negative effects by interfering with wild-type protein function, but this is not well established.

Gene Ontology (GO)

• protein binding • cytoplasm
• apoptotic process • cell proliferation
• negative regulation of cell population proliferation • adrenal gland development

Pathways

p53 signaling pathway (indirectly via apoptosis regulation)
cAMP signaling pathway (in adrenal steroidogenesis)
Cell cycle regulation

Protein Summary

The ARMC5 protein contains armadillo repeats, which are alpha-helical motifs that mediate protein-protein interactions. It is localized in the cytoplasm and is involved in regulating apoptosis and cell proliferation. In adrenal cortex, ARMC5 acts as a tumor suppressor, and its loss leads to abnormal cell growth and cortisol production. The protein may also interact with other proteins to modulate steroidogenic gene expression.

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