Description
Pheochromocytomas are neural crest-derived tumors that arise from inherited or sporadic mutations in at least six independent genes: RET, VHL, NF1, and subunits B, C and D of succinate dehydrogenase (SDH). The proteins encoded by these multiple genes regulate distinct functions. To identify molecular interactions between the distinct pathways we performed expression profiling of a large cohort of pheochromocytomas. We show here a functional link between tumors  with VHL mutations and those with disruption of the genes encoding for succinate  dehydrogenase (SDH) subunits B (SDHB) and D (SDHD). A transcription profile of reduced oxidoreductase is detected in all three of these tumor types, together with an  angiogenesis/hypoxia profile typical of VHL dysfunction. The oxidoreductase defect, not  previously detected in VHL-null tumors, is explained by suppression of the SDHB protein, a  component of mitochondrial complex II. The decrease in SDHB is also noted in tumors with  SDHD mutations. Gain-of-function and loss-of-function analyses show that the link between  hypoxia signals (via VHL) and mitochondrial signals (via SDH) is mediated by HIF1?. These  findings explain the shared features of pheochromocytomas with VHL and SDH mutations and  suggest an additional mechanism for increased HIF1? activity in tumors.