The SDHB gene provides instructions for making one of four subunits of the succinate dehydrogenase (SDH) enzyme. The SDH enzyme plays a critical role in mitochondria, which are structures inside cells that convert the energy from food into a form that cells can use.
Within mitochondria, the SDH enzyme links two important pathways in energy conversion: the citric acid cycle (or Krebs cycle) and oxidative phosphorylation. As part of the citric acid cycle, the SDH enzyme converts a compound called succinate to another compound called fumarate. Negatively charged particles called electrons are released during this reaction. The SDHB protein provides an attachment site for electrons as they are transferred to the oxidative phosphorylation pathway. In oxidative phosphorylation, the electrons help create an electrical charge that provides energy for the production of adenosine triphosphate (ATP), the cell's main energy source.
Succinate, the compound on which the SDH enzyme acts, is an oxygen sensor in the cell and can help turn on specific pathways that stimulate cells to grow in a low-oxygen environment (hypoxia). In particular, succinate stabilizes a protein called hypoxia-inducible factor (HIF) by preventing a reaction that would allow HIF to be broken down. HIF controls several important genes involved in cell division and the formation of new blood vessels in a hypoxic environment.
The SDHB gene is a tumor suppressor, which means it prevents cells from growing and dividing in an uncontrolled way.
Health Conditions Related to Genetic Changes
Gastrointestinal stromal tumor
At least four mutations in the SDHB 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. People with SDH-deficient GIST caused by SDHB gene mutations often also develop paragangliomas; this combination of tumors is a condition known as Carney-Stratakis syndrome. Rarely, individuals with these mutations develop only GIST or a different combination of tumors. The combination of GIST, paraganglioma, and pulmonary chondroma is known as Carney triad; and the combination of GIST and pulmonary chondroma is known as incomplete Carney triad.
An inherited (germline) mutation in the SDHB 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. SDHB gene mutations associated with GIST prevent the production of functional SDHB 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.More About This Health Condition
More than 150 mutations in the SDHB gene have been identified in people with hereditary paraganglioma-pheochromocytoma type 4. People with this condition have paragangliomas, pheochromocytomas, or both. Paragangliomas and pheochromocytomas (a type of paraganglioma) are noncancerous tumors associated with the nervous system. An inherited SDHB gene mutation predisposes an individual to the condition, and a somatic mutation that deletes the normal copy of the gene is needed to cause hereditary paraganglioma-pheochromocytoma type 4.
Most of the inherited SDHB gene mutations involved in hereditary paraganglioma-pheochromocytoma type 4 change single protein building blocks (amino acids) in the SDHB protein sequence or result in a shortened protein. As a result, there is little or no SDH enzyme activity. As in GIST (described above), the reduction of SDH enzyme activity stabilizes the HIF protein, causing it to build up in cells. Excess HIF protein abnormally stimulates cell division and the formation of blood vessels, which can lead to tumor formation.More About This Health Condition
Mutations in the SDHB gene are found in some cases of nonsyndromic paraganglioma or pheochromocytoma, which are forms of the condition that occur in people with no history of these tumors in their families. Most of the SDHB gene mutations involved in nonsyndromic paraganglioma change single amino acids in the SDHB protein. As in other tumors (described above), these mutations are expected to reduce SDH enzyme activity, which stabilizes the HIF protein. As a result, HIF builds up in cells. Excess HIF protein abnormally stimulates cell division and the formation of blood vessels, which can lead to tumor formation.
More About This Health Condition
MedlinePlus Genetics provides information about Cowden syndromeMore About This Health Condition
The SDHB gene is involved in several cancers. Mutations in the SDHB gene have been found in a small number of people with renal cell carcinoma, which is a type of kidney cancer. SDHB gene mutations have also been identified in people with both renal cell cancer and paraganglioma (described above). An inherited SDHB gene mutation predisposes an individual to cancer formation. An additional, somatic mutation that deletes the normal copy of the gene is needed to cause renal cell cancer and other tumor types.
Mutations of the SDHB gene lead to a reduction in the amount of SDHB protein in the cell and loss of SDH enzyme activity. Lack of SDH enzyme activity results in abnormal hypoxia signaling and formation of tumors.
Other Names for This Gene
- iron-sulfur subunit of complex II
- succinate dehydrogenase [ubiquinone] iron-sulfur subunit, mitochondrial
- succinate dehydrogenase [ubiquinone] iron-sulfur subunit, mitochondrial precursor
- succinate dehydrogenase complex subunit B, iron sulfur (Ip)
- succinate dehydrogenase complex, subunit B, iron sulfur (Ip)
Additional Information & Resources
Tests Listed in the Genetic Testing Registry
Scientific Articles on PubMed
Catalog of Genes and Diseases from OMIM
- Astuti D, Latif F, Dallol A, Dahia PL, Douglas F, George E, Sköldberg F, Husebye ES, Eng C, Maher ER. Gene mutations in the succinate dehydrogenase subunit SDHB cause susceptibility to familial pheochromocytoma and to familial paraganglioma. Am J Hum Genet. 2001 Jul;69(1):49-54. Epub 2001 Jun 12. Erratum in: Am J Hum Genet 2002 Feb;70(2):565. Citation on PubMed or Free article on PubMed Central
- Belinsky MG, Rink L, von Mehren M. Succinate dehydrogenase deficiency in pediatric and adult gastrointestinal stromal tumors. Front Oncol. 2013 May 17;3:117. doi: 10.3389/fonc.2013.00117. eCollection 2013. Citation on PubMed
- Burnichon N, Rohmer V, Amar L, Herman P, Leboulleux S, Darrouzet V, Niccoli P, Gaillard D, Chabrier G, Chabolle F, Coupier I, Thieblot P, Lecomte P, Bertherat J, Wion-Barbot N, Murat A, Venisse A, Plouin PF, Jeunemaitre X, Gimenez-Roqueplo AP; PGL.NET network. The succinate dehydrogenase genetic testing in a large prospective series of patients with paragangliomas. J Clin Endocrinol Metab. 2009 Aug;94(8):2817-27. doi: 10.1210/jc.2008-2504. Epub 2009 May 19. Citation on PubMed
- Gill AJ, Pachter NS, Clarkson A, Tucker KM, Winship IM, Benn DE, Robinson BG, Clifton-Bligh RJ. Renal tumors and hereditary pheochromocytoma-paraganglioma syndrome type 4. N Engl J Med. 2011 Mar 3;364(9):885-6. doi: 10.1056/NEJMc1012357. Citation on PubMed
- Gill AJ. Succinate dehydrogenase (SDH)-deficient neoplasia. Histopathology. 2018 Jan;72(1):106-116. doi: 10.1111/his.13277. Review. Citation on PubMed
- Janeway KA, Kim SY, Lodish M, Nosé V, Rustin P, Gaal J, Dahia PL, Liegl B, Ball ER, Raygada M, Lai AH, Kelly L, Hornick JL; NIH Pediatric and Wild-Type GIST Clinic, O'Sullivan M, de Krijger RR, Dinjens WN, Demetri GD, Antonescu CR, Fletcher JA, Helman L, Stratakis CA. Defects in succinate dehydrogenase in gastrointestinal stromal tumors lacking KIT and PDGFRA mutations. Proc Natl Acad Sci U S A. 2011 Jan 4;108(1):314-8. doi: 10.1073/pnas.1009199108. Epub 2010 Dec 20. Citation on PubMed or Free article on PubMed Central
- Müller U. Pathological mechanisms and parent-of-origin effects in hereditary paraganglioma/pheochromocytoma (PGL/PCC). Neurogenetics. 2011 Aug;12(3):175-81. doi: 10.1007/s10048-011-0280-y. Epub 2011 Mar 9. Review. Citation on PubMed
- Neumann HP, Bausch B, McWhinney SR, Bender BU, Gimm O, Franke G, Schipper J, Klisch J, Altehoefer C, Zerres K, Januszewicz A, Eng C, Smith WM, Munk R, Manz T, Glaesker S, Apel TW, Treier M, Reineke M, Walz MK, Hoang-Vu C, Brauckhoff M, Klein-Franke A, Klose P, Schmidt H, Maier-Woelfle M, Peçzkowska M, Szmigielski C, Eng C; Freiburg-Warsaw-Columbus Pheochromocytoma Study Group. Germ-line mutations in nonsyndromic pheochromocytoma. N Engl J Med. 2002 May 9;346(19):1459-66. Citation on PubMed
- Ni Y, He X, Chen J, Moline J, Mester J, Orloff MS, Ringel MD, Eng C. Germline SDHx variants modify breast and thyroid cancer risks in Cowden and Cowden-like syndrome via FAD/NAD-dependant destabilization of p53. Hum Mol Genet. 2012 Jan 15;21(2):300-10. doi: 10.1093/hmg/ddr459. Epub 2011 Oct 6. Citation on PubMed or Free article on PubMed Central
- Ni Y, Zbuk KM, Sadler T, Patocs A, Lobo G, Edelman E, Platzer P, Orloff MS, Waite KA, Eng C. Germline mutations and variants in the succinate dehydrogenase genes in Cowden and Cowden-like syndromes. Am J Hum Genet. 2008 Aug;83(2):261-8. doi: 10.1016/j.ajhg.2008.07.011. Citation on PubMed or Free article on PubMed Central
- Pasini B, McWhinney SR, Bei T, Matyakhina L, Stergiopoulos S, Muchow M, Boikos SA, Ferrando B, Pacak K, Assie G, Baudin E, Chompret A, Ellison JW, Briere JJ, Rustin P, Gimenez-Roqueplo AP, Eng C, Carney JA, Stratakis CA. Clinical and molecular genetics of patients with the Carney-Stratakis syndrome and germline mutations of the genes coding for the succinate dehydrogenase subunits SDHB, SDHC, and SDHD. Eur J Hum Genet. 2008 Jan;16(1):79-88. Epub 2007 Aug 1. Citation on PubMed
- Pasini B, Stratakis CA. SDH mutations in tumorigenesis and inherited endocrine tumours: lesson from the phaeochromocytoma-paraganglioma syndromes. J Intern Med. 2009 Jul;266(1):19-42. doi: 10.1111/j.1365-2796.2009.02111.x. Review. Citation on PubMed or Free article on PubMed Central
- Pollard PJ, Brière JJ, Alam NA, Barwell J, Barclay E, Wortham NC, Hunt T, Mitchell M, Olpin S, Moat SJ, Hargreaves IP, Heales SJ, Chung YL, Griffiths JR, Dalgleish A, McGrath JA, Gleeson MJ, Hodgson SV, Poulsom R, Rustin P, Tomlinson IP. Accumulation of Krebs cycle intermediates and over-expression of HIF1alpha in tumours which result from germline FH and SDH mutations. Hum Mol Genet. 2005 Aug 1;14(15):2231-9. Epub 2005 Jun 29. Citation on PubMed
- Ricketts C, Woodward ER, Killick P, Morris MR, Astuti D, Latif F, Maher ER. Germline SDHB mutations and familial renal cell carcinoma. J Natl Cancer Inst. 2008 Sep 3;100(17):1260-2. doi: 10.1093/jnci/djn254. Epub 2008 Aug 26. Citation on PubMed
- Selak MA, Armour SM, MacKenzie ED, Boulahbel H, Watson DG, Mansfield KD, Pan Y, Simon MC, Thompson CB, Gottlieb E. Succinate links TCA cycle dysfunction to oncogenesis by inhibiting HIF-alpha prolyl hydroxylase. Cancer Cell. 2005 Jan;7(1):77-85. Citation on PubMed
- Stratakis CA, Carney JA. The triad of paragangliomas, gastric stromal tumours and pulmonary chondromas (Carney triad), and the dyad of paragangliomas and gastric stromal sarcomas (Carney-Stratakis syndrome): molecular genetics and clinical implications. J Intern Med. 2009 Jul;266(1):43-52. doi: 10.1111/j.1365-2796.2009.02110.x. Review. Citation on PubMed or Free article on PubMed Central
- Vanharanta S, Buchta M, McWhinney SR, Virta SK, Peçzkowska M, Morrison CD, Lehtonen R, Januszewicz A, Järvinen H, Juhola M, Mecklin JP, Pukkala E, Herva R, Kiuru M, Nupponen NN, Aaltonen LA, Neumann HP, Eng C. Early-onset renal cell carcinoma as a novel extraparaganglial component of SDHB-associated heritable paraganglioma. Am J Hum Genet. 2004 Jan;74(1):153-9. Epub 2003 Dec 18. Citation on PubMed or Free article on PubMed Central