1
|
Hassan HA, Mazen I, Elaidy A, Kamel AK, Eissa NR, Essawi ML. Expanding the phenotypic spectrum of LHCGR signal peptide insertion variant: novel clinical and allelic findings causing Leydig cell hypoplasia type II. Hormones (Athens) 2024:10.1007/s42000-024-00546-x. [PMID: 38526829 DOI: 10.1007/s42000-024-00546-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 03/11/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE Leydig cell hypoplasia (LCH) type II is a rare disease with only a few cases reported. Patients presented with hypospadias, micropenis, undescended testes, or infertility. In this study, we report a new patient with compound heterozygous variants in the LHCGR gene and LCH type II phenotype. METHODS Whole exome sequencing (WES) was performed followed by Sanger sequencing to confirm the detected variants in the patient and his parents. RESULTS A novel missense variant (p.Phe444Cys) was identified in a highly conserved site and is verified to be in trans with the signal peptide's 33-bases insertion variant. CONCLUSION Our research provides a more comprehensive clinical and genetic spectrum of Leydig cell hypoplasia type II. It highlighted the importance of WES in the diagnosis of this uncommon genetic disorder as well as the expansion of the genotype of LCH type II.
Collapse
Affiliation(s)
- Heba Amin Hassan
- Department of Medical Molecular Genetics, Human Genetics & Genome Research Institute, National Research Centre, 33 El-Bohouth street, Cairo, 12311, Egypt.
| | - Inas Mazen
- Department of Clinical Genetics, Human Genetics & Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Aya Elaidy
- Department of Clinical Genetics, Human Genetics & Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Alaa K Kamel
- Department of Human Cytogenetics, Human Genetics & Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Noura R Eissa
- Department of Medical Molecular Genetics, Human Genetics & Genome Research Institute, National Research Centre, 33 El-Bohouth street, Cairo, 12311, Egypt
| | - Mona L Essawi
- Department of Medical Molecular Genetics, Human Genetics & Genome Research Institute, National Research Centre, 33 El-Bohouth street, Cairo, 12311, Egypt
| |
Collapse
|
2
|
Xia K, Wang F, Tan Z, Zhang S, Lai X, Ou W, Yang C, Chen H, Peng H, Luo P, Hu A, Tu X, Wang T, Ke Q, Deng C, Xiang AP. Precise Correction of Lhcgr Mutation in Stem Leydig Cells by Prime Editing Rescues Hereditary Primary Hypogonadism in Mice. Adv Sci (Weinh) 2023; 10:e2300993. [PMID: 37697644 PMCID: PMC10582410 DOI: 10.1002/advs.202300993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/20/2023] [Indexed: 09/13/2023]
Abstract
Hereditary primary hypogonadism (HPH), caused by gene mutation related to testosterone synthesis in Leydig cells, usually impairs male sexual development and spermatogenesis. Genetically corrected stem Leydig cells (SLCs) transplantation may provide a new approach for treating HPH. Here, a novel nonsense-point-mutation mouse model (LhcgrW495X ) is first generated based on a gene mutation relative to HPH patients. To verify the efficacy and feasibility of SLCs transplantation in treating HPH, wild-type SLCs are transplanted into LhcgrW495X mice, in which SLCs obviously rescue HPH phenotypes. Through comparing several editing strategies, optimized PE2 protein (PEmax) system is identified as an efficient and precise approach to correct the pathogenic point mutation in Lhcgr. Furthermore, delivering intein-split PEmax system via lentivirus successfully corrects the mutation in SLCs from LhcgrW495X mice ex vivo. Gene-corrected SLCs from LhcgrW495X mice exert ability to differentiate into functional Leydig cells in vitro. Notably, the transplantation of gene-corrected SLCs effectively regenerates Leydig cells, recovers testosterone production, restarts sexual development, rescues spermatogenesis, and produces fertile offspring in LhcgrW495X mice. Altogether, these results suggest that PE-based gene editing in SLCs ex vivo is a promising strategy for HPH therapy and is potentially leveraged to address more hereditary diseases in reproductive system.
Collapse
Affiliation(s)
- Kai Xia
- Center for Stem Cell Biology and Tissue EngineeringKey Laboratory for Stem Cells and Tissue EngineeringMinistry of Education National‐Local Joint Engineering Research Center for Stem Cells and Regenerative Medicine Zhongshan School of MedicineSun Yat‐sen UniversityGuangzhouGuangdong510080China
| | - Fulin Wang
- Department of Urology and AndrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdong510080China
| | - Zhipeng Tan
- Center for Stem Cell Biology and Tissue EngineeringKey Laboratory for Stem Cells and Tissue EngineeringMinistry of Education National‐Local Joint Engineering Research Center for Stem Cells and Regenerative Medicine Zhongshan School of MedicineSun Yat‐sen UniversityGuangzhouGuangdong510080China
| | - Suyuan Zhang
- Center for Stem Cell Biology and Tissue EngineeringKey Laboratory for Stem Cells and Tissue EngineeringMinistry of Education National‐Local Joint Engineering Research Center for Stem Cells and Regenerative Medicine Zhongshan School of MedicineSun Yat‐sen UniversityGuangzhouGuangdong510080China
| | - Xingqiang Lai
- Cardiovascular DepartmentThe Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenGuangdong518033China
| | - Wangsheng Ou
- State Key Laboratory of Ophthalmology Zhong Shan Ophthalmic CenterSun Yat‐sen UniversityGuangzhouGuangdong510000China
| | - Cuifeng Yang
- Department of Urology and AndrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdong510080China
| | - Hong Chen
- Center for Stem Cell Biology and Tissue EngineeringKey Laboratory for Stem Cells and Tissue EngineeringMinistry of Education National‐Local Joint Engineering Research Center for Stem Cells and Regenerative Medicine Zhongshan School of MedicineSun Yat‐sen UniversityGuangzhouGuangdong510080China
| | - Hao Peng
- Center for Stem Cell Biology and Tissue EngineeringKey Laboratory for Stem Cells and Tissue EngineeringMinistry of Education National‐Local Joint Engineering Research Center for Stem Cells and Regenerative Medicine Zhongshan School of MedicineSun Yat‐sen UniversityGuangzhouGuangdong510080China
| | - Peng Luo
- Department of Urology and AndrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdong510080China
| | - Anqi Hu
- Center for Stem Cell Biology and Tissue EngineeringKey Laboratory for Stem Cells and Tissue EngineeringMinistry of Education National‐Local Joint Engineering Research Center for Stem Cells and Regenerative Medicine Zhongshan School of MedicineSun Yat‐sen UniversityGuangzhouGuangdong510080China
| | - Xiang'an Tu
- Department of Urology and AndrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdong510080China
| | - Tao Wang
- Center for Stem Cell Biology and Tissue EngineeringKey Laboratory for Stem Cells and Tissue EngineeringMinistry of Education National‐Local Joint Engineering Research Center for Stem Cells and Regenerative Medicine Zhongshan School of MedicineSun Yat‐sen UniversityGuangzhouGuangdong510080China
| | - Qiong Ke
- Center for Stem Cell Biology and Tissue EngineeringKey Laboratory for Stem Cells and Tissue EngineeringMinistry of Education National‐Local Joint Engineering Research Center for Stem Cells and Regenerative Medicine Zhongshan School of MedicineSun Yat‐sen UniversityGuangzhouGuangdong510080China
| | - Chunhua Deng
- Department of Urology and AndrologyThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhouGuangdong510080China
| | - Andy Peng Xiang
- Center for Stem Cell Biology and Tissue EngineeringKey Laboratory for Stem Cells and Tissue EngineeringMinistry of Education National‐Local Joint Engineering Research Center for Stem Cells and Regenerative Medicine Zhongshan School of MedicineSun Yat‐sen UniversityGuangzhouGuangdong510080China
| |
Collapse
|
3
|
Bhattacharya I, Dey S, Banerjee A. Revisiting the gonadotropic regulation of mammalian spermatogenesis: evolving lessons during the past decade. Front Endocrinol (Lausanne) 2023; 14:1110572. [PMID: 37124741 PMCID: PMC10140312 DOI: 10.3389/fendo.2023.1110572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/23/2023] [Indexed: 05/02/2023] Open
Abstract
Spermatogenesis is a multi-step process of male germ cell (Gc) division and differentiation which occurs in the seminiferous tubules of the testes under the regulation of gonadotropins - Follicle Stimulating Hormone (FSH) and Luteinising hormone (LH). It is a highly coordinated event regulated by the surrounding somatic testicular cells such as the Sertoli cells (Sc), Leydig cells (Lc), and Peritubular myoid cells (PTc). FSH targets Sc and supports the expansion and differentiation of pre-meiotic Gc, whereas, LH operates via Lc to produce Testosterone (T), the testicular androgen. T acts on all somatic cells e.g.- Lc, PTc and Sc, and promotes the blood-testis barrier (BTB) formation, completion of Gc meiosis, and spermiation. Studies with hypophysectomised or chemically ablated animal models and hypogonadal (hpg) mice supplemented with gonadotropins to genetically manipulated mouse models have revealed the selective and synergistic role(s) of hormones in regulating male fertility. We here have briefly summarized the present concept of hormonal control of spermatogenesis in rodents and primates. We also have highlighted some of the key critical questions yet to be answered in the field of male reproductive health which might have potential implications for infertility and contraceptive research in the future.
Collapse
Affiliation(s)
- Indrashis Bhattacharya
- Department of Zoology, School of Biological Science, Central University of Kerala, Kasaragod, Kerala, India
- *Correspondence: Arnab Banerjee, ; Indrashis Bhattacharya,
| | - Souvik Dey
- Manipal Centre for Biotherapeutics Research, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Arnab Banerjee
- Department of Biological Sciences, Birla Institute of Technology and Science (BITS) Pilani, Goa, India
- *Correspondence: Arnab Banerjee, ; Indrashis Bhattacharya,
| |
Collapse
|
4
|
Alla A, Ongoth FEM, Tahiri A, Karrou M, Rouf S, Benhaddou H, Kamaoui I, Mcelreavey K, Latrech H. Novel homozygous inactivating mutation in the luteinizing hormone receptor gene ( LHCGR) associated with 46, XY DSD in a Moroccan family. J Pediatr Endocrinol Metab 2022; 35:1215-1221. [PMID: 35670320 DOI: 10.1515/jpem-2021-0717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 05/17/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES We present the first cases of two male brothers with Leydig cell hypoplasia secondary to a novel mutation in the LHCGR gene that has never been described before. CASE PRESENTATION We report the case of two brothers with Leydig cell hypoplasia (LCH) type II caused by novel homozygous inactivating mutation of the LHCGR gene, located in exon 10 in c 947 position. The two patients presented at 11 years 7 months and 1 year 6 months, respectively, with abnormal sexual development, micropenis and cryptorchidism. Genetic analysis revealed a homozygous deletion of approximately 4 bp encompassing exon 10 of the LHR gene in the two brothers indicating autosomal recessive inheritance. An hCG stimulation test induced testosterone secretion within the normal range. Subsequently, a treatment with enanthate of testosterone was started, with an increase in the length of the penis. CONCLUSIONS Leydig cell hypoplasia is a rare form of disorder of sex development. We report the occurrence of a new mutation of the LHCGR gene in two Moroccan brothers in whom the clinical features and the molecular diagnosis were correlated.
Collapse
Affiliation(s)
- Achwak Alla
- Department of Endocrinology-Diabetology, Mohammed VI University Hospital Centre, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
| | - Farel Elilie Mawa Ongoth
- Department of Endocrinology-Diabetology, Mohammed VI University Hospital Centre, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
| | - Abir Tahiri
- Department of Endocrinology-Diabetology, Mohammed VI University Hospital Centre, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
| | - Marouan Karrou
- Department of Endocrinology-Diabetology, Mohammed VI University Hospital Centre, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
| | - Siham Rouf
- Department of Endocrinology-Diabetology, Mohammed VI University Hospital Centre, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
| | - Houssain Benhaddou
- Department of Pediatric Surgery, Mohammed VI University Hospital Centre, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
| | - Imane Kamaoui
- Department of Radiology, Mohammed VI University Hospital Centre, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
| | | | - Hanane Latrech
- Department of Endocrinology-Diabetology, Mohammed VI University Hospital Centre, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco.,Laboratory of Epidemiology, clinical Research and Public health, Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
| |
Collapse
|
5
|
Sharif S, Vakili S, Mobini M, Lotfi M, Zarei F, Abbaszadegan MR, Vakili R. A novel variant luteinizing hormone receptor in the first transmembrane helix of two homozygous Iranian patients: case report. Egypt J Med Hum Genet 2022. [DOI: 10.1186/s43042-022-00305-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Leydig cell hypoplasia (LCH) is a rare autosomal recessive endocrine syndrome that affects the normal development of male external genitalia in 46, XY individuals and is one of the causes of disorder of sexual differentiation (DSD) in males. The responsible gene of LCH is LHCGR which is located on the chromosome 2 and its various mutations lead to different degrees of the disease ranging from micropenis to complete XY DSD.
Case presentation
In this study, we have investigated the clinical presentation and molecular findings of two siblings with complete male LCH and XY DSD. This is the first detailed report of individuals with LCH from Iran. It aimed to study the molecular and clinical characteristics of two sisters with type 1 LCH. Whole exome sequencing was used for these patients to find the underlying genetic cause of the disease. Our Iranian DSD patients had external genitalia (normal labia major and minor, the external opening of the urethra beneath the clitoris) and bilateral testicular tissues in the inguinal region, which were removed by surgical exploration.
Conclusions
Genetic sequencing showed the homozygous variants of the LHCGR gene in the patients, a novel duplication variant in exon 11, c.1091dupT -or pLeu365Profs*5. This mutation is described as likely pathogenic. We think that this case report can widen the genotypic spectrum of the LHCGR variants. Moreover, this study emphasizes the significant rule of Whole Exome Sequencing in differentiating various causes of disorder of sexual differentiation.
Collapse
|
6
|
Min K, Byambaragchaa M, Choi S, Joo H, Kim S, Kim Y, Park G. Activating and inactivating mutations of the human, rat, equine and eel luteinizing hormone/ chorionic gonadotropin receptors (LH/CGRs). J Anim Reprod Biotechnol 2021; 36:167-74. [DOI: 10.12750/jarb.36.4.169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
|
7
|
Aktar Karakaya A, Unal E, Beştaş A, Taş F, Onay H, Haspolat YK. A novel variant in LCHGR gene in 3 siblings with type 1 Leydig cell hypoplasia. Gynecol Endocrinol 2020; 36:1136-1139. [PMID: 32654531 DOI: 10.1080/09513590.2020.1789859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION Leydig cell hypoplasia (LCH) is an autosomal recessive disease that causes 46, XY sex development disorder. The patients with LCH are usually in the female phenotype and are presented with the complaints of no breast development and primary amenorrhea. In this article, the cases of three siblings who presented with primary amenorrhea and who had LCH were presented. CASE A 16-year-old patient with female phenotype is presented with primary amenorrhea. Breast development was at Tanner stage 1, the external genitalia were completely in female phenotype. The karyotype was determined as 46, XY. The hormonal analyses revealed that the testosterone synthesis was insufficient despite the high level of luteinizing hormone (LH). Cortisol, ACTH, 17-Hydroxyprogesterone, and AMH levels were normal. LCH diagnosis was considered in the patient with elevated LH and no testosterone synthesis. A new mutation of homozygous c.161 + 4A > G was detected in LHCGR gene. The same mutation was detected in the patient's two siblings with female phenotype and 46, XY karyotype. CONCLUSION In patients presenting with primary amenorrhea and karyotype 46, XY, there is no testosterone synthesis and if there is LH elevation, LCH should be considered. We found a novel variant in the LHCGR gene in three siblings with karyotype 46, XY and female phenotype.
Collapse
Affiliation(s)
- Amine Aktar Karakaya
- Department of Pediatric Endocrinology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Edip Unal
- Department of Pediatric Endocrinology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Aslı Beştaş
- Department of Pediatric Endocrinology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Funda Taş
- Department of Pediatric Endocrinology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Hüseyin Onay
- Ege University Faculty of Medicine, Department of Medical Genetics, Izmir, Turkey
| | - Yusuf Kenan Haspolat
- Department of Pediatric Endocrinology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| |
Collapse
|
8
|
Jahan S, Abul Hasanat M, Alam F, Fariduddin M, Tofail T. LEYDIG CELL HYPOPLASIA: A UNIQUE PARADOX IN THE DIAGNOSIS OF 46,XY DISORDERS OF SEX DEVELOPMENT. AACE Clin Case Rep 2020; 6:e117-e122. [PMID: 32524024 DOI: 10.4158/accr-2019-0152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 01/04/2020] [Indexed: 11/15/2022] Open
Abstract
Objective Disorders of sex development (DSD) are defined as conditions in which chromosomal sex is inconsistent with phenotypic sex, or in which the phenotype is not classifiable as either male or female. Mutations in genes present in X, Y or autosomal chromosomes can cause abnormalities of testis determination or 46,XY DSD. Leydig cell hypoplasia (LCH), also known as Leydig cell agenesis, is a rare autosomal recessive endocrine syndrome of 46,XY DSD. Our objective here is to present the case of a 27-year-old, phenotypic female who presented with primary amenorrhea and later found to have LCH. Methods We used formatted history and clinical examination followed by necessary hormonal investigations. The diagnosis was confirmed by histopathology of resected testes and genetic mutation analysis. Results The patient's physical examination was unremarkable except 2 ovoid lumps present in the inguinovulvar region. There were no müllerian structures on sonography. Estrogen and both basal and stimulated testosterone levels were low whereas luteinizing hormone and follicle-stimulating hormone were high. Her chromosomal sex was found to be 46,XY. The histopathology of the resected inguinal lumps showed atrophic testicular change lacking Leydig cells with relative preservation of Sertoli cells. Genetic mutation analysis failed to reveal any significant aberration in the LHCGR gene. At present she is on estrogen replacement therapy having undergone bilateral orchidectomy and vaginoplasty. Conclusion LCH represents a unique example of diagnostic dilemma in gender identification. It requires a multidisciplinary approach for optimum outcome.
Collapse
|
9
|
Kochar IS, Jain R, Ramachandran S. Apparent mineralocorticoid excess: A case of hypertension in a child with delayed diagnosis leading to stroke. ACTA ACUST UNITED AC 2019. [DOI: 10.17352/ijcem.000041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
10
|
Abstract
Gonadotropin receptors belong to the highly conserved subfamily of the G protein-coupled receptor (GPCR) superfamily, the so-called Rhodopsin-like family (class A), which is the largest class of GPCRs and currently a major drug target. Both the follicle-stimulating hormone receptor (FSHR) and the luteinizing hormone/chorionic gonadotropin hormone receptor (LHCGR) are mainly located in the gonads where they play key functions associated to essential reproductive functions. As any other protein, gonadotropin receptors must be properly folded into a mature tertiary conformation compatible with quaternary assembly and endoplasmic reticulum export to the cell surface plasma membrane. Several primary and secondary structural features, including presence of particular amino acid residues and short motifs and in addition, posttranslational modifications, regulate intracellular trafficking of gonadotropin receptors to the plasma membrane as well as internalization and recycling of the receptor back to the cell surface after activation by agonist. Inactivating mutations of gonadotropin receptors may derive from receptor misfolding and lead to absent or reduced plasma membrane expression of the altered receptor, thereby manifesting an array of phenotypical abnormalities mostly characterized by reproductive failure and/or abnormal or absence of development of secondary sex characteristics. In this chapter we review the structural requirements necessary for intracellular trafficking of the gonadotropin receptors, and describe how mutations in these receptors may lead to receptor misfolding and disease in humans.
Collapse
Affiliation(s)
- Alfredo Ulloa-Aguirre
- Red de Apoyo a la Investigación (RAI), Universidad Nacional Autónoma de México-Instituto Nacional de Ciencias Médicas y Nutrición SZ, Vasco de Quiroga 15, Tlalpan, Mexico City, 14000, Mexico.
| | - Teresa Zariñán
- Red de Apoyo a la Investigación (RAI), Universidad Nacional Autónoma de México-Instituto Nacional de Ciencias Médicas y Nutrición SZ, Vasco de Quiroga 15, Tlalpan, Mexico City, 14000, Mexico
| | - Rubén Gutiérrez-Sagal
- Red de Apoyo a la Investigación (RAI), Universidad Nacional Autónoma de México-Instituto Nacional de Ciencias Médicas y Nutrición SZ, Vasco de Quiroga 15, Tlalpan, Mexico City, 14000, Mexico
| | - James A Dias
- Department of Biomedical Sciences, School of Public Health, University at Albany, Albany, NY, USA
| |
Collapse
|
11
|
Newton CL, Anderson RC, Katz AA, Millar RP. Loss-of-Function Mutations in the Human Luteinizing Hormone Receptor Predominantly Cause Intracellular Retention. Endocrinology 2016; 157:4364-4377. [PMID: 27533885 DOI: 10.1210/en.2016-1104] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Mutations in G protein-coupled receptors (GPCRs) have been identified for many endocrine hormone signaling deficiencies. Inactivating mutations can impair ligand binding, receptor activation/coupling to signaling pathways, or can cause receptor misfolding and consequent impaired expression at the cell membrane. Here we examine the cell surface expression, ligand binding, and signaling of a range of mutant human luteinizing hormone receptors (LHRs) identified as causing reproductive dysfunction in human patients. The data obtained reveal how mutations in GPCRs can have diverse and severely deleterious effects on receptor function. Furthermore, it was found that impaired functionality of the majority of the mutant LHRs was due to reduced expression at the cell surface (14/20) while only two mutations caused impaired binding affinity and two impaired in signaling. An additional two mutations were found to cause no impairment of receptor function. These data demonstrate that the majority of LHR mutations lead to intracellular retention and highlight the potential for novel pharmacological chaperone therapeutics that can "rescue" expression/function of retained mutant GPCRs.
Collapse
Affiliation(s)
- Claire Louise Newton
- Centre for Neuroendocrinology (C.L.N., R.C.A., R.P.M.), Faculty of Health Sciences, University of Pretoria, Pretoria, 0001, South Africa; Department of Immunology (C.L.N), Faculty of Health Sciences, University of Pretoria, Pretoria, 0001, South Africa; UCT/MRC Receptor Biology Research Unit, Department of Integrative Biomedical Sciences and Institute of Infectious Diseases and Molecular Medicine (C.L.N., R.C.A., A.A.K., R.P.M.), Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; Department of Zoology and Entomology (R.C.A), Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, 0028, South Africa; SAMRC Gynaecology Cancer Research Centre (A.A.K), Department of Integrative Biomedical Sciences and Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7700, South Africa; and Department of Physiology (R.P.M), Faculty of Health Sciences, University of Pretoria, Pretoria, 0007, South Africa
| | - Ross Calley Anderson
- Centre for Neuroendocrinology (C.L.N., R.C.A., R.P.M.), Faculty of Health Sciences, University of Pretoria, Pretoria, 0001, South Africa; Department of Immunology (C.L.N), Faculty of Health Sciences, University of Pretoria, Pretoria, 0001, South Africa; UCT/MRC Receptor Biology Research Unit, Department of Integrative Biomedical Sciences and Institute of Infectious Diseases and Molecular Medicine (C.L.N., R.C.A., A.A.K., R.P.M.), Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; Department of Zoology and Entomology (R.C.A), Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, 0028, South Africa; SAMRC Gynaecology Cancer Research Centre (A.A.K), Department of Integrative Biomedical Sciences and Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7700, South Africa; and Department of Physiology (R.P.M), Faculty of Health Sciences, University of Pretoria, Pretoria, 0007, South Africa
| | - Arieh Anthony Katz
- Centre for Neuroendocrinology (C.L.N., R.C.A., R.P.M.), Faculty of Health Sciences, University of Pretoria, Pretoria, 0001, South Africa; Department of Immunology (C.L.N), Faculty of Health Sciences, University of Pretoria, Pretoria, 0001, South Africa; UCT/MRC Receptor Biology Research Unit, Department of Integrative Biomedical Sciences and Institute of Infectious Diseases and Molecular Medicine (C.L.N., R.C.A., A.A.K., R.P.M.), Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; Department of Zoology and Entomology (R.C.A), Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, 0028, South Africa; SAMRC Gynaecology Cancer Research Centre (A.A.K), Department of Integrative Biomedical Sciences and Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7700, South Africa; and Department of Physiology (R.P.M), Faculty of Health Sciences, University of Pretoria, Pretoria, 0007, South Africa
| | - Robert Peter Millar
- Centre for Neuroendocrinology (C.L.N., R.C.A., R.P.M.), Faculty of Health Sciences, University of Pretoria, Pretoria, 0001, South Africa; Department of Immunology (C.L.N), Faculty of Health Sciences, University of Pretoria, Pretoria, 0001, South Africa; UCT/MRC Receptor Biology Research Unit, Department of Integrative Biomedical Sciences and Institute of Infectious Diseases and Molecular Medicine (C.L.N., R.C.A., A.A.K., R.P.M.), Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa; Department of Zoology and Entomology (R.C.A), Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, 0028, South Africa; SAMRC Gynaecology Cancer Research Centre (A.A.K), Department of Integrative Biomedical Sciences and Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7700, South Africa; and Department of Physiology (R.P.M), Faculty of Health Sciences, University of Pretoria, Pretoria, 0007, South Africa
| |
Collapse
|
12
|
Juniarto AZ, van der Zwan YG, Santosa A, Ariani MD, Eggers S, Hersmus R, Themmen APN, Bruggenwirth HT, Wolffenbuttel KP, Sinclair A, White SJ, Looijenga LHJ, de Jong FH, Faradz SMH, Drop SLS. Hormonal evaluation in relation to phenotype and genotype in 286 patients with a disorder of sex development from Indonesia. Clin Endocrinol (Oxf) 2016; 85:247-57. [PMID: 26935236 DOI: 10.1111/cen.13051] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 01/22/2016] [Accepted: 02/28/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The objective of this study was to determine the aetiological spectrum of disorders of sex development (DSD) in a large cohort of underprivileged and undiagnosed patients from Indonesia. METHODS A total of 286 patients with atypical external and/or internal genitalia were evaluated using clinical, hormonal, molecular genetic and histological parameters. RESULTS The age (years) at presentation was 0-0·5 in 41 (14·3%), >0·5-12 in 181 (63·3%) and >12 in 64 cases (22·4%). 46,XY DSD was most common (68·2%, n = 195), 46,XX DSD was found in 23·4% (n = 67) and sex chromosomal DSD in 8·4% (n = 24). In 61·2% of 46,XX DSD patients, 17·9% of 46,XY DSD patients and all sex chromosome DSD patients (29·4% in total), a final diagnosis was reached based on genetic or histological gonadal tissue evaluation. 17-hydroxyprogesterone and androstenedione levels were the most distinctive parameters in 46,XX DSD patients. In 46,XY DSD, diagnostic groups were identified based on the external masculinization score: androgen action disorder (AAD), unknown male undermasculinization (UMU), and gonadal dysgenesis (GD). LH, FSH and testosterone levels were most informative especially in the older age group. HCG tests were of no additional value as no patients with androgen synthesis disorders were found. Hormonal profiles of patients with sex chromosome DSD and a Y-chromosome sequence containing karyotype showed high levels of LH and FSH, and low levels of AMH, inhibin B and testosterone compared with the normal male range. Gene mutations were found in all patients with CAH, but in only 24·5% and 1·8% of patients with AAD and UMU. In 32% of 46,XY GD patients, copy number variants of different genes were found. CONCLUSION A stepwise diagnostic approach led to a molecularly or histologically proven final diagnosis in 29·4% of the patients. The most informative parameters were serum levels of 17-hydroxyprogesterone and androstenedione in 46,XX DSD patients, and serum LH, FSH and testosterone levels in 46,XY DSD patients.
Collapse
Affiliation(s)
- A Zulfa Juniarto
- Division of Human Genetics, Center for Biomedical Research Faculty of Medicine Diponegoro University (FMDU), Semarang, Indonesia
| | - Yvonne G van der Zwan
- Department of Paediatrics, Division of Endocrinology, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Department of Pathology, Josephine Nefkens Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Ardy Santosa
- Department of Urology, Dr Kariadi Hospital, Semarang, Indonesia
| | - Mahayu Dewi Ariani
- Division of Human Genetics, Center for Biomedical Research Faculty of Medicine Diponegoro University (FMDU), Semarang, Indonesia
| | - Stefanie Eggers
- Murdoch Children's Research Institute, Royal Children's Hospital and Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Remko Hersmus
- Department of Pathology, Josephine Nefkens Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Axel P N Themmen
- Department of Internal Medicine, Section of Endocrinology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Hennie T Bruggenwirth
- Department of Clinical Genetics, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Katja P Wolffenbuttel
- Department of Paediatric Urology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Andrew Sinclair
- Murdoch Children's Research Institute, Royal Children's Hospital and Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Stefan J White
- Centre for Genetic Diseases, MIMR-PHI Institute of Medical Research, Monash University, Clayton, Australia
| | - Leendert H J Looijenga
- Department of Pathology, Josephine Nefkens Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Frank H de Jong
- Division of Human Genetics, Center for Biomedical Research Faculty of Medicine Diponegoro University (FMDU), Semarang, Indonesia
| | - Sultana M H Faradz
- Division of Human Genetics, Center for Biomedical Research Faculty of Medicine Diponegoro University (FMDU), Semarang, Indonesia
| | - Stenvert L S Drop
- Department of Paediatrics, Division of Endocrinology, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands
| |
Collapse
|
13
|
Charmandari E, Guan R, Zhang M, Silveira LG, Fan QR, Chrousos GP, Sertedaki AC, Latronico AC, Segaloff DL. Misfolding Ectodomain Mutations of the Lutropin Receptor Increase Efficacy of Hormone Stimulation. Mol Endocrinol 2015; 30:62-76. [PMID: 26554443 DOI: 10.1210/me.2015-1205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
We demonstrate 2 novel mutations of the LHCGR, each homozygous, in a 46,XY patient with severe Leydig cell hypoplasia. One is a mutation in the signal peptide (p.Gln18_Leu19ins9; referred to here as SP) that results in an alteration of the coding sequence of the N terminus of the mature mutant receptor. The other mutation (p.G71R) is also within the ectodomain. Similar to many other inactivating mutations, the cell surface expression of recombinant human LHR(SP,G71R) is greatly reduced due to intracellular retention. However, we made the unusual discovery that the intrinsic efficacy for agonist-stimulated cAMP in the reduced numbers of receptors on the cell surface was greatly increased relative to the same low number of cell surface wild-type receptor. Remarkably, this appears to be a general attribute of misfolding mutations in the ectodomains, but not serpentine domains, of the gonadotropin receptors. These findings suggest that there must be a common, shared mechanism by which disparate mutations in the ectodomain that cause misfolding and therefore reduced cell surface expression concomitantly confer increased agonist efficacy to those receptor mutants on the cell surface. Our data further suggest that, due to their increased agonist efficacy, extremely small changes in cell surface expression of misfolded ectodomain mutants cause larger than expected alterations in the cellular response to agonist. Therefore, for inactivating LHCGR mutations causing ectodomain misfolding, the numbers of cell surface mutant receptors on fetal Leydig cells of 46,XY individuals exert a more exquisite effect on the relative severity of the clinical phenotypes than already appreciated.
Collapse
Affiliation(s)
- E Charmandari
- Division of Endocrinology, Metabolism and Diabetes (E.C., G.P.C., A.C.S.), First Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, and Division of Endocrinology and Metabolism (E.C., G.P.C., A.C.S.), Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens 11527, Greece; Department of Pharmacology (Q.R.F.), Columbia University Medical Center, New York, New York 10032; Unidade de Endocrinologia do Desenvolvimento (L.G.S., A.C.L.), Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; and Department of Molecular Physiology and Biophysics (M.Z., R.G., D.L.S.), The University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - R Guan
- Division of Endocrinology, Metabolism and Diabetes (E.C., G.P.C., A.C.S.), First Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, and Division of Endocrinology and Metabolism (E.C., G.P.C., A.C.S.), Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens 11527, Greece; Department of Pharmacology (Q.R.F.), Columbia University Medical Center, New York, New York 10032; Unidade de Endocrinologia do Desenvolvimento (L.G.S., A.C.L.), Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; and Department of Molecular Physiology and Biophysics (M.Z., R.G., D.L.S.), The University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - M Zhang
- Division of Endocrinology, Metabolism and Diabetes (E.C., G.P.C., A.C.S.), First Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, and Division of Endocrinology and Metabolism (E.C., G.P.C., A.C.S.), Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens 11527, Greece; Department of Pharmacology (Q.R.F.), Columbia University Medical Center, New York, New York 10032; Unidade de Endocrinologia do Desenvolvimento (L.G.S., A.C.L.), Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; and Department of Molecular Physiology and Biophysics (M.Z., R.G., D.L.S.), The University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - L G Silveira
- Division of Endocrinology, Metabolism and Diabetes (E.C., G.P.C., A.C.S.), First Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, and Division of Endocrinology and Metabolism (E.C., G.P.C., A.C.S.), Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens 11527, Greece; Department of Pharmacology (Q.R.F.), Columbia University Medical Center, New York, New York 10032; Unidade de Endocrinologia do Desenvolvimento (L.G.S., A.C.L.), Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; and Department of Molecular Physiology and Biophysics (M.Z., R.G., D.L.S.), The University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - Q R Fan
- Division of Endocrinology, Metabolism and Diabetes (E.C., G.P.C., A.C.S.), First Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, and Division of Endocrinology and Metabolism (E.C., G.P.C., A.C.S.), Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens 11527, Greece; Department of Pharmacology (Q.R.F.), Columbia University Medical Center, New York, New York 10032; Unidade de Endocrinologia do Desenvolvimento (L.G.S., A.C.L.), Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; and Department of Molecular Physiology and Biophysics (M.Z., R.G., D.L.S.), The University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - G P Chrousos
- Division of Endocrinology, Metabolism and Diabetes (E.C., G.P.C., A.C.S.), First Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, and Division of Endocrinology and Metabolism (E.C., G.P.C., A.C.S.), Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens 11527, Greece; Department of Pharmacology (Q.R.F.), Columbia University Medical Center, New York, New York 10032; Unidade de Endocrinologia do Desenvolvimento (L.G.S., A.C.L.), Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; and Department of Molecular Physiology and Biophysics (M.Z., R.G., D.L.S.), The University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - A C Sertedaki
- Division of Endocrinology, Metabolism and Diabetes (E.C., G.P.C., A.C.S.), First Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, and Division of Endocrinology and Metabolism (E.C., G.P.C., A.C.S.), Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens 11527, Greece; Department of Pharmacology (Q.R.F.), Columbia University Medical Center, New York, New York 10032; Unidade de Endocrinologia do Desenvolvimento (L.G.S., A.C.L.), Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; and Department of Molecular Physiology and Biophysics (M.Z., R.G., D.L.S.), The University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - A C Latronico
- Division of Endocrinology, Metabolism and Diabetes (E.C., G.P.C., A.C.S.), First Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, and Division of Endocrinology and Metabolism (E.C., G.P.C., A.C.S.), Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens 11527, Greece; Department of Pharmacology (Q.R.F.), Columbia University Medical Center, New York, New York 10032; Unidade de Endocrinologia do Desenvolvimento (L.G.S., A.C.L.), Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; and Department of Molecular Physiology and Biophysics (M.Z., R.G., D.L.S.), The University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| | - D L Segaloff
- Division of Endocrinology, Metabolism and Diabetes (E.C., G.P.C., A.C.S.), First Department of Pediatrics, University of Athens Medical School, Aghia Sophia Children's Hospital, and Division of Endocrinology and Metabolism (E.C., G.P.C., A.C.S.), Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens 11527, Greece; Department of Pharmacology (Q.R.F.), Columbia University Medical Center, New York, New York 10032; Unidade de Endocrinologia do Desenvolvimento (L.G.S., A.C.L.), Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; and Department of Molecular Physiology and Biophysics (M.Z., R.G., D.L.S.), The University of Iowa Carver College of Medicine, Iowa City, Iowa 52242
| |
Collapse
|
14
|
Abstract
Normal male development requires three conditions: (1) adequate differentiation of the fetal testis; (2) synthesis and secretion of testicular hormones; and (3) effective action of these hormones on target organs. This requires the combined action of the inhibitory anti-müllerian hormone (AMH, secreted by Sertoli cells) to block the development of the uterus and fallopian tubes from the müllerian duct, together with the trophic stimulus of testosterone (a Leydig cell product), which leads to virilization of the wolffian ducts. Additionally, the development of external genitalia depends on the conversion of testosterone to dihydrotestosterone by the enzyme 5-α-reductase. Failure of any of these mechanisms leads to deficient virilization or the so-called "male pseudohermaphroditism" syndromes.
Collapse
Affiliation(s)
- Manuel Nistal
- 1 Pathology, Hospital La Paz, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo #2, Madrid 28029, Spain
| | - Ricardo Paniagua
- 2 Department of Cell Biology, Universidad de Alcala, Madrid, Spain
| | - Pilar González-Peramato
- 1 Pathology, Hospital La Paz, Universidad Autónoma de Madrid, Calle Arzobispo Morcillo #2, Madrid 28029, Spain
| | - Miguel Reyes-Múgica
- 3 Department of Pathology, Children's Hospital of Pittsburgh of UPMC, One Children's Hospital Drive, 4401 Penn Avenue, Pittsburgh, PA 15224, USA
| |
Collapse
|
15
|
Mitri F, Bentov Y, Behan LA, Esfandiari N, Casper RF. A novel compound heterozygous mutation of the luteinizing hormone receptor -implications for fertility. J Assist Reprod Genet 2014; 31:787-94. [PMID: 24849377 DOI: 10.1007/s10815-014-0249-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 04/02/2014] [Indexed: 01/21/2023] Open
Abstract
The luteinizing hormone/chorionic gonadotropin receptor (LHCGR) belongs to the family of G-protein coupled receptors and binds both luteinizing hormone (LH) and human chorionic gonadotropin (hCG). Ligand-receptor interaction mediates a downstream cascade of events which is essential for ovulation in women, and expression of the male phenotype in men. The human LHCGR gene consists of 11exons and 10 introns. Homozygous and compound heterozygous mutations may inactivate the receptor by altering its structure and subsequent function. Herein we reported a novel, compound heterozgygous inactivating LHCGR mutation in a woman who presented with secondary infertility, having previously carried to term a donor oocyte pregnancy. A 27 bp deletion was detected in exon I at amino acid number 12. This mutation involved the signal peptide region, which is important for protein targeting, maturation and cellular expression. Another mutation involving a 2 base pair (thymine and cytosine) deletion was detected in exon 11 at amino acid number 586. This deletion produced a frameshift resulting in a premature stop codon and a truncated protein. An XY sibling with the same mutations was phenotypically female and misdiagnosed as complete androgen insensitivity syndrome. Other unaffected family members were genetically tested and carried one of the two mutations.
Collapse
Affiliation(s)
- Frederic Mitri
- Toronto Center for Advanced Reproductive Technology (TCART), Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Toronto, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, 150 Bloor Street West, Suite 210, Toronto, ON, M5S 2X9, Canada,
| | | | | | | | | |
Collapse
|
16
|
Ramaswamy S, Weinbauer GF. Endocrine control of spermatogenesis: Role of FSH and LH/ testosterone. Spermatogenesis 2014; 4:e996025. [PMID: 26413400 PMCID: PMC4581062 DOI: 10.1080/21565562.2014.996025] [Citation(s) in RCA: 215] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 12/04/2014] [Indexed: 12/21/2022]
Abstract
Evaluation of testicular functions (production of sperm and androgens) is an important aspect of preclinical safety assessment and testicular toxicity is comparatively far more common than ovarian toxicity. This chapter focuses (1) on the histological sequelae of disturbed reproductive endocrinology in rat, dog and nonhuman primates and (2) provides a review of our current understanding of the roles of gonadotropins and androgens. The response of the rodent testis to endocrine disturbances is clearly different from that of dog and primates with different germ cell types and spermatogenic stages being affected initially and also that the end-stage spermatogenic involution is more pronounced in dog and primates compared to rodents. Luteinizing hormone (LH)/testosterone and follicle-stimulating hormone (FSH) are the pivotal endocrine factors controlling testicular functions. The relative importance of either hormone is somewhat different between rodents and primates. Generally, however, both LH/testosterone and FSH are necessary for quantitatively normal spermatogenesis, at least in non-seasonal species.
Collapse
Affiliation(s)
- Suresh Ramaswamy
- Center for Research in Reproductive Physiology (CRRP); Department of Obstetrics, Gynecology & Reproductive Sciences; University of Pittsburgh School of Medicine; Magee-Womens Research Institute; Pittsburgh, PA USA
| | | |
Collapse
|
17
|
Ulloa-Aguirre A, Zariñán T, Dias JA, Conn PM. Mutations in G protein-coupled receptors that impact receptor trafficking and reproductive function. Mol Cell Endocrinol 2014; 382:411-423. [PMID: 23806559 PMCID: PMC3844050 DOI: 10.1016/j.mce.2013.06.024] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 05/28/2013] [Accepted: 06/17/2013] [Indexed: 11/15/2022]
Abstract
G protein coupled receptors (GPCRs) are a large superfamily of integral cell surface plasma membrane proteins that play key roles in transducing extracellular signals, including sensory stimuli, hormones, neurotransmitters, or paracrine factors into the intracellular environment through the activation of one or more heterotrimeric G proteins. Structural alterations provoked by mutations or variations in the genes coding for GPCRs may lead to misfolding, altered plasma membrane expression of the receptor protein and frequently to disease. A number of GPCRs regulate reproductive function at different levels; these receptors include the gonadotropin-releasing hormone receptor (GnRHR) and the gonadotropin receptors (follicle-stimulating hormone receptor and luteinizing hormone receptor), which regulate the function of the pituitary-gonadal axis. Loss-of-function mutations in these receptors may lead to hypogonadotropic or hypergonadotropic hypogonadism, which encompass a broad spectrum of clinical phenotypes. In this review we describe mutations that provoke misfolding and failure of these receptors to traffick from the endoplasmic reticulum to the plasma membrane. We also discuss some aspects related to the therapeutic potential of some target-specific drugs that selectively bind to and rescue function of misfolded mutant GnRHR and gonadotropin receptors, and that represent potentially valuable strategies to treat diseases caused by inactivating mutations of these receptors.
Collapse
Affiliation(s)
- Alfredo Ulloa-Aguirre
- Division of Reproductive Health, Research Center in Population Health, National Institute of Public Health, Cuernavaca, Mexico; Divisions of Reproductive Sciences and Neuroscience, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR 97006, USA.
| | - Teresa Zariñán
- Research Unit in Reproductive Medicine, UMAE Hospital de Ginecobstetricia "Luis Castelazo Ayala", Mexico, DF, Mexico
| | - James A Dias
- Department of Biomedical Sciences, School of Public Health, University at Albany, Albany, NY, USA
| | - P Michael Conn
- Divisions of Reproductive Sciences and Neuroscience, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR 97006, USA; Department of Pharmacology and Physiology, Oregon Health and Science University, Beaverton, OR 97006, USA; Department of Cell and Developmental Biology, Oregon Health and Science University, Beaverton, OR 97006, USA; Department of Obstetrics and Gynecology, Oregon Health and Science University, Beaverton, OR 97006, USA
| |
Collapse
|
18
|
Troppmann B, Kleinau G, Krause G, Gromoll J. Structural and functional plasticity of the luteinizing hormone/choriogonadotrophin receptor. Hum Reprod Update 2013; 19:583-602. [DOI: 10.1093/humupd/dmt023] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
19
|
La Marca A, Sighinolfi G, Argento C, Grisendi V, Casarini L, Volpe A, Simoni M. Polymorphisms in gonadotropin and gonadotropin receptor genes as markers of ovarian reserve and response in in vitro fertilization. Fertil Steril 2013; 99:970-8.e1. [PMID: 23380184 DOI: 10.1016/j.fertnstert.2013.01.086] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 01/04/2013] [Accepted: 01/04/2013] [Indexed: 11/22/2022]
Abstract
Since gonadotropins are the fundamental hormones that control ovarian activity, genetic polymorphisms may alter gonadal responsiveness to glycoproteins; hence they are important regulators of hormone activity at the target level. The establishment of the pool of primordial follicles takes place during fetal life and is mainly under genetic control. Consequently, single nucleotide polymorphisms (SNPs) in gonadotropins and their receptors do not seem to be associated with any significant modification in the endowment of nongrowing follicles in the ovary. Indeed, the age at menopause, a biological characteristic strongly related to ovarian reserve, as well as markers of functional ovarian reserve such as anti-Müllerian hormone and antral follicle count, are not different in women with different genetic variants. Conversely, some polymorphisms in FSH receptor (FSHR) seem to be associated with modifications in ovarian activity. In particular, studies suggest that the Ser680 genotype for FSHR is a factor of relative resistance to FSH stimulation resulting in slightly higher FSH serum levels, thus leading to a prolonged duration of the menstrual cycle. Moreover, some FSHR gene polymorphisms show a positive association with ovarian response to exogenous gonadotropin administration, hence exhibiting some potential for a pharmacogenetic estimation of the FSH dosage in controlled ovarian stimulation. The study of SNPs of the FSHR gene is an interesting field of research that could provide us with new information about the way each woman responds to exogenous gonadotropin administration during ovulation induction.
Collapse
|
20
|
Capalbo A, Sagnella F, Apa R, Fulghesu AM, Lanzone A, Morciano A, Farcomeni A, Gangale MF, Moro F, Martinez D, Ciardulli A, Palla C, Uras ML, Spettu F, Cappai A, Carcassi C, Neri G, Tiziano FD. The 312N variant of the luteinizing hormone/choriogonadotropin receptor gene (LHCGR) confers up to 2·7-fold increased risk of polycystic ovary syndrome in a Sardinian population. Clin Endocrinol (Oxf) 2012; 77:113-9. [PMID: 22356187 DOI: 10.1111/j.1365-2265.2012.04372.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is a frequent condition, affecting about 15% of women of reproductive age. Because of its familial occurrence, a multifactorial model of susceptibility, including both genetic and environmental factors, has been proposed. However, the identification of genetic factors has been elusive. DESIGN Case-control study aimed at evaluating possible associations between functionally relevant variants of the luteinizing hormone/choriogonadotrophin receptor gene (LHCGR) and PCOS phenotype. PATIENTS A total of 198 PCOS and 187 non-PCOS women, aged 14-35 years, of Sardinian origin, were referred to the outpatient clinic of the Department of Obstetrics and Gynaecology of the University of Cagliari (Sardinia). PCOS diagnosis was based on the Rotterdam criteria. MEASUREMENTS We determined the genotype of ins18LQ, S291N and S312N variants at the LHCGR locus. Genotype was related to the presence or absence of PCOS and to several clinical and biochemical characteristics. RESULTS The presence of at least one 312N allele was strongly associated with PCOS risk (OR, 2·04; 95% CI, 1·32-3·14; χ(2) , 10·47; P = 0·001). 312N homozygosity was associated with a further risk increase (OR, 2·73; 95% CI, 1·25-5·95; χ(2) , 6·65; P = 0·01). The number of ins18LQ alleles was associated with LH serum levels in controls (χ(2) , 8·04, P = 0·017). CONCLUSIONS For the first time, we have identified a genetic variant that is strongly associated with PCOS in an isolated population. These results, if confirmed in other cohorts, may provide the opportunity to test the S312N genotype at the LHCGR locus in fertile women to assess the risk of PCOS. The avoidance of triggering factors like weight increase may improve the reproductive outcome of potentially at-risk subjects.
Collapse
Affiliation(s)
- A Capalbo
- Istituto di Genetica Medica, Università Cattolica del Sacro Cuore, Roma, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Abstract
The glycoprotein hormone receptors are G protein-coupled receptors containing a large extracellular domain fused to a prototypical serpentine domain. cis-activation occurs when binding of hormone to the extracellular domain stabilizes the serpentine domain in an active conformation. Studies by others suggested that these receptors can also signal by trans-activation, where hormone binding to one receptor protomer activates the serpentine domain of an associated protomer, as documented by the partial rescue of hormone-dependent signaling when a binding defective mutant is coexpressed with a signaling defective mutant. However, our characterizations of several LH receptor (LHR) mutants used in previous studies differ markedly from those originally reported. Also, when examining a pair of LHR mutants previously shown to functionally rescue in vitro as well as in vivo, in addition to finding that the properties of the individual mutants differ significantly from those originally described, we determined that when this pair of mutants was coexpressed in vitro, quantitative analyses did not indicate functional rescue. Additional data are presented that provide a plausible alternate explanation for the apparent in vivo trans-activation that was reported. Finally, using LHR mutants that we have documented to be expressed at the cell surface but to lack human chorionic gonadotropin binding activity or to be severely impaired in their ability to activate Gs, we did not observe functional rescue of human chorionic gonadotropin-stimulated cAMP when the mutants were coexpressed, even though bioluminescence resonance energy transfer analyses confirmed that the coexpressed mutants formed dimers. Taken altogether, our data substantively question the concept of functional rescue between LHR mutants.
Collapse
Affiliation(s)
- Meilin Zhang
- Department of Molecular Physiology and Biophysics, The Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa 52246, USA
| | | | | |
Collapse
|
22
|
Juniarto AZ, van der Zwan YG, Santosa A, Hersmus R, de Jong FH, Olmer R, Bruggenwirth HT, Themmen APN, Wolffenbuttel KP, Looijenga LHJ, Faradz SMH, Drop SLS. Application of the new classification on patients with a disorder of sex development in indonesia. Int J Endocrinol 2012; 2012:237084. [PMID: 22253624 PMCID: PMC3255103 DOI: 10.1155/2012/237084] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 10/07/2011] [Indexed: 12/24/2022] Open
Abstract
Disorder of sex development (DSD) patients in Indonesia most often do not receive a proper diagnostic evaluation and treatment. This study intended to categorize 88 Indonesian patients in accordance with the new consensus DSD algorithm. Diagnostic evaluation including clinical, hormonal, genetic, imaging, surgical, and histological parameters was performed. Fifty-three patients were raised as males, and 34 as females. Of 22 patients with 46, XX DSD, 15 had congenital adrenal hyperplasia, while in one patient, an ovarian Leydig cell tumor was found. In all 58 46, XY DSD patients, 29 were suspected of a disorder of androgen action (12 with an androgen receptor mutation), and in 9, gonadal dysgenesis was found and, in 20, severe hypospadias e.c.i. Implementation of the current consensus statement in a resource-poor environment is very difficult. The aim of the diagnostic workup in developing countries should be to end up with an evidence-based diagnosis. This is essential to improve treatment and thereby to improve the patients' quality of life.
Collapse
Affiliation(s)
- A. Zulfa Juniarto
- Department of Human Genetics, Center for Biomedical Research, Faculty of Medicine Diponegoro University (FMDU), Semarang 50321, Indonesia
| | - Yvonne G. van der Zwan
- Division of Pediatric Endocrinology, Department of Pediatrics, Sophia Children's Hospital, Erasmus MC, P.O. Box 2060, 3000 CD Rotterdam, The Netherlands
| | - Ardy Santosa
- Department of Urology, Dr. Kariadi Hospital, Semarang 50321, Indonesia
| | - Remko Hersmus
- Department of Pathology, Josephine Nefkens Institute, Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands
| | - Frank H. de Jong
- Section of Endocrinology, Department of Internal Medicine, Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands
| | - Renske Olmer
- Department of Clinical Genetics, Erasmus University Medical Centre, 3015 CE Rotterdam, The Netherlands
| | - Hennie T. Bruggenwirth
- Department of Clinical Genetics, Erasmus University Medical Centre, 3015 CE Rotterdam, The Netherlands
| | - Axel P. N. Themmen
- Section of Endocrinology, Department of Internal Medicine, Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands
| | - Katja P. Wolffenbuttel
- Department of Paediatric Urology, Erasmus University Medical Centre, 3015 CE Rotterdam, The Netherlands
| | - Leendert H. J. Looijenga
- Department of Pathology, Josephine Nefkens Institute, Erasmus University Medical Center, 3015 CE Rotterdam, The Netherlands
| | - Sultana M. H. Faradz
- Department of Human Genetics, Center for Biomedical Research, Faculty of Medicine Diponegoro University (FMDU), Semarang 50321, Indonesia
| | - Stenvert L. S. Drop
- Division of Pediatric Endocrinology, Department of Pediatrics, Sophia Children's Hospital, Erasmus MC, P.O. Box 2060, 3000 CD Rotterdam, The Netherlands
- *Stenvert L. S. Drop:
| |
Collapse
|
23
|
Abstract
Gonadotropins, the action of which is mediated at the level of their gonadal receptors, play a key role in sexual development, reproductive functions and in metabolism. The involvement of the gonadotropins and their receptor genotypes on reproductive function are widely studied. A large number of gonadotropins and their receptors gene polymorphisms are known, but the only one considerable as a clear, absolute genetic marker of reproductive features or disfunctions is the FSHR Asn680Ser polymorphism, since it modulates ovarian response to FSH. The aim of these studies would to be the prediction of the genetic causes of sex-related diseases to enable a customized clinical setting based on individual response of patients undergoing gonadotropin stimulation. In this review we discuss the latest information about the effects of polymorphisms of the gonadotropins and their receptor genes on reproductive functions of both male and female, and discuss their patho-physiological implications.
Collapse
Affiliation(s)
- Livio Casarini
- Department of Medicine, Endocrinology, Metabolism and Geriatrics, University of Modena and Reggio Emilia, via P. Giardini 1355, 41126 Modena, Italy
| | | | | |
Collapse
|
24
|
Sinha SK, Bhangoo A, Ten S, Gromoll J. Leydig Cell Hypoplasia due to Inactivating Luteinizing Hormone/Chorionic Gonadotropin Receptor Gene Mutation Presenting as a 46,XY DSD. In: New MI, Simpson JL, editors. Hormonal and Genetic Basis of Sexual Differentiation Disorders and Hot Topics in Endocrinology: Proceedings of the 2nd World Conference. New York: Springer; 2011. pp. 147-8. [DOI: 10.1007/978-1-4419-8002-1_32] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|
25
|
Richard N, Leprince C, Gruchy N, Pigny P, Andrieux J, Mittre H, Manouvrier S, Lahlou N, Weill J, Kottler ML. Identification by array-Comparative Genomic Hybridization (array-CGH) of a large deletion of luteinizing hormone receptor gene combined with a missense mutation in a patient diagnosed with a 46,XY disorder of sex development and application to prenatal diagnosis. Endocr J 2011; 58:769-76. [PMID: 21720050 DOI: 10.1507/endocrj.k11e-119] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This paper reports the case of an infant presenting with sexual ambiguity at birth. The child presented with labia majora synechia, thready genital tubercle and perineal hypospadias. The karyotype was 46,XY. Low testosterone levels with no response to hCG administration, associated with high LH level for her age, high FSH level, high inhibin B levels and normal AMH indicated a lack of LH receptivity and prompted us to screen the LHCGR gene for mutations. A previously described missense mutation (p.Cys131Arg) was identified at homozygous state in the propositus and at heterozygous state in the mother. This variation, however, was not found in the father. Our attention was drawn by the presence of several single nucleotide polymorphisms (SNPs), identified at homozygous state without any paternal contribution from exon 1 to exon 10 of LHCGR, suggesting a paternal deletion. Array DNA analysis was performed revealing a large deletion extending from 61,493 to 135,344 bp and including the LHCGR gene. Adequate genetic counselling was provided. This paper describes the first application of prenatal diagnosis in LHCGR deficiency for 46,XY disorders of sex development with the subsequent delivery of a normal baby.
Collapse
Affiliation(s)
- Nicolas Richard
- Department of Genetics, Caen University Hospital, Avenue Clemenceau, Caen, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Holterhus PM. Störungen der Geschlechtsentwicklung. Gynäkologische Endokrinologie 2009. [DOI: 10.1007/s10304-009-0312-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
27
|
Segaloff DL. Chapter 4 Diseases Associated with Mutations of the Human Lutropin Receptor. Progress in Molecular Biology and Translational Science 2009; 89:97-114. [DOI: 10.1016/s1877-1173(09)89004-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
28
|
Haasl RJ, Ahmadi MR, Meethal SV, Gleason CE, Johnson SC, Asthana S, Bowen RL, Atwood CS. A luteinizing hormone receptor intronic variant is significantly associated with decreased risk of Alzheimer's disease in males carrying an apolipoprotein E epsilon4 allele. BMC Med Genet 2008; 9:37. [PMID: 18439297 PMCID: PMC2396156 DOI: 10.1186/1471-2350-9-37] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2007] [Accepted: 04/25/2008] [Indexed: 01/04/2023]
Abstract
Genetic and biochemical studies support the apolipoprotein E (APOE) ε4 allele as a major risk factor for late-onset Alzheimer's disease (AD), though ~50% of AD patients do not carry the allele. APOE transports cholesterol for luteinizing hormone (LH)-regulated steroidogenesis, and both LH and neurosteroids have been implicated in the etiology of AD. Since polymorphisms of LH beta-subunit (LHB) and its receptor (LHCGR) have not been tested for their association with AD, we scored AD and age-matched control samples for APOE genotype and 14 polymorphisms of LHB and LHCGR. Thirteen gene-gene interactions between the loci of LHB, LHCGR, and APOE were associated with AD. The most strongly supported of these interactions was between an LHCGR intronic polymorphism (rs4073366; lhcgr2) and APOE in males, which was detected using all three interaction analyses: linkage disequilibrium, multi-dimensionality reduction, and logistic regression. While the APOE ε4 allele carried significant risk of AD in males [p = 0.007, odds ratio (OR) = 3.08(95%confidence interval: 1.37, 6.91)], ε4-positive males carrying 1 or 2 C-alleles at lhcgr2 exhibited significantly decreased risk of AD [OR = 0.06(0.01, 0.38); p = 0.003]. This suggests that the lhcgr2 C-allele or a closely linked locus greatly reduces the risk of AD in males carrying an APOE ε4 allele. The reversal of risk embodied in this interaction powerfully supports the importance of considering the role gene-gene interactions play in the etiology of complex biological diseases and demonstrates the importance of using multiple analytic methods to detect well-supported gene-gene interactions.
Collapse
Affiliation(s)
- Ryan J Haasl
- Section of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA.
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Kossack N, Simoni M, Richter-Unruh A, Themmen APN, Gromoll J. Mutations in a novel, cryptic exon of the luteinizing hormone/chorionic gonadotropin receptor gene cause male pseudohermaphroditism. PLoS Med 2008; 5:e88. [PMID: 18433292 PMCID: PMC2323302 DOI: 10.1371/journal.pmed.0050088] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2006] [Accepted: 03/10/2008] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Male pseudohermaphroditism, or Leydig cell hypoplasia (LCH), is an autosomal recessive disorder in individuals with a 46,XY karyotype, characterized by a predominantly female phenotype, a blind-ending vagina, absence of breast development, primary amenorrhea, and the presence of testicular structures. It is caused by mutations in the luteinizing hormone/chorionic gonadotropin receptor gene (LHCGR), which impair either LH/CG binding or signal transduction. However, molecular analysis has revealed that the LHCGR is apparently normal in about 50% of patients with the full clinical phenotype of LCH. We therefore searched the LHCGR for novel genomic elements causative for LCH. METHODS AND FINDINGS In the present study we have identified a novel, primate-specific bona fide exon (exon 6A) within the LHCGR gene. It displays composite characteristics of an internal/terminal exon and possesses stop codons triggering nonsense-mediated mRNA decay (NMD) in LHCGR. Transcripts including exon 6A are physiologically highly expressed in human testes and granulosa cells, and result in an intracellular, truncated LHCGR protein of 209 amino acids. We sequenced exon 6A in 16 patients with unexplained LCH and detected mutations in three patients. Functional studies revealed a dramatic increase in the expression of the mutated internal exon 6A transcripts, indicating aberrant NMD. These altered ratios of LHCGR transcripts result in the generation of predominantly nonfunctional LHCGR isoforms, thereby preventing proper expression and functioning. CONCLUSIONS The identification and characterization of this novel exon not only identifies a new regulatory element within the genomic organization of LHCGR, but also points toward a complex network of receptor regulation, including events at the transcriptional level. These findings add to the molecular diagnostic tools for LCH and extend our understanding of the endocrine regulation of sexual differentiation.
Collapse
Affiliation(s)
- Nina Kossack
- Institute of Reproductive Medicine, University of Muenster, Muenster, Germany
| | - Manuela Simoni
- Institute of Reproductive Medicine, University of Muenster, Muenster, Germany
| | | | - Axel P. N Themmen
- Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Jörg Gromoll
- Institute of Reproductive Medicine, University of Muenster, Muenster, Germany
- * To whom correspondence should be addressed. E-mail:
| |
Collapse
|
30
|
Holterhus P. Grundlagen und Klinik der Störungen der Geschlechtsentwicklung. Monatsschr Kinderheilkd 2008; 156:217-225. [DOI: 10.1007/s00112-008-1676-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
31
|
|
32
|
Kerkelä E, Skottman H, Friden B, Bjuresten K, Kere J, Hovatta O. Exclusion of coding-region mutations in luteinizing hormone and follicle-stimulating hormone receptor genes as the cause of ovarian hyperstimulation syndrome. Fertil Steril 2007; 87:603-6. [PMID: 17074323 DOI: 10.1016/j.fertnstert.2006.06.060] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2006] [Revised: 06/28/2006] [Accepted: 06/28/2006] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To sequence the coding regions of the luteinizing hormone receptor (LHR) and follicle-stimulating hormone receptor (FSHR) genes to find out if polymorphisms in them are responsible for the severe form of ovarian hyperstimulation syndrome (OHSS) in Swedish patients. DESIGN A mutation analysis of gonadotropin receptor genes from women undergoing gonadotropin treatment. SETTING The Fertility Unit of Karolinska University Hospital Huddinge, Stockholm, Sweden. PATIENT(S) A set of 10 well-characterized patients with severe OHSS, and 10 control women who did not develop OHSS after FSH stimulation. An additional 11 patients and 41 control women were screened for a two-amino-acid insertion in the first exon of the LHR gene. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Changes in the sequence of the receptor genes between patients and controls. RESULT(S) No association was found between polymorphisms of the coding region of LHR or FSHR genes and the development of OHSS. Incidence of the two-amino-acid insertion in the first exon of the LHR gene was slightly higher in patients than in controls, but no statistically significant difference was seen. CONCLUSION LHR and FSHR coding polymorphisms are not a major cause of severe OHSS in Swedish patients.
Collapse
Affiliation(s)
- Erja Kerkelä
- Department of Biosciences, Novum, Karolinska Institutet, Huddinge, Sweden
| | | | | | | | | | | |
Collapse
|
33
|
Piersma D, Verhoef-Post M, Berns EMJJ, Themmen APN. LH receptor gene mutations and polymorphisms: an overview. Mol Cell Endocrinol 2007; 260-262:282-6. [PMID: 17030087 DOI: 10.1016/j.mce.2005.11.048] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2005] [Accepted: 11/07/2005] [Indexed: 11/30/2022]
Affiliation(s)
- Djura Piersma
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | | | | | | |
Collapse
|
34
|
Petkovic V, Salemi S, Vassella E, Karamitopoulou-Diamantis E, Meinhardt UJ, Flück CE, Mullis PE. Leydig-Cell Tumour in Children: Variable Clinical Presentation, Diagnostic Features, Follow-Up and Genetic Analysis of Four Cases. Horm Res Paediatr 2006; 67:89-95. [PMID: 17047343 DOI: 10.1159/000096356] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2006] [Accepted: 08/09/2006] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Testicular tumours are relatively uncommon in infants and children, accounting for only 1-2% of all paediatric solid tumours. Of these approximately 1.5% are Leydig-cell tumours. Further, activating mutations of the luteinizing hormone receptor gene (LHR), as well as of the G protein genes, such as Gsalpha (gsp) and Gialpha (gip2) subunits, and cyclin-dependent kinase gene 4(CDK4) have been associated with the development of several endocrine neoplasms. AIMS/METHODS In this report, the clinical variability of Leydig-cell tumours in four children is described. The LHR-, gsp-, gip2- and CDK4 genes were investigated to establish the possible molecular pathogenesis of the variable phenotype of the Leydig-cell tumours. RESULTS No activating mutations in these genes were found in the four Leydig-cell tumours studied. Therefore, the absence of activating mutations in LHR, as well as in both the 'hot spot' regions for activating mutations within the G-alpha subunits and in the regulatory 'hot spot' on the CDK4 genes in these tumours indicates molecular heterogeneity among Leydig-cell tumours. CONCLUSION Four children with a variable phenotype caused by Leydig-cell tumours are described. A molecular analysis of all the 'activating' genes and mutational regions known so far was performed, but no abnormalities were found. The lessons learnt from these clinically variable cases are: perform ultrasound early and most importantly, consider discrepancies between testicular swelling, tumour size and androgen production.
Collapse
Affiliation(s)
- Vibor Petkovic
- Paediatric Endocrinology, University Children's Hospital, Inselspital, Bern, Switzerland
| | | | | | | | | | | | | |
Collapse
|
35
|
Tao YX. Inactivating mutations of G protein-coupled receptors and diseases: Structure-function insights and therapeutic implications. Pharmacol Ther 2006; 111:949-73. [PMID: 16616374 DOI: 10.1016/j.pharmthera.2006.02.008] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2006] [Accepted: 02/21/2006] [Indexed: 12/20/2022]
Abstract
Since the discovery of the first rhodopsin mutation that causes retinitis pigmentosa in 1990, significant progresses have been made in elucidating the pathophysiology of diseases caused by inactivating mutations of G protein-coupled receptors (GPCRs). This review aims to compile the compelling evidence accumulated during the past 15 years demonstrating the etiologies of more than a dozen diseases caused by inactivating GPCR mutations. A generalized classification scheme, based on the life cycle of GPCRs, is proposed. Insights gained through detailed studies of these naturally occurring mutations into the structure-function relationship of these receptors are reviewed. Therapeutic approaches directed against the different classes of mutants are being developed. Since intracellular retention emerges as the most common defect, recent progresses aimed at correcting this defect through membrane permeable pharmacological chaperones are highlighted.
Collapse
MESH Headings
- Animals
- Diabetes Insipidus, Nephrogenic/etiology
- Dwarfism/etiology
- Humans
- Hypogonadism/etiology
- Mutation
- Obesity/etiology
- Receptor, Melanocortin, Type 1/genetics
- Receptor, Melanocortin, Type 2/genetics
- Receptor, Melanocortin, Type 3/genetics
- Receptor, Parathyroid Hormone, Type 1/genetics
- Receptors, CCR5/genetics
- Receptors, Calcium-Sensing/genetics
- Receptors, G-Protein-Coupled/chemistry
- Receptors, G-Protein-Coupled/genetics
- Receptors, G-Protein-Coupled/physiology
- Receptors, LHRH/genetics
- Receptors, Vasopressin/genetics
- Retinitis Pigmentosa/etiology
- Rhodopsin/genetics
- Structure-Activity Relationship
Collapse
Affiliation(s)
- Ya-Xiong Tao
- Department of Anatomy, Physiology and Pharmacology, 213 Greene Hall, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA.
| |
Collapse
|
36
|
Leung MYK, Steinbach PJ, Bear D, Baxendale V, Fechner PY, Rennert OM, Chan WY. Biological effect of a novel mutation in the third leucine-rich repeat of human luteinizing hormone receptor. Mol Endocrinol 2006; 20:2493-503. [PMID: 16709601 DOI: 10.1210/me.2005-0510] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
A novel heterozygous mutation A340T leading to the substitution of Phe for the conserved amino acid Ile114 was identified by nucleotide sequencing of the human LH/chorionic gonadotropin receptor (hLHR) of a patient with Leydig cell hypoplasia. This mutation is located in the third leucine-rich repeat in the ectodomain of the hLHR. In vitro expression studies demonstrated that this mutation results in reduced ligand binding and signal transduction of the receptor. Studies of hLHR constructs in which various amino acids were substituted for the conserved Ile114 showed that receptor activity is sensitive to changes in size, shape, and charge of the side chain. A homology model of the wild-type hLHR ectodomain was made, illustrating the packing of conserved hydrophobic side chains in the protein core. Substitution of Ile114 by Phe might disrupt intermolecular contacts between hormone and receptor. This mutation might also affect an LHR-dimer interaction. Thus, the I114F mutation reduces ligand binding and signal transduction by the hLHR, and it is partially responsible for Leydig cell hypoplasia in the patient.
Collapse
Affiliation(s)
- Michael Yiu-Kwong Leung
- Laboratory of Clinical Genomics, National Institute of Child Health and Human Development, National Institutes of Health, Building 49, Room 2A08, 49 Convent Drive, MSC 4429, Bethesda, Maryland 20892-4429, USA
| | | | | | | | | | | | | |
Collapse
|
37
|
Latronico AC, Costa EMF, Mendonça BB, Arnhold IJP. [Leydig cell hypoplasia]. ACTA ACUST UNITED AC 2006; 49:83-6. [PMID: 16544038 DOI: 10.1590/s0004-27302005000100011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The Leydig cell hypoplasia is a rare and well defined form of male pseudohermaphroditism with autosomal recessive inheritance pattern. An inadequate fetal testicular Leydig cell differentiation and, consequently a low androgenic production during intra uterine and post natal periods, result in absence or incomplete virilization in patients with 46,XY karyotype. These patients exhibit a wide clinical spectrum, ranging from complete female external genitalia to male external genital with micropenis, low serum testosterone levels associated with high LH levels. Inactivating mutations of the LH/hCG receptor gene have been identified in affected families in the last decade. However, the low frequency of inactivating mutations in this gene, and the lack of segregation of intragenic polymorphisms among affected members from families with typical phenotype of Leydig cell hypoplasia, suggest the genetic heterogeneity of this condition.
Collapse
Affiliation(s)
- Ana Claudia Latronico
- Laboratório de Hormônios e Genética Molecular, LIM/42, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP.
| | | | | | | |
Collapse
|
38
|
Abstract
Tall stature is less often experienced as an important problem than short stature. However, a correct diagnosis may be of eminent importance, especially when interventions are planned, or to know the natural history. Overgrowth can be caused by endocrine disorders and skeletal dysplasias, but also by several genetic syndromes. Despite a systematic diagnostic approach, there will be patients with tall stature who do not fit a known diagnosis. In this group of patients possibilities of genetic analysis do exist, but are not common practice. The FMR1 gene should be analyzed in patients with tall stature and mental retardation, and in these patients the NSD1 gene can be considered whenever some features of Sotos syndrome do exist. In tall patients without mental retardation and some features of Sotos or Beckwith-Wiedemann syndrome it may still be useful to look for mutations in the NSD1 gene, but also for changes in the 11p15 region. The various possibilities are discussed and placed in a flowchart.
Collapse
Affiliation(s)
- S G Kant
- Center for Human and Clinical Genetics, Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands.
| | | | | |
Collapse
|
39
|
Abstract
New information about mutations and polymorphisms in the genes for the gonadotrophins and their receptors has become available in the last few years. In this short review mutations and polymorphisms in gonadotrophins, their receptors and their pathophysiological effects and implications are discussed. An increasingly clear picture about the structure–function relationships of gonadotrophin action is emerging from the combining the types and the locations of the mutations with their phenotypic effects and the information about the crystal structure of these molecules.
Collapse
Affiliation(s)
- Axel P N Themmen
- Department of Internal Medicine, Erasmus MC, PO Box 1738, 3000 DR Rotterdam, The Netherlands.
| |
Collapse
|
40
|
Richter-Unruh A, Korsch E, Hiort O, Holterhus PM, Themmen AP, Wudy SA. Novel insertion frameshift mutation of the LH receptor gene: problematic clinical distinction of Leydig cell hypoplasia from enzyme defects primarily affecting testosterone biosynthesis. Eur J Endocrinol 2005; 152:255-9. [PMID: 15745934 DOI: 10.1530/eje.1.01852] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Leydig cell hypoplasia (LCH) is a rare autosomal recessive condition that interferes with normal development of male external genitalia in 46,XY individuals and is caused by inactivating mutations of the LH receptor gene. The clinical and biochemical diagnostic parameters of LCH are not always specific and may therefore show significant overlap with other causes of insufficient testicular steroid biosynthesis. We have studied a 46,XY newborn with completely female external genitalia and palpable testes. Due to an increased basal serum ratio of androstenedione/testosterone, 17 beta-hydroxysteroid dehydrogenase type 3 (17 beta-HSD 3) deficiency was initially suspected. DNA analysis of the corresponding HSD17B3 gene, however, showed no abnormalities in the entire coding region. In contrast, direct sequencing of the LH receptor gene revealed a novel homozygous single nucleotide insertion in exon 11 (codon A589fs) producing a frame shift in the open reading frame predicting for premature termination of translation 17 amino acids downstream. From the genetic perspective, this mutation represents the first frame shift mutation in the LH receptor gene ever reported to date. From the clinical standpoint, LCH should always be considered in the differential diagnosis as steroid profiles may not be informative. Therefore, molecular genetic analysis should be warranted for androgen biosynthesis defects in all cases.
Collapse
Affiliation(s)
- A Richter-Unruh
- Department of Pediatric Hematology, Oncology and Endocrinology, University Children's Hospital, Hufelandstr. 55, University of Essen, 45 122 Essen, Germany.
| | | | | | | | | | | |
Collapse
|
41
|
Salameh W, Choucair M, Guo TB, Zahed L, Wu SM, Leung MYK, Rennert OM, Chan WY. Leydig cell hypoplasia due to inactivation of luteinizing hormone receptor by a novel homozygous nonsense truncation mutation in the seventh transmembrane domain. Mol Cell Endocrinol 2005; 229:57-64. [PMID: 15607529 DOI: 10.1016/j.mce.2004.09.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2003] [Revised: 09/27/2004] [Accepted: 09/30/2004] [Indexed: 11/23/2022]
Abstract
Inactivating mutations in the LH receptor are the predominant cause for male pseudohermaphroditism in subjects with Leydig cell hypoplasia (LCH). The severity of the mutations, correlates with residual receptor activities. Here, we detail the clinical presentation of one subject with complete male pseudohermaphroditism and LCH. We identify within the proband and her similarly afflicted sibling a homozygous T to G transversion at nucleotide 1836 in exon 11 of the LH/CGR gene. This causes conversion of a tyrosine codon into a stop codon at codon 612 in the seventh transmembrane domain, resulting in a truncated receptor that lacks a cytoplasmic tail. In vitro, in contrast to cells expressing a normal LHR, cells transfected with the mutant cDNA exhibit neither surface binding of radiolabeled hCG nor cAMP generation. In vitro expression under the control of the LHR signal peptide of either a wild type or mutant LHR-GFP fusion protein shows no differences in receptor cellular localization. In conclusion, the in vitro studies suggest that residues in the seventh transmembrane domain and cytoplasmic tail are important for receptor binding and activation without playing a major role in receptor cellular trafficking.
Collapse
Affiliation(s)
- W Salameh
- Division of Endocrinology and Metabolism, Harbor-University of California-Los Angeles Medical Center and Research and Education Institute, Torrance, CA 90502, USA.
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Pals-Rylaarsdam R, Liu G, Brickman W, Duranteau L, Monroe J, El-Awady MK, Gad YZ, Shenker A. A novel double mutation in the luteinizing hormone receptor in a kindred with familial Leydig cell hypoplasia and male pseudohermaphroditism. Endocr Res 2005; 31:307-23. [PMID: 16433250 DOI: 10.1080/07435800500430890] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We report a novel mutant of the luteinizing hormone receptor (LHR) in a case of familial Leydig cell hypoplasia and pseudohermaphrotidism. The proband was homozygous for two missense mutations, T1121C and C1175T, causing substitutions I374T and T3921. The molecular effects of the mutations were investigated by heterologous expression of the WT LHR, the double mutant LHR, or receptors with either the I374T or the T392I mutation, and measuring hormone binding and cAMP signaling. All mutant LHRs exhibited severe defects, including loss of ligand binding and cAMP production. Immunoblots showed little difference in protein levels between the WT and mutant receptors.
Collapse
Affiliation(s)
- Robin Pals-Rylaarsdam
- Department of Pediatrics, Northwestern University Medical School and Children's Memorial Institute for Education and Research, Chicago, Illinois, USA.
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Leung MYK, Al-Muslim O, Wu SM, Aziz A, Inam S, Awadh M, Rennert OM, Chan WY. A novel missense homozygous inactivating mutation in the fourth transmembrane helix of the luteinizing hormone receptor in leydig cell hypoplasia. ACTA ACUST UNITED AC 2004; 130A:146-53. [PMID: 15372531 DOI: 10.1002/ajmg.a.20681] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Loss-of-function mutations/inactivating mutations of the human chorionic gonadotropin/luteinizing hormone receptor (hCG/LHR), a G-protein coupled receptor, lead to impaired Leydig cell differentiation. Leydig cell hypoplasia/agenesis/dysplasia (LCH) is one of the causes of male pseudohermaphroditism (MPH). We studied a 19-year-old MPH patient with female phenotype and 46,XY karyotype. Testicular histology and hormonal profile of the patient is typical of LCH. Nucleotide sequencing of exon 11 of hLHR identified a novel T1505C transversion mutation. The mutation is homozygous in the patient and is heterozygous in both parents. The single base mutation caused the substitution of a conserved leucine at 502 position to proline in transmembrane helix (TM) IV of the hLHR. This is the first LCH causing mutation identified in TM IV of the hLHR. Expression study of the mutated hLHR in human embryonic kidney (HEK)293 cells showed reduced cAMP production and ligand binding. Receptor trafficking was not affected by the mutation when the green fluorescence protein conjugated mutated receptor was expressed in HEK293 cells. The mutation caused inactivation of the hLHR and resulted in LCH in the patient.
Collapse
Affiliation(s)
- Michael Yiu-Kwong Leung
- Section on Developmental Genomics, Laboratory of Clinical Genomics, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 50892-4429, USA
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Powell BL, Piersma D, Kevenaar ME, van Staveren IL, Themmen APN, Iacopetta BJ, Berns EMJJ. Luteinizing hormone signaling and breast cancer: polymorphisms and age of onset. J Clin Endocrinol Metab 2003; 88:1653-7. [PMID: 12679452 DOI: 10.1210/jc.2002-021585] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Estrogen exposure has repeatedly been shown to associate with the risk of developing breast cancer. Estrogen synthesis is under the control of LH and FSH, where LH, through its receptor (LHR), stimulates production of ovarian androgens; and FSH, their aromatization to estrogens. Here, we investigated whether functional polymorphic variants in the LH signaling pathway are associated with the risk of breast cancer or its clinical phenotype. A PCR-restriction fragment length polymorphism genotyping approach was used to investigate this in 266 breast cancers. The LHR18insLQ allele does not seem to influence breast cancer risk. However, women who were homozygous for the LHR18insLQ allele were, on average, 8.3 yr younger at diagnosis, compared with those homozygous for the wild-type LHR allele (mean age, 51.9 yr vs. 60.2 yr; P = 0.03). Trends were observed for associations between LHR18insLQ carriers and nodal involvement or larger tumor size. Patients who were LHR18insLQ carriers revealed a significantly worse overall survival, compared with those who were homozygous for LHR [hazard ratio = 2.4; 95% CI (1.3-4.3); P = 0.006]. In contrast, no associations between the LH genotype and any of the clinical parameters were observed. Our findings suggest that the LHR18insLQ gene polymorphism determines an earlier age of disease onset and is prognostic for poor outcome of breast cancer.
Collapse
Affiliation(s)
- B L Powell
- Department of Surgery, University of Western Australia, Nedlands 6907, Australia
| | | | | | | | | | | | | |
Collapse
|