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Allouch A, Al-Barazenji T, Al-Shafai M, Abdallah AM. The landscape of genetic variations in non-syndromic primary ovarian insufficiency in the MENA region: a systematic review. Front Endocrinol (Lausanne) 2024; 14:1289333. [PMID: 38737775 PMCID: PMC11082268 DOI: 10.3389/fendo.2023.1289333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 12/01/2023] [Indexed: 05/14/2024] Open
Abstract
Introduction Premature ovarian insufficiency (POI) is a primary cause of infertility with variable clinical manifestations. POI is a multifactorial disease with both environmental and known genetic etiologies, but data on the genetic variations associated with POI in the Middle East and North Africa (MENA) region are scarce. The aim of this study was to systematically review all known genetic causes of POI in the MENA region. Methods The PubMed, Science Direct, ProQuest, and Embase databases were searched from inception to December 2022 for all reports of genetic variants associated with POI in the MENA region. Clinical and genetic data were collected from eligible articles, and ClinVar and PubMed (dbSNP) were searched for variants. Results Of 1,803 studies, 25 met the inclusion criteria. Fifteen studies were case-control studies and ten were case reports representing 1,080 non-syndromic POI patients in total. Seventy-nine variants in 25 genes associated with POI were reported in ten MENA countries. Of the 79 variants, 46 were rare and 33 were common variants. Of the 46 rare variants, 19 were pathogenic or likely pathogenic according to ACMG classification guidelines and ClinVar. No clear phenotype-genotype association was observed. Male family members carrying pathogenic variants also had infertility problems. Discussion To our best knowledge, this is the first systematic review of the genetic variants associated with POI in the MENA region. Further functional studies are needed to assess the disease-causing molecular mechanisms of these variants. Knowledge of the genetic basis of POI in the Middle East could facilitate early detection of the condition and thus early implementation of therapeutic interventions, paving the way for precision medicine options in specific populations.
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Affiliation(s)
- Asma Allouch
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Tara Al-Barazenji
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Mashael Al-Shafai
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
- Biomedical Research Center, Qatar University, Doha, Qatar
| | - Atiyeh M. Abdallah
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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Zhang T, Ma Q, Shen Q, Jiang C, Zou F, Shen Y, Wang Y. Identification of novel biallelic variants in BMP15 in two siblings with premature ovarian insufficiency. J Assist Reprod Genet 2022; 39:2125-2134. [PMID: 35861920 PMCID: PMC9474791 DOI: 10.1007/s10815-022-02574-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 07/08/2022] [Indexed: 10/17/2022] Open
Abstract
BACKGROUND Premature ovarian insufficiency (POI) occurs in women before the age of 40 years, accompanied by amenorrhea, hypoestrogenism, hypergonadotropinism, and infertility. The pathology of POI is complex and the molecular genetic mechanisms are poorly understood. Bone morphogenetic protein 15 (BMP15) plays a crucial role in oocyte maturation and follicular development through the activation of granulosa cells. Dysfunction of BMP15 causes ovarian dysgenesis and is related to POI. Identifying pathogenic variants contributes to revealing genetic mechanisms and making clinical diagnoses of POI. METHODS The study involved two sisters diagnosed with POI. Whole-exome sequencing (WES) was performed to identify causative genes. Sanger sequencing was used to validate the mutations in patients with POI and members of the family with no clinical signs or symptoms. The effect of the novel mutations on the BMP15 structure was analyzed by PSIPRED. By over-expressing wild-type (WT) or mutant BMP15 plasmids in vitro, a functional study of the BMP15 mutant was conducted by real-time qPCR and western blotting. Through cocultivation with HEK293T cells, the effects of secreted BMP15 WT and variants on granulosa cell proliferation and apoptosis were detected through a cell counting kit-8 assay and flow cytometric analysis. RESULTS We identified biallelic variants in BMP15, c.791G > A (p. R264Q) and c.1076C > T (p. P359L), in two siblings with POI. Both sisters carried the same biallelic variants, while the other female members of their family carried only one of them. Structural prediction showed that the variants have not affected the secondary structure of BMP15 but may change the conformation of water molecules around protein surfaces and thermal stability of BMP15. Real-time qPCR showed no significant difference in mRNA levels among WT and the two variants. Western blotting indicated a reduction in BMP15 expression with the c.791G > A and c.1076C > T variants compared to WT. Moreover, mutants 791G > A and 1076C > T impaired the function of secreted BMP15 in promoting granulosa cell proliferation and suppressing cell apoptosis caused by reactive oxygen species. CONCLUSIONS This study identified novel biallelic variants, c.791G > A and c.1076C > T, of BMP15 in two siblings with POI. Both missense variants reduced the level of the BMP15 protein and impaired the function of BMP15 in promoting granulosa cell proliferation in vitro. Taken together, our findings provide a novel molecular genetic basis and potential pathogenesis of BMP15 variants in POI.
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Affiliation(s)
- Tao Zhang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
- College of Life Sciences, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Qianhong Ma
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
- Key Laboratory of Obstetric, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Qiongyan Shen
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Chuan Jiang
- Department of Obstetrics/Gynecology, Joint Laboratory of Reproductive Medicine (SCU-CUHK), West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Fangdong Zou
- College of Life Sciences, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ying Shen
- Department of Obstetrics/Gynecology, Joint Laboratory of Reproductive Medicine (SCU-CUHK), West China Second University Hospital, Sichuan University, Chengdu, 610041, China
- Key Laboratory of Obstetric, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Yan Wang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, 610041, China.
- Key Laboratory of Obstetric, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, China.
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Najafabadi HA, Khansefid M, Mahmoud GG, Haruna IL, Zhou H, Hickford JGH. Identification of sequence variation in the oocyte-derived bone morphogenetic protein 15 (BMP15) gene (BMP15) associated with litter size in New Zealand sheep (Ovis aries) breeds. Mol Biol Rep 2021; 48:6335-6342. [PMID: 34379287 DOI: 10.1007/s11033-021-06627-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/03/2021] [Indexed: 11/25/2022]
Abstract
Advances in the study of reproductive traits indicate that functional variation in fertility genes may be useful for improving sheep fertility. The aim of this study was to search for variation in the bone morphogenetic protein 15 gene (BMP15) and ascertain any association with litter size in purebred Finnish Landrace sheep (n = 148), Finnish Landrace × Texel-cross sheep (n = 45), and composite sheep (of varying breed background; n = 58) from New Zealand (NZ). A 482 bp and 312 bp fragment of exon 1 and 2, respectively, of BMP15 were analysed using polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP). The additive and dominance effect of BMP15 variation on litter size were estimated using animal and sire models. Two variants (A and B) were detected in exon 1; no sequence variation was detected in exon 2. Variant A had the nucleotide sequence CTT between positions c.31 and c.33, while variant B had a deletion (c.31_33del). The observed frequency for variant A in the Finnish Landrace sheep, Finnish Landrace × Texel-cross sheep and the composite sheep, was 0.77, 0.92, and 0.68, respectively while the frequency of variant B (c.31_33del) was 0.23, 0.08, and 0.32, respectively. An association between litter size and c.31_33del (P < 0.001) was observed in composite sheep. Analysis of more sheep will be required to confirm these results. Litter size did not differ significantly between sheep breeds regardless of the presence/absence of c.31_33del. Results suggested that c.31_33del might be a genetic marker for improving fecundity in some NZ sheep.
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Affiliation(s)
- Hamed Amirpour Najafabadi
- Gene-Marker Laboratory, Department of Agricultural Sciences, Lincoln University, Lincoln, 7647, Christchurch, New Zealand
| | - Majid Khansefid
- Agriculture Victoria, AgriBio, Centre for AgriBioscience, Bundoora, VIC, 3083, Australia
| | - Ghassan Ghaith Mahmoud
- Gene-Marker Laboratory, Department of Agricultural Sciences, Lincoln University, Lincoln, 7647, Christchurch, New Zealand
| | - Ishaku Lemu Haruna
- Gene-Marker Laboratory, Department of Agricultural Sciences, Lincoln University, Lincoln, 7647, Christchurch, New Zealand
| | - Huitong Zhou
- Gene-Marker Laboratory, Department of Agricultural Sciences, Lincoln University, Lincoln, 7647, Christchurch, New Zealand
| | - Jon G H Hickford
- Gene-Marker Laboratory, Department of Agricultural Sciences, Lincoln University, Lincoln, 7647, Christchurch, New Zealand.
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Rydze RT, Patton B, Briley SM, Salazar-Torralba H, Gipson G, James R, Rajkovic A, Thompson T, Pangas SA. Deletion of Gremlin-2 alters estrous cyclicity and disrupts female fertility in mice. Biol Reprod 2021; 105:1205-1220. [PMID: 34333627 DOI: 10.1093/biolre/ioab148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/28/2021] [Accepted: 07/27/2021] [Indexed: 11/13/2022] Open
Abstract
Members of the differential screening-selected gene aberrative in neuroblastoma (DAN) protein family are developmentally conserved extracellular binding proteins that antagonize bone morphogenetic protein (BMP) signaling. This protein family includes the Gremlin proteins, GREM1 and GREM2, which have key functions during embryogenesis and adult physiology. While BMPs play essential roles in ovarian follicle development, the role of the DAN family in female reproductive physiology is less understood. We generated mice null for Grem2 to determine its role in female reproduction in addition to screening patients with primary ovarian insufficiency for variants in GREM2. Grem2-/- mice are viable, but female Grem2-/- mice have diminished fecundity and irregular estrous cycles. This is accompanied by significantly reduced production of ovarian anti-Müllerian hormone (AMH) from small growing follicles, leading to a significant decrease in serum AMH. Surprisingly, as AMH is a well-established marker of the ovarian reserve, morphometric analysis of ovarian follicles showed maintenance of primordial follicles in Grem2-/- mice like wild type littermates. While Grem2 mRNA transcripts were not detected in the pituitary, Grem2 is expressed in hypothalami of wild type female mice, suggesting the potential for dysfunction in multiple tissues composing the hypothalamic-pituitary-ovarian axis that contribute to the subfertility phenotype. Additionally, screening 106 women with primary ovarian insufficiency identified one individual with a heterozygous variant in GREM2 that lies within the predicted BMP-GREM2 interface. In total, these data suggest Grem2 is necessary for female fecundity by playing a novel role in regulating the HPO axis and contributing to female reproductive disease.
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Affiliation(s)
- Robert T Rydze
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, TX, 77030, USA.,Graduate Program in Clinical Scientist Training, Baylor College of Medicine, Houston, TX 77030
| | - Bethany Patton
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX 77030.,Graduate Program in Molecular & Cellular Biology, Baylor College of Medicine, Houston, TX 77030
| | - Shawn M Briley
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX 77030.,Graduate Program in Biochemistry & Molecular Biology, Baylor College of Medicine, Houston, TX 77030
| | | | - Gregory Gipson
- Department of Molecular Genetics, Biochemistry, & Microbiology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Rebecca James
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX 77030
| | - Aleksandar Rajkovic
- Department of Pathology, University of California, San Francisco, USA, Department of OB-GYN, University of California, San Francisco, USA, Institute of Human Genetics, University of California, San Francisco, USA
| | - Thomas Thompson
- Department of Molecular Genetics, Biochemistry, & Microbiology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Stephanie A Pangas
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX 77030.,Graduate Program in Molecular & Cellular Biology, Baylor College of Medicine, Houston, TX 77030.,Graduate Program in Biochemistry & Molecular Biology, Baylor College of Medicine, Houston, TX 77030.,Department of Molecular & Cellular Biology, Baylor College of Medicine, Houston, TX 77030
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Orisaka M, Miyazaki Y, Shirafuji A, Tamamura C, Tsuyoshi H, Tsang BK, Yoshida Y. The role of pituitary gonadotropins and intraovarian regulators in follicle development: A mini-review. Reprod Med Biol 2021; 20:169-175. [PMID: 33850449 PMCID: PMC8022101 DOI: 10.1002/rmb2.12371] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/15/2021] [Accepted: 01/25/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The process of follicle development is tightly regulated by pituitary gonadotropins (follicle-stimulating hormone [FSH] and luteinizing hormone [LH]) and intraovarian regulators (eg, steroids, growth factors, and cytokines). METHODS This review outlines recent findings on the mechanisms of human follicle development, based on the research on animal models such as mice, rats, cows, and sheep. MAIN FINDINGS Phosphatidylinositol 3-kinase/protein kinase B signaling pathway and anti-Müllerian hormone are involved in primordial follicle activation during the gonadotropin-independent phase. The intraovarian regulators, such as androgen, insulin-like growth factor system, activin, oocyte-derived factors (growth differentiation factor-9 and bone morphogenetic protein 15), and gap junction membrane channel protein (connexin), play a central role in the acquisition of FSH dependence in preantral follicles during the gonadotropin-responsive phase. Antral follicle development can be divided into FSH-dependent growth and LH-dependent maturation. The indispensable tetralogy for follicle selection and final maturation of antral follicles involves (a) acquisition of LH dependence, (b) greater capacity for E2 production, (c) activation of the IGF system, and (d) an antiapoptotic follicular microenvironment. CONCLUSION We reproductive endocrinologists should accumulate further knowledge from animal model studies to develop methods that promote early folliculogenesis and connect to subsequent gonadotropin therapy in infertile women.
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Affiliation(s)
- Makoto Orisaka
- Department of Obstetrics and GynecologyUniversity of FukuiYoshida‐GunJapan
| | - Yumiko Miyazaki
- Department of Obstetrics and GynecologyUniversity of FukuiYoshida‐GunJapan
| | - Aya Shirafuji
- Department of Obstetrics and GynecologyUniversity of FukuiYoshida‐GunJapan
| | - Chiyo Tamamura
- Department of Obstetrics and GynecologyUniversity of FukuiYoshida‐GunJapan
| | - Hideaki Tsuyoshi
- Department of Obstetrics and GynecologyUniversity of FukuiYoshida‐GunJapan
| | - Benjamin K. Tsang
- Reproductive Biology UnitDepartments of Obstetrics & Gynecology and Cellular & Molecular MedicineUniversity of OttawaOttawaONCanada
- Chronic Disease ProgramOttawa Hospital Research InstituteCritical Care WingThe Ottawa Hospital ‐ General CampusOttawaONCanada
| | - Yoshio Yoshida
- Department of Obstetrics and GynecologyUniversity of FukuiYoshida‐GunJapan
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Venturella R, De Vivo V, Carlea A, D'Alessandro P, Saccone G, Arduino B, Improda FP, Lico D, Rania E, De Marco C, Viglietto G, Zullo F. The Genetics of Non-Syndromic Primary Ovarian Insufficiency: A Systematic Review. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2019; 13:161-168. [PMID: 31310068 PMCID: PMC6642427 DOI: 10.22074/ijfs.2019.5599] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 01/15/2019] [Indexed: 01/19/2023]
Abstract
Several causes for primary ovarian insufficiency (POI) have been described, including iatrogenic and environmental
factor, viral infections, chronic disease as well as genetic alterations. The aim of this review was to collect all the ge-
netic mutations associated with non-syndromic POI. All studies, including gene screening, genome-wide study and as-
sessing genetic mutations associated with POI, were included and analyzed in this systematic review. Syndromic POI
and chromosomal abnormalities were not evaluated. Single gene perturbations, including genes on the X chromosome
(such as BMP15, PGRMC1 and FMR1) and genes on autosomal chromosomes (such as GDF9, FIGLA, NOBOX,
ESR1, FSHR and NANOS3) have a positive correlation with non-syndromic POI. Future strategies include linkage
analysis of families with multiple affected members, array comparative genomic hybridization (CGH) for analysis of
copy number variations, next generation sequencing technology and genome-wide data analysis. This review showed
variability of the genetic factors associated with POI. These findings may help future genetic screening studies on
large cohort of women.
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Affiliation(s)
- Roberta Venturella
- Department of Obstetrics and Gynaecology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Valentino De Vivo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Annunziata Carlea
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Pietro D'Alessandro
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy. Electronic Address:
| | - Bruno Arduino
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Francesco Paolo Improda
- Department of Obstetrics and Gynaecology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Daniela Lico
- Department of Obstetrics and Gynaecology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Erika Rania
- Department of Obstetrics and Gynaecology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Carmela De Marco
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Giuseppe Viglietto
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Fulvio Zullo
- Department of Obstetrics and Gynaecology, Magna Graecia University of Catanzaro, Catanzaro, Italy
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Jedidi I, Ouchari M, Yin Q. Sex chromosomes-linked single-gene disorders involved in human infertility. Eur J Med Genet 2018; 62:103560. [PMID: 31402110 DOI: 10.1016/j.ejmg.2018.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 10/01/2018] [Accepted: 10/24/2018] [Indexed: 10/28/2022]
Abstract
Human infertility is a healthcare problem that has a worldwide impact. Genetic causes of human infertility include chromosomal aneuploidies and rearrangements and single-gene defects. The sex chromosomes (X and Y) are critical players in human fertility since they contain several genes essential for sex determination and reproductive traits for both men and women. This paper provides a review of the most common sex chromosomes-linked single-gene disorders involved in human infertility and their corresponding phenotypes. In addition to the Y-linked SRY gene, which mutations may cause XY gonadal dysgenesis and sex reversal, the deletions of genes present in AZF regions of the Y chromosome (DAZ, RBMY, DBY and USP9Y genes) are implicated in varying degrees of spermatogenic dysfunction. Furthermore, a list of X-linked genes (KAL1, NR0B1, AR, TEX11, FMR1, PGRMC1, BMP15 and POF1 and 2 regions genes (XPNPEP2, POF1B, DACH2, CHM and DIAPH2)) were reported to have critical roles in pubertal and reproductive deficiencies in humans, affecting only men, only women or both sexes. Mutations in these genes may be transmitted to the offspring by a dominant or a recessive inheritance.
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Affiliation(s)
- Ines Jedidi
- Faculty of Medicine of Sousse, Sousse, Tunisia.
| | - Mouna Ouchari
- Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Qinan Yin
- Clinical Center, National Institutes of Health, Bethesda, MD, USA; Department of Obstetrics and Gynecology, China Meitan General Hospital, Beijing, China
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Laissue P. Aetiological coding sequence variants in non-syndromic premature ovarian failure: From genetic linkage analysis to next generation sequencing. Mol Cell Endocrinol 2015; 411:243-57. [PMID: 25960166 DOI: 10.1016/j.mce.2015.05.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 04/14/2015] [Accepted: 05/04/2015] [Indexed: 01/19/2023]
Abstract
Premature ovarian failure (POF) is a frequent pathology affecting 1-1.5% of women under 40 years old. Despite advances in diagnosing and treating human infertility, POF is still classified as being idiopathic in 50-80% of cases, strongly suggesting a genetic origin for the disease. Different types of autosomal and X-linked genetic anomalies can originate the phenotype in syndromic and non-syndromic POF cases. Particular interest has been focused on research into non-syndromic POF causative coding variants during the past two decades. This has been based on the assumption that amino acid substitutions might modify the intrinsic physicochemical properties of functional proteins, thereby inducing pathological phenotypes. In this case, a restricted number of mutations might originate the disease. However, like other complex pathologies, POF might result from synergistic/compensatory effects caused by several low-to-mildly drastic mutations which have frequently been classified as non-functional SNPs. Indeed, reproductive phenotypes can be considered as quantitative traits resulting from the subtle interaction of many genes. Although numerous sequencing projects have involved candidate genes, only a few coding mutations explaining a low percentage of cases have been described. Such apparent failure to identify aetiological coding sequence variations might have been due to the inherent molecular complexity of mammalian reproduction and to the difficulty of simultaneously analysing large genomic regions by Sanger sequencing. The purpose of this review is to present the molecular and cellular effects caused by non-synonymous mutations which have been formally associated, by functional tests, with the aetiology of hypergonadotropic non-syndromic POF. Considerations have also been included regarding the polygenic nature of reproduction and POF, as well as future approaches for identifying novel aetiological genes based on next generation sequencing (NGS).
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Affiliation(s)
- Paul Laissue
- Unidad de Genética, Grupo GENIUROS, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia.
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Qin Y, Jiao X, Simpson JL, Chen ZJ. Genetics of primary ovarian insufficiency: new developments and opportunities. Hum Reprod Update 2015; 21:787-808. [PMID: 26243799 PMCID: PMC4594617 DOI: 10.1093/humupd/dmv036] [Citation(s) in RCA: 318] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 07/09/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Primary ovarian insufficiency (POI) is characterized by marked heterogeneity, but with a significant genetic contribution. Identifying exact causative genes has been challenging, with many discoveries not replicated. It is timely to take stock of the field, outlining the progress made, framing the controversies and anticipating future directions in elucidating the genetics of POI. METHODS A search for original articles published up to May 2015 was performed using PubMed and Google Scholar, identifying studies on the genetic etiology of POI. Studies were included if chromosomal analysis, candidate gene screening and a genome-wide study were conducted. Articles identified were restricted to English language full-text papers. RESULTS Chromosomal abnormalities have long been recognized as a frequent cause of POI, with a currently estimated prevalence of 10-13%. Using the traditional karyotype methodology, monosomy X, mosaicism, X chromosome deletions and rearrangements, X-autosome translocations, and isochromosomes have been detected. Based on candidate gene studies, single gene perturbations unequivocally having a deleterious effect in at least one population include Bone morphogenetic protein 15 (BMP15), Progesterone receptor membrane component 1 (PGRMC1), and Fragile X mental retardation 1 (FMR1) premutation on the X chromosome; Growth differentiation factor 9 (GDF9), Folliculogenesis specific bHLH transcription factor (FIGLA), Newborn ovary homeobox gene (NOBOX), Nuclear receptor subfamily 5, group A, member 1 (NR5A1) and Nanos homolog 3 (NANOS3) seem likely as well, but mostly being found in no more than 1-2% of a single population studied. Whole genome approaches have utilized genome-wide association studies (GWAS) to reveal loci not predicted on the basis of a candidate gene, but it remains difficult to locate causative genes and susceptible loci were not always replicated. Cytogenomic methods (array CGH) have identified other regions of interest but studies have not shown consistent results, the resolution of arrays has varied and replication is uncommon. Whole-exome sequencing in non-syndromic POI kindreds has only recently begun, revealing mutations in the Stromal antigen 3 (STAG3), Synaptonemal complex central element 1 (SYCE1), minichromosome maintenance complex component 8 and 9 (MCM8, MCM9) and ATP-dependent DNA helicase homolog (HFM1) genes. Given the slow progress in candidate-gene analysis and relatively small sample sizes available for GWAS, family-based whole exome and whole genome sequencing appear to be the most promising approaches for detecting potential genes responsible for POI. CONCLUSION Taken together, the cytogenetic, cytogenomic (array CGH) and exome sequencing approaches have revealed a genetic causation in ∼20-25% of POI cases. Uncovering the remainder of the causative genes will be facilitated not only by whole genome approaches involving larger cohorts in multiple populations but also incorporating environmental exposures and exploring signaling pathways in intragenic and intergenic regions that point to perturbations in regulatory genes and networks.
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Affiliation(s)
- Yingying Qin
- Center for Reproductive Medicine, Shandong Provincial Hospital, Shandong University, National Research Center for Assisted Reproductive Technology and Reproductive Genetics, The Key Laboratory for Reproductive Endocrinology of Ministry of Education, Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan 250001, China
| | - Xue Jiao
- Center for Reproductive Medicine, Shandong Provincial Hospital, Shandong University, National Research Center for Assisted Reproductive Technology and Reproductive Genetics, The Key Laboratory for Reproductive Endocrinology of Ministry of Education, Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan 250001, China
| | - Joe Leigh Simpson
- Research and Global Programs March of Dimes Foundation, White Plains, NY, USA Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Shandong Provincial Hospital, Shandong University, National Research Center for Assisted Reproductive Technology and Reproductive Genetics, The Key Laboratory for Reproductive Endocrinology of Ministry of Education, Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan 250001, China Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
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Investigation of some genetic variations in BMP15 accompanied with premature ovarian failure (POF) in Syrian women. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2015. [DOI: 10.1016/j.mefs.2014.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Cerra C, Oliver J, Roberts SA, Horne G, Newman WG, Mohiyiddeen L. A single nucleotide polymorphism of bone morphogenic protein-15 is not associated with ovarian reserve or response to ovarian stimulation. Hum Reprod 2014; 29:2832-7. [PMID: 25336710 DOI: 10.1093/humrep/deu264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Is there any effect of the -9C>G variant in the bone morphogenic protein-15 (BMP15) gene on ovarian response and/or current markers of ovarian reserve in patients undergoing in vitro fertilization (IVF) treatment? SUMMARY ANSWER No significant associations of BMP15 genotypes with ovarian response (number of oocytes retrieved) and/or markers of ovarian reserve were detected in our cohort of women undergoing IVF treatment. WHAT IS KNOWN ALREADY There is evidence that genetic variation influences patients' response to ovarian stimulation therapy. BMP15 plays a role in the recruitment of primordial follicles. Therefore, variation in BMP15 could predict ovarian reserve and response to ovarian stimulation. Two previous studies have determined a significant correlation between the BMP15 -9C>G variant and over-response to ovarian stimulation. No studies to date have correlated this variant with ovarian reserve markers. STUDY DESIGN, SIZE, DURATION In this prospective observational study, we genotyped the BMP15 -9C>G single nucleotide polymorphism in 239 unrelated women undergoing their first cycle of controlled ovarian stimulation for IVF and ICSI (intra-cytoplasmic sperm injection) using gonadotrophins at a tertiary referral centre for reproductive medicine between March 2009 and August 2010. PARTICIPANTS/MATERIALS, SETTINGS, METHODS Baseline pelvic ultrasound and blood tests were taken on Days 2-3 of the cycle for assessment of baseline hormones and for DNA extraction. Genotypes were determined using TaqMan allelic discrimination assay. Regression analysis was performed to assess the effect of the BMP15 genotype on the ovarian reserve markers, serum anti-Müllerian hormone (s-AMH), follicle stimulating hormone (s-FSH) and antral follicle count (AFC), with adjustment for age and body mass index (BMI), and on the primary outcomes of response (number of oocytes retrieved and gonadotrophin dose) with adjustment for age, BMI and treatment received. MAIN RESULTS AND THE ROLE OF CHANCE There was no evidence of any statistically significant (P < 0.05) difference in basal s-FSH, s-AMH and AFC between individuals with different BMP15 genotypes. The number of oocytes retrieved and gonadotrophin dose used were also comparable between the individuals with different genotypes. LIMITATIONS, REASONS FOR CAUTION A larger sample size would be required in order to determine if the BMP15 genotype has a small effect on ovarian reserve or response. WIDER IMPLICATIONS OF THE FINDINGS When considering the development of integrative clinical algorithms for individual FSH doses, our analysis suggests that the genotyping of BMP15 -9C>G does not provide additional useful information as a predictor of ovarian reserve or response to ovarian stimulation. STUDY FUNDING/COMPETING INTERESTS The study was funded by the Manchester Biomedical Research Centre. The authors have no competing interests to declare.
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Affiliation(s)
- Christian Cerra
- Department of Reproductive Medicine, St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, UK Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester M13 9WL, UK
| | - Jonathan Oliver
- Department of Reproductive Medicine, St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, UK Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester M13 9WL, UK
| | - Stephen A Roberts
- Centre for Biostatistics, Institute of Population Health, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, Manchester, UK
| | - Gregory Horne
- Clinical Embryology, Department of Reproductive Medicine, St. Mary's Hospital, Manchester, UK
| | - William G Newman
- Manchester Centre for Genomic Medicine, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester M13 9WL, UK Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, UK
| | - Lamiya Mohiyiddeen
- Department of Reproductive Medicine, St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, UK
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Abstract
Ovarian reserve and its utilization, over a reproductive life span, are determined by genetic, epigenetic, and environmental factors. The establishment of the primordial follicle pool and the rate of primordial follicle activation have been under intense study to determine genetic factors that affect reproductive lifespan. Much has been learned from transgenic animal models about the developmental origins of the primordial follicle pool and mechanisms that lead to primordial follicle activation, folliculogenesis, and the maturation of a single oocyte with each menstrual cycle. Recent genome-wide association studies on the age of human menopause have identified approximately 20 loci, and shown the importance of factors involved in double-strand break repair and immunology. Studies to date from animal models and humans show that many genes determine ovarian aging, and that there is no single dominant allele yet responsible for depletion of the ovarian reserve. Personalized genomic approaches will need to take into account the high degree of genetic heterogeneity, family pedigree, and functional data of the genes critical at various stages of ovarian development to predict women's reproductive life span.
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Affiliation(s)
- Michelle A Wood
- Department of Obstetrics, Gynecology, and Reproductive Sciences
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Zhao H, Chen ZJ. Genetic association studies in female reproduction: from candidate-gene approaches to genome-wide mapping. Mol Hum Reprod 2013; 19:644-54. [PMID: 23723134 DOI: 10.1093/molehr/gat040] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Many genetic association studies have been performed to investigate disorders of female reproduction, such as polycystic ovary syndrome, premature ovarian failure and endometriosis. These disorders typically manifest heterogeneously, and their pathogeneses are influenced by polygenic and environmental factors. Researchers evaluating these genetic associations have chosen candidate genes related to hormone action, steroid biosynthesis, inflammatory cytokines and autoimmune factors. Several of these genes have yielded statistically significant associations with female reproductive disorders; however, few associations have been robust and reproducible. Whole-genome association studies generate more reliable and unbiased results and represent a breakthrough in genetic studies of female reproduction. Nevertheless, to date only a very small fraction of the overall heritability has been identified and so further studies are needed.
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Affiliation(s)
- Han Zhao
- Center for Reproductive Medicine, Shandong Provincial Hospital, Shandong University, Shandong, China
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14
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Mutational screening of SF1 and WNT4 in Tunisian women with premature ovarian failure. Gene 2012; 509:298-301. [DOI: 10.1016/j.gene.2012.08.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 07/19/2012] [Accepted: 08/02/2012] [Indexed: 11/21/2022]
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Mohiyiddeen L, Newman WG, McBurney H, Mulugeta B, Roberts SA, Nardo LG. Follicle-stimulating hormone receptor gene polymorphisms are not associated with ovarian reserve markers. Fertil Steril 2012; 97:677-81. [DOI: 10.1016/j.fertnstert.2011.12.040] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Revised: 12/18/2011] [Accepted: 12/21/2011] [Indexed: 11/27/2022]
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Tiotiu D, Alvaro Mercadal B, Imbert R, Verbist J, Demeestere I, De Leener A, Englert Y, Vassart G, Costagliola S, Delbaere A. Variants of the BMP15 gene in a cohort of patients with premature ovarian failure. Hum Reprod 2010; 25:1581-7. [PMID: 20364024 DOI: 10.1093/humrep/deq073] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Bone morphogenetic protein 15 (BMP15) is an oocyte-derived growth factor acting as a major player in follicle differentiation in mammals. Mutations in the BMP15 gene, some of which lead to defective secretion of bioactive dimers, have been associated with premature ovarian failure (POF) in humans. METHODS Fifty patients diagnosed with POF with a normal karyotype were included in the study. After DNA extraction and amplification by PCR, the entire coding sequence and intron-exon junctions of BMP15 gene were analysed in the cohort of POF patients and in a control group of 214 patients. RESULTS Nine variants of the BMP15 gene including six missense substitutions and one insertion of three nucleotides were identified in the POF group. Three of them were previously described as single nucleotide polymorphisms and were also found in the control group. Two variants (H81R and G199R) have not been previously described and were not identified among controls but were not predicted to be deleterious. One variant (A180T) was identified among two POF cases, and also in two controls. One variant (F194S), predicted as potentially deleterious, was identified for the first time in a POF patient but also identified in one control. One variant (L148P), potentially deleterious, previously reported in POF patients, was identified for the first time among controls. The variant 788insTCT, previously identified among POF patients, probably has a low biological impact as it was also found in control patients and is a common polymorphism in sub-Saharan African populations. CONCLUSIONS Various missense variants of the BMP15 gene were identified among patients with POF. For most variants, the impact of the amino-acid substitution on the protein structure and function was predicted to be low. The two variants predicted as potentially deleterious were also identified among controls and could be considered as rare polymorphisms. Although some of these variants could contribute to the development of POF in a complex manner, the demonstration of their role in the pathogenesis of POF requires additional functional studies.
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Affiliation(s)
- D Tiotiu
- Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (IRIBHM), Faculté de Médecine, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
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Lakhal B, Laissue P, Braham R, Elghezal H, Saâd A, Fellous M, Veitia RA. BMP15 and premature ovarian failure: causal mutations, variants, polymorphisms? Clin Endocrinol (Oxf) 2010; 72:425-6. [PMID: 19508678 DOI: 10.1111/j.1365-2265.2009.03651.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Besma Lakhal
- Department of Cytogenetics and Reproductive Biology, Farhat Hached University Teaching Hospital, Sousse, Tunisia
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Veitia RA, Caburet S. Extensive sequence turnover of the signal peptides of members of the GDF/BMP family: exploring their evolutionary landscape. Biol Direct 2009; 4:22. [PMID: 19607682 PMCID: PMC2717928 DOI: 10.1186/1745-6150-4-22] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Accepted: 07/16/2009] [Indexed: 02/06/2023] Open
Abstract
UNLABELLED We show that the predicted signal peptide (SP) sequences of the secreted factors GDF9, BMP15 and AMH are well conserved in mammals but dramatic divergence is noticed for more distant orthologs. Interestingly, bioinformatic predictions show that the divergent protein segments do encode SPs. Thus, such SPs have undergone extensive sequence turnover with full preservation of functionality. This can be explained by a pervasive accumulation of neutral and compensatory mutations. An exploration of the potential evolutionary landscape of some SPs is presented. Some of these signal sequences highlight an apparent paradox: they are encoded, by definition, by orthologous DNA segments but they are, given their striking divergence, examples of what can be called functional convergence. REVIEWERS This article was reviewed by Fyodor Kondrashov and Eugene V. Koonin.
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