2021, Number 4
Next >>
Rev Mex Urol 2021; 81 (4)
Cytogenetic and molecular characterization in gonadal tissue of patients with ovotesticular syndrome and gonadal dysgenesis 46,XY and 46,XX
Manotas MC, García-Acero M, González D, Bernal C, Guerra M, Moreno-Niño O, Suárez F, Céspedes C, Forero C, Pérez J, Rojas A
Language: English
References: 50
Page:
PDF size: 848.20 Kb.
ABSTRACT
Objectives: The etiology of gonadal dysgenesis and the ovotesticular syndrome
is unknown in most cases. The aim of the study was to perform cytogenetic and
molecular characterization of a group of patients with ovotesticular syndrome
and complete gonadal dysgenesis from peripheral blood and gonadal tissue
samples.
Materials and methods: A total of 6 patients were included, 3 with 46,XX
ovotesticular syndrome diagnosis, 1 diagnosed with 46,XY ovotesticular syndrome;
1 suspected with 46,XX gonadal dysgenesis, and 1 with 46,XY complete
gonadal dysgenesis.
Results: All patients were evaluated with karyotype, fluorescence in situ hybridization
(FISH) for SRY, multiplex ligation-dependent probe amplification
(MLPA) and comparative genomic hybridization (aCGH) in peripheral blood
samples. In cases with available gonadal tissue, the levels of genetic expression
of SOX3, SRY, and SOX9 were determined by real-time PCR and immunofluorescence.
Rearrangements involving SRY gene were ruled out. No deletions/duplications
or copy-number variations (CNVs) were identified as the etiology for the sexual
development disorder in any of the studied patients. In one case of 46,XX
ovotesticular syndrome, the gonadal karyotype was different from the karyotype
in peripheral blood. Aberrant expression of SOX3 and SOX9 in gonadal
tissue was observed in one case of 46,XX ovotesticular syndrome.
Conclusions: Lower levels of SRY and SOX9 expression were documented in
the gonadal tissue of a case of 46,XY ovotesticular syndrome, in commparison
with the levels in human cellular lines of embryonic testicle and Sertoli cells.
Cytogenetic and molecular studies of gonads complementary to peripheral
blood studies have the potential of enhancing the understanding of sexual development
disorders in patients who are XX or XY in peripheral blood.
REFERENCES
Snell DM, Turner JMA. Sex Chromosome Effects on Male-Female Differences in Mammals. Curr Biol. 2018;28(22):R1313–24. doi: 10.1016/j.cub.2018.09.018
Ngun TC, Ghahramani N, Sánchez FJ, Bocklandt S, Vilain E. The genetics of sex differences in brain and behavior. Front Neuroendocrinol. 2011;32(2):227–46. doi: 10.1016/j.yfrne.2010.10.001
Eggers S, Ohnesorg T, Sinclair A. Genetic regulation of mammalian gonad development. Nat Rev Endocrinol. 2014;10(11):673–83. doi: 10.1038/nrendo.2014.163
García-Acero M, Moreno O, Suárez F, Rojas A. Disorders of Sexual Development: Current Status and Progress in the Diagnostic Approach. CUR. 2019;13(4):169–78. doi: 10.1159/000499274
Li Y, Zheng M, Lau Y-FC. The sexdetermining factors SRY and SOX9 regulate similar target genes and promote testis cord formation during testicular differentiation. Cell Rep. 2014;8(3):723–33. doi: 10.1016/j. celrep.2014.06.055
Knower KC, Kelly S, Ludbrook LM, Bagheri- Fam S, Sim H, Bernard P, et al. Failure of SOX9 regulation in 46XY disorders of sex development with SRY, SOX9 and SF1 mutations. PLoS One. 2011;6(3):e17751. doi: 10.1371/journal. pone.0017751
Kanai Y, Koopman P. Structural and functional characterization of the mouse Sox9 promoter: implications for campomelic dysplasia. Hum Mol Genet. 1999;8(4):691–6. doi: 10.1093/ hmg/8.4.691
Lin L, Achermann JC. Steroidogenic factor-1 (SF-1, Ad4BP, NR5A1) and disorders of testis development. Sex Dev. 2008;2(4–5):200–9. doi: 10.1159/000152036
Klattig J, Sierig R, Kruspe D, Besenbeck B, Englert C. Wilms’ Tumor Protein Wt1 Is an Activator of the Anti-Müllerian Hormone Receptor Gene Amhr2. Mol Cell Biol. 2007;27(12):4355–64. doi: 10.1128/ MCB.01780-06
Wilhelm D, Englert C. The Wilms tumor suppressor WT1 regulates early gonad development by activation of Sf1. Genes Dev. 2002;16(14):1839–51. doi: 10.1101/gad.220102
Park SY, Meeks JJ, Raverot G, Pfaff LE, Weiss J, Hammer GD, et al. Nuclear receptors Sf1 and Dax1 function cooperatively to mediate somatic cell differentiation during testis development. Development. 2005;132(10):2415–23. doi: 10.1242/dev.01826
García-Acero M, Molina M, Moreno O, Ramirez A, Forero C, Céspedes C, et al. Gene dosage of DAX-1, determining in sexual differentiation: duplication of DAX-1 in two sisters with gonadal dysgenesis. Mol Biol Rep. 2019;46(3):2971–8. doi: 10.1007/s11033-019-04758-y
Cederroth CR, Pitetti J-L, Papaioannou MD, Nef S. Genetic programs that regulate testicular and ovarian development. Mol Cell Endocrinol. 2007;265–266:3–9. doi: 10.1016/j. mce.2006.12.029
Lee PA, Houk CP, Ahmed SF, Hughes IA, International Consensus Conference on Intersex organized by the Lawson Wilkins Pediatric Endocrine Society and the European Society for Paediatric Endocrinology. Consensus statement on management of intersex disorders. International Consensus Conference on Intersex. Pediatrics. 2006;118(2):e488-500. doi: 10.1542/peds.2006-0738
Bouty A, Ayers KL, Pask A, Heloury Y, Sinclair AH. The Genetic and Environmental Factors Underlying Hypospadias. Sex Dev. 2015;9(5):239–59. doi: 10.1159/000441988
Kohmanaee S, Dalili S, Rad AH. Pure gonadal dysgenesis (46 XX type) with a familial pattern. Adv Biomed Res. 2015; 4:162. doi: 10.4103/2277-9175.162536
Özdemir M, Kavak RP, Yalcinkaya I, Guresci K. Ovotesticular Disorder of Sex Development: An Unusual Presentation. J Clin Imaging Sci. 2019; 9:34. doi: 10.25259/JCIS_45_2019
Moshiri M, Chapman T, Fechner PY, Dubinsky TJ, Shnorhavorian M, Osman S, et al. Evaluation and management of disorders of sex development: multidisciplinary approach to a complex diagnosis. Radiographics. 2012;32(6):1599–618. doi: 10.1148/ rg.326125507
Hersmus R, de Leeuw BHCGM, Stoop H, Bernard P, van Doorn HC, Brüggenwirth HT, et al. A novel SRY missense mutation affecting nuclear import in a 46,XY female patient with bilateral gonadoblastoma. Eur J Hum Genet. 2009;17(12):1642–9. doi: 10.1038/ejhg.2009.96
Rocha VBC, Guerra-Júnior G, Marques-de- Faria AP, de Mello MP, Maciel-Guerra AT. Complete gonadal dysgenesis in clinical practice: the 46, XY karyotype accounts for more than one third of cases. Fertil Steril. 2011;96(6):1431–4. doi: 10.1016/j.fertnstert.2011.09.009
Mohnach L, Fechner PY, Keegan CE. Nonsyndromic Disorders of Testicular Development. In: Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJ, Mirzaa G, et al., editors. GeneReviews®. Seattle (WA): University of Washington, Seattle; 1993.
Werner R, Merz H, Birnbaum W, Marshall L, Schröder T, Reiz B, et al. 46,XY Gonadal Dysgenesis due to a Homozygous Mutation in Desert Hedgehog (DHH) Identified by Exome Sequencing. J Clin Endocrinol Metab. 2015;100(7):E1022–9. doi: 10.1210/jc.2015- 1314
Granados A, Alaniz VI, Mohnach L, Barseghyan H, Vilain E, Ostrer H, et al. MAP3K1- related gonadal dysgenesis: Six new cases and review of the literature. Am J Med Genet C Semin Med Genet. 2017;175(2):253–9. doi: 10.1002/ajmg.c.31559
Barbaro M, Balsamo A, Anderlid BM, Myhre AG, Gennari M, Nicoletti A, et al. Characterization of deletions at 9p affecting the candidate regions for sex reversal and deletion 9p syndrome by MLPA. Eur J Hum Genet. 2009;17(11):1439–47. doi: 10.1038/ejhg.2009.70
Délot EC, Vilain EJ. Nonsyndromic 46,XX Testicular Disorders of Sex Development. In: Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJ, Mirzaa G, et al., editors. GeneReviews®. Seattle (WA): University of Washington, Seattle; 1993.
Moalem S, Babul-Hirji R, Stavropolous DJ, Wherrett D, Bägli DJ, Thomas P, et al. XX male sex reversal with genital abnormalities associated with a de novo SOX3 gene duplication. American Journal of Medical Genetics Part A. 2012;158A (7):1759–64. doi: 10.1002/ajmg.a.35390
Haines B, Hughes J, Corbett M, Shaw M, Innes J, Patel L, et al. Interchromosomal insertional translocation at Xq26.3 alters SOX3 expression in an individual with XX male sex reversal. J Clin Endocrinol Metab. 2015;100(5):E815-820. doi: 10.1210/jc.2014-4383
Baetens D, Stoop H, Peelman F, Todeschini A-L, Rosseel T, Coppieters F, et al. NR5A1 is a novel disease gene for 46,XX testicular and ovotesticular disorders of sex development. Genet Med. 2017;19(4):367–76. doi: 10.1038/ gim.2016.118
Araujo FC, Milsted A, Watanabe IKM, Del Puerto HL, Santos RAS, Lazar J, et al. Similarities and differences of X and Y chromosome homologous genes, SRY and SOX3, in regulating the renin-angiotensin system promoters. Physiol Genomics. 2015;47(5):177– 86. doi: 10.1152/physiolgenomics.00138.2014
Sutton E, Hughes J, White S, Sekido R, Tan J, Arboleda V, et al. Identification of SOX3 as an XX male sex reversal gene in mice and humans. J Clin Invest. 2011;121(1):328–41. doi: 10.1172/ JCI42580
Swartz JM, Ciarlo R, Guo MH, Abrha A, Weaver B, Diamond DA, et al. A 46,XX Ovotesticular Disorder of Sex Development Likely Caused by a Steroidogenic Factor-1 (NR5A1) Variant. HRP. 2017;87(3):191–5. doi: 10.1159/000452888
Eser M, Ayaz A. Haploinsufficiency of the DMRT Gene Cluster in a Case with 46,XY Ovotesticular Disorder of Sexual Development. Balkan Med J. 2018;35(3):272–4. doi: 10.4274/ balkanmedj.2017.0378
García-Acero M, Moreno-Niño O, Suárez- Obando F, Molina M, Manotas MC, Prieto JC, et al. Disorders of sex development: Genetic characterization of a patient cohort. Molecular Medicine Reports. 2020;21(1):97–106. doi: 10.3892/mmr.2019.10819
Moorhead PS, Nowell PC, Mellman WJ, Battips DM, Hungerford DA. Chromosome preparations of leukocytes cultured from human peripheral blood. Exp Cell Res. 1960;20:613–6. doi: 10.1016/0014-4827(60)90138-5
Tannour-Louet M, Han S, Corbett ST, Louet J-F, Yatsenko S, Meyers L, et al. Identification of De Novo Copy Number Variants Associated with Human Disorders of Sexual Development. PLOS ONE. 2010;5(10):e15392. doi: 10.1371/ journal.pone.0015392
Vidal VP, Chaboissier MC, de Rooij DG, Schedl A. Sox9 induces testis development in XX transgenic mice. Nat Genet. 2001;28(3):216–7. doi: 10.1038/90046
Hou J, Shi X, Chen C, Islam MS, Johnson AF, Kanno T, et al. Global impacts of chromosomal imbalance on gene expression in Arabidopsis and other taxa. PNAS. 2018;115(48):E11321– 30. doi: 10.1073/pnas.1807796115
Kamel AK, Abd El-Ghany HM, Mekkawy MK, Makhlouf MM, Mazen IM, El Dessouky N, et al. Sex Chromosome Mosaicism in the Gonads of DSD Patients: A Karyotype/Phenotype Correlation. Sex Dev. 2015;9(5):279–88. doi: 10.1159/000442332
McClelland K, Bowles J, Koopman P. Male sex determination: insights into molecular mechanisms. Asian J Androl. 2012;14(1):164– 71. doi: 10.1038/aja.2011.169
Barsoum I, Yao HHC. Redundant and differential roles of transcription factors Gli1 and Gli2 in the development of mouse fetal Leydig cells. Biol Reprod. 2011;84(5):894–9. doi: 10.1095/biolreprod.110.088997
Varjosalo M, Taipale J. Hedgehog: functions and mechanisms. Genes Dev. 2008 Sep 15;22(18):2454–72. doi: 10.1101/gad.1693608
Giroux-Leprieur E, Costantini A, Ding VW, He B. Hedgehog Signaling in Lung Cancer: From Oncogenesis to Cancer Treatment Resistance. Int J Mol Sci. 2018;19(9):2835. doi: 10.3390/ ijms19092835
Breehl L, Caban O. Genetics, Gonadal Dysgenesis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2020.
Kojima Y, Hayashi Y, Mizuno K, Sasaki S, Fukui Y, Koopman P, et al. Up-regulation of SOX9 in human sex-determining region on the Y chromosome (SRY)-negative XX males. Clin Endocrinol (Oxf). 2008;68(5):791–9. doi: 10.1111/j.1365-2265.2007.03101.x
Eggers S, Sinclair A. Mammalian sex determination—insights from humans and mice. Chromosome Res. 2012;20(1):215–38. doi: 10.1007/s10577-012-9274-3
Tanaka SS, Nishinakamura R. Regulation of male sex determination: genital ridge formation and Sry activation in mice. Cell Mol Life Sci. 2014;71(24):4781–802. doi: 10.1007/s00018- 014-1703-3
Délot E, Vilain E. Disorders of Sex Development. In: Reproductive Endocrinology: Physiology, Pathophysiology, and Clinical Management: Elsevier; 2018.
Lau Y-FC, Li Y, Kido T. Gonadoblastoma locus and the TSPY gene on the human Y chromosome. Birth Defects Res C Embryo Today. 2009;87(1):114–22. doi: 10.1002/ bdrc.20144
Kido T, Lau Y-FC. Roles of the Y chromosome genes in human cancers. Asian J Androl. 2015;17(3):373–80. doi: 10.4103/1008- 682X.150842
Wang H, Zhang L, Wang N, Zhu H, Han B, Sun F, et al. Next-generation sequencing reveals genetic landscape in 46, XY disorders of sexual development patients with variable phenotypes. Hum Genet. 2018;137(3):265–77. doi: 10.1007/ s00439-018-1879-y