Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
JCI Insight. 2020 Jun 4;5(11):133434. doi: 10.1172/jci.insight.133434.
The initiation of puberty is driven by an upsurge in hypothalamic gonadotropin-releasing hormone (GnRH) secretion. In turn, GnRH secretion upsurge depends on the development of a complex GnRH neuroendocrine network during embryonic life. Although delayed puberty (DP) affects up to 2% of the population, is highly heritable, and is associated with adverse health outcomes, the genes underlying DP remain largely unknown. We aimed to discover regulators by whole-exome sequencing of 160 individuals of 67 multigenerational families in our large, accurately phenotyped DP cohort. LGR4 was the only gene remaining after analysis that was significantly enriched for potentially pathogenic, rare variants in 6 probands. Expression analysis identified specific Lgr4 expression at the site of GnRH neuron development. LGR4 mutant proteins showed impaired Wnt/β-catenin signaling, owing to defective protein expression, trafficking, and degradation. Mice deficient in Lgr4 had significantly delayed onset of puberty and fewer GnRH neurons compared with WT, whereas lgr4 knockdown in zebrafish embryos prevented formation and migration of GnRH neurons. Further, genetic lineage tracing showed strong Lgr4-mediated Wnt/β-catenin signaling pathway activation during GnRH neuron development. In conclusion, our results show that LGR4 deficiency impairs Wnt/β-catenin signaling with observed defects in GnRH neuron development, resulting in a DP phenotype.
青春期的启动是由下丘脑促性腺激素释放激素(GnRH)分泌的激增驱动的。反过来,GnRH 分泌的激增取决于胚胎期 GnRH 神经内分泌网络的发育。尽管迟发性青春期(DP)影响了多达 2%的人群,具有高度遗传性,并与不良健康结果相关,但 DP 的潜在基因仍然知之甚少。我们旨在通过对我们大型、准确表型 DP 队列中的 160 名 67 个多代家族个体进行全外显子组测序来发现调节因子。在对 6 名先证者进行分析后,只有 LGR4 基因仍然存在,其潜在致病性的稀有变异明显富集。表达分析确定了 GnRH 神经元发育部位的特定 Lgr4 表达。由于蛋白表达、运输和降解缺陷,LGR4 突变蛋白显示出 Wnt/β-catenin 信号受损。与 WT 相比,Lgr4 缺失的小鼠青春期起始明显延迟,GnRH 神经元数量减少,而斑马鱼胚胎中 lgr4 的敲低阻止了 GnRH 神经元的形成和迁移。此外,遗传谱系追踪显示,在 GnRH 神经元发育过程中,Lgr4 介导的 Wnt/β-catenin 信号通路被强烈激活。总之,我们的研究结果表明,LGR4 缺乏会损害 Wnt/β-catenin 信号通路,导致 GnRH 神经元发育缺陷,从而出现 DP 表型。