Department of Endocrinology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
Mol Genet Genomic Med. 2020 Sep;8(9):e1396. doi: 10.1002/mgg3.1396. Epub 2020 Jul 11.
Minichromosome maintenance complex component 8 (MCM8) is responsible for homologous recombination and DNA double-strand breaks (DSBs) repair and is the cause of primary ovarian insufficiency (POI), which is seldom diagnosed in adolescents and children.
Whole-exome sequencing was performed in a 13-year-old girl, and Sanger sequencing was used to identify potentially pathogenic variants in her sister (aged 6 years and 7 months) and parents. To identify potential pathogenic mutations, DSBs were induced by mitomycin C (MMC), and the DNA repair capacity was evaluated by the histone H2AX phosphorylation level.
Two novel mutations of MCM8, i.e., c.724T>C (p.C242R) and c.1334C>A (p.S445*), were identified in a 13-year-old girl with POI who exhibited disappeared bilateral ovaries and short stature (height standard difference score [HtSDS] = -3.05), and her sister (aged 6 years and 7 months) with progressive POI whose ovary size decreased from normal to unclear and height growth gradually slowed. In the functional experiments, compared with the wild-type, HeLa cells overexpressing mutant p.C242R and p.S445* showed a higher sensitivity to MMC. Furthermore, the mutant p.S445* has a more deleterious effect on DNA damage repair.
Our results reveal that affected children with the novel pathogenetic mutations p.C242R and p.S445* in the MCM8 gene are characterized by POI, short stature, cancer susceptibility, and genomic instability.
微小染色体维持复合物成分 8(MCM8)负责同源重组和 DNA 双链断裂(DSBs)修复,是原发性卵巢功能不全(POI)的病因,这种病症在青少年和儿童中很少被诊断。
对一名 13 岁女孩进行全外显子组测序,并用 Sanger 测序对其 6 岁 7 个月大的妹妹和父母的潜在致病性变异进行鉴定。为了鉴定潜在的致病突变,用丝裂霉素 C(MMC)诱导 DSBs,并通过组蛋白 H2AX 磷酸化水平评估 DNA 修复能力。
在一名患有 POI 的 13 岁女孩中发现了 MCM8 的两个新突变,即 c.724T>C(p.C242R)和 c.1334C>A(p.S445*),该女孩表现为双侧卵巢消失和身材矮小(身高标准差评分 [HtSDS] = -3.05),其 6 岁 7 个月大的妹妹也患有进行性 POI,其卵巢大小从正常变为不清楚,身高增长逐渐缓慢。在功能实验中,与野生型相比,过表达突变 p.C242R 和 p.S445的 HeLa 细胞对 MMC 更敏感。此外,突变 p.S445对 DNA 损伤修复的影响更具破坏性。
我们的研究结果表明,携带 MCM8 基因新致病突变 p.C242R 和 p.S445*的受影响儿童表现为 POI、身材矮小、癌症易感性和基因组不稳定性。