Chen Yinwei, Sun Taotao, Niu Yonghua, Wang Daoqi, Liu Kang, Wang Tao, Wang Shaogang, Xu Hao, Liu Jihong
Institute of Urology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Urology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Transl Androl Urol. 2021 Apr;10(4):1676-1687. doi: 10.21037/tau-20-1390.
Idiopathic hypogonadotropic hypogonadism (IHH) is a rare genetic disease attributed to the disorder of hypothalamic-pituitary-gonadal axis. Mutations in the gene are one of the most common genetic causes of IHH. Herein, we aimed to investigate variants in a Chinese cohort with IHH, and to characterize them at the molecular level.
A total of 153 IHH patients were recruited, and variants were detected using a tailored next-generation sequencing panel. rare sequencing variant (RSV) was verified using Sanger sequencing. Phenotypic features and therapeutic outcomes of patients were followed up. In order to examine the pathogenicity of the RSV, we performed conservative analysis, crystal structure prediction, expression analysis as well as the assessment of ERK1/2 activation and IP3/Ca response.
The same heterozygous RSV (p.R240Q) in was identified in four sporadic IHH patients. These patients exhibited different severity of testicular development and hormone profile. hCG treatment was effective in improving gonadal development, serum testosterone, and semen quality. The RSV has no effect on the expression of mRNA and protein, whereas damaged ERK1/2 activation and inositol triphosphate/calcium signaling.
The study expands mutation spectrum in IHH patients, and reveals that the RSV is a partial loss-of-function mutation. Although this heterozygous RSV may not have a significant influence on the pathogenesis of IHH, but its homozygous/ compound status should be paid attention in this research field.
特发性低促性腺激素性性腺功能减退(IHH)是一种罕见的遗传性疾病,归因于下丘脑 - 垂体 - 性腺轴功能紊乱。该基因的突变是IHH最常见的遗传原因之一。在此,我们旨在研究中国IHH队列中的该基因变异,并在分子水平上对其进行表征。
共招募了153例IHH患者,使用定制的二代测序panel检测变异。罕见测序变异(RSV)通过桑格测序进行验证。对患者的表型特征和治疗结果进行随访。为了研究该RSV的致病性,我们进行了保守性分析、晶体结构预测、表达分析以及ERK1/2激活和IP3/Ca反应的评估。
在4例散发性IHH患者中鉴定出相同的杂合RSV(p.R240Q)。这些患者表现出不同程度的睾丸发育和激素水平。人绒毛膜促性腺激素(hCG)治疗有效改善了性腺发育、血清睾酮和精液质量。该RSV对mRNA和蛋白质的表达没有影响,但损害了ERK1/2激活和肌醇三磷酸/钙信号传导。
本研究扩展了IHH患者中的该基因突变谱,并揭示该RSV是一种部分功能丧失突变。虽然这种杂合RSV可能对IHH的发病机制没有显著影响,但在该研究领域应关注其纯合/复合状态。