Department of Obstetrics/Gynecology, Joint Laboratory of Reproductive Medicine (SCU-CUHK), Key Laboratory of Obstetric, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
Reproduction Medical Center of West China Second University Hospital, Key Laboratory of Obstetric, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, China.
Reprod Biomed Online. 2021 Sep;43(3):532-541. doi: 10.1016/j.rbmo.2021.05.009. Epub 2021 May 21.
Asthenoteratospermia is characterized by malformed spermatozoa with motility defects, which results in male infertility. Multiple morphological abnormalities of the sperm flagella (MMAF) is a hallmark of asthenoteratospermia. The genetic causes of MMAF, however, are unknown in about one-third of cases. Which other MMAF-associated genes are waiting to be discovered?
Whole-exome sequencing was conducted to identify causative genes in a man with MMAF. Immunofluorescence staining and western blot were applied to assess the pathogenicity of the identified variant. Intracytoplasmic sperm injection (ICSI) was used to assist fertilization for the patient with MMAF.
Sanger sequencing of the family demonstrated that the infertile man carried a homozygous DNAH17 variant (c. 4810C>T [p.R1604C]). The obviously decreased DNAH17 expression was observed in HEK293T cells transfected with MUT-DNAH17 plasmid compared with cells with WT-DNAH17 plasmid. Immunofluorescence analysis showed that this mutation induced significant decrease in DNAH17 expression, which negatively affected the DNAH8 expression in the patient's spermatozoa. Moreover, the outcome of ICSI in the patient was unsuccessful.
Our study revealed a novel homozygous missense mutation in DNAH17 involved in MMAF phenotype. The finding of the novel mutation in DNAH17 enriches the gene variant spectrum of MMAF, further contributing to diagnosis, genetic counselling and prognosis for male infertility.
弱精子症的特征是精子形态畸形伴有运动缺陷,导致男性不育。精子鞭毛多发形态异常(MMAF)是弱精子症的一个标志。然而,大约三分之一的病例中,MMAF 的遗传原因尚不清楚。还有哪些与 MMAF 相关的基因有待发现?
对一名患有 MMAF 的男性进行全外显子组测序,以确定致病基因。应用免疫荧光染色和 Western blot 评估鉴定出的变异的致病性。采用卵胞浆内单精子注射(ICSI)辅助 MMAF 患者受精。
对家系的 Sanger 测序显示,这名不育男性携带 DNAH17 纯合变异(c.4810C>T [p.R1604C])。与 WT-DNAH17 质粒转染的 HEK293T 细胞相比,MUT-DNAH17 质粒转染的细胞中 DNAH17 表达明显降低。免疫荧光分析表明,该突变导致 DNAH17 表达显著下降,进而影响患者精子中的 DNAH8 表达。此外,该患者的 ICSI 结局不成功。
我们的研究揭示了一种新型的 DNAH17 纯合错义突变与 MMAF 表型有关。该发现丰富了 MMAF 的基因变异谱,进一步有助于男性不育症的诊断、遗传咨询和预后。