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Herlin MK. Genetics of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: advancements and implications. Front Endocrinol (Lausanne) 2024; 15:1368990. [PMID: 38699388 PMCID: PMC11063329 DOI: 10.3389/fendo.2024.1368990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital anomaly characterized by agenesis/aplasia of the uterus and upper part of the vagina in females with normal external genitalia and a normal female karyotype (46,XX). Patients typically present during adolescence with complaints of primary amenorrhea where the diagnosis is established with significant implications including absolute infertility. Most often cases appear isolated with no family history of MRKH syndrome or related anomalies. However, cumulative reports of familial recurrence suggest genetic factors to be involved. Early candidate gene studies had limited success in their search for genetic causes of MRKH syndrome. More recently, genomic investigations using chromosomal microarray and genome-wide sequencing have been successful in detecting promising genetic variants associated with MRKH syndrome, including 17q12 (LHX1, HNF1B) and 16p11.2 (TBX6) deletions and sequence variations in GREB1L and PAX8, pointing towards a heterogeneous etiology with various genes involved. With uterus transplantation as an emerging fertility treatment in MRKH syndrome and increasing evidence for genetic etiologies, the need for genetic counseling concerning the recurrence risk in offspring will likely increase. This review presents the advancements in MRKH syndrome genetics from early familial occurrences and candidate gene searches to current genomic studies. Moreover, the review provides suggestions for future genetic investigations and discusses potential implications for clinical practice.
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Affiliation(s)
- Morten Krogh Herlin
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus N, Denmark
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2
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Dube R, Kar SS, Jhancy M, George BT. Molecular Basis of Müllerian Agenesis Causing Congenital Uterine Factor Infertility-A Systematic Review. Int J Mol Sci 2023; 25:120. [PMID: 38203291 PMCID: PMC10778982 DOI: 10.3390/ijms25010120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Infertility affects around 1 in 5 couples in the world. Congenital absence of the uterus results in absolute infertility in females. Müllerian agenesis is the nondevelopment of the uterus. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a condition of uterovaginal agenesis in the presence of normal ovaries and the 46 XX Karyotype. With advancements in reproductive techniques, women with MA having biological offspring is possible. The exact etiology of MA is unknown, although several genes and mechanisms affect the development of Müllerian ducts. Through this systematic review of the available literature, we searched for the genetic basis of MA. The aims included identification of the genes, chromosomal locations, changes responsible for MA, and fertility options, in order to offer proper management and counseling to these women with MA. A total of 85 studies were identified through searches. Most of the studies identified multiple genes at various locations, although the commonest involved chromosomes 1, 17, and 22. There is also conflicting evidence of the involvement of various candidate genes in the studies. The etiology of MA seems to be multifactorial and complex, involving multiple genes and mechanisms including various mutations and mosaicism.
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Affiliation(s)
- Rajani Dube
- Department of Obstetrics and Gynaecology, RAK College of Medical Sciences, RAK Medical & Health Sciences University, Ras al Khaimah P.O. Box 11172, United Arab Emirates
| | - Subhranshu Sekhar Kar
- Department of Paediatrics and Neonatology, RAK College of Medical Sciences, RAK Medical & Health Sciences University, Ras al Khaimah P.O. Box 11172, United Arab Emirates; (S.S.K.); (M.J.)
| | - Malay Jhancy
- Department of Paediatrics and Neonatology, RAK College of Medical Sciences, RAK Medical & Health Sciences University, Ras al Khaimah P.O. Box 11172, United Arab Emirates; (S.S.K.); (M.J.)
| | - Biji Thomas George
- Department of General Surgery, RAK College of Medical Sciences, RAK Medical & Health Sciences University, Ras al Khaimah P.O. Box 11172, United Arab Emirates;
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Ragitha TS, Sunish KS, Gilvaz S, Daniel S, Varghese PR, Raj S, Francis J, Suresh Kumar R. Mutation analysis of WNT4 gene in SRY negative 46,XX DSD patients with Mullerian agenesis and/or gonadal dysgenesis- An Indian study. Gene 2023; 861:147236. [PMID: 36738897 DOI: 10.1016/j.gene.2023.147236] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/17/2022] [Accepted: 01/26/2023] [Indexed: 02/05/2023]
Abstract
Developmental disruption of the Mullerian duct and gonads in females leads to Mullerian agenesis and gonadal dysgenesis, respectively. These two structural abnormalities are coming under the 46,XX DSD (Disorders of Sexual Development) classification, the majority of cases the aetiology remains elusive. Without the SRY gene, WNT4 plays a key role in female reproductive structure development. Since there are no studies that explored the involvement of the WNT4 gene in Indian 46,XX DSD patients, we analysed the role of WNT4 in Indian 46,XX DSD patients with Mullerian agenesis and/or Gonadal dysgenesis. In our study, we recruited 103 adolescent girls with primary amenorrhea. After the cytogenetic and SRY gene analysis, we included thirty-two 46,XX DSD patients with Mullerian agenesis and/or gonadal dysgenesis for WNT4 gene mutation analysis. PCR sequencing was performed for all the coding exons of the WNT4 gene. Bioinformatic tools like Mutation Taster, Human Splicing Finder, and miRDB were used. We observed single nucleotide variations in three patients. One patient showed a known synonymous polymorphism (c.861C > T; p.G287G, rs544988174). miRDB data revealed the absence of microRNA regulatory sites in this region. The other two cases carried a nucleotide substitution in intronic regions and did not affect the normal splicing mechanism. In conclusion, we could not find any indication about WNT4 involvement in the disease condition. In the future, WNT4 promoter analysis in these patients and molecular characterization of the WNT4 coding and promoter region in more patients are needed to link WNT4 variants with these structural abnormalities.
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Affiliation(s)
- T S Ragitha
- Maharaja's College (Government- Autonomous), Ernakulam, Kerala, India; Jubilee Centre for Medical Research, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
| | - K S Sunish
- Maharaja's College (Government- Autonomous), Ernakulam, Kerala, India
| | - Sareena Gilvaz
- Department of Obstetrics and Gynaecology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
| | - Saley Daniel
- Department of Obstetrics and Gynaecology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
| | - P R Varghese
- Jubilee Centre for Medical Research, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
| | - Soumya Raj
- Jubilee Centre for Medical Research, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
| | - Jijo Francis
- Jubilee Centre for Medical Research, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
| | - R Suresh Kumar
- Jubilee Centre for Medical Research, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.
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Identification of Genetic Causes in Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome: A Systematic Review of the Literature. CHILDREN 2022; 9:children9070961. [PMID: 35883945 PMCID: PMC9322756 DOI: 10.3390/children9070961] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 06/19/2022] [Accepted: 06/22/2022] [Indexed: 01/17/2023]
Abstract
Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital condition characterizing females with absence of the uterus and part of the vagina. Several genetic defects have been correlated with the presence of MRKH; however, the exact etiology is still unknown due to the complexity of the genetic pathways implicated during the embryogenetic development of the Müllerian ducts. A systematic review (SR) of the literature was conducted to investigate the genetic causes associated with MRKH syndrome and Congenital Uterine Anomalies (CUAs). This study aimed to identify the most affected chromosomal areas and genes along with their associated clinical features in order to aid clinicians in distinguishing and identifying the possible genetic cause in each patient offering better genetic counseling. We identified 76 studies describing multiple genetic defects potentially contributing to the pathogenetic mechanism of MRKH syndrome. The most reported chromosomal regions and the possible genes implicated were: 1q21.1 (RBM8A gene), 1p31-1p35 (WNT4 gene), 7p15.3 (HOXA gene), 16p11 (TBX6 gene), 17q12 (LHX1 and HNF1B genes), 22q11.21, and Xp22. Although the etiology of MRKH syndrome is complex, associated clinical features can aid in the identification of a specific genetic defect.
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Santana González L, Artibani M, Ahmed AA. Studying Müllerian duct anomalies - from cataloguing phenotypes to discovering causation. Dis Model Mech 2021; 14:269240. [PMID: 34160006 PMCID: PMC8246269 DOI: 10.1242/dmm.047977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Müllerian duct anomalies (MDAs) are developmental disorders of the Müllerian duct, the embryonic anlage of most of the female reproductive tract. The prevalence of MDAs is 6.7% in the general female population and 16.7% in women who exhibit recurrent miscarriages. Individuals affected by these anomalies suffer from high rates of infertility, first-trimester pregnancy losses, premature labour, placental retention, foetal growth retardation and foetal malpresentations. The aetiology of MDAs is complex and heterogeneous, displaying a range of clinical pictures that generally lack a direct genotype-phenotype correlation. De novo and familial cases sharing the same genomic lesions have been reported. The familial cases follow an autosomal-dominant inheritance, with reduced penetrance and variable expressivity. Furthermore, few genetic factors and molecular pathways underpinning Müllerian development and dysregulations causing MDAs have been identified. The current knowledge in this field predominantly derives from loss-of-function experiments in mouse and chicken models, as well as from human genetic association studies using traditional approaches, such as microarrays and Sanger sequencing, limiting the discovery of causal factors to few genetic entities from the coding genome. In this Review, we summarise the current state of the field, discuss limitations in the number of studies and patient samples that have stalled progress, and review how the development of new technologies provides a unique opportunity to overcome these limitations. Furthermore, we discuss how these new technologies can improve functional validation of potential causative alterations in MDAs. Summary: Here, we review the current knowledge about Müllerian duct anomalies in the context of new high-throughput technologies and model systems and their implications in the prevention of these disorders.
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Affiliation(s)
- Laura Santana González
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX3 9DS, UK.,Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford OX3 9DU, UK
| | - Mara Artibani
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX3 9DS, UK.,Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford OX3 9DU, UK.,Gene Regulatory Networks in Development and Disease Laboratory, MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DS, UK
| | - Ahmed Ashour Ahmed
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford OX3 9DS, UK.,Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford OX3 9DU, UK
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Zhu Y, Wang R, Cheng Y, Han Y, Li T, Cao Y, Wang B. Analysis of copy number variations of WNT4 gene in a Chinese population with Müllerian anomalies. Orphanet J Rare Dis 2021; 16:258. [PMID: 34099025 PMCID: PMC8183036 DOI: 10.1186/s13023-021-01888-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 05/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To investigate the genetic contribution of copy number variations (CNVs) in Wingless-type MMTV integration site family, member 4 (WNT4), in a Chinese population with Müllerian anomalies (MA), copy number analysis of WNT4 by Multiplex ligation-dependent probe amplification (MLPA) was performed on 248 female patients. Some studies have shown that heterozygous missense mutation of WNT4 can lead to MA. However, few studies on the relationship between WNT4 CNVs and MA have been performed. RESULTS Among the 248 Chinese women affected by MA in this study, heterozygous deletion of WNT4 was detected in a single patient. CONCLUSIONS MLPA identified one heterozygous deletion in WNT4 in a single female patient among 248 Chinese women affected by MA. This study firstly reports CNVs of WNT4 in a large sample of MA patients from the Chinese population, which suggests that CNVs of WNT4 cannot be excluded in the occurrence of MA. This provides a genetic basis for precise treatment in the future.
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Affiliation(s)
- Ying Zhu
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan, Hefei, 230022, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, Biopreservation and Artificial Organs, Hefei, China.,Anhui Provincial Engineering Research Center, Anhui Medical University, Hefei, People's Republic of China
| | - Ruyi Wang
- Graduate School of Peking Union Medical College, Beijing, China.,Center for Genetics, National Research Institute for Family Planning, 12 Dahuisi Road, Haidian, Beijing, 100081, China
| | - Yun Cheng
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan, Hefei, 230022, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, Biopreservation and Artificial Organs, Hefei, China.,Anhui Provincial Engineering Research Center, Anhui Medical University, Hefei, People's Republic of China
| | - Yang Han
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan, Hefei, 230022, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, Biopreservation and Artificial Organs, Hefei, China.,Anhui Provincial Engineering Research Center, Anhui Medical University, Hefei, People's Republic of China
| | - Tengyan Li
- Center for Genetics, National Research Institute for Family Planning, 12 Dahuisi Road, Haidian, Beijing, 100081, China
| | - Yunxia Cao
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan, Hefei, 230022, China. .,Anhui Province Key Laboratory of Reproductive Health and Genetics, Biopreservation and Artificial Organs, Hefei, China. .,Anhui Provincial Engineering Research Center, Anhui Medical University, Hefei, People's Republic of China.
| | - Binbin Wang
- Graduate School of Peking Union Medical College, Beijing, China. .,Center for Genetics, National Research Institute for Family Planning, 12 Dahuisi Road, Haidian, Beijing, 100081, China.
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Santana Gonzalez L, Rota IA, Artibani M, Morotti M, Hu Z, Wietek N, Alsaadi A, Albukhari A, Sauka-Spengler T, Ahmed AA. Mechanistic Drivers of Müllerian Duct Development and Differentiation Into the Oviduct. Front Cell Dev Biol 2021; 9:605301. [PMID: 33763415 PMCID: PMC7982813 DOI: 10.3389/fcell.2021.605301] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/28/2021] [Indexed: 12/15/2022] Open
Abstract
The conduits of life; the animal oviducts and human fallopian tubes are of paramount importance for reproduction in amniotes. They connect the ovary with the uterus and are essential for fertility. They provide the appropriate environment for gamete maintenance, fertilization and preimplantation embryonic development. However, serious pathologies, such as ectopic pregnancy, malignancy and severe infections, occur in the oviducts. They can have drastic effects on fertility, and some are life-threatening. Despite the crucial importance of the oviducts in life, relatively little is known about the molecular drivers underpinning the embryonic development of their precursor structures, the Müllerian ducts, and their successive differentiation and maturation. The Müllerian ducts are simple rudimentary tubes comprised of an epithelial lumen surrounded by a mesenchymal layer. They differentiate into most of the adult female reproductive tract (FRT). The earliest sign of Müllerian duct formation is the thickening of the anterior mesonephric coelomic epithelium to form a placode of two distinct progenitor cells. It is proposed that one subset of progenitor cells undergoes partial epithelial-mesenchymal transition (pEMT), differentiating into immature Müllerian luminal cells, and another subset undergoes complete EMT to become Müllerian mesenchymal cells. These cells invaginate and proliferate forming the Müllerian ducts. Subsequently, pEMT would be reversed to generate differentiated epithelial cells lining the fully formed Müllerian lumen. The anterior Müllerian epithelial cells further specialize into the oviduct epithelial subtypes. This review highlights the key established molecular and genetic determinants of the processes involved in Müllerian duct development and the differentiation of its upper segment into oviducts. Furthermore, an extensive genome-wide survey of mouse knockout lines displaying Müllerian or oviduct phenotypes was undertaken. In addition to widely established genetic determinants of Müllerian duct development, our search has identified surprising associations between loss-of-function of several genes and high-penetrance abnormalities in the Müllerian duct and/or oviducts. Remarkably, these associations have not been investigated in any detail. Finally, we discuss future directions for research on Müllerian duct development and oviducts.
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Affiliation(s)
- Laura Santana Gonzalez
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom.,Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Ioanna A Rota
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom.,Developmental Immunology Research Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Mara Artibani
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom.,Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom.,Gene Regulatory Networks in Development and Disease Laboratory, MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Matteo Morotti
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom.,Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Zhiyuan Hu
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom.,Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Nina Wietek
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom.,Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Abdulkhaliq Alsaadi
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom.,Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Ashwag Albukhari
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Tatjana Sauka-Spengler
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom.,Gene Regulatory Networks in Development and Disease Laboratory, MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Ahmed A Ahmed
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom.,Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom
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Ledig S, Tewes A, Hucke J, Römer T, Kapczuk K, Schippert C, Hillemanns P, Wieacker P. Array-comparative genomic hybridization analysis in patients with Müllerian fusion anomalies. Clin Genet 2018; 93:640-646. [DOI: 10.1111/cge.13160] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 10/19/2017] [Accepted: 10/20/2017] [Indexed: 12/18/2022]
Affiliation(s)
- S. Ledig
- Institute of Human Genetics; Westfälische Wilhelms-Universität Münster (WWU); Münster Germany
| | - A.C. Tewes
- Institute of Human Genetics; Westfälische Wilhelms-Universität Münster (WWU); Münster Germany
| | - J. Hucke
- Department of Obstetrics and Gynecology; Agaplesion Bethesda Krankenhaus; Wuppertal Germany
| | - T. Römer
- Department of Obstetrics and Gynecology; Evangelisches Krankenhaus Köln-Weyertal; Köln-Weyertal Germany
| | - K. Kapczuk
- Division of Gynecology; Poznan University of Medical Sciences; Poznan Poland
| | - C. Schippert
- Department of Obstetrics and Gynecology; Medical School Hannover; Hannover Germany
| | - P. Hillemanns
- Department of Obstetrics and Gynecology; Medical School Hannover; Hannover Germany
| | - P. Wieacker
- Institute of Human Genetics; Westfälische Wilhelms-Universität Münster (WWU); Münster Germany
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Fontana L, Gentilin B, Fedele L, Gervasini C, Miozzo M. Genetics of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Clin Genet 2016; 91:233-246. [PMID: 27716927 DOI: 10.1111/cge.12883] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 09/21/2016] [Accepted: 09/22/2016] [Indexed: 12/16/2022]
Abstract
Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, also referred to as Müllerian agenesis, is the second most common cause of primary amenorrhea. It is characterized by congenital absence of the uterus, cervix, and the upper part of the vagina in otherwise phenotypically normal 46,XX females. MRKH syndrome has an incidence of about 1 in 4,500-5,000 newborn females and it is generally divided into two subtypes: MRKH type 1, in which only the upper vagina, cervix and the uterus are affected, and MRKH type 2, which is associated with additional malformations generally affecting the renal and skeletal systems, and also includes MURCS (MÜllerian Renal Cervical Somite) characterized by cervico-thoracic defects. MRKH syndrome is mainly sporadic; however, familial cases have been described indicating that, at least in a subset of patients, MRKH may be an inherited disorder. The syndrome appears to demonstrate an autosomal dominant inheritance pattern, with incomplete penetrance and variable expressivity. The etiology of MRKH syndrome is still largely unknown, probably because of its intrinsic heterogeneity. Several candidate causative genes have been investigated, but to date only WNT4 has been associated with MRKH with hyperandrogenism. This review summarizes and discusses the clinical features and details progress to date in understanding the genetics of MRKH syndrome.
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Affiliation(s)
- L Fontana
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milano, Italy
| | - B Gentilin
- Medical Genetics Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - L Fedele
- Department of Obstetrics and Gynecology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milano, Italy
| | - C Gervasini
- Medical Genetics, Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
| | - M Miozzo
- Department of Pathophysiology & Transplantation, Università degli Studi di Milano, Milano, Italy.,Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
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Jacquinet A, Millar D, Lehman A. Etiologies of uterine malformations. Am J Med Genet A 2016; 170:2141-72. [PMID: 27273803 DOI: 10.1002/ajmg.a.37775] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 03/10/2016] [Indexed: 12/11/2022]
Abstract
Ranging from aplastic uterus (including Mayer-Rokitansky-Kuster-Hauser syndrome) to incomplete septate uterus, uterine malformations as a group are relatively frequent in the general population. Specific causes remain largely unknown. Although most occurrences ostensibly seem sporadic, familial recurrences have been observed, which strongly implicate genetic factors. Through the study of animal models, human syndromes, and structural chromosomal variation, several candidate genes have been proposed and subsequently tested with targeted methods in series of individuals with isolated, non-isolated, or syndromic uterine malformations. To date, a few genes have garnered strong evidence of causality, mainly in syndromic presentations (HNF1B, WNT4, WNT7A, HOXA13). Sequencing of candidate genes in series of individuals with isolated uterine abnormalities has been able to suggest an association for several genes, but confirmation of a strong causative effect is still lacking for the majority of them. We review the current state of knowledge about the developmental origins of uterine malformations, with a focus on the genetic variants that have been implicated or associated with these conditions in humans, and we discuss potential reasons for the high rate of negative results. The evidence for various environmental and epigenetic factors is also reviewed. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Adeline Jacquinet
- Department of Medical Genetics, University of British Columbia, Vancouver, Canada.,Center for Human Genetics, Centre Hospitalier Universitaire and University of Liège, Liège, Belgium
| | - Debra Millar
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| | - Anna Lehman
- Department of Medical Genetics, University of British Columbia, Vancouver, Canada.,Child and Family Research Institute, Vancouver, Canada
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11
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Ma W, Li Y, Wang M, Li H, Su T, Li Y, Wang S. Associations of Polymorphisms in WNT9B and PBX1 with Mayer-Rokitansky-Küster-Hauser Syndrome in Chinese Han. PLoS One 2015; 10:e0130202. [PMID: 26075712 PMCID: PMC4468103 DOI: 10.1371/journal.pone.0130202] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 05/16/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a rare syndrome that is characterized by congenital aplasia of the uterus and the upper portion (2/3) of the vagina. Previous attempts to identify causal mutations of MRKH syndrome have primarily resulted in negative outcomes. We investigated whether these reported variants are associated with MRKH syndrome (types I and II) in a relatively large sample size of Chinese Han patients, and whether any gene-gene epistatic interactions exist among these variants. METHODS This study included 182 unrelated Chinese women with MRKH syndrome (155 with type I and 27 with type II) and 228 randomized female controls. Seventeen candidate loci in the AMH, PBX1, WNT4, WNT7A, WNT9B, HOXA10, HOXA11, LHXA1 and GALT genes were genotyped using the Sequenom MassARRAY iPLEX platform. Single-marker association, additive effects and multifactor interactions were investigated. RESULTS The gene frequency distributions of MRKH type 1 and type 2 were similar. Rs34072914 in WNT9B was found to be associated with MRKH syndrome (P = 0.024, OR = 2.65, 95%CI = 1.14-6.17). The dominant models of rs34072914 and rs2275558 in WNT9B and PBX1, respectively, were significantly associated with MRKH syndrome risk in the Chinese Han patients. Additive gene-gene interaction analyses indicated a significant synergetic interaction between WNT9B and PBX1 (RERI = 1.397, AP = 0.493, SI = 4.204). Multifactor dimensionality reduction (MDR) analysis revealed novel dimensional epistatic four-gene effects (AMH, PBX1, WNT7A and WNT9B) in MRKH syndrome. CONCLUSIONS This association study successfully identified two susceptibility SNPs (WNT9B and PBX1) associated with MRKH syndrome risk, both separately and interactively. The discovery of a four-gene epistatic effect (AMH, PBX1, WNT7A and WNT9B) in MRKH syndrome provides novel information for the elucidation of the genetic mechanism underlying the etiology of MRKH syndrome.
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Affiliation(s)
- Wenqing Ma
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Ya Li
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Man Wang
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Haixia Li
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Tiefen Su
- Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Yan Li
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Shixuan Wang
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
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Nonsense mutation of EMX2 is potential causative for uterus didelphysis: first molecular explanation for isolated incomplete müllerian fusion. Fertil Steril 2015; 103:769-74.e2. [DOI: 10.1016/j.fertnstert.2014.11.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 11/04/2014] [Accepted: 11/22/2014] [Indexed: 11/23/2022]
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13
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Milsom SR, Ogilvie CM, Jefferies C, Cree L. Discordant Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome in identical twins - a case report and implications for reproduction in MRKH women. Gynecol Endocrinol 2015; 31:684-7. [PMID: 26291808 DOI: 10.3109/09513590.2015.1032928] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Infertility has previously been considered as an inevitable consequence of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. With modern assisted reproductive technology (ART) techniques becoming increasingly accessible, MRKH women have the opportunity for their own genetic offspring. The availability of such technology, however, increases the importance of understanding the aetiology of this complex condition. The literature debating the relevance of genetic versus post-zygotic events in the aetiology of MRKH syndrome is reviewed in the context of this report of monozygotic twins discordant for MRKH syndrome.
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Affiliation(s)
- Stella Ruth Milsom
- a Department of Reproductive Endocrinology, Womens' Health Division , Auckland District Health Board , Auckland , New Zealand
- b Department of Endocrinology , Fertility Associates Auckland , Auckland , New Zealand
- c Department of Obstetrics and Gynaecology , University of Auckland University , Auckland , New Zealand , and
| | - Cara Megan Ogilvie
- a Department of Reproductive Endocrinology, Womens' Health Division , Auckland District Health Board , Auckland , New Zealand
- b Department of Endocrinology , Fertility Associates Auckland , Auckland , New Zealand
| | - Craig Jefferies
- d Department of Paediatric Endocrinology , Auckland District Health Board , Auckland , New Zealand
| | - Lynsey Cree
- b Department of Endocrinology , Fertility Associates Auckland , Auckland , New Zealand
- c Department of Obstetrics and Gynaecology , University of Auckland University , Auckland , New Zealand , and
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14
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Laino L, Majore S, Preziosi N, Grammatico B, De Bernardo C, Scommegna S, Rapone AM, Marrocco G, Bottillo I, Grammatico P. Disorders of sex development: a genetic study of patients in a multidisciplinary clinic. Endocr Connect 2014; 3:180-92. [PMID: 25248670 PMCID: PMC4195882 DOI: 10.1530/ec-14-0085] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Sex development is a process under genetic control directing both the bi-potential gonads to become either a testis or an ovary, and the consequent differentiation of internal ducts and external genitalia. This complex series of events can be altered by a large number of genetic and non-genetic factors. Disorders of sex development (DSD) are all the medical conditions characterized by an atypical chromosomal, gonadal, or phenotypical sex. Incomplete knowledge of the genetic mechanisms involved in sex development results in a low probability of determining the molecular definition of the genetic defect in many of the patients. In this study, we describe the clinical, cytogenetic, and molecular study of 88 cases with DSD, including 29 patients with 46,XY and disorders in androgen synthesis or action, 18 with 46,XX and disorders in androgen excess, 17 with 46,XY and disorders of gonadal (testicular) development, 11 classified as 46,XX other, eight with 46,XX and disorders of gonadal (ovarian) development, and five with sex chromosome anomalies. In total, we found a genetic variant in 56 out of 88 of them, leading to the clinical classification of every patient, and we outline the different steps required for a coherent genetic testing approach. In conclusion, our results highlight the fact that each category of DSD is related to a large number of different DNA alterations, thus requiring multiple genetic studies to achieve a precise etiological diagnosis for each patient.
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Affiliation(s)
- Luigi Laino
- Department of Molecular MedicineMedical Genetics, San Camillo-Forlanini Hospital, Sapienza University, A.O. San Camillo-Forlanini, Padiglione Morgagni, I piano, UOC Laboratorio di Genetica Medica, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatrics and HematologySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, ItalyPsychology DepartmentSan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Dipartimento di Pscicologia, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatric SurgerySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, Italy
| | - Silvia Majore
- Department of Molecular MedicineMedical Genetics, San Camillo-Forlanini Hospital, Sapienza University, A.O. San Camillo-Forlanini, Padiglione Morgagni, I piano, UOC Laboratorio di Genetica Medica, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatrics and HematologySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, ItalyPsychology DepartmentSan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Dipartimento di Pscicologia, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatric SurgerySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, Italy
| | - Nicoletta Preziosi
- Department of Molecular MedicineMedical Genetics, San Camillo-Forlanini Hospital, Sapienza University, A.O. San Camillo-Forlanini, Padiglione Morgagni, I piano, UOC Laboratorio di Genetica Medica, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatrics and HematologySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, ItalyPsychology DepartmentSan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Dipartimento di Pscicologia, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatric SurgerySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, Italy
| | - Barbara Grammatico
- Department of Molecular MedicineMedical Genetics, San Camillo-Forlanini Hospital, Sapienza University, A.O. San Camillo-Forlanini, Padiglione Morgagni, I piano, UOC Laboratorio di Genetica Medica, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatrics and HematologySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, ItalyPsychology DepartmentSan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Dipartimento di Pscicologia, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatric SurgerySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, Italy
| | - Carmelilia De Bernardo
- Department of Molecular MedicineMedical Genetics, San Camillo-Forlanini Hospital, Sapienza University, A.O. San Camillo-Forlanini, Padiglione Morgagni, I piano, UOC Laboratorio di Genetica Medica, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatrics and HematologySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, ItalyPsychology DepartmentSan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Dipartimento di Pscicologia, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatric SurgerySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, Italy
| | - Salvatore Scommegna
- Department of Molecular MedicineMedical Genetics, San Camillo-Forlanini Hospital, Sapienza University, A.O. San Camillo-Forlanini, Padiglione Morgagni, I piano, UOC Laboratorio di Genetica Medica, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatrics and HematologySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, ItalyPsychology DepartmentSan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Dipartimento di Pscicologia, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatric SurgerySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, Italy
| | - Anna Maria Rapone
- Department of Molecular MedicineMedical Genetics, San Camillo-Forlanini Hospital, Sapienza University, A.O. San Camillo-Forlanini, Padiglione Morgagni, I piano, UOC Laboratorio di Genetica Medica, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatrics and HematologySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, ItalyPsychology DepartmentSan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Dipartimento di Pscicologia, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatric SurgerySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, Italy
| | - Giacinto Marrocco
- Department of Molecular MedicineMedical Genetics, San Camillo-Forlanini Hospital, Sapienza University, A.O. San Camillo-Forlanini, Padiglione Morgagni, I piano, UOC Laboratorio di Genetica Medica, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatrics and HematologySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, ItalyPsychology DepartmentSan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Dipartimento di Pscicologia, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatric SurgerySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, Italy
| | - Irene Bottillo
- Department of Molecular MedicineMedical Genetics, San Camillo-Forlanini Hospital, Sapienza University, A.O. San Camillo-Forlanini, Padiglione Morgagni, I piano, UOC Laboratorio di Genetica Medica, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatrics and HematologySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, ItalyPsychology DepartmentSan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Dipartimento di Pscicologia, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatric SurgerySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, Italy
| | - Paola Grammatico
- Department of Molecular MedicineMedical Genetics, San Camillo-Forlanini Hospital, Sapienza University, A.O. San Camillo-Forlanini, Padiglione Morgagni, I piano, UOC Laboratorio di Genetica Medica, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatrics and HematologySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, ItalyPsychology DepartmentSan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Dipartimento di Pscicologia, Circonvallazione Gianicolense 87, Rome 00152, ItalyDepartment of Pediatric SurgerySan Camillo-Forlanini Hospital, A.O. San Camillo-Forlanini, Padiglione Baccelli, II piano, Pediatria ed Ematologia Pediatrica, Circonvallazione Gianicolense 87, Rome 00152, Italy
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15
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Azam SS, Mirza AH. Role of thumb index fold in Wnt-4 protein and its dynamics through a molecular dynamics simulation study. J Mol Liq 2014. [DOI: 10.1016/j.molliq.2014.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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16
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Herlin M, Højland AT, Petersen MB. Familial occurrence of Mayer-Rokitansky-Küster-Hauser syndrome: a case report and review of the literature. Am J Med Genet A 2014; 164A:2276-86. [PMID: 24975471 DOI: 10.1002/ajmg.a.36652] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 05/26/2014] [Indexed: 11/10/2022]
Abstract
Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder of still unknown etiology, characterized by uterovaginal agenesis and can be associated with renal, skeletal and cardiac malformations. Most cases are sporadic. We report on a familial case of two female cousins with MRKH syndrome and unilateral renal agenesis. Family history revealed two cases of renal agenesis in male relatives and ultrasonographic (US) examination of healthy relatives diagnosed an uncle with multiple renal cysts. We have reviewed the literature on familial occurrence of MRKH syndrome and its associated anomalies and collected a total of 67 familial cases. We found familial cases to share the same associated anomalies as sporadic cases and we discuss the necessity of US examination of healthy relatives.
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Affiliation(s)
- Morten Herlin
- Department of Clinical Genetics, Aalborg University Hospital, Aalborg, Denmark
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17
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Mutations in HOXA11 are not responsible for Müllerian duct anomalies in Chinese patients. Reprod Biomed Online 2014; 28:739-42. [DOI: 10.1016/j.rbmo.2014.01.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 12/03/2013] [Accepted: 01/29/2014] [Indexed: 01/13/2023]
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18
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Shoar Z, Ganguly T, Anderson CE, De Luca F, Suarez E. Absence of WNT4 gene mutation in a patient with MURCS association. J Pediatr Endocrinol Metab 2014; 27:555-9. [PMID: 24356390 DOI: 10.1515/jpem-2013-0335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 10/30/2013] [Indexed: 11/15/2022]
Abstract
MURCS (Mullerian duct aplasia, Renal anomalies, and Cervicothoracic Somite dysplasia) association is a group of congenital genito-urinary and skeletal malformations. We report an adolescent girl with the cardinal features of MURCS association, obesity, and clinical findings of hyperandrogenism who did not show any exonic mutation of the WNT4 gene. Our finding excludes WNT4 gene as a candidate for MURCS association and suggests the need for further genetic studies.
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19
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Nodale C, Ceccarelli S, Giuliano M, Cammarota M, D’Amici S, Vescarelli E, Maffucci D, Bellati F, Panici PB, Romano F, Angeloni A, Marchese C. Gene expression profile of patients with Mayer-Rokitansky-Küster-Hauser syndrome: new insights into the potential role of developmental pathways. PLoS One 2014; 9:e91010. [PMID: 24608967 PMCID: PMC3946625 DOI: 10.1371/journal.pone.0091010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 02/05/2014] [Indexed: 11/18/2022] Open
Abstract
Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) is a rare disease characterized by congenital aplasia of uterus and vagina. Although many studies have investigated several candidate genes, up to now none of them seem to be responsible for the aetiology of the syndrome. In our study, we identified differences in gene expression profile of in vitro cultured vaginal tissue of MRHKS patients using whole-genome microarray analysis. A group of eight out of sixteen MRKHS patients that underwent reconstruction of neovagina with an autologous in vitro cultured vaginal tissue were subjected to microarray analysis and compared with five healthy controls. Results obtained by array were confirmed by qRT-PCR and further extended to other eight MRKHS patients. Gene profiling of MRKHS patients delineated 275 differentially expressed genes, of which 133 downregulated and 142 upregulated. We selected six deregulated genes (MUC1, HOXC8, HOXB2, HOXB5, JAG1 and DLL1) on the basis of their fold change, their differential expression in most patients and their relevant role in embryological development. All patients showed upregulation of MUC1, while HOXB2 and HOXB5 were downregulated, as well as Notch ligands JAG1 and DLL1 in the majority of them. Interestingly, HOXC8 was significantly upregulated in 47% of patients, with a differential expression only in MRKHS type I patients. Taken together, our results highlighted the dysregulation of developmental genes, thus suggesting a potential alteration of networks involved in the formation of the female reproductive tract and providing a useful clue for understanding the pathophysiology of MRKHS.
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Affiliation(s)
- Cristina Nodale
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Simona Ceccarelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Mariateresa Giuliano
- Department of Experimental Medicine, Biotechnology and Molecular Biology Section, Second University of Naples, Naples, Italy
| | - Marcella Cammarota
- Department of Experimental Medicine, Biotechnology and Molecular Biology Section, Second University of Naples, Naples, Italy
| | - Sirio D’Amici
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Enrica Vescarelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Diana Maffucci
- Department of Gynecologic-Obstetrical and Urologic Sciences, Sapienza University of Rome, Rome, Italy
| | - Filippo Bellati
- Department of Gynecologic-Obstetrical and Urologic Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Ferdinando Romano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Antonio Angeloni
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Cinzia Marchese
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
- * E-mail:
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20
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Tang R, Dang Y, Qin Y, Zou S, Li G, Wang Y, Chen ZJ. WNT9B in 542 Chinese women with Müllerian duct abnormalities: mutation analysis. Reprod Biomed Online 2013; 28:503-7. [PMID: 24581601 DOI: 10.1016/j.rbmo.2013.11.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 11/10/2013] [Accepted: 11/13/2013] [Indexed: 11/25/2022]
Abstract
The WNT9B gene is a common organizing signal regulating different segments of the mammalian urogenital system and plays a primary role in the development of the female reproductive tract. The aim of the present work was to examine the presence of WNT mutations in a population of women with Müllerian duct abnormalities (MDA) in order to elucidate whether mutations in WNT9B are causative for MDA in Chinese women. Initially, 191 Chinese MDA patients and 192 healthy individuals (controls) were recruited. All coding regions were amplified by PCR and sequenced to search for variants. To verify the initial results, the numbers of patients and ethnic-matched controls were expanded to 542 and 563, respectively. One known single-nucleotide polymorphism and four novel variants were identified in the first stage: two were synonymous; the other two were rare nonsynonymous novel variants (c.566G>A (p.Arg189Gln) and c.773G>A (p.Arg258His)). None of the four novel variants was found in controls. In the second stage, both novel nonsynonymous variants were detected in MDA cases and controls. The results indicate that mutations in the coding sequence of WNT9B are not responsible for MDA in the Chinese population.
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Affiliation(s)
- Rong Tang
- Center for Reproductive Medicine, Provincial Hospital Affiliated with Shandong University, Jinan 250021, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, 250021, China; The Key Laboratory for Reproductive Endocrinology of Ministry of Education, 250021, China; Shandong Provincial Key Laboratory of Reproductive Medicine,324 Jingwu Road, Jinan 250021, China
| | - Yujie Dang
- Center for Reproductive Medicine, Provincial Hospital Affiliated with Shandong University, Jinan 250021, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, 250021, China; The Key Laboratory for Reproductive Endocrinology of Ministry of Education, 250021, China; Shandong Provincial Key Laboratory of Reproductive Medicine,324 Jingwu Road, Jinan 250021, China
| | - Yingying Qin
- Center for Reproductive Medicine, Provincial Hospital Affiliated with Shandong University, Jinan 250021, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, 250021, China; The Key Laboratory for Reproductive Endocrinology of Ministry of Education, 250021, China; Shandong Provincial Key Laboratory of Reproductive Medicine,324 Jingwu Road, Jinan 250021, China
| | - Shuhua Zou
- Qingdao Women and Children Medical Healthcare Center, Qingdao 266000, China
| | - Guangyu Li
- Center for Reproductive Medicine, Provincial Hospital Affiliated with Shandong University, Jinan 250021, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, 250021, China; The Key Laboratory for Reproductive Endocrinology of Ministry of Education, 250021, China; Shandong Provincial Key Laboratory of Reproductive Medicine,324 Jingwu Road, Jinan 250021, China
| | - Yu Wang
- Center for Reproductive Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Provincial Hospital Affiliated with Shandong University, Jinan 250021, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, 250021, China; The Key Laboratory for Reproductive Endocrinology of Ministry of Education, 250021, China; Shandong Provincial Key Laboratory of Reproductive Medicine,324 Jingwu Road, Jinan 250021, China; Center for Reproductive Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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22
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Lack of association of WNT5A mutations with Müllerian duct abnormalities. Reprod Biomed Online 2013; 26:164-7. [DOI: 10.1016/j.rbmo.2012.10.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Revised: 10/15/2012] [Accepted: 10/16/2012] [Indexed: 11/17/2022]
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23
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Matsumoto H, Shimizu Y, Tanaka A, Nogi T, Tabuchi I, Oyama K, Taniguchi M, Mannen H, Sasazaki S. The SNP in the promoter region of the bovine ELOVL5 gene influences economic traits including subcutaneous fat thickness. Mol Biol Rep 2012; 40:3231-7. [DOI: 10.1007/s11033-012-2398-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 12/17/2012] [Indexed: 12/31/2022]
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