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Giuliatti S, Benedetti AFF, Ramos RM, Petroli RJ, Domenice S, Mendonca BB, Batista RL. Hydropathic AF-2 variants in the androgen receptor gene among androgen insensitivity patients. Andrology 2024. [PMID: 38923406 DOI: 10.1111/andr.13680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 05/20/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Androgen insensitivity syndrome (AIS) is a common condition among individuals with differences of sexual development (DSD) and results from germline allelic variants in the androgen receptor (AR) gene. Understanding the phenotypic consequences of AR allelic variants that disrupt the activation function 2 (AF2) region is essential to grasping its clinical significance. OBJECTIVES This study aims to provide insights into the phenotypic characteristics and clinical impact of AR mutations affecting the AF2 region in AIS patients. We achieve this by reviewing reported AR variants in the AF2 region among individuals with AIS, including identifying a new phenotype associated with the c.2138T>C variant (p.Leu713Pro) in the AR gene. MATERIALS AND METHODS We comprehensively reviewed AR variants within the AF2 region reported in AIS and applied molecular dynamics simulations to assess the impact of the p.Leu713Pro variant on protein dynamics. RESULTS Our review of reported AR variants in the AF2 region revealed a spectrum of phenotypic outcomes in AIS patients. Molecular dynamics simulations indicated that the p.Leu713Pro variant significantly alters the local dynamics of the AR protein and disrupts the correlation and covariance between variables. DISCUSSION The diverse phenotypic presentations observed among individuals with AR variants in the AF2 region highlight the complexity of AIS. The altered protein dynamics resulting from the p.Leu713Pro variant further emphasize the importance of the AF2 region in AR function. CONCLUSION Our study provides valuable insights into AR mutations' phenotypic characteristics and clinical impact on the AF2 region in AIS. Moreover, the disruption of protein dynamics underscores the significance of the AF2 region in AR function and its role in the pathogenesis of AIS.
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Affiliation(s)
- Silvana Giuliatti
- Department of Genetics, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Anna Flavia Figueredo Benedetti
- Developmental Endocrinology Unit, Hormone and Molecular Genetics Laboratory (LIM/42), Endocrinology Division, Internal Medicine Department, University of São Paulo (USP), São Paulo, Brazil
| | - Raquel Martinez Ramos
- Developmental Endocrinology Unit, Hormone and Molecular Genetics Laboratory (LIM/42), Endocrinology Division, Internal Medicine Department, University of São Paulo (USP), São Paulo, Brazil
| | - Reginaldo José Petroli
- Faculdade de Medicina da Universidade Federal de Alagoas (UFAL), Programa de Pós-Graduação em Ciências Médicas - UFAL, Alagoas, Brazil
| | - Sorahia Domenice
- Developmental Endocrinology Unit, Hormone and Molecular Genetics Laboratory (LIM/42), Endocrinology Division, Internal Medicine Department, University of São Paulo (USP), São Paulo, Brazil
| | - Berenice Bilharinho Mendonca
- Developmental Endocrinology Unit, Hormone and Molecular Genetics Laboratory (LIM/42), Endocrinology Division, Internal Medicine Department, University of São Paulo (USP), São Paulo, Brazil
| | - Rafael Loch Batista
- Developmental Endocrinology Unit, Hormone and Molecular Genetics Laboratory (LIM/42), Endocrinology Division, Internal Medicine Department, University of São Paulo (USP), São Paulo, Brazil
- Instituto do Câncer do Estado de São Paulo da Faculdade de Medicina da Universidade de São Paulo (ICESP), São Paulo, Brazil
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Abou Alchamat G, Madania A, Alhalabi M. Mild androgen insensitivity syndrome (MAIS): the identification of c.1783C>T mutation in two unrelated infertile men. BMJ Case Rep 2017; 2017:bcr-2017-220361. [PMID: 28659371 DOI: 10.1136/bcr-2017-220361] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Two unrelated men complaining of primary male infertility presented to Orient Hospital in Damascus city. Physical examination showed moderate hypoandrogenic features. Both men were azoospermic. Hormone profiles revealed an elevation of follicle-stimulating hormone in one patient, but all the other hormones tested were within normal limits for both patients. Further genetic analyses, including karyotype and microdeletions in the AZF region of the Y chromosome, were normal in both patients. Mild androgen insensitivity syndrome was expected in the two patients. Sequencing analysis of the first exon in the androgen receptor (AR) gene have shown c.1783C>T mutation in the two patients with azoospermia. This paper sheds light on the need to screen for mutations in the AR gene, causing male infertility whenever mild hypoandrogenic features are present with unexplained male infertility.
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Affiliation(s)
- Ghalia Abou Alchamat
- Department of Biology, Faculty of Sciences, Damascus University, Damascus, Syrian Arab Republic
| | - Ammar Madania
- Department of Radiation Medicine, Atomic Energy Commission, Damascus, Syrian Arab Republic
| | - Marwan Alhalabi
- Department of Reproductive Medicine, Genetics and Embryology, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic.,Assisted Reproduction Unit, Orient Hospital, Damascus, Syrian Arab Republic
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SARANYA BALACHANDRAN, BHAVANI GUNASEKARAN, ARUMUGAM BRINDHA, JAYASHANKAR MEENA, SANTHIYA SATHIYAVEDUTHYAGARAJAN. Three novel and two known androgen receptor gene mutations associated with androgen insensitivity syndrome in sex-reversed XY female patients. J Genet 2016; 95:911-921. [DOI: 10.1007/s12041-016-0716-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Wang S, Xu H, An W, Zhu D, Li D. Mutational analysis of the androgen receptor gene in two Chinese families with complete androgen insensitivity syndrome. Exp Ther Med 2016; 11:2277-2283. [PMID: 27284311 PMCID: PMC4887926 DOI: 10.3892/etm.2016.3234] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 03/09/2016] [Indexed: 01/02/2023] Open
Abstract
Androgens are essential for normal male sex differentiation and are responsible for the normal development of male secondary sexual characteristics at puberty. The physiological effects of androgens are mediated by the androgen receptor (AR). Mutations in the AR gene are the most common cause of androgen insensitivity syndrome. The present study undertook a genetic analysis of the AR gene in two unrelated families affected by complete androgen insensitivity syndrome (CAIS) in China. In family 1, a previously reported nonsense mutation (G-to-A; p.W751X) was identified in exon 5 of the AR gene. In addition, a novel missense mutation was detected in exon 6 of the AR gene from family 2; this mutation resulted in a predicted amino acid change from phenylalanine to serine at codon 804 (T-to-C; p.F804S) in the ligand-binding domain (LBD) of AR. Computer simulation of the structural changes generated by the p.F804S substitution revealed marked conformational alterations in the hydrophobic core responsible for the stability and function of the AR-LBD. In conclusion, the present study identified two mutations from two unrelated Chinese families affected by CAIS. The novel mutation (p.F804S) may provide insights into the molecular mechanism underlying CAIS. Furthermore, it expands on the number of mutational hot spots in the international AR mutation database, which may be useful in the future for prenatal diagnosis and genetic counseling.
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Affiliation(s)
- Song Wang
- Department of Urology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Haikun Xu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, Jilin 130033, P.R. China
| | - Wei An
- Department of Urology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Dechun Zhu
- Department of Urology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Dejun Li
- Center for Prenatal Diagnosis, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
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V G A, S R, K M M, K T, S A, S N, A MP, J M, D A. Clinical, cytogenetic and molecular analysis of androgen insensitivity syndromes from south Indian cohort and detection and in-silico characterization of androgen receptor gene mutations. Clin Chim Acta 2015; 453:123-30. [PMID: 26688387 DOI: 10.1016/j.cca.2015.12.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 12/07/2015] [Accepted: 12/10/2015] [Indexed: 01/07/2023]
Abstract
Rare cases of 9 complete androgen insensitivity syndromes, 9 cases of partial androgen insensitivity syndromes and equal number of male control samples were selected for this study. Few strong variations in clinical features were noticed; Giemsa banded metaphase revealed a 46,XY karyotype and the frequency of chromosome aberrations were significantly higher when compared with control samples. DNA sequence analysis of the androgen receptor gene of androgen insensitivity syndromes revealed three missense mutations - c.C1713>G resulting in the replacement of a highly conserved histidine residue with glutamine p.(His571Glu) in DNA-binding domain, c.A1715>G resulting in the replacement of a highly conserved tyrosine residue with cysteine p.(Tyr572Cys) in DNA-binding domain and c.G2599>A resulting in the replacement of a highly conserved valine residue with methionine p.(Val867Met) in ligand-binding domain of androgen receptor gene respectively. The heterozygous type of mutations c.C1713>G and c.G2599>A observed in mothers of the patients for familial cases concluding that the mutation was inherited from the mother. The novel mutation c.C1713>G is reported first time in androgen insensitivity syndrome. In-silico analysis of mutations observed in androgen receptor gene of androgen insensitivity syndrome predicted that the substitution at Y572C and V867M could probably disrupt the protein structure and function.
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Affiliation(s)
- Abilash V G
- Division of Biomolecules and Genetics, School of Biosciences and Technology, VIT University, Vellore 632 014, Tamilnadu, India.
| | - Radha S
- Division of Biomolecules and Genetics, School of Biosciences and Technology, VIT University, Vellore 632 014, Tamilnadu, India
| | - Marimuthu K M
- University of Madras, New No.55 (Old.No.26), Ist Main Road, Indira Nagar, Adyar, Chennai 600020, Tamilnadu, India
| | - Thangaraj K
- Centre for Cellular and Molecular Biology, Uppal Road, Hyderabad 500007, India
| | - Arun S
- Human Molecular Genetics Laboratory, Department of Zoology, Bharathiar University, Coimbatore-641046, Tamil Nadu, India
| | - Nishu S
- Division of Biomolecules and Genetics, School of Biosciences and Technology, VIT University, Vellore 632 014, Tamilnadu, India
| | - Mohana Priya A
- Bioinformatics Division, School of Biosciences and Technology, VIT University, Vellore 632 014, Tamilnadu, India
| | - Meena J
- Institute of Obstetrics and Gynecology, Madras Medical College, Government Hospital for Women and Children, Egmore, Chennai 600 008, Tamil Nadu, India
| | - Anuradha D
- Institute of Obstetrics and Gynecology, Madras Medical College, Government Hospital for Women and Children, Egmore, Chennai 600 008, Tamil Nadu, India
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Alptekin H, Barış S, Yıldız M. Chromosomal sex determines gonadal sex, but it is not enough for male phenotype: Novel mutation in androgen receptor gene. J OBSTET GYNAECOL 2015; 35:859-60. [DOI: 10.3109/01443615.2015.1019434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Shao J, Hou J, Li B, Li D, Zhang N, Wang X. Different types of androgen receptor mutations in patients with complete androgen insensitivity syndrome. Intractable Rare Dis Res 2015; 4:54-9. [PMID: 25674389 PMCID: PMC4322596 DOI: 10.5582/irdr.2014.01035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 01/16/2015] [Accepted: 01/22/2015] [Indexed: 01/13/2023] Open
Abstract
Mutations of androgen receptor (AR) are the most frequent cause of 46, XY disorders of sex development and associated with a variety of phenotypes, ranging from phenotypic women (complete androgen insensitivity syndrome (CAIS)) to milder degrees of undervirilization (partial form or PAIS) or men with only infertility (mild form or MAIS). From 2009 to 2012, two young Chinese female individuals with CAIS from two families were referred to our hospital due to primary amenorrhea. Defects in testosterone (T) and dihydrotestosterone (DHT) synthesis were excluded. Physical examination revealed that the patients have normal female external genitalia, normal breast development, vellus hair in the axilla and on the arms and legs, but absence of pubic hair, and a blind-ending vagina. Two different types of AR mutations have been detected by sequencing of genomic DNA: Family A showed deletion of exon 2 in AR gene; Family B showed a single nucleotide C-to-T transition in exon 8 of AR gene resulting in a proline 893-to-leucine substitution (Pro893Leu). Testicular histology showed developmental immaturity of seminiferous tubules with the absence of spermatogenic cells or spermatozoa. No AR immunoreactivity was observed in either case. Three adult patients recovered well from bilateral orchiectomy. The juvenile patient of family B was followed up. Our present study on these two families revealed two different types of AR mutation. The definitive diagnosis of AIS was based on clinical examination and genetic investigations. Our findings verified the mechanism of CAIS and also enriched AR Gene Mutation Database.
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Affiliation(s)
- Jialiang Shao
- Department of Urology, Huashan Hospital of Fudan University, Shanghai, China
| | - Jiangang Hou
- Department of Urology, Huashan Hospital of Fudan University, Shanghai, China
| | - Bingkun Li
- Department of Urology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Dongyang Li
- Department of Urology, Huashan Hospital of Fudan University, Shanghai, China
| | - Ning Zhang
- Department of Urology, Huashan Hospital of Fudan University, Shanghai, China
| | - Xiang Wang
- Department of Urology, Huashan Hospital of Fudan University, Shanghai, China
- Address correspondence to: Dr. Xiang Wang, Department of Urology, Huashan Hospital of Fudan University, 12 Middle Wulumuqi Road, Shanghai 200040, China. E-mail:
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Sun S, Luo F, Zhou Z, Wu W. A novel androgen receptor gene mutation in a Chinese patient with complete androgen insensitivity syndrome. Eur J Obstet Gynecol Reprod Biol 2010; 153:173-5. [PMID: 20833465 DOI: 10.1016/j.ejogrb.2010.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2010] [Revised: 07/11/2010] [Accepted: 08/10/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To identify the underlying androgen receptor gene mutation in a Chinese patient with typical symptoms of complete androgen insensitivity syndrome. STUDY DESIGN A Chinese female phenotype with 46, XY karyotype was diagnosed because of primary amenorrhea. Mutations were determined by polymerase chain reaction followed by DNA sequencing. RESULTS DNA sequencing of the androgen receptor gene showed a G2439T transition causing E442X mutation in exon 1 in the patient with complete androgen insensitivity syndrome. The E442X mutation was a new de novo non-sense mutation in exon 1 of the androgen receptor gene. This non-sense mutation is located in the N-terminal transactivation domain and leads to a predicted truncated protein of 441 amino acids with loss of the end part of the N-terminal transactivation domain, and the DNA-binding and ligand-binding domain. CONCLUSION This E442X non-sense point mutation has not been described previously in cases of androgen insensitivity syndrome, and could lead to the synthesis of a short truncated non-functional androgen receptor probably responsible for the phenotype of complete androgen insensitivity syndrome in the affected individual. Gonadectomy should be planned to eliminate the risk of gonadal malignancy.
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Affiliation(s)
- Shunchang Sun
- Department of Clinical Laboratory, Shenzhen Baoan Hospital, Southern Medical University, 118 Longjing Er Road, Baoan, Shenzhen, Guangdong 518101, China.
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Current world literature. Curr Opin Endocrinol Diabetes Obes 2009; 16:260-77. [PMID: 19390324 DOI: 10.1097/med.0b013e32832c937e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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