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Jordan P, Verebi C, Hervé B, Perol S, Bernard V, Karila D, Jali E, Brac de la Perrière A, Grouthier V, Jonard-Catteau S, Touraine P, Fouveaut C, Plu-Bureau G, Michel Dupont J, Bachelot A, Christin-Maitre S, Bienvenu T. Revisiting GDF9 variants in primary ovarian insufficiency: A shift from dominant to recessive pathogenicity? Gene 2024:148734. [PMID: 38942181 DOI: 10.1016/j.gene.2024.148734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/27/2024] [Accepted: 06/25/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND Primary ovarian insufficiency (POI) affects around 2-4% of women before the age of 40. Genetic factors play an important role in POI. The GDF9 gene has been identified as a significant genetic contributor of POI. However, the pathogenicity and penetrance of GDF9 variants remain uncertain. METHODS A next-generation sequencing approach was employed to investigate the entire coding region of the GDF9 gene in a cohort of 1281 patients with POI or diminished ovarian reserve (DOR). The frequency of each identified GDF9 variant was then compared with that of the general population, taking into account the ethnicity of each individual. RESULTS By screening the entire coding region of the GDF9 gene, we identified 19 different variants, including 1 pathogenic frameshift variant. In total, 36 patients with POI/DOR (2.8%) carried at least one GDF9 variant. With regard to missense variants, no significant overrepresentation of the most common variants was observed in our POI/DOR cohort in comparison to the general or specific ethnic subgroups. Only one homozygous subject had a frameshift loss of function variant. CONCLUSION This epidemiological study suggests that the vast majority of heterozygous missense variants could be considered as variants of uncertain significance and the homozygous loss-of-function variant could be considered as a pathogenic variant. The identification of a novel case of a homozygous POI patient with a heterozygous mother carrying the same variant with normal ovarian function strongly suggests that GDF9 syndrome is an autosomal recessive disorder.
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Affiliation(s)
- Pénélope Jordan
- Service de Médecine Génomique des Maladies de Système et d'Organe, Hôpital Cochin, APHP.Centre Université de Paris Cité, 75014 Paris, France
| | - Camille Verebi
- Service de Médecine Génomique des Maladies de Système et d'Organe, Hôpital Cochin, APHP.Centre Université de Paris Cité, 75014 Paris, France
| | - Bérénice Hervé
- Service de Médecine Génomique des Maladies de Système et d'Organe, Hôpital Cochin, APHP.Centre Université de Paris Cité, 75014 Paris, France
| | - Sandrine Perol
- Unité de gynécologie médicale, APHP. Centre Université Paris Cité, Hôpital Cochin Port-Royal, 75014 Paris, France
| | - Valérie Bernard
- Service de Chirurgie gynécologique et Médecine de la reproduction · Gynécologie médicale, CHU Bordeaux, Bordeaux, France
| | - Daphné Karila
- Service d'endocrinologie, diabétologie et médecine de la reproduction, APHP. Sorbonne Université, Hôpital Saint-Antoine, 75012 Paris, France
| | - Eva Jali
- Service d'Endocrinologie, Hôpital de la Cavale Blanc, 29200 Brest, France
| | - Aude Brac de la Perrière
- Service d'Endocrinologie, de diabétologie et des maladies métaboliques A, Hospices Civiles de Lyon, 69000 Lyon, France
| | - Virginie Grouthier
- Service d'Endocrinologie, Diabétologie et Nutrition, Hôpital Haut-Lévêque, CHU de Bordeaux, 33000 Bordeaux, France
| | - Sophie Jonard-Catteau
- Département d'assistance médicale à la procréation, Hôpital Jeanne de Flandre, 59000 Lille, France
| | - Philippe Touraine
- Département d'Endocrinologie et médecine de la reproduction, APHP. Sorbonne Université, Pitié-Salpêtrière Hospital, Center for Rare Endocrine and Gynecological Disorders, ERN-HCP, Paris, France
| | - Corinne Fouveaut
- Service de Médecine Génomique des Maladies de Système et d'Organe, Hôpital Cochin, APHP.Centre Université de Paris Cité, 75014 Paris, France
| | - Geneviève Plu-Bureau
- Unité de gynécologie médicale, APHP. Centre Université Paris Cité, Hôpital Cochin Port-Royal, 75014 Paris, France
| | - Jean Michel Dupont
- Service de Médecine Génomique des Maladies de Système et d'Organe, Hôpital Cochin, APHP.Centre Université de Paris Cité, 75014 Paris, France
| | - Anne Bachelot
- Département d'Endocrinologie et médecine de la reproduction, APHP. Sorbonne Université, Pitié-Salpêtrière Hospital, Center for Rare Endocrine and Gynecological Disorders, ERN-HCP, Paris, France
| | - Sophie Christin-Maitre
- Service d'endocrinologie, diabétologie et médecine de la reproduction, APHP. Sorbonne Université, Hôpital Saint-Antoine, 75012 Paris, France
| | - Thierry Bienvenu
- Service de Médecine Génomique des Maladies de Système et d'Organe, Hôpital Cochin, APHP.Centre Université de Paris Cité, 75014 Paris, France.
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Allouch A, Al-Barazenji T, Al-Shafai M, Abdallah AM. The landscape of genetic variations in non-syndromic primary ovarian insufficiency in the MENA region: a systematic review. Front Endocrinol (Lausanne) 2024; 14:1289333. [PMID: 38737775 PMCID: PMC11082268 DOI: 10.3389/fendo.2023.1289333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 12/01/2023] [Indexed: 05/14/2024] Open
Abstract
Introduction Premature ovarian insufficiency (POI) is a primary cause of infertility with variable clinical manifestations. POI is a multifactorial disease with both environmental and known genetic etiologies, but data on the genetic variations associated with POI in the Middle East and North Africa (MENA) region are scarce. The aim of this study was to systematically review all known genetic causes of POI in the MENA region. Methods The PubMed, Science Direct, ProQuest, and Embase databases were searched from inception to December 2022 for all reports of genetic variants associated with POI in the MENA region. Clinical and genetic data were collected from eligible articles, and ClinVar and PubMed (dbSNP) were searched for variants. Results Of 1,803 studies, 25 met the inclusion criteria. Fifteen studies were case-control studies and ten were case reports representing 1,080 non-syndromic POI patients in total. Seventy-nine variants in 25 genes associated with POI were reported in ten MENA countries. Of the 79 variants, 46 were rare and 33 were common variants. Of the 46 rare variants, 19 were pathogenic or likely pathogenic according to ACMG classification guidelines and ClinVar. No clear phenotype-genotype association was observed. Male family members carrying pathogenic variants also had infertility problems. Discussion To our best knowledge, this is the first systematic review of the genetic variants associated with POI in the MENA region. Further functional studies are needed to assess the disease-causing molecular mechanisms of these variants. Knowledge of the genetic basis of POI in the Middle East could facilitate early detection of the condition and thus early implementation of therapeutic interventions, paving the way for precision medicine options in specific populations.
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Affiliation(s)
- Asma Allouch
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Tara Al-Barazenji
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Mashael Al-Shafai
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
- Biomedical Research Center, Qatar University, Doha, Qatar
| | - Atiyeh M. Abdallah
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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Hashemi Sheikhshabani S, Ghafouri-Fard S, Hosseini E, Omrani MD. A novel homozygote nonsense variant of MSH4 leads to primary ovarian insufficiency and non-obstructive azoospermia. Mol Biol Rep 2024; 51:68. [PMID: 38175272 DOI: 10.1007/s11033-023-09000-4] [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: 09/08/2023] [Accepted: 11/02/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Both non-obstructive azoospermia (NOA) and primary ovarian insufficiency (POI) are pathological conditions characterized by premature and frequently complete gametogenesis failure. Considering that the conserved meiosis I steps are the same between oogenesis and spermatogenesis, inherited defects in meiosis I may result in common causes for both POI and NOA. The present research is a retrospective investigation on an Iranian family with four siblings of both genders who were affected by primary gonadal failure. METHODS Proband, an individual with NOA, was subjected to clinical examination, hormonal assessment, and genetic consultation. After reviewing the medical history of other infertile members of the family, patients with NOA went through genetic investigations including karyotyping and assessment of Y chromosome microdeletions, followed by Whole exome sequencing (WES) on the proband. After analyzing WES data, the candidate variant was validated using Sanger sequencing and traced in the family. RESULTS WES analysis of the proband uncovered a novel homozygote nonsense variant, namely c.118C>T in MSH4. This variant resulted in the occurrence of a premature stop codon in residue 40 of MSH4. Notably, the variant was absent in all public exome databases and in the exome data of 400 fertile Iranian individuals. Additionally, the variant was found to co-segregate with infertility in the family. It was also observed that all affected members had homozygous mutations, while their parents were heterozygous and the fertile sister had no mutant allele, corresponding to autosomal recessive inheritance. In addition, we conducted a review of variants reported so far in MSH4, as well as available clinical features related to these variants. The results show that the testicular sperm retrieval and ovarian stimulation cycles have not been successful yet. CONCLUSION Overall, the results of this study indicate that the identification of pathogenic variants in this gene will be beneficial in selecting proper therapeutic strategies. Also, the findings of this study demonstrate that clinicians should obtain the history of other family members of the opposite sex when diagnosing for POI and/or NOA.
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Affiliation(s)
- Somayeh Hashemi Sheikhshabani
- Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soudeh Ghafouri-Fard
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Hosseini
- Department of Obstetrics and Gynecology, Mousavi Hospital, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mir Davood Omrani
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Jordan P, Verebi C, Perol S, Grotto S, Fouveaut C, Christin-Maitre S, de la Perrière AB, Grouthier V, Jonard-Catteau S, Touraine P, Plu-Bureau G, Dupont JM, El Khattabi L, Bienvenu T. NOBOX gene variants in premature ovarian insufficiency: ethnicity-dependent insights. J Assist Reprod Genet 2024; 41:135-146. [PMID: 37921973 PMCID: PMC10789696 DOI: 10.1007/s10815-023-02981-y] [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: 08/03/2023] [Accepted: 10/20/2023] [Indexed: 11/05/2023] Open
Abstract
PURPOSE Premature ovarian insufficiency (POI) affects approximately 1% of women before the age of 40. Genetic contribution is a significant component of POI. The NOBOX gene was considered one of the major genetic causes of POI. However, the pathogenicity and the penetrance of NOBOX variants remain unclear. METHODS We studied the whole coding region of the NOBOX gene by next generation sequencing in a cohort of 810 patients with POI, and we compared the frequency of each identified NOBOX variant to the general population taking into account the ethnicity of each individual. RESULTS Screening of the whole coding region of the NOBOX gene allowed us to identify 35 different variants, including 5 loss-of-function variants. In total, 171 patients with POI (25%) carried out at least one NOBOX variant. Regarding missense variants, we observed a significant overrepresentation of the most frequent ones in our 810 POI patients as compared to the general, except for p.(Arg117Trp). However, taking into account the ethnic origin of the individuals, we observed no significant OR difference for p.(Arg44Leu) and p.(Arg117Trp) in African subgroup and for p.(Asp452Asn) in European subgroup. CONCLUSION This population study suggests that the p.(Arg44Leu) variant could be considered benign variant and that the p.(Asp452Asn) and p.(Arg117Trp) variants could be considered moderate risk pathogenic variants with probably partial and very low penetrance and/or expressivity. In contrast, p.(Gly91Trp) and p.(Gly152Arg) variants could be considered pathogenic variants with a moderate functional impact.
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Affiliation(s)
- Pénélope Jordan
- Service de Médecine Génomique Des Maladies de Système Et d'Organe, Hôpital Cochin, APHP, Centre Université de Paris Cité, 123 Boulevard de Port-Royal, 75014, Paris, France
| | - Camille Verebi
- Service de Médecine Génomique Des Maladies de Système Et d'Organe, Hôpital Cochin, APHP, Centre Université de Paris Cité, 123 Boulevard de Port-Royal, 75014, Paris, France
| | - Sandrine Perol
- Unité de Gynécologie Médicale, APHP, Centre Université de Paris Cité Cité, Hôpital Cochin Port-Royal, 75014, Paris, France
| | - Sarah Grotto
- Unité de Gynécologie Médicale, APHP, Centre Université de Paris Cité Cité, Hôpital Cochin Port-Royal, 75014, Paris, France
| | - Corinne Fouveaut
- Service de Médecine Génomique Des Maladies de Système Et d'Organe, Hôpital Cochin, APHP, Centre Université de Paris Cité, 123 Boulevard de Port-Royal, 75014, Paris, France
| | - Sophie Christin-Maitre
- Service d'endocrinologie, Diabétologie Et Médecine de La Reproduction, APHP, Sorbonne Université, Hôpital Saint-Antoine, 75012, Paris, France
| | - Aude Brac de la Perrière
- Service d'Endocrinologie, de Diabétologie Et Des Maladies Métaboliques A, Hospices Civiles de Lyon, 69000, Lyon, France
| | - Virginie Grouthier
- Service de Gynécologie Médicale, CHU de Bordeaux, 33000, Bordeaux, France
| | - Sophie Jonard-Catteau
- Département d'assistance Médicale À La Procréation, Hôpital Jeanne de Flandre, 59000, Lille, France
| | - Philippe Touraine
- Département d'Endocrinologie Et Médecine de La Reproduction, APHP. Sorbonne Université, Pitié-Salpêtrière Hospital, Center for Rare Endocrine and Gynecological Disorders, ERN-HCP, Paris, France
| | - Geneviève Plu-Bureau
- Unité de Gynécologie Médicale, APHP, Centre Université de Paris Cité Cité, Hôpital Cochin Port-Royal, 75014, Paris, France
| | - Jean Michel Dupont
- Service de Médecine Génomique Des Maladies de Système Et d'Organe, Hôpital Cochin, APHP, Centre Université de Paris Cité, 123 Boulevard de Port-Royal, 75014, Paris, France
| | - Laila El Khattabi
- Service de Médecine Génomique Des Maladies de Système Et d'Organe, Hôpital Cochin, APHP, Centre Université de Paris Cité, 123 Boulevard de Port-Royal, 75014, Paris, France
- Département de Génétique Médicale, Unité Fonctionnelle de Génomique Chromosomique, APHP. Sorbonne Université, Hôpital Armand Trousseau, 75012, Paris, France
| | - Thierry Bienvenu
- Service de Médecine Génomique Des Maladies de Système Et d'Organe, Hôpital Cochin, APHP, Centre Université de Paris Cité, 123 Boulevard de Port-Royal, 75014, Paris, France.
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Gurpinar Tosun B, Guran T. Rare forms of congenital adrenal hyperplasia. Clin Endocrinol (Oxf) 2023. [PMID: 38126084 DOI: 10.1111/cen.15009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/10/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders due to pathogenic variants in genes encoding enzymes and cofactors involved in adrenal steroidogenesis. Although 21-hydroxylase, 11β-hydroxylase, 3β-hydroxysteroid dehydrogenase type 2, 17α-hydroxylase/17,20-lyase, P450 oxidoreductase, steroidogenic acute regulatory protein, cholesterol side-chain cleavage enzyme deficiencies are considered within the definition of CAH, the term 'CAH' is often used to refer to '21-hydroxylase deficiency (21OHD)' since 21OHD accounts for approximately 95% of CAH in most populations. The prevalence of the rare forms of CAH varies according to ethnicity and geographical location. In most cases, the biochemical fingerprint of impaired steroidogenesis points to the specific subtypes of CAH, and genetic testing is usually required to confirm the diagnosis. Despite there are significant variations in clinical characteristics and management, most data about the rare CAH forms are extrapolated from 21OHD. This review article aims to collate the currently available data about the diagnosis and the management of rare forms of CAH.
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Affiliation(s)
- Busra Gurpinar Tosun
- Department of Paediatric Endocrinology and Diabetes, School of Medicine, Marmara University, Istanbul, Turkey
| | - Tulay Guran
- Department of Paediatric Endocrinology and Diabetes, School of Medicine, Marmara University, Istanbul, Turkey
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