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Guarneri C, Reschini M, Pinna M, Perego L, Sanzani E, Somigliana E, Sorrentino U, Cassina M, Zuccarello D, Ciaffaglione M. The impact of a second embryo biopsy for preimplantation genetic testing for monogenic diseases (PGT-M) with inconclusive results on pregnancy potential: results from a matched case-control study. J Assist Reprod Genet 2024:10.1007/s10815-024-03078-w. [PMID: 38557804 DOI: 10.1007/s10815-024-03078-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
PURPOSE To evaluate whether a second biopsy, following a first diagnostic failure on blastocysts tested for preimplantation genetic testing for monogenic diseases (PGT-M), allows to obtain genetic diagnosis and to what extent this procedure can influence clinical pregnancy and live birth rates compared to the PGT-M process with a successful genetic diagnosis from the first biopsy. METHODS Embryos from women who underwent PGT-M in an infertility centre and who had been transferred after two biopsies for genetic analysis (n = 27) were matched in a 1:1 ratio accordingly to women's age (± 1 year) and fertility status (fertile vs infertile), as well as with the study period, with embryos who were transferred after receiving a conclusive PGT result straight after the first biopsy (n = 27). The main evaluated outcome was clinical pregnancy rate following embryo transfers in which healthy embryos were transferred after only one biopsy and those in which an embryo was transferred after being re-biopsied. Live birth rate was the secondary outcome. RESULTS Clinical pregnancy rate was 52% (95% CI: 34-69) following the transfer of a single-biopsy blastocyst and 30% (95% CI: 16-48) following the transfer of a re-biopsied blastocyst. The likelihood to have a healthy baby was 33% (95% CI: 19-52) following the transfer of a blastocyst biopsied once and 22% (95% CI: 11-41) following the transfer of a re-biopsied blastocyst. CONCLUSIONS The re-biopsy intervention seems to considerably reduce the pregnancy potential of a blastocyst. However, a greater sample size is necessary to clarify this issue definitively.
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Affiliation(s)
- Cristina Guarneri
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Manfredo Fanti 6, 20122, Milano, Italy.
| | - Marco Reschini
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Manfredo Fanti 6, 20122, Milano, Italy
| | - Monica Pinna
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Manfredo Fanti 6, 20122, Milano, Italy
| | - Lucia Perego
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Manfredo Fanti 6, 20122, Milano, Italy
| | - Elena Sanzani
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Manfredo Fanti 6, 20122, Milano, Italy
| | - Edgardo Somigliana
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Manfredo Fanti 6, 20122, Milano, Italy
| | - Ugo Sorrentino
- Department of Lab Medicine, Unit of Clinical Genetics and Epidemiology, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Matteo Cassina
- Department of Lab Medicine, Unit of Clinical Genetics and Epidemiology, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Daniela Zuccarello
- Department of Lab Medicine, Unit of Clinical Genetics and Epidemiology, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy
| | - Marta Ciaffaglione
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Manfredo Fanti 6, 20122, Milano, Italy
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Persico T, Tranquillo ML, Seracchioli R, Zuccarello D, Sorrentino U. PGT-M for Premature Ovarian Failure Related to CGG Repeat Expansion of the FMR1 Gene. Genes (Basel) 2023; 15:6. [PMID: 38275588 PMCID: PMC10815814 DOI: 10.3390/genes15010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024] Open
Abstract
Primary ovarian failure (POF) is caused by follicle exhaustion and is associated with menstrual irregularities and elevated gonadotropin levels, which lead to infertility before the age of 40 years. The etiology of POI is mostly unknown, but a heterogeneous genetic and familial background can be identified in a subset of cases. Abnormalities in the fragile X mental retardation 1 gene (FMR1) are among the most prevalent monogenic causes of POI. These abnormalities are caused by the expansion of an unstable CGG repeat in the 5' untranslated region of FMR1. Expansions over 200 repeats cause fragile X syndrome (FXS), whereas expansions between 55 and 200 CGG repeats, which are defined as a fragile X premutation, have been associated with premature ovarian failure type 1 (POF1) in heterozygous females. Preimplantation genetic testing for monogenic diseases (PGT-M) can be proposed when the female carries a premutation or a full mutation. In this narrative review, we aim to recapitulate the clinical and molecular features of POF1 and their implications in the context of PGT-M.
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Affiliation(s)
- Tiziana Persico
- Medically Assisted Procreation Center, Maternal and Child Department, Beauregard Hospital, Valle D’Aosta Local Public Health, 11100 Aoste, Italy
| | - Maria Lucrezia Tranquillo
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (M.L.T.); (R.S.)
| | - Renato Seracchioli
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (M.L.T.); (R.S.)
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero, University of Bologna, 40138 Bologna, Italy
| | - Daniela Zuccarello
- Clinical Genetics and Epidemiology Unit, University of Padova, 35128 Padova, Italy; (D.Z.); (U.S.)
| | - Ugo Sorrentino
- Clinical Genetics and Epidemiology Unit, University of Padova, 35128 Padova, Italy; (D.Z.); (U.S.)
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Giuliano R, Maione A, Vallefuoco A, Sorrentino U, Zuccarello D. Preimplantation Genetic Testing for Genetic Diseases: Limits and Review of Current Literature. Genes (Basel) 2023; 14:2095. [PMID: 38003038 PMCID: PMC10671162 DOI: 10.3390/genes14112095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/26/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
Preimplantation genetic testing (PGT) has emerged as a revolutionary technique in the field of reproductive medicine, allowing for the selection and transfer of healthy embryos, thus reducing the risk of transmitting genetic diseases. However, despite remarkable advancements, the implementation of PGT faces a series of limitations and challenges that require careful consideration. This review aims to foster a comprehensive reflection on the constraints of preimplantation genetic diagnosis, encouraging a broader discussion about its utility and implications. The objective is to inform and guide medical professionals, patients, and society overall in the conscious and responsible adoption of this innovative technology, taking into account its potential benefits and the ethical and practical challenges that it presents.
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Affiliation(s)
- Roberta Giuliano
- Preimplantation Genetic Diagnosis, Department of Women’s and Children’s Health, University of Padova, 35128 Padova, Italy
| | - Anna Maione
- Fertility Unit, Maternal-Child Department, AOU Federico II, 80131 Naples, Italy;
| | - Angela Vallefuoco
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy;
| | - Ugo Sorrentino
- Clinical Genetics and Epidemiology Unit, University Hospital of Padova, Via Giustiniani 3, 35128 Padova, Italy; (U.S.); (D.Z.)
| | - Daniela Zuccarello
- Clinical Genetics and Epidemiology Unit, University Hospital of Padova, Via Giustiniani 3, 35128 Padova, Italy; (U.S.); (D.Z.)
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Calosci D, Passaglia L, Gabbiato I, Cartisano F, Affuso R, Sorrentino U, Zuccarello D. Public Awareness and Acceptability of PGT-M in Cancer Predisposition Syndromes. Genes (Basel) 2023; 14:2069. [PMID: 38003012 PMCID: PMC10671058 DOI: 10.3390/genes14112069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Cancer Predisposition Syndromes (CPSs), also known as Hereditary Cancer Syndromes (HCSs), represent a group of genetic disorders associated with an increased lifetime risk of developing cancer. In this article, we provide an overview of the reproductive options for patients diagnosed with CPS, focusing on the emerging role of Preimplantation Genetic Testing for Monogenic disorders (PGT-M). Specifically, we conducted a literature review about the awareness and acceptability of its application to CPSs. Based on the available data, the awareness of the applicability of PGT-M for CPSs appears to be limited among both patients and physicians, and a heterogeneous set of factors seems to influence the acceptability of the procedure. Our findings highlight the need for increasing education about the use of PGT-M for CPSs. In this context, guidelines developed by professional or institutional bodies would represent a useful reference tool to assist healthcare professionals in providing proper preconception counseling.
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Affiliation(s)
- Davide Calosci
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, Via Giustiniani 3, 35128 Padova, Italy; (L.P.); (I.G.); (F.C.); (R.A.); (U.S.)
| | - Lisa Passaglia
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, Via Giustiniani 3, 35128 Padova, Italy; (L.P.); (I.G.); (F.C.); (R.A.); (U.S.)
| | - Ilaria Gabbiato
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, Via Giustiniani 3, 35128 Padova, Italy; (L.P.); (I.G.); (F.C.); (R.A.); (U.S.)
| | - Francesca Cartisano
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, Via Giustiniani 3, 35128 Padova, Italy; (L.P.); (I.G.); (F.C.); (R.A.); (U.S.)
| | - Rebecca Affuso
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, Via Giustiniani 3, 35128 Padova, Italy; (L.P.); (I.G.); (F.C.); (R.A.); (U.S.)
| | - Ugo Sorrentino
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, Via Giustiniani 3, 35128 Padova, Italy; (L.P.); (I.G.); (F.C.); (R.A.); (U.S.)
| | - Daniela Zuccarello
- Department of Lab Medicine Unit of Clinical Genetics and Epidemiology, University Hospital of Padova, Via Giustiniani 3, 35128 Padova, Italy;
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Ancora C, Marchi M, Bonardi CM, Sartori G, Lopreiato R, Zuccarello D, D'Errico I, Nosadini M, Sartori S, Boniver C, Toldo I, Salviati L. Electroclinical Features in Two Novel STRADA Patients and a Functional Yeast Assay for the Validation of Missense STRADA Mutations. Pediatr Neurol 2023; 148:152-156. [PMID: 37722301 DOI: 10.1016/j.pediatrneurol.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 09/20/2023]
Abstract
Loss of function of the STRADA gene, an upstream mTOR inhibitor, causes a rare neurodevelopmental disorder characterized by polyhydramnios, megalencephaly, and symptomatic epilepsy (PMSE syndrome). Patients display a homogeneous phenotype including early-onset drug-resistant epilepsy, severe psychomotor delay, multisystemic comorbidities, and increased risk of premature death. The administration of sirolimus, an mTOR inhibitor, is helpful in controlling seizures in this syndrome. We report the electroclinical phenotype of two novel patients and the development of a yeast model to validate the pathogenicity of missense variants. Patient 1 harbored a missense STRADA variant and had a peculiar electroclinical phenotype with a relatively mild epilepsy course. Patient 2 harbored a truncating STRADA variant and showed a typical PMSE phenotype and a favorable response to early treatment with sirolimus. When we modeled the p.(Ser264Arg) STRADA change in its yeast homolog SPS1, it impaired SPS1 function. The results underlie the importance of a timely molecular diagnosis in these patients and show that yeast is a simple yet effective model to validate the pathogenicity of missense variants.
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Affiliation(s)
- Caterina Ancora
- Pediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Marco Marchi
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy; Clinical Genetics Lab, Città della Speranza Pediatric Research Institute, Padua, Italy
| | - Claudia Maria Bonardi
- Pediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Geppo Sartori
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | | | - Daniela Zuccarello
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | | | - Margherita Nosadini
- Pediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Stefano Sartori
- Pediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Clementina Boniver
- Pediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Irene Toldo
- Pediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy.
| | - Leonardo Salviati
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy; Clinical Genetics Lab, Città della Speranza Pediatric Research Institute, Padua, Italy
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Sorrentino U, Gabbiato I, Canciani C, Calosci D, Rigon C, Zuccarello D, Cassina M. Homozygous TNNI3 Mutations and Severe Early Onset Dilated Cardiomyopathy: Patient Report and Review of the Literature. Genes (Basel) 2023; 14:genes14030748. [PMID: 36981019 PMCID: PMC10048074 DOI: 10.3390/genes14030748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/14/2023] [Accepted: 03/16/2023] [Indexed: 03/22/2023] Open
Abstract
The TNNI3 gene encodes for the cardiac isoform of troponin I, a pivotal component of the sarcomeric structure of the myocardium. While heterozygous TNNI3 missense mutations have long been associated with autosomal dominant hypertrophic and restrictive cardiomyopathies, the role of TNNI3 null mutations has been more debated due to the paucity and weak characterization of reported cases and the low penetrance of heterozygous genotypes. In recent years, however, an increasing amount of evidence has validated the hypothesis that biallelic TNNI3 null mutations cause a severe form of neonatal dilated cardiomyopathy. Here, we expand the case series reporting two unrelated patients afflicted with early onset dilated cardiomyopathy, due to homozygosity for the p.Arg98* TNNI3 variant, which had thus far been documented only in heterozygous patients and apparently healthy carriers, and the recurrent p.Arg69Alafs*8 variant, respectively. A review of previously reported biallelic TNNI3 loss-of-function variants and their associated cardiac phenotypes was also performed.
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Affiliation(s)
- Ugo Sorrentino
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, 35128 Padova, Italy; (U.S.); (I.G.); (C.C.); (D.C.); (C.R.); (M.C.)
| | - Ilaria Gabbiato
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, 35128 Padova, Italy; (U.S.); (I.G.); (C.C.); (D.C.); (C.R.); (M.C.)
| | - Chiara Canciani
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, 35128 Padova, Italy; (U.S.); (I.G.); (C.C.); (D.C.); (C.R.); (M.C.)
| | - Davide Calosci
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, 35128 Padova, Italy; (U.S.); (I.G.); (C.C.); (D.C.); (C.R.); (M.C.)
| | - Chiara Rigon
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, 35128 Padova, Italy; (U.S.); (I.G.); (C.C.); (D.C.); (C.R.); (M.C.)
| | - Daniela Zuccarello
- Clinical Genetics Unit, University Hospital of Padova, 35128 Padova, Italy
- Correspondence: ; Tel.: +39-0498212524
| | - Matteo Cassina
- Clinical Genetics Unit, Department of Women’s and Children’s Health, University of Padova, 35128 Padova, Italy; (U.S.); (I.G.); (C.C.); (D.C.); (C.R.); (M.C.)
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Capalbo A, Gabbiato I, Caroselli S, Picchetta L, Cavalli P, Lonardo F, Bianca S, Giardina E, Zuccarello D. Considerations on the use of carrier screening testing in human reproduction: comparison between recommendations from the Italian Society of Human Genetics and other international societies. J Assist Reprod Genet 2022; 39:2581-2593. [PMID: 36370240 PMCID: PMC9722986 DOI: 10.1007/s10815-022-02653-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 10/31/2022] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Carrier screening (CS) is a term used to describe a genetic test performed on individuals without family history of genetic disorders, to investigate the carrier status for pathogenic variants associated with multiple recessive conditions. The advent of next-generation sequencing enabled simultaneous CS for an increasing number of conditions; however, a consensus on which diseases to include in gene panels and how to best develop the provision of CS is far to be reached. Therefore, the provision of CS is jeopardized and inconsistent and requires solving several important issues. METHODS In 2020, the Italian Society of Human Genetics (SIGU) established a working group composed of clinical and laboratory geneticists from public and private fields to elaborate a document to define indications and best practice of CS provision for couples planning a pregnancy. RESULTS Hereby, we present the outcome of the Italian working group's activity and compare it with previously published international recommendations (American College of Medical Genetics and Genomics (ACMG), American College of Obstetricians and Gynecologists (ACOG), and Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG)). We determine a core message on genetic counseling and nine main subject categories to explore, spanning from goals and execution to technical scientific, ethical, and socio-economic topics. Moreover, a level of agreement on the most critical points is discussed using a 5-point agreement scale, demonstrating a high level of consensus among the four societies. CONCLUSIONS This document is intended to provide genetic and healthcare professionals involved in human reproduction with guidance regarding the clinical implementation of CS.
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Affiliation(s)
| | - Ilaria Gabbiato
- Department of Lab Medicine, Unit of Clinical Genetics and Epidemiology University Hospital of Padova, Padua, Italy
| | | | | | | | - Fortunato Lonardo
- UOSD Genetica Medica, AORN "San Pio" - P.O. "G. Rummo", Benevento, Italy
| | | | - Emiliano Giardina
- Laboratorio Di Medicina Genomica - UILDM Università Degli Studi Di Roma "Tor Vergata", Fondazione Santa Lucia-IRCCS, Rome, Italy
| | - Daniela Zuccarello
- Department of Lab Medicine, Unit of Clinical Genetics and Epidemiology University Hospital of Padova, Padua, Italy
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Zuccarello D, Sorrentino U, Brasson V, Marin L, Piccolo C, Capalbo A, Andrisani A, Cassina M. Epigenetics of pregnancy: looking beyond the DNA code. J Assist Reprod Genet 2022; 39:801-816. [PMID: 35301622 PMCID: PMC9050975 DOI: 10.1007/s10815-022-02451-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/01/2022] [Indexed: 12/19/2022] Open
Abstract
Epigenetics is the branch of genetics that studies the different mechanisms that influence gene expression without direct modification of the DNA sequence. An ever-increasing amount of evidence suggests that such regulatory processes may play a pivotal role both in the initiation of pregnancy and in the later processes of embryonic and fetal development, thus determining long-term effects even in adult life. In this narrative review, we summarize the current knowledge on the role of epigenetics in pregnancy, from its most studied and well-known mechanisms to the new frontiers of epigenetic regulation, such as the role of ncRNAs and the effects of the gestational environment on fetal brain development. Epigenetic mechanisms in pregnancy are a dynamic phenomenon that responds both to maternal-fetal and environmental factors, which can influence and modify the embryo-fetal development during the various gestational phases. Therefore, we also recapitulate the effects of the most notable environmental factors that can affect pregnancy and prenatal development, such as maternal nutrition, stress hormones, microbiome, and teratogens, focusing on their ability to cause epigenetic modifications in the gestational environment and ultimately in the fetus. Despite the promising advancements in the knowledge of epigenetics in pregnancy, more experience and data on this topic are still needed. A better understanding of epigenetic regulation in pregnancy could in fact prove valuable towards a better management of both physiological pregnancies and assisted reproduction treatments, other than allowing to better comprehend the origin of multifactorial pathological conditions such as neurodevelopmental disorders.
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Affiliation(s)
- Daniela Zuccarello
- Clinical Genetics Unit, Department of Women's and Children's Health, University Hospital of Padova, Padua, Italy.
| | - Ugo Sorrentino
- Clinical Genetics Unit, Department of Women's and Children's Health, University Hospital of Padova, Padua, Italy
| | - Valeria Brasson
- Clinical Genetics Unit, Department of Women's and Children's Health, University Hospital of Padova, Padua, Italy
| | - Loris Marin
- Gynaecological Clinic, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Chiara Piccolo
- Clinical Genetics Unit, Department of Women's and Children's Health, University Hospital of Padova, Padua, Italy
| | | | - Alessandra Andrisani
- Gynaecological Clinic, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Matteo Cassina
- Clinical Genetics Unit, Department of Women's and Children's Health, University Hospital of Padova, Padua, Italy
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Picchetta L, Caroselli S, Figliuzzi M, Cogo F, Zambon P, Costa M, Pergher I, Patassini C, Cortellessa F, Zuccarello D, Poli M, Capalbo A. Molecular tools for the genomic assessment of oocyte’s reproductive competence. J Assist Reprod Genet 2022; 39:847-860. [PMID: 35124783 PMCID: PMC9050973 DOI: 10.1007/s10815-022-02411-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/24/2022] [Indexed: 12/15/2022] Open
Abstract
The most important factor associated with oocytes' developmental competence has been widely identified as the presence of chromosomal abnormalities. However, growing application of genome-wide sequencing (GS) in population diagnostics has enabled the identification of multifactorial genetic predispositions to sub-lethal pathologies, including those affecting IVF outcomes and reproductive fitness. Indeed, GS analysis in families with history of isolated infertility has recently led to the discovery of new genes and variants involved in specific human infertility endophenotypes that impact the availability and the functionality of female gametes by altering unique mechanisms necessary for oocyte maturation and early embryo development. Ongoing advancements in analytical and bioinformatic pipelines for the study of the genetic determinants of oocyte competence may provide the biological evidence required not only for improving the diagnosis of isolated female infertility but also for the development of novel preventive and therapeutic approaches for reproductive failure. Here, we provide an updated discussion and review of the progresses made in preconception genomic medicine in the identification of genetic factors associated with oocyte availability, function, and competence.
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Somigliana E, Costantini MP, Filippi F, Terenziani M, Riccaboni A, Nicotra V, Rago R, Paffoni A, Mencaglia L, Magnolfi S, Zuccarello D, Rienzi L, Spinella F, Capalbo A, Scaravelli G, Testa S. Fertility counseling in women with hereditary cancer syndromes. Crit Rev Oncol Hematol 2022; 171:103604. [DOI: 10.1016/j.critrevonc.2022.103604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/16/2022] [Accepted: 01/21/2022] [Indexed: 12/29/2022] Open
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Cimadomo D, Capalbo A, Scarica C, Sosa Fernandez L, Rienzi L, Ciriminna R, Minasi MG, Novelli A, De Santis L, Zuccarello D. When embryology meets genetics: the definition of developmentally incompetent preimplantation embryos (DIPE)-the consensus of two Italian scientific societies. J Assist Reprod Genet 2021; 38:319-331. [PMID: 33236289 PMCID: PMC7884494 DOI: 10.1007/s10815-020-02015-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
A clear definition of developmentally incompetent preimplantation embryo (DIPE) in literature is still missing, while several scientific societies are discussing this challenging topic. From both a clinical and scientific perspective, the identification of embryos unfit for reproductive purpose is crucial. This aim should be pursued in light of all diagnostic technologies for embryo evaluation, encompassing also genetic analyses, of recent implementation in IVF. The Italian context is characterized by an unusual scenario: embryos can be discarded only if not viable and cannot be used for research purposes either. Therefore, thousands of embryos, diagnosed as affected and/or aneuploid as resulting from preimplantation genetic testing (PGT) and clinically not utilizable, are cryopreserved and stored indefinitely, with important psychological, legal, and financial implications. With the aim of updating the definition of DIPE, also on the basis of the embryo genetic status, the Italian Society of Embryology, Reproduction and Research (SIERR) and the Italian Society of Human Genetic (SIGU) reviewed the literature on this topic, found a consensus, and produced a list of relevant criteria.
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Affiliation(s)
- Danilo Cimadomo
- GeneraLife IVF centers, Clinica Valle Giulia, via G. de Notaris 2b, 00197, Rome, Italy.
| | | | - Catello Scarica
- Center for Reproductive Medicine, Casa di Cura Villa Salaria in Partnership with Institut Marques, Rome, Italy
| | | | - Laura Rienzi
- GeneraLife IVF centers, Clinica Valle Giulia, via G. de Notaris 2b, 00197, Rome, Italy
| | | | | | - Antonio Novelli
- Laboratory of Medical Genetics, IRCCS-Bambino Gesù Children's Hospital, Rome, Italy
| | - Lucia De Santis
- Department of Obstetrics & Gynecology, IVF Unit, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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12
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Botto LD, Meeths M, Campos-Xavier B, Bergamaschi R, Mazzanti L, Scarano E, Finocchi A, Cancrini C, Zirn B, Kühnle I, Kramm CM, Alanay Y, Jones WD, Irving M, Sabir A, Henter JI, Borgström B, Nordgren A, Hammarsjö A, Putti C, Mozzato C, Zuccarello D, Nishimura G, Bonafè L, Grigelioniene G, Unger S, Superti-Furga A. Chondrodysplasia and growth failure in children after early hematopoietic stem cell transplantation for non-oncologic disorders. Am J Med Genet A 2021; 185:517-527. [PMID: 33398909 DOI: 10.1002/ajmg.a.62021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/10/2020] [Accepted: 11/27/2020] [Indexed: 11/09/2022]
Abstract
Bone dysplasias (osteochondrodysplasias) are a large group of conditions associated with short stature, skeletal disproportion, and radiographic abnormalities of skeletal elements. Nearly all are genetic in origin. We report a series of seven children with similar findings of chondrodysplasia and growth failure following early hematopoietic stem cell transplantation (HSCT) for pediatric non-oncologic disease: hemophagocytic lymphohistiocytosis or HLH (five children, three with biallelic HLH-associated variants [in PRF1 and UNC13D] and one with HLH secondary to visceral Leishmaniasis), one child with severe combined immunodeficiency and one with Omenn syndrome (both children had biallelic RAG1 pathogenic variants). All children had normal growth and no sign of chondrodysplasia at birth and prior to their primary disease. After HSCT, all children developed growth failure, with standard deviation scores for height at or below -3. Radiographically, all children had changes in the spine, metaphyses and epiphyses, compatible with a spondyloepimetaphyseal dysplasia. Genomic sequencing failed to detect pathogenic variants in genes associated with osteochondrodysplasias. We propose that such chondrodysplasia with growth failure is a novel, rare, but clinically important complication following early HSCT for non-oncologic pediatric diseases. The pathogenesis is unknown but could possibly involve loss or perturbation of the cartilage-bone stem cell population.
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Affiliation(s)
- Lorenzo D Botto
- Division of Genetic Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Marie Meeths
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institutet, and Clinical Genetics, Karolinska University Laboratory and Karolinska University Hospital, Stockholm, Sweden.,Theme of Children's Health, Karolinska University Hospital, Stockholm, Sweden
| | - Belinda Campos-Xavier
- Division of Genetic Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Rosalba Bergamaschi
- Department of Pediatrics, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Laura Mazzanti
- Department of Pediatrics, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Emanuela Scarano
- Department of Pediatrics, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Andrea Finocchi
- Immunology and Infectious Diseases Unit, University-Hospital Pediatric Department (DPUO), Bambino Gesù Children's Hospital, IRCSS, Rome, Italy.,Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Caterina Cancrini
- Immunology and Infectious Diseases Unit, University-Hospital Pediatric Department (DPUO), Bambino Gesù Children's Hospital, IRCSS, Rome, Italy.,Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Birgit Zirn
- Genetikum Stuttgart, Genetic Counselling and Diagnostics, Stuttgart, Germany
| | - Ingrid Kühnle
- Division of Pediatric Hematology and Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Christof Maria Kramm
- Division of Pediatric Hematology and Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Yasemin Alanay
- Department of Pediatrics, Pediatric Genetics Unit, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - Wendy D Jones
- North East Thames Regional Genetics Service, Great Ormond Street Hospital, London, UK
| | - Melita Irving
- Clinical Genetics Department, Guy's and St Thomas' NHS Hospital, London, UK.,Division of Medical and Molecular Genetics, King's College London, UK
| | - Ataf Sabir
- Clinical Genetics Department, Guy's and St Thomas' NHS Hospital, London, UK
| | - Jan-Inge Henter
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Theme of Children's Health, Karolinska University Hospital, Stockholm, Sweden
| | - Birgit Borgström
- Department of Oncology-Pathology, Karolinska Institutet, Solna, Sweden
| | - Ann Nordgren
- Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institutet, and Clinical Genetics, Karolinska University Laboratory and Karolinska University Hospital, Stockholm, Sweden
| | - Anna Hammarsjö
- Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institutet, and Clinical Genetics, Karolinska University Laboratory and Karolinska University Hospital, Stockholm, Sweden
| | - Caterina Putti
- Pediatric Onco-Hematology Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Chiara Mozzato
- Clinical Genetics and Epidemiology Unit, Department of Laboratory Medicine, University Hospital of Padova, Padova, Italy
| | - Daniela Zuccarello
- Clinical Genetics and Epidemiology Unit, Department of Laboratory Medicine, University Hospital of Padova, Padova, Italy
| | - Gen Nishimura
- Center for Intractable Diseases, Saitama Medical University Hospital, Saitama, Japan
| | - Luisa Bonafè
- Division of Genetic Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Giedre Grigelioniene
- Department of Molecular Medicine and Surgery, Center for Molecular Medicine, Karolinska Institutet, and Clinical Genetics, Karolinska University Laboratory and Karolinska University Hospital, Stockholm, Sweden
| | - Sheila Unger
- Division of Genetic Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Andrea Superti-Furga
- Division of Genetic Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Morbidoni V, Agolini E, Slep KC, Pannone L, Zuccarello D, Cassina M, Grosso E, Gai G, Salviati L, Dallapiccola B, Novelli A, Martinelli S, Trevisson E. Biallelic mutations in the TOGARAM1 gene cause a novel primary ciliopathy. J Med Genet 2020; 58:526-533. [PMID: 32747439 DOI: 10.1136/jmedgenet-2020-106833] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Dysfunction in non-motile cilia is associated with a broad spectrum of developmental disorders characterised by clinical heterogeneity. While over 100 genes have been associated with primary ciliopathies, with wide phenotypic overlap, some patients still lack a molecular diagnosis. OBJECTIVE To investigate and functionally characterise the molecular cause of a malformation disorder observed in two sibling fetuses characterised by microphthalmia, cleft lip and palate, and brain anomalies. METHODS A trio-based whole exome sequencing (WES) strategy was used to identify candidate variants in the TOGARAM1 gene. In silico, in vitro and in vivo (Caenorhabditis elegans) studies were carried out to explore the impact of mutations on protein structure and function, and relevant biological processes. RESULTS TOGARAM1 encodes a member of the Crescerin1 family of proteins regulating microtubule dynamics. Its orthologue in C. elegans, che-12, is expressed in a subset of sensory neurons and localises in the dendritic cilium where it is required for chemosensation. Nematode lines harbouring the corresponding missense variant in TOGARAM1 were generated by CRISPR/Cas9 technology. Although chemotaxis ability on a NaCl gradient was not affected, che-12 point mutants displayed impaired lipophilic dye uptake, with shorter and altered cilia in sensory neurons. Finally, in vitro analysis of microtubule polymerisation in the presence of wild-type or mutant TOG2 domain revealed a faster polymerisation associated with the mutant protein, suggesting aberrant tubulin binding. CONCLUSIONS Our data are in favour of a causative role of TOGARAM1 variants in the pathogenesis of this novel disorder, connecting this gene with primary ciliopathy.
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Affiliation(s)
- Valeria Morbidoni
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Laboratorio di Genetica ed Epidemiologia Clinica, Instituto di Ricerca Pediatrica Citta della Speranza, Padova, Italy
| | - Emanuele Agolini
- Laboratory of Medical Genetics, Ospedale Pediatrico Bambino Gesù, Roma, Italy
| | - Kevin C Slep
- Department of Biology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Luca Pannone
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Roma, Italy.,Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, Roma, Italy
| | - Daniela Zuccarello
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Matteo Cassina
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Enrico Grosso
- Medical Genetics Unit, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Giorgia Gai
- Medical Genetics Unit, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Leonardo Salviati
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Laboratorio di Genetica ed Epidemiologia Clinica, Instituto di Ricerca Pediatrica Citta della Speranza, Padova, Italy
| | - Bruno Dallapiccola
- Scientific Directorate, Ospedale Pediatrico Bambino Gesù, Roma, Lazio, Italy
| | - Antonio Novelli
- Laboratory of Medical Genetics, Ospedale Pediatrico Bambino Gesù, Roma, Italy
| | - Simone Martinelli
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Roma, Italy
| | - Eva Trevisson
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy .,Laboratorio di Genetica ed Epidemiologia Clinica, Instituto di Ricerca Pediatrica Citta della Speranza, Padova, Italy
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14
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Carvalho F, Moutou C, Dimitriadou E, Dreesen J, Giménez C, Goossens V, Kakourou G, Vermeulen N, Zuccarello D, De Rycke M. ESHRE PGT Consortium good practice recommendations for the detection of monogenic disorders. Hum Reprod Open 2020; 2020:hoaa018. [PMID: 32500103 PMCID: PMC7257022 DOI: 10.1093/hropen/hoaa018] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 02/10/2020] [Indexed: 02/07/2023] Open
Abstract
The field of preimplantation genetic testing (PGT) is evolving fast and best practice advice is essential for regulation and standardisation of diagnostic testing. The previous ESHRE guidelines on best practice for PGD, published in 2005 and 2011, are considered outdated, and the development of new papers outlining recommendations for good practice in PGT was necessary. The current paper provides recommendations on the technical aspects of PGT for monogenic/single-gene defects (PGT-M) and covers recommendations on basic methods for PGT-M and testing strategies. Furthermore, some specific recommendations are formulated for special cases, including de novo pathogenic variants, consanguineous couples, HLA typing, exclusion testing and disorders caused by pathogenic variants in the mitochondrial DNA. This paper is one of a series of four papers on good practice recommendations on PGT. The other papers cover the organisation of a PGT centre, embryo biopsy and tubing and the technical aspects of PGT for chromosomal structural rearrangements/aneuploidies. Together, these papers should assist scientists interested in PGT in developing the best laboratory and clinical practice possible.
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Affiliation(s)
| | - Filipa Carvalho
- Genetics – Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
- i3s – Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
| | - Céline Moutou
- Université de Strasbourg, Strasbourg, France
- Laboratoire de Diagnostic Préimplantatoire, Hôpitaux Universitaires de Strasbourg, Schiltigheim, France
| | - Eftychia Dimitriadou
- Department of Human Genetics, Center for Human Genetics, University Hospitals Leuven, KU Leuven, O&N I Herestraat 49, Leuven, Belgium
| | - Jos Dreesen
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
- School for Oncology and Developmental Biology, GROW, Maastricht University, Maastricht, The Netherlands
| | | | | | - Georgia Kakourou
- National and Kapodistrian University of Athens, Athens, Greece
- Department of Medical Genetics, ‘Aghia Sophia’ Children’s Hospital, Athens, Greece
| | | | - Daniela Zuccarello
- Department of Lab Medicine, Unit of Clinical Genetics and Epidemiology, University Hospital of Padova, Padova, Italy
| | - Martine De Rycke
- Centre for Medical Genetics, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Reproduction and Genetics, Vrije Universiteit Brussel (VUB), Brussels Belgium
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15
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De Santis L, Cimadomo D, Capalbo A, Di Pietro C, Zuccarello D, Anastasi A, Licata E, Scarica C, Fernandez LS, Klinger FG. IUI and uterine lavage of in vivo-produced blastocysts for PGT purposes: is it a technically and ethically reasonable perspective? Is it actually needed? J Assist Reprod Genet 2020; 37:1579-1582. [PMID: 32458102 DOI: 10.1007/s10815-020-01813-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/07/2020] [Indexed: 01/25/2023] Open
Abstract
A recent study by Munné et al. portrayed a protocol to retrieve in vivo produced blastocysts after IUI and uterine lavage for preimplantation genetic testing (PGT) purposes. The authors claimed this protocol might represent a reasonable future perspective for patients who do not want to undergo IVF, but still want to be informed about their embryos' genetic/chromosomal defects. Although the intent of making PGT available also to patients who cannot or do not need to undergo IVF is respectable, the value of this study is undermined by severe technical and ethical issues. Munné and colleagues' paper was discussed within the executive committee (i.e., president and vice-president of the society, director and vice-director of the scientific committee, secretariat, and counselors), the special interest group in reproductive genetics, the scientific committee, and the collegio dei probiviri of the Italian Society of Embryology, Reproduction and Research (SIERR). The points raised from this discussion are summarized in this opinion paper.
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Affiliation(s)
- Lucia De Santis
- Department of Obstetrics & Gynecology, IVF Unit, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Danilo Cimadomo
- GENERA Center for Reproductive Medicine, Clinica Valle Giulia, Rome, Italy.
| | - Antonio Capalbo
- Igenomix, Marostica, Italy
- Department of Biomedical and Biotechnological Sciences, Section of Biology and Genetics "G. Sichel", University of Catania, Catania, Italy
| | - Cinzia Di Pietro
- DAHFMO, Unit of Histology and Medical Embryology, Sapienza, University of Rome, Rome, Italy
| | - Daniela Zuccarello
- Unit of Clinical Genetics and Epidemiology, Department of Lab Medicine, University Hospital of Padova, Padova, Italy
| | - Attilio Anastasi
- Physiopathology of Human Reproduction Center, Hospital "del Delta", Lagosanto, Italy
| | - Emanuele Licata
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - Catello Scarica
- Casa di Cura Villa Salaria in partnership with Institut Marques, Reproductive Medicine, Rome, Italy
| | | | - Francesca Gioia Klinger
- Department of Biomedicine and Prevention, Section of Histology and Embryology, University of Rome "Tor Vergata", Rome, Italy
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16
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Catusi I, Recalcati MP, Bestetti I, Garzo M, Valtorta C, Alfonsi M, Alghisi A, Cappellani S, Casalone R, Caselli R, Ceccarini C, Ceglia C, Ciaschini AM, Coviello D, Crosti F, D'Aprile A, Fabretto A, Genesio R, Giagnacovo M, Granata P, Longo I, Malacarne M, Marseglia G, Montaldi A, Nardone AM, Palka C, Pecile V, Pessina C, Postorivo D, Redaelli S, Renieri A, Rigon C, Tiberi F, Tonelli M, Villa N, Zilio A, Zuccarello D, Novelli A, Larizza L, Giardino D. Testing single/combined clinical categories on 5110 Italian patients with developmental phenotypes to improve array-based detection rate. Mol Genet Genomic Med 2019; 8:e1056. [PMID: 31851782 PMCID: PMC6978242 DOI: 10.1002/mgg3.1056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/23/2019] [Accepted: 10/28/2019] [Indexed: 01/09/2023] Open
Abstract
Background Chromosomal microarray analysis (CMA) is nowadays widely used in the diagnostic path of patients with clinical phenotypes. However, there is no ascertained evidence to date on how to assemble single/combined clinical categories of developmental phenotypic findings to improve the array‐based detection rate. Methods The Italian Society of Human Genetics coordinated a retrospective study which included CMA results of 5,110 Italian patients referred to 17 genetics laboratories for variable combined clinical phenotypes. Results Non‐polymorphic copy number variants (CNVs) were identified in 1512 patients (30%) and 615 (32%) present in 552 patients (11%) were classified as pathogenic. CNVs were analysed according to type, size, inheritance pattern, distribution among chromosomes, and association to known syndromes. In addition, the evaluation of the detection rate of clinical subgroups of patients allowed to associate dysmorphisms and/or congenital malformations combined with any other single clinical sign to an increased detection rate, whereas non‐syndromic neurodevelopmental signs and non‐syndromic congenital malformations to a decreased detection rate. Conclusions Our retrospective study resulted in confirming the high detection rate of CMA and indicated new clinical markers useful to optimize their inclusion in the diagnostic and rehabilitative path of patients with developmental phenotypes.
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Affiliation(s)
- Ilaria Catusi
- Lab. di Citogenetica Medica, Istituto Auxologico Italiano, IRCCS, Milano, Italy
| | | | - Ilaria Bestetti
- Lab. di Citogenetica Medica, Istituto Auxologico Italiano, IRCCS, Milano, Italy
| | - Maria Garzo
- Lab. di Citogenetica Medica, Istituto Auxologico Italiano, IRCCS, Milano, Italy
| | - Chiara Valtorta
- Lab. di Citogenetica Medica, Istituto Auxologico Italiano, IRCCS, Milano, Italy
| | - Melissa Alfonsi
- U.O.C. di Genetica medica, Ospedale SS Annunziata, Chieti, Italy
| | - Alberta Alghisi
- U.O.S. Genetica e Biologia Molecolare, Azienda ULSS 6, Vicenza, Italy
| | | | - Rosario Casalone
- SMeL specializzato Citogenetica e Genetica Medica, ASST Sette Laghi, Osp. di Circolo e Fond. Macchi, Varese, Italy
| | - Rossella Caselli
- U.O.C. Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | | | - Carlo Ceglia
- UOSD Genetica Medica, AORN "SG Moscati", Avellino, Italy
| | - Anna Maria Ciaschini
- A.O.U. Ospedali Riuniti Umberto I - G.M.Lancisi - G.Salesi, Lab. Genetica Medica SOS Malattie Rare, Ancona, Italy
| | - Domenico Coviello
- Lab. di Genetica Umana, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Francesca Crosti
- U.S. Genetica Medica, Ospedale San Gerardo ASST Monza, Monza, Italy
| | | | | | - Rita Genesio
- U.O.C. di Citogenetica, A.O.U. Federico II, Napoli, Italy
| | | | - Paola Granata
- SMeL specializzato Citogenetica e Genetica Medica, ASST Sette Laghi, Osp. di Circolo e Fond. Macchi, Varese, Italy
| | - Ilaria Longo
- U.O.C. Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Michela Malacarne
- Lab. di Genetica Umana, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | | | | | | | - Chiara Palka
- Dipartimento di Pediatria, Università G. D'Annunzio, Chieti-Pescara, Italy
| | - Vanna Pecile
- S.C. Genetica Medica, IRCCS Burlo Garofolo, Trieste, Italy
| | - Chiara Pessina
- SMeL specializzato Citogenetica e Genetica Medica, ASST Sette Laghi, Osp. di Circolo e Fond. Macchi, Varese, Italy
| | - Diana Postorivo
- U.O.C. Lab. di Genetica Medica, Policlinico Tor Vergata, Roma, Italy
| | - Serena Redaelli
- Dipartimento di Medicina e Chirurgia, Università di Milano-Bicocca, Monza, Italy
| | - Alessandra Renieri
- U.O.C. Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Chiara Rigon
- U.O.C. Genetica e Epidemiologia Clinica, A.O.U. di Padova, Padova, Italy
| | - Fabiola Tiberi
- A.O.U. Ospedali Riuniti Umberto I - G.M.Lancisi - G.Salesi, Lab. Genetica Medica SOS Malattie Rare, Ancona, Italy
| | - Mariella Tonelli
- LCGM Dipartimento di Medicina Molecolare e Traslazionale, Università di Brescia, Brescia, Italy
| | - Nicoletta Villa
- U.S. Genetica Medica, Ospedale San Gerardo ASST Monza, Monza, Italy
| | - Anna Zilio
- U.O.S. Genetica e Biologia Molecolare, Azienda ULSS 6, Vicenza, Italy
| | - Daniela Zuccarello
- U.O.C. Genetica e Epidemiologia Clinica, A.O.U. di Padova, Padova, Italy
| | - Antonio Novelli
- U.O.C. Laboratorio di Genetica Medica, Ospedale Pediatrico del Bambino Gesù, Roma, Italy
| | - Lidia Larizza
- Lab. di Citogenetica Medica, Istituto Auxologico Italiano, IRCCS, Milano, Italy
| | - Daniela Giardino
- Lab. di Citogenetica Medica, Istituto Auxologico Italiano, IRCCS, Milano, Italy
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17
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Bottesi G, Spoto A, Trevisson E, Zuccarello D, Vidotto G, Cassina M, Clementi M. Dysfunctional coping is related to impaired skin-related quality of life and psychological distress in patients with neurofibromatosis type 1 with major skin involvement. Br J Dermatol 2019; 182:1449-1457. [PMID: 31329288 DOI: 10.1111/bjd.18363] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Low skin-related quality of life (QoL) is usually associated with low levels of self-confidence and self-esteem and with high levels of anxiety and depression symptoms. The way patients cope with a physical disease impacts significantly on their psychosocial adjustment to the disorder and on their emotional functioning. OBJECTIVES To explore how coping strategies, skin-related QoL, psychological distress and self-esteem interact in a sample of individuals with neurofibromatosis type 1 (NF1). METHODS Seventy-two adult patients with NF1 completed the following questionnaires: Coping Orientation to Problem Experiences (COPE), Skindex-29, Padua Skin-Related QoL questionnaire (PSRQ), State-Trait Anxiety Inventory-X2 form (STAI-X2), Depression Questionnaire (DQ) and Rosenberg Self-Esteem Scale (RSES). The k-modes algorithm was used to identify clusters of patients based on four variables: sex, NF1 severity, number and distribution of cutaneous neurofibromas. Individuals in different clusters were compared with regard to their scores; correlations between scores were analysed within each cluster. RESULTS Two main clusters were identified: individuals in Cluster 1 had a larger number and more widespread distribution of neurofibromas compared with Cluster 2. Patients in Cluster 1 scored higher only on several PSRQ and Skindex-29 scales. Among patients in Cluster 1, the COPE 'avoidance strategies' scale was significantly correlated with the PSRQ 'physical distress and impairments' scale, the Skindex-29 'physical symptoms' and 'functioning' scales, the STAI-X2, the DQ and the RSES. CONCLUSIONS Patients with major skin involvement have reduced skin-related QoL. Among them, current findings tentatively suggest that the higher the use of dysfunctional coping, the more impaired are QoL, psychological distress and self-esteem. What's already known about this topic? Neurofibromatosis type 1 (NF1) can affect the quality of life (QoL) in adolescent and adult patients. Low skin-related QoL is usually associated with low levels of self-confidence and self-esteem and with high levels of anxiety and depression symptoms. Questionnaires evaluating skin-related QoL, anxiety, depression, self-esteem and coping are available. What does this study add? Patients with a large number and a widespread distribution of cutaneous neurofibromas have reduced skin-related QoL compared with patients with minor skin involvement. The newly developed Padua Skin-Related QoL questionnaire allows the simultaneous evaluation of discomfort and comfort skin-related QoL dimensions in patients with NF1. Among patients with major skin involvement, the higher the use of dysfunctional coping, the more impaired are skin-related QoL, psychological distress and self-esteem. Our data suggest that patients with NF1 with major skin involvement who endorse dysfunctional beliefs about their own coping abilities might benefit from psychological counselling and coping skills treatments aiming to both improve perceived self-efficacy and learn more adaptive coping strategies.
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Affiliation(s)
- G Bottesi
- Department of General Psychology, University of Padova, Via Giustiniani 3, 35128, Italy
| | - A Spoto
- Department of General Psychology, University of Padova, Via Giustiniani 3, 35128, Italy
| | - E Trevisson
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Via Giustiniani 3, 35128, Padova, Italy
| | - D Zuccarello
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Via Giustiniani 3, 35128, Padova, Italy
| | - G Vidotto
- Department of General Psychology, University of Padova, Via Giustiniani 3, 35128, Italy
| | - M Cassina
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Via Giustiniani 3, 35128, Padova, Italy
| | - M Clementi
- Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Via Giustiniani 3, 35128, Padova, Italy
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Poli M, Girardi L, Fabiani M, Moretto M, Romanelli V, Patassini C, Zuccarello D, Capalbo A. Past, Present, and Future Strategies for Enhanced Assessment of Embryo's Genome and Reproductive Competence in Women of Advanced Reproductive Age. Front Endocrinol (Lausanne) 2019; 10:154. [PMID: 30941103 PMCID: PMC6433971 DOI: 10.3389/fendo.2019.00154] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 02/21/2019] [Indexed: 12/13/2022] Open
Abstract
Recent advancements in genomic analysis allow testing of an increasing number of genetic features in human preimplantation embryos. Typical single gene mutation and whole chromosomes testing can now be integrated with assessment of mitochondrial DNA and polygenic conditions. Diagnostic expansion into epigenetic and transcriptomic assessment in the near future are potential technological targets which may improve the prognostic outlook of patients of advanced reproductive age and overall in vitro fertilization (IVF) treatment outcomes. In this review, we discuss the technological progress of recent years and their future applications in preimplantation genetic testing in IVF.
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Affiliation(s)
- Maurizio Poli
- IGENOMIX, Marostica, Italy
- REPROOMICS, Amsterdam, Netherlands
| | | | | | | | | | | | | | - Antonio Capalbo
- IGENOMIX, Marostica, Italy
- IGENOMIX, Parque Tecnologico Paterna, Valencia, Spain
- Sezione Istologia ed Embriologia Medica, Dipartimento di Scienze Anatomiche, Istologiche, Medico-Legali e dell'Apparato Locomotore, University of Rome “La Sapienza”, Rome, Italy
- *Correspondence: Antonio Capalbo
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Cimadomo D, Ubaldi FM, Capalbo A, Maggiulli R, Scarica C, Romano S, Poggiana C, Zuccarello D, Giancani A, Vaiarelli A, Rienzi L. Failure mode and effects analysis of witnessing protocols for ensuring traceability during PGD/PGS cycles. Reprod Biomed Online 2016; 33:360-9. [PMID: 27372783 DOI: 10.1016/j.rbmo.2016.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 06/06/2016] [Accepted: 06/09/2016] [Indexed: 10/21/2022]
Abstract
Preimplantation genetic diagnosis and aneuploidy testing (PGD/PGS) use is constantly growing in IVF, and embryo/biopsy traceability during the additional laboratory procedures needed is pivotal. An electronic witnessing system (EWS), which showed a significant value in decreasing mismatch occurrence and increasing detection possibilities during standard care IVF, still does not guarantee the same level of efficiency during PGD/PGS cycles. Specifically, EWS cannot follow single embryos throughout the procedure. This is however critical when an unambiguous diagnosis corresponds to each embryo. Failure Mode and Effects Analysis (FMEA) is a proactive method generally adopted to define tools ensuring safety along a procedure. Due to the implementation of a large quantitative PCR (qPCR)-based blastocyst stage PGD/PGS programme in our centre, and to evaluate the potential procedural risks, a FMEA was performed in September 2014. Forty-four failure modes were identified, among which six were given a moderate risk priority number (>15) (RPN; product of estimated occurrence, severity and detection). Specific corrective measures were then introduced and implemented, and a second evaluation performed six months later. The meticulous and careful application of such measures allowed the risks to be decreased along the whole protocol, by reducing their estimated occurrence and/or increasing detection possibilities.
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Affiliation(s)
- Danilo Cimadomo
- GENERA centers for reproductive medicine, via G de Notaris 2/b, Rome, Italy; University of Rome, Sapienza, Dipartimento di Scienze Anatomiche, Istologiche, Medico-Legali e dell'Apparato Locomotore, Sezione Istologia ed Embriologia Medica, via A. Scarpa 16, Rome, Italy.
| | - Filippo Maria Ubaldi
- GENERA centers for reproductive medicine, via G de Notaris 2/b, Rome, Italy; GENETYX Molecular Genetics Laboratory, via Fermi 1, Marostica, Italy
| | - Antonio Capalbo
- GENERA centers for reproductive medicine, via G de Notaris 2/b, Rome, Italy; GENETYX Molecular Genetics Laboratory, via Fermi 1, Marostica, Italy
| | - Roberta Maggiulli
- GENERA centers for reproductive medicine, via G de Notaris 2/b, Rome, Italy
| | - Catello Scarica
- GENERA centers for reproductive medicine, via G de Notaris 2/b, Rome, Italy; University of Rome, Sapienza, Dipartimento di Scienze Anatomiche, Istologiche, Medico-Legali e dell'Apparato Locomotore, Sezione Istologia ed Embriologia Medica, via A. Scarpa 16, Rome, Italy
| | - Stefania Romano
- GENERA centers for reproductive medicine, via G de Notaris 2/b, Rome, Italy
| | - Cristina Poggiana
- GENETYX Molecular Genetics Laboratory, via Fermi 1, Marostica, Italy
| | | | - Adriano Giancani
- GENERA centers for reproductive medicine, via G de Notaris 2/b, Rome, Italy; GENETYX Molecular Genetics Laboratory, via Fermi 1, Marostica, Italy
| | - Alberto Vaiarelli
- GENERA centers for reproductive medicine, via G de Notaris 2/b, Rome, Italy
| | - Laura Rienzi
- GENERA centers for reproductive medicine, via G de Notaris 2/b, Rome, Italy; GENETYX Molecular Genetics Laboratory, via Fermi 1, Marostica, Italy
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De Toni L, Di Nisio A, Speltra E, Rocca MS, Ghezzi M, Zuccarello D, Turiaco N, Ferlin A, Foresta C. Polymorphism rs2274911 of GPRC6A as a Novel Risk Factor for Testis Failure. J Clin Endocrinol Metab 2016; 101:953-61. [PMID: 26735260 DOI: 10.1210/jc.2015-3967] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The G protein-coupled receptor GPRC6A is an emerging effector with multiple endocrine roles, including stimulation of T production from the testis. Recently, two men with an inactivating mutation (F464Y) of GPRC6A have been identified, and they showed primary testicular failure and deranged spermatogenesis. Furthermore, one of them also reported cryptorchidism at birth. In addition, a polymorphism (rs2274911, Pro91Ser) in GPRC6A is associated with prostate cancer, a typical androgen-sensitive cancer. OBJECTIVE To study the possible association between rs2274911 polymorphism and male fertility and/or cryptorchidism. Design, Patients, Settings: A total of 611 subjects, including 343 infertile patients, 197 normozoospermic controls, and 71 cryptorchid newborns, were retrospectively selected. METHODS Sequencing analysis for rs2274911 polymorphism and F464Y mutation, and serum levels of FSH, LH, and T were assessed. In vitro functional studies for rs2274911 and F464Y were also performed. RESULTS Homozygous subjects for the risk allele A of rs2274911 had a 4.60-fold increased risk of oligozoospermia and 3.52-fold increased risk of cryptorchidism. A significant trend for increased levels of LH in the GA and AA genotypes, compared with GG homozygotes, was detected in men with azoospermia/cryptozoospermia (P for trend = .027), further supporting an association with primary testicular failure. The mutation F464Y was found in one cryptorchid child (one in 71; 1.41%). Functional studies showed that the A allele of rs2274911 and the F464Y substitution were associated with lower exposition of the receptor on the cell membrane and a reduced downstream phosphorylation of ERK1/2 with respect to wild type. CONCLUSION Our results suggest that GPRC6A inactivation or sub-function contributes to reduced exposure to androgens, leading to cryptorchidism during fetal life and/or low sperm production in adulthood.
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Affiliation(s)
- Luca De Toni
- Department of Medicine (L.D.T., A.D.N., E.S., M.S.R., M.G., A.F., C.F.), Unit of Andrology and Reproductive Medicine, University of Padova, 35128 Padova, Italy; Clinical Genetics Unit (D.Z.), Department of Woman and Child Health, University of Padova, 35128 Padova, Italy; and Department of Paediatric, Gynaecological, Microbiological, and Biomedical Sciences (N.T.), University of Messina, 98124 Messina, Italy
| | - Andrea Di Nisio
- Department of Medicine (L.D.T., A.D.N., E.S., M.S.R., M.G., A.F., C.F.), Unit of Andrology and Reproductive Medicine, University of Padova, 35128 Padova, Italy; Clinical Genetics Unit (D.Z.), Department of Woman and Child Health, University of Padova, 35128 Padova, Italy; and Department of Paediatric, Gynaecological, Microbiological, and Biomedical Sciences (N.T.), University of Messina, 98124 Messina, Italy
| | - Elena Speltra
- Department of Medicine (L.D.T., A.D.N., E.S., M.S.R., M.G., A.F., C.F.), Unit of Andrology and Reproductive Medicine, University of Padova, 35128 Padova, Italy; Clinical Genetics Unit (D.Z.), Department of Woman and Child Health, University of Padova, 35128 Padova, Italy; and Department of Paediatric, Gynaecological, Microbiological, and Biomedical Sciences (N.T.), University of Messina, 98124 Messina, Italy
| | - Maria Santa Rocca
- Department of Medicine (L.D.T., A.D.N., E.S., M.S.R., M.G., A.F., C.F.), Unit of Andrology and Reproductive Medicine, University of Padova, 35128 Padova, Italy; Clinical Genetics Unit (D.Z.), Department of Woman and Child Health, University of Padova, 35128 Padova, Italy; and Department of Paediatric, Gynaecological, Microbiological, and Biomedical Sciences (N.T.), University of Messina, 98124 Messina, Italy
| | - Marco Ghezzi
- Department of Medicine (L.D.T., A.D.N., E.S., M.S.R., M.G., A.F., C.F.), Unit of Andrology and Reproductive Medicine, University of Padova, 35128 Padova, Italy; Clinical Genetics Unit (D.Z.), Department of Woman and Child Health, University of Padova, 35128 Padova, Italy; and Department of Paediatric, Gynaecological, Microbiological, and Biomedical Sciences (N.T.), University of Messina, 98124 Messina, Italy
| | - Daniela Zuccarello
- Department of Medicine (L.D.T., A.D.N., E.S., M.S.R., M.G., A.F., C.F.), Unit of Andrology and Reproductive Medicine, University of Padova, 35128 Padova, Italy; Clinical Genetics Unit (D.Z.), Department of Woman and Child Health, University of Padova, 35128 Padova, Italy; and Department of Paediatric, Gynaecological, Microbiological, and Biomedical Sciences (N.T.), University of Messina, 98124 Messina, Italy
| | - Nunzio Turiaco
- Department of Medicine (L.D.T., A.D.N., E.S., M.S.R., M.G., A.F., C.F.), Unit of Andrology and Reproductive Medicine, University of Padova, 35128 Padova, Italy; Clinical Genetics Unit (D.Z.), Department of Woman and Child Health, University of Padova, 35128 Padova, Italy; and Department of Paediatric, Gynaecological, Microbiological, and Biomedical Sciences (N.T.), University of Messina, 98124 Messina, Italy
| | - Alberto Ferlin
- Department of Medicine (L.D.T., A.D.N., E.S., M.S.R., M.G., A.F., C.F.), Unit of Andrology and Reproductive Medicine, University of Padova, 35128 Padova, Italy; Clinical Genetics Unit (D.Z.), Department of Woman and Child Health, University of Padova, 35128 Padova, Italy; and Department of Paediatric, Gynaecological, Microbiological, and Biomedical Sciences (N.T.), University of Messina, 98124 Messina, Italy
| | - Carlo Foresta
- Department of Medicine (L.D.T., A.D.N., E.S., M.S.R., M.G., A.F., C.F.), Unit of Andrology and Reproductive Medicine, University of Padova, 35128 Padova, Italy; Clinical Genetics Unit (D.Z.), Department of Woman and Child Health, University of Padova, 35128 Padova, Italy; and Department of Paediatric, Gynaecological, Microbiological, and Biomedical Sciences (N.T.), University of Messina, 98124 Messina, Italy
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Zuccarello D, Bazzato MF, Ferlin A, Pengo M, Frigo AC, Favero G, Foresta C, Stellini E. Role of familiarity versus interleukin-1 genes cluster polymorphisms in chronic periodontitis. Gene 2013; 535:286-9. [PMID: 24275344 DOI: 10.1016/j.gene.2013.11.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 10/14/2013] [Accepted: 11/06/2013] [Indexed: 11/24/2022]
Abstract
Periodontitis (PO) is a multifactorial disease affecting about 10% to 20% of the general population. Several studies have suggested that part of the clinical variability in PO might be explained by genetic factors. Among the candidate genes for PO, IL1 gene polymorphisms have been broadly investigated, with variable results, for their relationship with the disease. We studied three IL1 polymorphisms, IL1A C[-889]T (rs1800587), IL1B C[3953/4]T (rs1143634), and IL1RN VNTR [+2018] (rs419598) in relation to different life styles and familiarities. We did not find correlation between these IL1 polymorphisms and chronic PO, as well as between chronic PO and life styles (smoking, alcohol, coffee, fizzy drink and fish). We found a strong correlation, also after adjustment for age, between familiarity and PO onset (P=0.0062; OR 5.754, 95% CI 1.644-20.145). In conclusion, we did confirm the previously suggested association between PO and IL1 gene cluster polymorphisms, and between PO and four common risk factors (coffee, smoking, alcohol and fizzy drinks) and one common protective factor (fish). On the contrary, we found a strong role of familiarity.
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Affiliation(s)
- Daniela Zuccarello
- Department of Medicine, Centre for Human Reproduction Pathology, University of Padova, Padova, Italy.
| | - M Federica Bazzato
- Department of Neurosciences, Odontostomatology Institute, University of Padova, Padova, Italy
| | - Alberto Ferlin
- Department of Medicine, Centre for Human Reproduction Pathology, University of Padova, Padova, Italy
| | - Manuel Pengo
- Department of Medicine, Centre for Human Reproduction Pathology, University of Padova, Padova, Italy
| | - Anna Chiara Frigo
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Giovanni Favero
- Department of Neurosciences, Odontostomatology Institute, University of Padova, Padova, Italy
| | - Carlo Foresta
- Department of Medicine, Centre for Human Reproduction Pathology, University of Padova, Padova, Italy
| | - Edoardo Stellini
- Department of Neurosciences, Odontostomatology Institute, University of Padova, Padova, Italy
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Ottaviano G, Zuccarello D, Frasson G, Scarpa B, Nardello E, Foresta C, Marioni G, Staffieri A. Olfactory Sensitivity and Sexual Desire in Young Adult and Elderly Men: An Introductory Investigation. Am J Rhinol Allergy 2013; 27:157-61. [DOI: 10.2500/ajra.2013.27.3879] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background It has been suggested that olfaction could influence human sexual behavior. Age is negatively associated with many aspects of sexuality and, with increasing age, people tend to show a declining sexual desire. The present pilot study investigated the relationship between sexual desire and olfactory sensitivity in healthy men of two age groups, young adult and elderly (≥65 years old), to ascertain whether their sense of smell could determine sexual desire and whether an age-related weaker olfactory sensitivity could correlate with the decline in sexual appetite in elderly patients. Methods Sixty-three volunteers were recruited and divided into two groups, one consisting of 48 healthy young adult men, the other of 15 healthy elderly men. All participants were tested to ascertain their odor threshold for n-butanol (Sniffin’ Sticks) and their sexual desire using the International Index of Erectile Function (IIEF), presenting only the questions relating to frequency (IIEF1) and level (IIEF2) of sexual desire. Results Sexual desire and mean olfactory thresholds were higher in the younger adults than in the elderly men (p = 0.001 and p = 0.02, respectively). There was a significant association between butanol threshold and sexual desire for the young adult group (p = 0.02), but not for the elderly group (p = 0.35). Conclusion This study found a preliminary association between olfaction and sexual behavior, in young adults at least. More studies are needed to improve our knowledge in this intriguing field, possibly using electrophysiological olfactory methods.
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Affiliation(s)
| | | | - Giuliana Frasson
- Departments of Neurosciences, Otolaryngology Section, Padova, Italy
| | - Bruno Scarpa
- Statistical Sciences, Padova University, Padova, Italy
| | - Ennio Nardello
- Departments of Neurosciences, Otolaryngology Section, Padova, Italy
| | | | - Gino Marioni
- Departments of Neurosciences, Otolaryngology Section, Padova, Italy
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Ottaviano G, Zuccarello D, Menegazzo M, Perilli L, Marioni G, Frigo AC, Staffieri A, Foresta C. Human olfactory sensitivity for bourgeonal and male infertility: a preliminary investigation. Eur Arch Otorhinolaryngol 2013; 270:3079-86. [PMID: 23525651 DOI: 10.1007/s00405-013-2441-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 03/08/2013] [Indexed: 10/27/2022]
Abstract
Olfactory receptor (OR) expression is also present in the sperm cells and could mediate sperm chemotaxis. OR1D2 was the first OR expressed in the testis demonstrated to be involved in chemotaxis and to be expressed also in the nose with a similar behavior. Bourgeonal is the OR1D2 most potent known agonist. Infertility affects ~15 % of couples in western countries and sometimes it is unexplained. This pilot study compared the bourgeonal olfactory thresholds, the ability of sperm to sense the bourgeonal and the frequency of 13 single nucleotide polymorphisms (SNPs) of OR1D2 gene in nine males suffering of unexplained infertility with a control group of 15 healthy males. The mean olfactory threshold for bourgeonal was statistically different between the study group (10.5 ± 3.7; median 12.3) and the control group (14.0 ± 2.8; median 15.5) (p = 0.006). Statistical analysis showed a significantly higher percentage of spermatozoa that migrated toward the capillaries filled with bourgeonal in the control group compared to the study group (p < 0.0001). Sperm migration was equally inhibited in both groups of subjects when, together with bourgeonal, capillaries were filled with undecanal, a strong bourgeonal inhibitor (p = 0.42). The 13 SNPs of OR1D2 revealed a statistically significant difference for allele and genotype frequency of rs769423 in study group versus control group (p = 0.02). The present preliminary study seems to confirm the important role of OR1D2 both in nose and spermatozoa and may explain the idiopathic infertility of the study group. Further studies on larger series are mandatory to confirm our preliminary evidence.
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Affiliation(s)
- G Ottaviano
- Department of Neurosciences, Otolaryngology Section, University of Padova, Via Giustiniani 2, 35128, Padua, Italy,
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Zuccarello D, Ghezzi M, Pengo M, Forzan M, Frigo AC, Ferlin A, Foresta C. No Difference in 5-HTTLPR and Stin2 Polymorphisms Frequency Between Premature Ejaculation Patients and Controls. J Sex Med 2012; 9:1659-68. [DOI: 10.1111/j.1743-6109.2012.02715.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Foresta C, Caretta N, Palego P, Ferlin A, Zuccarello D, Lenzi A, Selice R. Reduced artery diameters in Klinefelter syndrome. ACTA ACUST UNITED AC 2012; 35:720-5. [DOI: 10.1111/j.1365-2605.2012.01269.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Goglia U, Vinanzi C, Zuccarello D, Malpassi D, Ameri P, Casu M, Minuto F, Foresta C, Ferone D. Identification of a novel mutation in exon 1 of androgen receptor gene in an azoospermic patient with mild androgen insensitivity syndrome: case report and literature review. Fertil Steril 2011; 96:1165-9. [PMID: 21962961 DOI: 10.1016/j.fertnstert.2011.08.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Revised: 08/10/2011] [Accepted: 08/25/2011] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To report a case of an azoospermic subject with mild androgen insensitivity syndrome (MAIS) and review the relevant literature. DESIGN Case report. SETTING Academic research hospital. PATIENT(S) A 49-year-old man with undermasculinized features and a history of cryptorchidism and azoospermia. INTERVENTION(S) Hormonal evaluation and genetic testing of the androgen receptor gene (AR). MAIN OUTCOME MEASURE(S) Hormonal levels and sequence chromatogram of the proband and his mother. RESULT(S) We found total T in the normal range and high levels of gonadotropins. Karyotype was 46,XY. Genetic testing identified a novel mutation of exon 1 of AR, which resulted in an alanine to serine substitution in the transactivation domain at codon 240 (A240S). Fourteen other mutations of exon 1 of AR have been associated with MAIS to date. CONCLUSION(S) The novel mutation A240S of AR is involved in MAIS, a syndrome associated with azoospermia.
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Affiliation(s)
- Umberto Goglia
- Department of Endocrinological and Medical Sciences, University of Genova, Genova, Italy.
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Menegazzo M, Zuccarello D, Luca G, Ferlin A, Calvitti M, Mancuso F, Calafiore R, Foresta C. Improvements in human sperm quality by long-term in vitro co-culture with isolated porcine Sertoli cells. Hum Reprod 2011; 26:2598-605. [PMID: 21771775 DOI: 10.1093/humrep/der248] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Spermatogenesis is a complex process where spermatogonial germ cells become spermatozoa with the indispensable support of Sertoli cells (SCs), which provide 'ad hoc' structural and nutritional support. Unfortunately, for most sperm dysfunctions, no therapies are yet available except assisted reproductive technologies (ART) that are based on the use of different culture media to preserve sperm in vitro. However, sperm culture is only possible for short periods of time, since long-term culture would invariably and irreversibly damage the cells with negative impact on their fertilization potential. METHODS Fresh sperm cells (5 ml of 20 × 10(6)/ml) were co-cultured with SCs layers, derived from prepubertal pig testes or incubated in cell free SC medium or BWW (Biggers, Whitten and Whittingham) medium for 2, 4 or 7 days. Sperm viability, motility, mitochondrial status, DNA fragmentation, chromatin integrity, intracellular calcium and acrosome status were assessed after every co-culture or incubation time, but capacitation and induction of acrosome reaction (AR) with progesterone was only evaluated after 7 days. RESULTS SCs layers derived from prepubertal pig testes (co-culture of sperm and SC feeder, CCSCF) were able to preserve normal sperm viability, motility and normal mitochondrial function, after 7 days of culture; CCSCF did not induce AR or hyperactivation of spermatozoa, keeping the sperm in a quiescent state for 7 days of culture. Nevertheless, the sperm were readily able to initiate AR after stimulation with progesterone. CONCLUSIONS CCSCF maintained good sperm viability and motility for 7 days. This approach could improve retention of sperm viability and motility during ART procedures and maintain sperm viability, during transfer between two distant Centres, avoiding the need for cryopreservation.
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Affiliation(s)
- Massimo Menegazzo
- Department of Histology, Microbiology and Medical Biotechnologies, Section of Clinical Pathology and Centre for Male Gamete Cryopreservation, University of Padova, 35128 Padova, Italy
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Zuccarello D, Ferlin A, Garolla A, Menegazzo M, Perilli L, Ambrosini G, Foresta C. How the human spermatozoa sense the oocyte: a new role of SDF1-CXCR4 signalling. ACTA ACUST UNITED AC 2011; 34:e554-65. [DOI: 10.1111/j.1365-2605.2011.01158.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Zuccarello D, Dallapiccola B, Novelli A, Foresta C. Azoospermia in a man with a constitutional ring 22 chromosome. Eur J Med Genet 2010; 53:389-91. [PMID: 20709628 DOI: 10.1016/j.ejmg.2010.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2009] [Accepted: 07/29/2010] [Indexed: 10/19/2022]
Abstract
A mosaic ring chromosome 22 (mos 46,XY,r(22)[93]/45,XY,-22[7]) was found in an euploid azoospermic otherwise phenotypically normal individual. Testicular cytological analysis showed hypospermatogenesis with a complete spermatogonial arrest. The majority of subjects with constitutional r(22) are dysmorphic and mentally retarded due to deletion of a sizable segment of the chromosome 22q. Only a few cases of r(22) chromosome are known in which deletion of the very distal telomeric regions is associated with unremarkable phenotype and fertility, both in males and females. The present patient is the first example of male infertility associated with this cytogenetic anomaly. It is likely that infertility arose from a mechanical block of meiosis, resulting from pairing failure of chromosomes 22, similarly to azoospermia occurring in few known males with r(21) chromosomes.
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Affiliation(s)
- Daniela Zuccarello
- Department of Histology, Microbiology and Medical Biotechnologies, Section of Clinical Pathology, Centre for Male Gamete Cryopreservation, University of Padova, Padova, Italy
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Foresta C, Pati MA, Perilli L, Menegazzo M, Zuccarello D, Ferlin A, Garolla A. Retraction: Expression of phosphodiesterase type 5A in human spermatozoa and influence of its inhibition on motility and functional sperm parameters. J Endocrinol Invest 2010:7142. [PMID: 20595799 DOI: 10.3275/7142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The paper entitled "Expression of phosphodiesterase type 5A in human spermatozoa and influence of its inhibition on motility and functional sperm parameters" by C. Foresta et al, which was published online on 1 July 2010, has been withdrawn at the authors' request.
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Affiliation(s)
- C Foresta
- Department of Histology, Microbiology and Medical Biotechnologies, Section of Clinical 11 Pathology, Centre for Male Gamete Cryopreservation, University of Padua, Padua, Italy.
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Foresta C, Ferlin A, Bertoldo A, Patassini C, Zuccarello D, Garolla A. Human papilloma virus in the sperm cryobank: an emerging problem? ACTA ACUST UNITED AC 2010; 34:242-6. [DOI: 10.1111/j.1365-2605.2010.01075.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Foresta C, Garolla A, Zuccarello D, Pizzol D, Moretti A, Barzon L, Palù G. Human papillomavirus found in sperm head of young adult males affects the progressive motility. Fertil Steril 2010; 93:802-6. [DOI: 10.1016/j.fertnstert.2008.10.050] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2008] [Revised: 10/14/2008] [Accepted: 10/16/2008] [Indexed: 10/21/2022]
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Foresta C, Di Mambro A, Caretta N, De Toni L, Zuccarello D, Ferlin A. Effect of vardenafil on endothelial progenitor cells in hypogonadotrophic hypogonadal patients: role of testosterone treatment. Clin Endocrinol (Oxf) 2009; 71:412-6. [PMID: 19094070 DOI: 10.1111/j.1365-2265.2008.03507.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
CONTEXT Endothelial progenitor cells (EPCs) are bone marrow-derived cells required for endothelial repair. Circulating EPC concentration is low in conditions characterized by endothelial dysfunction but their number can be increased by treatment with phosphodiesterase-5 (PDE5) inhibitors. EPCs are also reduced in hypogonadal men and testosterone (T) treatment restores their concentration. OBJECTIVE To evaluate the relationship between the effect of PDE5 inhibitors and T on EPCs, we analysed the acute effect of vardenafil on the number of EPCs in hypogonadotrophic hypogonadal (HH) patients, before and after T treatment. DESIGN AND SETTING A case-control study at a university andrology centre. PATIENTS Fifteen HH subjects and 25 aged-matched controls. MAIN OUTCOME MEASURES The number of circulating EPCs and progenitor cells (PCs) in HH patients was evaluated after acute vardenafil administration at baseline and after 6 months of T supplementation. RESULTS At baseline, HH men had significantly lower numbers of PCs and EPCs with respect to controls and vardenafil administration had no effect on the number of these cells. After 6 months of T treatment, all HH patients were eugonadal. With respect to baseline, PCs and EPCs were significantly higher and reached the levels observed in controls. Vardenafil administration in HH men at the end of T treatment induced a significant increase in PCs and EPCs in a manner similar to that in controls. CONCLUSIONS This study showed that normal T levels are necessary to restore the responsiveness of EPCs to PDE5 inhibitors, suggesting that T positively modulates PDE5 in bone marrow.
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Affiliation(s)
- Carlo Foresta
- Department of Histology, Microbiology and Medical Biotechnologies, Section of Clinical Pathology and Centre for Male Gamete Cryopreservation, University of Padova, Padova, Italy.
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Ferlin A, Zuccarello D, Garolla A, Selice R, Vinanzi C, Ganz F, Zanon GF, Zuccarello B, Foresta C. Mutations in INSL3 and RXFP2 genes in cryptorchid boys. Ann N Y Acad Sci 2009; 1160:213-4. [PMID: 19416190 DOI: 10.1111/j.1749-6632.2008.03784.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Mutations in the INSL3 and RXFP2 genes have been associated with human cryptorchidism but with contrasting data. We analyzed the frequency of mutations in these genes in 600 newborns with cryptorchidism (396 unilateral and 204 bilateral) and 300 noncryptorchid subjects. We found five RXFP2 mutations in five bilateral cryptorchid boys, one INSL3 mutation in a unilateral cryptorchid boy, and one INSL3 mutation in a boy with unilateral cryptorchidism at birth and spontaneous descent during the first month of life. Overall, the frequency of INSL3 and RXFP2 mutations was therefore 7/600 at birth (1.2%) and 7/303 (2.3%) in persistent cryptorchid boys, with a higher prevalence of bilateral forms (5/120, 4.2%). No mutations were found in controls. This study confirmed the association between INSL3 and RXFP2 gene mutations and human cryptorchidism.
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Affiliation(s)
- Alberto Ferlin
- Department of Histology, Section of Clinical Pathology & Centre for Male Gamete Cryopreservation, University of Padova, Padova, Italy
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Foresta C, Toni LD, Mambro AD, Garolla A, Ferlin A, Zuccarello D. ORIGINAL RESEARCH—BASIC SCIENCE: The PDE5 Inhibitor Sildenafil Increases Circulating Endothelial Progenitor Cells and CXCR4 Expression. J Sex Med 2009; 6:369-72. [DOI: 10.1111/j.1743-6109.2008.01014.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
CONTEXT Cryptorchidism is the most frequent congenital birth defect in male children and represents an important risk factor for infertility and testicular cancer. Major regulators of testicular descent are the hormones insulin-like factor 3 (INSL3) and testosterone, and disruption of these pathways might cause cryptorchidism. OBJECTIVE To determine the frequency of genetic alterations in cryptorchidism. DESIGN AND SETTING Case-control study in 2 departments of pediatric surgery in Italy between January 2003 and March 2005. PATIENTS Six hundred male infants with cryptorchidism. Boys were followed up for 2 to 3 years (through January 2008) and orchidopexy was performed in those who were persistently cryptorchid. We analyzed 300 noncryptorchid male children aged 1 to 4 years as controls. MAIN OUTCOME MEASURES Karyotype anomalies and INSL3, INSL3 receptor, and androgen receptor gene mutations. RESULTS The frequency of genetic alterations in boys with cryptorchidism was low (17/600 [2.8%; 95% confidence interval {CI}, 1.7%-4.5%]) and was significantly higher in participants with persistent cryptorchidism (16/303 [5.3%; 95% CI, 3.0%-8.4%]; P = .001) and those with bilateral cryptorchidism (10/120 [8.3%; 95% CI, 4.1%-14.8%]; P = .001) than in controls (1/300 [0.3%; 95% CI, 0.1%-0.8%]). Boys with persistent cryptorchidism had a 17-fold greater odds of having a genetic alteration (odds ratio, 16.7; 95% CI, 2.2-126.5). The most common genetic findings in those with cryptorchidism were 8 cases of Klinefelter syndrome and 5 cases of mutations in the INSL3 receptor gene. Genetic alterations were not found in boys with low birth weight or low gestational age, who had frequent spontaneous descent of the testes. CONCLUSION In a small percentage of the study population, there was a statistically significant association between bilateral and persistent cryptorchidism and genetic alterations, including Klinefelter syndrome and INSL3 receptor gene mutations.
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Affiliation(s)
- Alberto Ferlin
- Section of Clinical Pathology and Centre for Male Gamete Cryopreservation, Department of Histology, Microbiology and Medical Biotechnologies, University of Padova, Via Gabelli 63, 35121 Padova, Italy
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Abstract
Cryptorchidism is the most frequent congenital birth defect in male children (2-4% in full-term male births), and it has the potential to impact the health of the human male. In fact, although it is often considered a mild malformation, it represents the best-characterized risk factor for reduced fertility and testicular cancer. Furthermore, some reports have highlighted a significant increase in the prevalence of cryptorchidism over the last few decades. Etiology of cryptorchidism remains for the most part unknown, and cryptorchidism itself might be considered a complex disease. Major regulators of testicular descent from intraabdominal location into the bottom of the scrotum are the Leydig-cell-derived hormones testosterone and insulin-like factor 3. Research on possible genetic causes of cryptorchidism has increased recently. Abundant animal evidence supports a genetic cause, whereas the genetic contribution to human cryptorchidism is being elucidated only recently. Mutations in the gene for insulin-like factor 3 and its receptor and in the androgen receptor gene have been recognized as causes of cryptorchidism in some cases, but some chromosomal alterations, above all the Klinefelter syndrome, are also frequently involved. Environmental factors acting as endocrine disruptors of testicular descent might also contribute to the etiology of cryptorchidism and its increased incidence in recent years. Furthermore, polymorphisms in different genes have recently been investigated as contributing risk factors for cryptorchidism, alone or by influencing susceptibility to endocrine disruptors. Obviously, the interaction of environmental and genetic factors is fundamental, and many aspects have been clarified only recently.
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Affiliation(s)
- Carlo Foresta
- University of Padova, Department of Histology, Microbiology and Medical Biotechnologies, Section of Clinical Pathology and Centre for Male Gamete Cryopreservation, Via Gabelli 63, 35121 Padova, Italy.
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Zuccarello D, Ferlin A, Cazzadore C, Pepe A, Garolla A, Moretti A, Cordeschi G, Francavilla S, Foresta C. Mutations in dynein genes in patients affected by isolated non-syndromic asthenozoospermia. Hum Reprod 2008; 23:1957-62. [PMID: 18492703 DOI: 10.1093/humrep/den193] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Asthenozoospermia (AZS) is a common cause of male infertility characterized by reduced forward motility (WHO grade A+B sperm motility <50% or A < 25%) or absent sperm motility in fresh ejaculate. AZS may exist as an isolated disorder, in combination with other sperm anomalies or as part of a syndromic association. Up to date, only a few genes, constituting the cilia/flagella structure, have been associated with isolated AZS in humans, whereas several other genes are known to be involved in syndromic form of AZS, including primary ciliary dyskinesia (PCD) and Kartagener syndrome (KS). Axonemal ultrastructural defects, including absent or shortened arms of dyneins, can be found in >50% of PCD/KS patients. Approximately 90% of KS male patients are affected by AZS. The majority of KS patients can be ascribed to dynein genes mutations. METHODS Mutation screening of DNAI1, DNAH5 and DNAH11 genes was performed in 90 patients with isolated non-syndromic AZS and 200 controls. RESULTS We found three mutations (one in each gene) specifically associated with AZS in seven patients (7.8%). Mutations are inherited from the mothers and may be found in familial clusters. No ultrastructural axonemal anomaly was detected in sperm. CONCLUSIONS We report for the first time a possible association between mutations in dynein genes and isolated AZS. Male carriers of the mutations always exhibit AZS, whereas female carriers manifest no alterations in either fertility or pulmonary clearance.
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Affiliation(s)
- D Zuccarello
- Department of Histology, Microbiology and Medical Biotechnologies, Centre for Male Gamete Cryopreservation, University of Padova, Via Gabelli 63, 35121 Padova, Italy
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Zuccarello D, Ferlin A, Vinanzi C, Prana E, Garolla A, Callewaert L, Claessens F, Brinkmann AO, Foresta C. Detailed functional studies on androgen receptor mild mutations demonstrate their association with male infertility. Clin Endocrinol (Oxf) 2008; 68:580-8. [PMID: 17970778 DOI: 10.1111/j.1365-2265.2007.03069.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONTEXT Mutations in the androgen receptor (AR) gene can cause the androgen insensitivity syndrome (AIS). For complete and severe partial AIS, well-characterized in vitro functional assays can be used for genotype-phenotype correlation; however, for mild forms of AIS, as associated with male infertility, experimental evidence is scarce or lacking. In particular, optimal in vitro functional tests informative about the genotype-phenotype relation have not been described. OBJECTIVE The objective of this study was to investigate the association among genotype and phenotype for AR mutations found in infertile males by conventional functional assays and additional in-depth studies performed with several gene reporters. DESIGN To this aim, we selected four AR missense mutations associated with isolated male infertility (L547F and two novel mutations A474V and S650G) or partial AIS (Y571H). After introduction of the specific mutations in AR expression plasmid, we performed classical in vitro studies (Western immunoblotting, electrophoretic mobility shift assay, hormone-response curves) and transactivation assays with different reporter constructs (MMTV, Sc-ARU-TK, TAT-GRE- 2X, Slp-ARU-TK and PEM). RESULTS AND CONCLUSIONS Our results showed that standard functional tests provide sufficient information only for severe AR mutations, whereas for AR mutations found in mild AIS patients with male infertility, only an extensive analysis with different in vitro systems, and in particular with PEM promoter, can give information on the functionality of the AR and therefore on the pathogenicity of the mutations and on genotype-phenotype correlation.
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Affiliation(s)
- D Zuccarello
- Department of Histology, Microbiology and Medical Biotechnology, University of Padova, Italy
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Abstract
BACKGROUND AND OBJECTIVE Testosterone (T) treatment has recently been shown to induce an increase in the number of endothelial progenitor cells (EPCs) through a possible effect on bone marrow. Hypogonadotrophic hypogonadal (HH) men have low circulating EPCs that increase significantly after T treatment. Moreover, expression of the androgen receptor (AR) has been demonstrated by immunohistochemistry in these cells, suggesting that T might also have a direct effect on EPC function. In the present study we investigated the expression and function of the AR in human EPCs and the in vitro effect of androgens on EPC function. Design and patients EPCs obtained from healthy male anonymous blood donors were analysed after androgen stimulation with and without AR antagonist administration (flutamide). RESULTS Reverse transcriptase polymerase chain reaction (RT-PCR), Western blotting and immunofluorescence analyses demonstrated the expression of AR mRNA and protein in human EPCs. Stimulation of these cells with the synthetic androgen methyltrienolone (R1881) caused AR translocation in the nucleus, suggesting its activation. Colony forming unit (CFU), proliferation and migration assays under different doses of R1881 demonstrated a dose-dependent increase in EPC proliferation, migration and colony formation. All these effects are abolished by flutamide pretreatment. CONCLUSIONS This study showed that the increase in the proliferation, migration and colony formation activity of EPCs induced by androgens is an AR-mediated pathway. Androgen exerts these effects at concentrations that are physiologically present in men and therefore further studies are needed to clarify the clinical significance of these effects in normal and pathological conditions.
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Affiliation(s)
- Carlo Foresta
- Department of Histology, Microbiology and Medical Biotechnologies, Centre for Male Gamete Cryopreservation, University of Padova, Padova, Italy.
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Zuccarello D, Ferlin A, Garolla A, Pati MA, Moretti A, Cazzadore C, Francavilla S, Foresta C. A possible association of a human tektin-t gene mutation (A229V) with isolated non-syndromic asthenozoospermia: case report. Hum Reprod 2008; 23:996-1001. [PMID: 18227105 DOI: 10.1093/humrep/dem400] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Asthenozoospermia (AZS), characterized by grade A + B sperm motility (as in World Health Organization Guidelines) < or =50% or A <25% in fresh ejaculate, may exist as an isolated disorder, in combination with other sperm anomalies or as part of syndromic association. The majority of syndromic patients can be ascribed to mutations in dynein genes, while, to date, no genes have been described to be associated in humans with non-syndromic, isolated AZS. An interesting family of axonemal proteins, the tektins, has been recently identified in various mammals and they are thought to play a fundamental role in ciliary movement. Recently, the human tektin-t (or h-tekB1 or Tektin-2) gene has been cloned, showing specific expression in flagella of mature sperm. We report the screening of tektin-t gene in 90 isolated non-syndromic AZS patients. We found a heterozygous mutation (A229V) in one patient. Ultrastructural analysis showed anomalies in > or =80% of examined spermatozoa involving axoneme microtubules and mitochondria. Moreover, the viability and mitochondrial function of sperm were altered in the patient with the A229V mutation. This is the first description of human pathology linked to a tektin-family gene, since only murine models are available for these genes.
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Affiliation(s)
- Daniela Zuccarello
- Department of Histology, Microbiology and Medical Biotechnologies, Centre for Male Gamete Cryopreservation, University of Padova, Via Gabelli 63, 35121 Padova, Italy
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Abstract
Cryptorchidism has the potential to affect the health of the human male. Although it is often considered a mild malformation, it represents the best-characterized risk factor for reduced fertility and testicular cancer. The aetiology of cryptorchidism remains, for the most part, unknown and cryptorchidism itself might be considered a complex disease. This reflects the intricate mechanisms regulating testicular development and descent from intra-abdominal location into the bottom of the scrotum, involving different anatomical and hormonal factors. Major actors of testicular descent are the Leydig cell-derived hormones testosterone and insulin-like factor 3, even if other factors may play a role. Although considerable evidence exists in animals to support a genetic cause, the genetic contribution to human cryptorchidism is only recently being elucidated. Environmental factors might also contribute to the aetiology of cryptorchidism and its increased incidence in recent years. Mutations in the gene for insulin-like factor 3 and its receptor and in the androgen receptor gene explain a minority of cases of cryptorchidism, but research on genetic polymorphisms that may also influence susceptibility to endocrine disruptors is shedding light on this field.
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Affiliation(s)
- Alberto Ferlin
- University of Padova, Department of Histology, Microbiology and Medical Biotechnologies, Centre for Male Gamete Cryopreservation, Via Gabelli 63, 35121 Padova, Italy.
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Foresta C, Zuccarello D, Biagioli A, De Toni L, Prana E, Nicoletti V, Ambrosini G, Ferlin A. Oestrogen stimulates endothelial progenitor cells via oestrogen receptor-alpha. Clin Endocrinol (Oxf) 2007; 67:520-5. [PMID: 17573901 DOI: 10.1111/j.1365-2265.2007.02918.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
CONTEXT Oestrogens play an important protective role on the vascular system. The endothelial cell layer is a direct target for these hormones, and expresses at least two oestrogen receptors, ER-alpha and ER-beta. Recent studies have shown that vascular healing is significantly modulated by circulating bone marrow-derived cells. A subset of these stem cells, endothelial progenitor cells (EPCs), have recently been described as a population of pluripotent cells within the peripheral blood capable of differentiating into endothelial cells. OBJECTIVE In the present study we investigated the expression of ER-alpha and ER-beta on human EPCs and the effect that oestrogens have on the function of EPCs in vitro. METHODS EPCs were isolated and cultured from healthy donors. RT-PCR, western blotting and immunohistochemistry were used to assess expression of ER-alpha and ER-beta. Proliferation and CFU assays were used to assess the response of EPCs to different doses of 17,beta-oestradiol. MAIN OUTCOME MEASURES Expression of ER-alpha and ER-beta in EPCs, and the effect of 17,beta-oestradiol on proliferation of EPCs. RESULTS Human EPCs express ER-alpha mRNA and protein. 17,beta-oestradiol increases proliferation of EPCs and CFU in a dose-dependent manner. CONCLUSIONS Human EPCs express ER-alpha but not ER-beta, and oestrogens can stimulate the proliferation of these cells in vitro. Oestrogens exert these effects at concentrations that are usually reached during stimulation for in vitro fertilization in women, and therefore further studies are needed to clarify the clinical significance of these effects.
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Affiliation(s)
- Carlo Foresta
- Department of Histology, Microbiology and Medical Biotechnologies, Centre for Male Gamete Cryopreservation, University of Padua, Padova, Italy.
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Ferlin A, Speltra E, Garolla A, Selice R, Zuccarello D, Foresta C. Y chromosome haplogroups and susceptibility to testicular cancer. Mol Hum Reprod 2007; 13:615-9. [PMID: 17682003 DOI: 10.1093/molehr/gam052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Although in the past decades much progress in testicular cancer (TC) management has been made, little is known about the possible genetic causes and molecular mechanisms involved in its aetiopathogenesis. Some studies on possible contribution of the Y chromosome in TC development have been previously published, but data are not conclusive. In particular, ethnic influence and spermatogenic activity of patients with TC have not been adequately considered in previous studies, although they may represent important confounding factors. The objective of this study is to analyse the contribution of the Y chromosome in testicular germ cell cancer subjects who are well defined at the microgeographical, clinical and seminological level. We analysed Y chromosome classic azoospermia factor (AZF) deletions, partial AZFc deletions and Y haplogroups in 118 sporadic cases of testicular germ cell cancer and 93 microgeographically matched controls. Y chromosome screening failed to identify Y chromosome microdeletions in either cases or controls. Y chromosome haplogroup distribution and frequencies did not differ between cases and controls. Furthermore, no difference was observed when comparing patients with seminoma and non-seminoma, nor when comparing patients with TC with normozoospermia and azoo-oligozoospermia. Our findings combined with data reported so far suggest that classic AZF deletions and partial AZFc deletions are not a frequent cause or risk factor for TC and that different Y haplogroup distribution does not contribute to susceptibility to this tumour.
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Affiliation(s)
- A Ferlin
- Department of Histology, Microbiology and Medical Biotechnologies, Centre for Male Gamete Cryopreservation, University of Padova, Padova, Italy
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Abstract
Male infertility represents one of the clearest examples of a complex disease with a substantial genetic basis. Numerous male mouse models, mutation screening and association studies reported over the last few years reveal the high prevalence of genetic causes of spermatogenic impairment, accounting for 10-15% of severe male infertility, including chromosomal aberrations and single gene mutations. Natural selection prevents the transmission of mutations causing infertility, but this protective mechanism may be overcome by assisted reproduction techniques. Consequently, the identification of genetic factors is important for appropriate management of the infertile couple. However, a large proportion of infertile males are diagnosed as idiopathic, reflecting poor understanding of the basic mechanisms regulating spermatogenesis and sperm function. Furthermore, the molecular mechanisms underlying spermatogenic damage in cases of genetic infertility (for example Yq microdeletions) are not known. These problems can be addressed only by large scale association studies and testicular or spermatozoal expression studies in well-defined alterations of spermatogenesis. It is conceivable that these studies will have important diagnostic and therapeutic implications in the future. This review discusses the genetic causes of male infertility known to date, the genetic polymorphisms possibly associated with male infertility, and reports novel results of global gene expression profiling of normal human testis by microarray technology.
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Affiliation(s)
- Alberto Ferlin
- University of Padova, Department of Histology, Microbiology and Medical Biotechnologies, Centre for Male Gamete Cryopreservation, Via Gabelli 63, 35121 Padova, Italy
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Foresta C, Caretta N, Zuccarello D, Poletti A, Biagioli A, Caretti L, Galan A. Expression of the PDE5 enzyme on human retinal tissue: new aspects of PDE5 inhibitors ocular side effects. Eye (Lond) 2007; 22:144-9. [PMID: 17585311 DOI: 10.1038/sj.eye.6702908] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE We tested the effect of two phosphodiesterase type-5 (PDE5) inhibitors, sildenafil and tadalafil, on ophthalmic artery (OA) blood flow velocity and investigated the presence of the PDE5 enzyme on human retinal tissue in comparison with the PDE6 enzyme localization. METHODS Using Colour Doppler ultrasonography (CDU) we investigated, in 30 healthy young subjects (27.8 years of age; range, 24.3-33.7 years), the effects of a single oral dose of sildenafil (100 mg), tadalafil (20 mg), and placebo on OA blood flow velocity. Western blot for PDE6 and PDE5 protein expression was performed on frozen samples of human retina, testis, sperm, skin, and corpus cavernosum. Immunohistochemistry was performed on two ocular globes from dead donors. RESULTS CDU showed a relationship between the administration of PDE5 inhibitors and OA blood flow velocity modifications in a time-dependent manner. Western blot and immunohistochemical analysis showed PDE6 and PDE5 presence in human retinal tissue and gave a map of its distribution. CONCLUSION We demonstrated that (a) tadalafil and sildenafil are able to modify the OA flux in a time-dependent manner; (b) the PDE5 enzyme is expressed on retinal and choroid vasculature (smooth muscle and endothelial cells), on ganglion and bipolar cells; (c) human retinal tissues express the PDE6 enzyme in the rod and cone photoreceptors; (d) visual side effects after PDE5 inhibitors administration may be linked to a specific effect on the PDE5 enzyme; and (e) the PDE5 enzyme may have a physiologic role on ganglion and bipolar cells that need to be further investigated.
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Affiliation(s)
- C Foresta
- Department of Histology, Microbiology and Medical Biotechnologies, University of Padova, Padova, Italy.
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Arredi B, Ferlin A, Speltra E, Bedin C, Zuccarello D, Ganz F, Marchina E, Stuppia L, Krausz C, Foresta C. Y-chromosome haplogroups and susceptibility to azoospermia factor c microdeletion in an Italian population. J Med Genet 2006; 44:205-8. [PMID: 17158590 PMCID: PMC2598019 DOI: 10.1136/jmg.2006.046433] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND A limited number of studies aimed at investigating the possible association of Y-chromosome haplogroups with microdeletions of the azoospermia factors (AZFs) or with particular infertile phenotypes, but definitive conclusions have not been attained. The main confounding elements in these association studies are the small sample sizes and the lack of homogeneity in the geographical origin of studied populations, affecting, respectively, the statistical power and the haplogroup distribution. MATERIALS AND METHODS To assess whether some Y-chromosome haplogroups are predisposing to, or protecting against, azoospermia factor c (AZFc; b2/b4) deletions, 31 north Italian patients carrying the AZFc b2/b4 microdeletion were characterised for 8 Y-chromosome haplogroups, and compared with the haplogroup frequency shown by a north Italian population without the microdeletion (n = 93). RESULTS AND DISCUSSION A significant difference was observed between the two populations, patients with microdeletions showing a higher frequency of the E haplogroup (29.3% vs 9.7%, p<0.01). The geographical homogeneity of the microdeleted samples and of the control population, controlled at microgeographical level, allows the possibility that the geographical structure of the Y genetic variability has affected our results to be excluded. CONCLUSION Thus, it is concluded that in the north Italian population Y-chromosome background affects the occurrence of AZFc b2/b4 deletions.
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Affiliation(s)
- Barbara Arredi
- Department of Histology, Microbiology and Medical Biotechnologies, Centre for Male Gamete Cryopreservation, University of Padova, Padova, Italy
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Ferlin A, Vinanzi C, Garolla A, Selice R, Zuccarello D, Cazzadore C, Foresta C. Male infertility and androgen receptor gene mutations: clinical features and identification of seven novel mutations. Clin Endocrinol (Oxf) 2006; 65:606-10. [PMID: 17054461 DOI: 10.1111/j.1365-2265.2006.02635.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Androgens and a functioning androgen receptor (AR) are essential for development and maintenance of the male phenotype and spermatogenesis. Consistent with this, mutations in the AR gene cause a variety of defects related to androgen insensitivity, ranging from complete feminization to phenotypic males with infertility. The aim of his study was to analyse the prevalence of AR gene mutations in male infertility and to clarify the genotype-phenotype relation. DESIGN Males with infertility were recruited consecutively at the Centre for Male Gamete Cryopreservation at the University of Padova from January 1996 to January 2005. PATIENTS One thousand five hundred and seventeen men with < 10 million sperm/ml and 310 age-matched normozoospermic controls. METHODS Screening for AR gene mutation was done by DHPLC and sequencing, and reproductive hormone concentrations were measured. RESULTS We found 20 mutations in 26 of 1517 patients (1.7%) and no mutations in controls. A high number of mutations localized in exon 1 of the AR gene coding for the transactivation domain of the protein. Of 20 mutations, 7 represent novel mutations. With respect to men without AR mutations, subjects with AR mutations have lower ejaculate volume, higher testosterone levels, higher oestradiol levels, and higher androgen sensitivity index. However, the ranges for these variables were highly overlapping between men with and without AR gene mutations. Also clinical manifestations of AR mutations are not unique and 22 men had only spermatogenic impairment. CONCLUSIONS AR gene mutations are quite frequent in unselected infertile men but no specific hormonal or clinical data could be used to preselect patients at risk of mutations.
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Affiliation(s)
- Alberto Ferlin
- University of Padova, Department of Histology, Microbiology and Medical Biotechnologies, Centre for Male Gamete Cryopreservation, Padova, Italy
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Abstract
Insulin-like factor 3 (INSL3) is expressed in Leydig cells of the testis and theca cells of the ovary. This peptide affects testicular descent by acting on gubernaculum via its specific receptor leucine-rich repeat-containing G protein-coupled receptor 8 (LGR8). From initial animal data showing the cryptorchid phenotype of Insl3/Lgr8 mutants, an extensive search for mutations in INSL3 and LGR8 genes was undertaken in human patients with cryptorchidism, and a frequency of mutation of 4-5% has been detected. However, definitive proofs of a causative role for some of these mutations are still lacking. More recent data suggest additional paracrine (in the testis and ovary) and endocrine actions of INSL3 in adults. INSL3 circulates at high concentrations in serum of adult males and its production is dependent on the differentiation effect of LH. Therefore, INSL3 is increasingly used as a specific marker of Leydig cell differentiation and function.
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Affiliation(s)
- A Ferlin
- University of Padova, Department of Histology, Microbiology and Medical Biotechnologies, Center for Male Gamete Cryopreservation, Padua, Italy
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Novelli A, Ceccarini C, Bernardini L, Zuccarello D, Digilio MC, Mingarelli R, Dallapiccola B. Pure trisomy 19p syndrome in an infant with an extra ring chromosome. Cytogenet Genome Res 2006; 111:182-5. [PMID: 16103663 DOI: 10.1159/000086391] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2004] [Accepted: 01/18/2005] [Indexed: 11/19/2022] Open
Abstract
We report a 12-month-old infant evaluated for severe hypotonia, psychomotor retardation, and facial dysmorphisms, including round face, high prominent forehead, downward slanted palpebral fissures, hypertelorism, short nose, chubby cheeks, long philtrum, anteverted lower lip, low-set asymmetric and dysmorphic ears. Karyotype analysis disclosed an extra mosaic ring chromosome, which included the whole 19p arm. Four additional patients with supernumerary ring 19 chromosomes have been reported, but none of them had pure trisomy 19p.
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Affiliation(s)
- A Novelli
- Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo e Istituto CSS-Mendel, Rome, Italy.
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