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Mutation analysis of genes involved in differentiation and maintenance of germ cells in patients with 46,XX disorders of gonadal development

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Author(s):
Mariza Augusta Gerdulo dos Santos
Total Authors: 1
Document type: Doctoral Thesis
Press: São Paulo.
Institution: Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD)
Defense date:
Examining board members:
Berenice Bilharinho de Mendonça; Tânia Aparecida Sartori Sanchez Bachega; Gil Guerra Júnior; Maria Beatriz da Fonte Kohek; Gustavo Arantes Rosa Maciel
Advisor: Berenice Bilharinho de Mendonça
Abstract

Several genes expressing during the germ cell differentiation act in ovary development. The differentiation of somatic ovary cells depends of a pool of pre meiotic germ cells migration into the gonad. The space and temporal expression pattern of some genes involved with germ cell differentiation and the subsequently oocyte survival should be investigated in the disorders of sexual development (DSD) 46,XX. Some key genes involved with these processes are: NANOS3, BMP15 and STRA8. The NANOS3, a RNA binding molecule that blocks the apoptotic pathway, ensures the survival during migration into genital ridge. The STRA8 acts in the bigining of germ cells meioses in XX embryos and mark the first sexual gonadal dimorphism. In other hand the subsequently oocyte survival is controlled through transforming growth factor member BMP15, that guarantees granulose cells differentiation that acts indirectly in meiotic oocyte and theca cells differentiation. In this work we searched for the presence of inactivating mutations in NANOS3 and BMP15 in 45 patients with 46XX gonadal dysgenesis (10 familial cases) and 40 patients with secondary amenorrhea without FSHR and SF1 mutation. We also searched for inactivating mutations in coding and proximal promoter region of STRA8 in 45 patients with 46XX gonadal dysgenesis, 16 ovotesticular disorder of sex development (DSD) patients and five 46XX testicular DSD patients all SRY negative and molecular defects in DAX1, WNT4 and SOX9 gene. In NANOS3 we identified the mutation p.E120K in homozygous state, the first associated with DG 46,XX phenotype. This missense mutation was identified in two sisters with 46XX GD and affects a zinc finger domain of the protein. The new variant was absent in 200 control alleles. In BMP15, a new nonsense mutation p.Q115X was identified two sisters in homozygous state and in one sporadic case of secondary amenorrhea in heterozygous state. The premature codon STOP affects the pro-peptide domain of the protein. The new variant was absent in 200 control alleles. In STRA8, only a previously described polymorphism (rs7805859) was identified without any other variation in coding or proximal promoter region. In conclusion, we identified for the fist time mutation in NANOS3 associated with DG 46XX and corroborate the role of BMP15 in this phenotype. Disorders of gonadal development 46,XX may be involved with differentiation and maintenance of ovarian germ cells. (AU)