Abstract

CONTEXT
Steroidogenic factor-1 (SF-1/NR5A1) is a nuclear receptor that regulates adrenal and reproductive development and function. NR5A1 mutations have been detected in 46,XY individuals with disorders of sexual development (DSD) but apparently normal adrenal function and in 46,XX women with normal sexual development yet primary ovarian insufficiency (POI).
OBJECTIVE
A group of 100 46,XY DSD and two POI was studied for NR5A1 mutations and their impact.
DESIGN
Clinical, biochemical, histological, genetic, and functional characteristics of the patients with NR5A1 mutations are reported.
SETTING
Patients were referred from different centers in Spain, Switzerland, and Turkey. Histological and genetic studies were performed in Barcelona, Spain. In vitro studies were performed in Bern, Switzerland.
PATIENTS
A total of 65 Spanish and 35 Turkish patients with 46,XY DSD and two Swiss 46,XX patients with POI were investigated.
MAIN OUTCOME
Ten novel heterozygote NR5A1 mutations were detected and characterized (five missense, one nonsense, three frameshift mutations, and one duplication).
RESULTS
The novel NR5A1 mutations were tested in vitro by promoter transactivation assays showing grossly reduced activity for mutations in the DNA binding domain and variably reduced activity for other mutations. Dominant negative effect of the mutations was excluded. We found high variability and thus no apparent genotype-structure-function-phenotype correlation. Histological studies of testes revealed vacuolization of Leydig cells due to fat accumulation.
CONCLUSIONS
SF-1/NR5A1 mutations are frequently found in 46,XY DSD individuals (9%) and manifest with a broad phenotype. Testes histology is characteristic for fat accumulation and degeneration over time, similar to findings observed in patients with lipoid congenital adrenal hyperplasia (due to StAR mutations). Genotype-structure-function-phenotype correlation remains elusive.

Links

Publisher Full Text

Authors

Camats N, Pandey AV, Fernández-Cancio M, Andaluz P, Janner M, Torán N, Moreno F, Bereket A, Akcay T, García-García E, Muñoz MT, Gracia R, Nistal M, Castaño L, Mullis PE, Carrascosa A, Audí L, Flück CE

Institution

Pediatric Endocrinology Research Unit, Hospital Vall d’Hebron, Passeig Vall d’Hebron 119, Barcelona 08035, Spain.

Source

The Journal of clinical endocrinology and metabolism 97:7 2012 Jul pg E1294-306

MeSH

46, XX Disorders of Sex Development
46, XY Disorders of Sex Development
Adolescent
Base Sequence
Child
Child, Preschool
DNA Mutational Analysis
Female
Genetic Predisposition to Disease
Humans
Male
Molecular Sequence Data
Phenotype
Point Mutation
Primary Ovarian Insufficiency
Steroidogenic Factor 1
Young Adult

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22549935