Pub Date : 2024-01-01Epub Date: 2025-02-24DOI: 10.1159/000544037
Erika Milena Corrêa Guimarães, Patrik Ferreira Viana, Vanessa Susan Pinheiro-Figliuolo, Leandro Marajó, José Francisco de Sousa E Souza, Eliana Feldberg
Introduction: Needlefish (Belonidae family) comprises 44 known species distributed worldwide. These species are predominantly marine but include estuarine representatives and 12 freshwater species. Among the recognized species, 8 are endemic to South American rivers. Cytogenetic studies of Belonidae are scarce and mostly limited to describing the diploid chromosome number (2n) and karyotypic structure.
Methods: We used classical and molecular cytogenetic markers to karyotypically characterize Pseudotylosurus microps to understand the evolutionary processes of Belonidae species in the Amazon basin.
Results: P. microps exhibited different diploid numbers between males (2n = 47, 3m + 3sm + 41st/a FN = 53) and females (2n = 48, 4m + 4sm + 40st/a FN = 56). Our study revealed the first case of multiple sex chromosomes in the Belonidae family.
Conclusion: These findings describe a multiple sex chromosome system of the type X1X1X2X2/X1X2Y. The C-banding pattern and 5S rDNA mapping suggest that this system likely resulted from a tandem fusion between a homolog of pair 1 and a homolog of pair 3, producing a large acrocentric Y chromosome. We propose that karyotypic changes due to internal chromosomal rearrangements, as observed in P. microps, can lead to species diversification and, in some cases, the emergence of a heteromorphic and multiple sex chromosome system.
{"title":"Repetitive DNA Mapping Reveals Multiple Sex Chromosomes X1X1X2X2/X1X2Y in Pseudotylosurus microps (Günther 1866) (Beloniformes, Teleostei) from the Amazon.","authors":"Erika Milena Corrêa Guimarães, Patrik Ferreira Viana, Vanessa Susan Pinheiro-Figliuolo, Leandro Marajó, José Francisco de Sousa E Souza, Eliana Feldberg","doi":"10.1159/000544037","DOIUrl":"10.1159/000544037","url":null,"abstract":"<p><strong>Introduction: </strong>Needlefish (Belonidae family) comprises 44 known species distributed worldwide. These species are predominantly marine but include estuarine representatives and 12 freshwater species. Among the recognized species, 8 are endemic to South American rivers. Cytogenetic studies of Belonidae are scarce and mostly limited to describing the diploid chromosome number (2n) and karyotypic structure.</p><p><strong>Methods: </strong>We used classical and molecular cytogenetic markers to karyotypically characterize Pseudotylosurus microps to understand the evolutionary processes of Belonidae species in the Amazon basin.</p><p><strong>Results: </strong>P. microps exhibited different diploid numbers between males (2n = 47, 3m + 3sm + 41st/a FN = 53) and females (2n = 48, 4m + 4sm + 40st/a FN = 56). Our study revealed the first case of multiple sex chromosomes in the Belonidae family.</p><p><strong>Conclusion: </strong>These findings describe a multiple sex chromosome system of the type X1X1X2X2/X1X2Y. The C-banding pattern and 5S rDNA mapping suggest that this system likely resulted from a tandem fusion between a homolog of pair 1 and a homolog of pair 3, producing a large acrocentric Y chromosome. We propose that karyotypic changes due to internal chromosomal rearrangements, as observed in P. microps, can lead to species diversification and, in some cases, the emergence of a heteromorphic and multiple sex chromosome system.</p>","PeriodicalId":49536,"journal":{"name":"Sexual Development","volume":" ","pages":"70-80"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-09-09DOI: 10.1159/000541137
Maria Helena Palma Sircili, Rafael Loch Batista, Enoch Quindere de Sá Barreto, Solange Paiva Bueno, Anna Flávia Figueredo Benedetti, Flora Ladeira Craveiro, Raquel Matinez Ramos, Marcelo Praxedes Monteiro Filho, Sorahia Domenice, Berenice Bilharinho Mendonca, Francisco Tibor Dénes
Introduction: Hydrocolpos, a rare condition characterized by cystic dilatation of the vagina, can arise from various etiologies, including isolated imperforate hymen and vaginal atresia. Genetic conditions, such as Bardet-Biedl syndrome (BBS), may also manifest with hydrocolpos as part of urogenital malformations.
Methods: We present a case of neonatal hydrocolpos associated with BBS. Sequencing of 19 BBS genes was performed to elucidate the genetic basis of the syndrome.
Results: Genetic analysis revealed a novel frameshift indel variant (c.1543_1546dup p.Thr516Argfs*7) in the BBS10 gene. This finding expands the spectrum of BBS mutations and underscores the importance of genetic evaluation in patients with hydrocolpos, particularly when associated with additional clinical features suggestive of syndromic etiology.
Conclusion: Pediatric urologists should maintain a high index of suspicion for underlying genetic conditions, including BBS, in neonates presenting with hydrocolpos, given the potential for more severe associated complications such as renal and retinal diseases, obesity, and polydactyly.
{"title":"Neonatal Hydrocolpos in Bardet-Biedl Syndrome due to a Novel Frameshift Indel in the BBS10 Gene.","authors":"Maria Helena Palma Sircili, Rafael Loch Batista, Enoch Quindere de Sá Barreto, Solange Paiva Bueno, Anna Flávia Figueredo Benedetti, Flora Ladeira Craveiro, Raquel Matinez Ramos, Marcelo Praxedes Monteiro Filho, Sorahia Domenice, Berenice Bilharinho Mendonca, Francisco Tibor Dénes","doi":"10.1159/000541137","DOIUrl":"10.1159/000541137","url":null,"abstract":"<p><strong>Introduction: </strong>Hydrocolpos, a rare condition characterized by cystic dilatation of the vagina, can arise from various etiologies, including isolated imperforate hymen and vaginal atresia. Genetic conditions, such as Bardet-Biedl syndrome (BBS), may also manifest with hydrocolpos as part of urogenital malformations.</p><p><strong>Methods: </strong>We present a case of neonatal hydrocolpos associated with BBS. Sequencing of 19 BBS genes was performed to elucidate the genetic basis of the syndrome.</p><p><strong>Results: </strong>Genetic analysis revealed a novel frameshift indel variant (c.1543_1546dup p.Thr516Argfs*7) in the BBS10 gene. This finding expands the spectrum of BBS mutations and underscores the importance of genetic evaluation in patients with hydrocolpos, particularly when associated with additional clinical features suggestive of syndromic etiology.</p><p><strong>Conclusion: </strong>Pediatric urologists should maintain a high index of suspicion for underlying genetic conditions, including BBS, in neonates presenting with hydrocolpos, given the potential for more severe associated complications such as renal and retinal diseases, obesity, and polydactyly.</p>","PeriodicalId":49536,"journal":{"name":"Sexual Development","volume":" ","pages":"34-39"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-11-06DOI: 10.1159/000542245
Paulina Krzeminska
Background: Canine cryptorchidism, manifested by an abnormal testicular position, poses significant health risks and reproductive challenges in affected males. Despite a high prevalence, estimated at up to 10% in the canine population, a comprehensive understanding of its pathogenesis remains elusive. Studies in human cryptorchids and knockout mice have identified key factors involved in testicular descent, including INSL3, RXFP2, and AR. To date, only three DNA variants, found in the RXFP2, HMGA2, and KAT6A genes, have been associated with canine cryptorchidism.
Summary: This review briefly summarizes current knowledge on testicular descent and the factors that regulate this process, based on cryptorchidism in humans and mice. It also highlights recent findings related to canine cryptorchidism, focusing on the INSL3, HMGA2, and KAT6A genes. The most significant results are discussed, with an emphasis on the role of the epididymis in testicular descent. This report presents insights that may facilitate further research aiming to broaden our understanding of canine cryptorchidism pathogenesis.
Key messages: DNA polymorphism in the KAT6A gene, associated with changes in global H3K9 acetylation, as well as the DNA methylation pattern in the INSL3 gene, suggest that further research should strongly focus on epigenetic modifications. In addition, the development of the epididymo-testicular junction and the link between cryptorchidism prevalence and dog size should be further investigated.
背景 犬隐睾症表现为睾丸位置异常,对患病雄性犬的健康和生殖造成极大的威胁。尽管隐睾症的发病率很高,估计在犬类群体中高达 10%,但人们对其发病机理的全面了解却仍然遥遥无期。对人类隐睾和基因敲除小鼠的研究已经确定了参与睾丸下降的关键因素,包括 INSL3、RXFP2 和 AR。迄今为止,只有在 RXFP2、HMGA2 和 KAT6A 基因中发现的三种 DNA 变异与犬隐睾症有关。摘要 本综述以人类和小鼠的隐睾症为基础,简要总结了目前有关睾丸下降和调节这一过程的因素的知识。综述还重点介绍了与犬隐睾症有关的最新研究成果,重点关注 INSL3、HMGA2 和 KAT6A 基因。报告讨论了最重要的结果,重点是附睾在睾丸下降过程中的作用。本报告提出的见解可促进进一步的研究,从而拓宽我们对犬隐睾症发病机制的认识。关键信息 KAT6A 基因的 DNA 多态性与全局 H3K9 乙酰化的变化有关,INSL3 基因的 DNA 甲基化模式也表明,进一步的研究应重点关注表观遗传修饰。此外,还应进一步研究附睾-睾丸交界处的发育以及隐睾症发病率与狗的体型之间的联系。
{"title":"Exploring Testicular Descent: Recent Findings and Future Prospects in Canine Cryptorchidism.","authors":"Paulina Krzeminska","doi":"10.1159/000542245","DOIUrl":"10.1159/000542245","url":null,"abstract":"<p><strong>Background: </strong>Canine cryptorchidism, manifested by an abnormal testicular position, poses significant health risks and reproductive challenges in affected males. Despite a high prevalence, estimated at up to 10% in the canine population, a comprehensive understanding of its pathogenesis remains elusive. Studies in human cryptorchids and knockout mice have identified key factors involved in testicular descent, including INSL3, RXFP2, and AR. To date, only three DNA variants, found in the RXFP2, HMGA2, and KAT6A genes, have been associated with canine cryptorchidism.</p><p><strong>Summary: </strong>This review briefly summarizes current knowledge on testicular descent and the factors that regulate this process, based on cryptorchidism in humans and mice. It also highlights recent findings related to canine cryptorchidism, focusing on the INSL3, HMGA2, and KAT6A genes. The most significant results are discussed, with an emphasis on the role of the epididymis in testicular descent. This report presents insights that may facilitate further research aiming to broaden our understanding of canine cryptorchidism pathogenesis.</p><p><strong>Key messages: </strong>DNA polymorphism in the KAT6A gene, associated with changes in global H3K9 acetylation, as well as the DNA methylation pattern in the INSL3 gene, suggest that further research should strongly focus on epigenetic modifications. In addition, the development of the epididymo-testicular junction and the link between cryptorchidism prevalence and dog size should be further investigated.</p>","PeriodicalId":49536,"journal":{"name":"Sexual Development","volume":" ","pages":"1-13"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Recent studies have demonstrated that the production of bidirectional enhancer-derived transcripts (eRNAs) is a characteristic of an active cis-regulatory element (CRE). Higher levels of eRNAs synthesis correlate with the activation of histone modifications, a potentially valuable tool for deciphering the complexity of the gene regulatory network.
Method: To understand the changes of CREs during gonadal development in mice, we collected gonadal WT1-positive cells from the piggyBac-Wt1-mCherry-2A-EGFP (PBWt1-RG) reporter strain at E13.5, E16.5, and P0 in both sexes and conducted cap analysis of gene expression (CAGE) analysis, which is capable to capture transcription start sites (TSSs). We compared the levels of intergenic bidirectional RNAs, i.e., potentially eRNAs, according to sex at each stage (testis somatic cells vs. ovary somatic cells at E13.5, E16.5, and P0) and stage in each sex (E13.5 vs. E16.5, E16.5 vs. P0, and E13.5 vs. P0 in testis somatic cells or ovary somatic cells). Intergenic RNAs with significant changes (|Log2FC| > 1, p < 0.05) were selected.
Results: The TSS profile of intergenic RNAs changed more profoundly in testis somatic cells than in ovary somatic cells, suggesting that embryonic testicular development is driven by larger changes in the transcriptional regulatory network than ovarian development. Based on the profiles of the predicted transcription factors (TFs) that would bind to the active CREs during gonadal development, the NR4A, EGR, and TCF3 families would be novel TFs to play pivotal roles in gonadal development.
Conclusion: Identifying active CREs using eRNAs would provide a means to comprehensively understand the transcriptional regulatory system, leading to valuable insights into the gonadal development of male and female individuals.
最近的研究表明,双向增强子衍生转录本(erna)的产生是活性顺式调控元件(CRE)的一个特征。较高水平的eRNA合成与组蛋白修饰的激活相关,组蛋白修饰是破译基因调控网络复杂性的潜在有价值的工具。为了了解cre在小鼠性腺发育过程中的变化,我们从两性piggyBac-Wt1-mCherry-2A-EGFP (PBWt1-RG)报告菌株中收集了E13.5、E16.5和P0处的性腺wt1阳性细胞,并进行了能够捕获转录起始位点(TSS)的Cap基因表达分析(CAGE)。我们比较了基因间双向RNA的水平,即潜在的eRNA,根据性别在每个阶段(睾丸体细胞vs卵巢体细胞在E13.5, E16.5和P0)和阶段在每个性别(E13.5 vs E16.5, E16.5 vs P0, E13.5 vs P0在睾丸体细胞或卵巢体细胞)。选择有显著变化的基因间rna (|Log2FC| > 1, p < 0.05)。在睾丸体细胞中,基因间RNA的TSS谱变化比在卵巢体细胞中更深刻,这表明胚胎睾丸的发育是由转录调控网络的更大变化驱动的。基于在性腺发育过程中与活性cre结合的预测转录因子(tf)的特征,NR4A、EGR和TCF3家族可能是在性腺发育中发挥关键作用的新tf。利用erna识别活性cre将为全面了解转录调控系统提供一种手段,从而对男性和女性个体的性腺发育产生有价值的见解。
{"title":"Analysis of Functional cis-Regulatory Elements Reveals Novel Transcriptional Regulatory Mechanisms in Gonadal Development.","authors":"Shizuka Kirino, Ryuichi Nakagawa, Maki Gau, Kei Takasawa, Yasuhiro Murakawa, Hideya Kawaji, Yoshihide Hayashizaki, Tomohiro Morio, Kenichi Kashimada","doi":"10.1159/000543594","DOIUrl":"10.1159/000543594","url":null,"abstract":"<p><strong>Introduction: </strong>Recent studies have demonstrated that the production of bidirectional enhancer-derived transcripts (eRNAs) is a characteristic of an active cis-regulatory element (CRE). Higher levels of eRNAs synthesis correlate with the activation of histone modifications, a potentially valuable tool for deciphering the complexity of the gene regulatory network.</p><p><strong>Method: </strong>To understand the changes of CREs during gonadal development in mice, we collected gonadal WT1-positive cells from the piggyBac-Wt1-mCherry-2A-EGFP (PBWt1-RG) reporter strain at E13.5, E16.5, and P0 in both sexes and conducted cap analysis of gene expression (CAGE) analysis, which is capable to capture transcription start sites (TSSs). We compared the levels of intergenic bidirectional RNAs, i.e., potentially eRNAs, according to sex at each stage (testis somatic cells vs. ovary somatic cells at E13.5, E16.5, and P0) and stage in each sex (E13.5 vs. E16.5, E16.5 vs. P0, and E13.5 vs. P0 in testis somatic cells or ovary somatic cells). Intergenic RNAs with significant changes (|Log2FC| > 1, p < 0.05) were selected.</p><p><strong>Results: </strong>The TSS profile of intergenic RNAs changed more profoundly in testis somatic cells than in ovary somatic cells, suggesting that embryonic testicular development is driven by larger changes in the transcriptional regulatory network than ovarian development. Based on the profiles of the predicted transcription factors (TFs) that would bind to the active CREs during gonadal development, the NR4A, EGR, and TCF3 families would be novel TFs to play pivotal roles in gonadal development.</p><p><strong>Conclusion: </strong>Identifying active CREs using eRNAs would provide a means to comprehensively understand the transcriptional regulatory system, leading to valuable insights into the gonadal development of male and female individuals.</p>","PeriodicalId":49536,"journal":{"name":"Sexual Development","volume":" ","pages":"14-26"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2024-01-27DOI: 10.1159/000536236
Camilla Mains Balle, Christine Gaasdal Kassentoft, Jolinda Iris van Heusden, Michael Knudsen, Line Raaby, Claus Højbjerg Gravholt
Introduction: The presence of Y-chromosomal material in females with Turner syndrome (TS) is a well-established risk factor for developing gonadoblastoma and malignant transformations thereof. However, these events are rarely seen in TS patients with no Y-chromosomal material. Thus, it is the current understanding that parts of the Y-chromosome are essential for the malignant transformation of gonadoblastoma in the dysgenetic gonad.
Methods: We report a case of a TS female with an apparent 46,X,idic(Xq) karyotype, who was diagnosed with a metastatic dysgerminoma. Whole exome sequencing of the tumor and blood, along with RNA sequencing of the tumor, was performed to comprehensively search for cryptic Y-chromosomal material and pathogenic variants.
Results: No Y-chromosomal material was detected in either tumor or blood. Whole exome-sequencing of DNA and RNA revealed a pathogenic somatic gain-of-function mutation in KIT and a pathogenic missense mutation in MTOR. The patient underwent total hysterectomy with bilateral salpingo-oophorectomy, followed by adjuvant chemotherapy. Unfortunately, she died due to chemotherapy-induced pneumonitis 7 months after the initial diagnosis.
Conclusion: Females with TS can develop metastatic dysgerminoma even in the absence of Y-chromosomal material. This questions the current understanding of Y-chromosomal material being essential for the malignant transformation of a gonadoblastoma in the dysgenetic gonad.
简介特纳综合征(Turner Syndrome,TS)女性患者体内的 Y 染色体物质是导致性腺母细胞瘤及其恶性转化的一个公认的危险因素。然而,在没有 Y 染色体材料的 TS 患者中却很少出现这些情况。因此,目前的理解是,Y 染色体的一部分对于遗传性性腺发育不良的性腺母细胞瘤的恶性转化至关重要:我们报告了一例TS女性病例,她的核型明显为46,X,idic(Xq),被诊断为转移性畸形生殖细胞瘤。我们对肿瘤和血液进行了全外显子组测序,并对肿瘤进行了 RNA 测序,以全面寻找隐性 Y 染色体材料和致病变体:肿瘤和血液中均未检测到 Y 染色体材料。DNA和RNA的全外显子组测序发现了KIT的致病性体细胞功能增益突变和MTOR的致病性错义突变。患者接受了全子宫切除术和双侧输卵管切除术,随后接受了辅助化疗。不幸的是,她在确诊七个月后死于化疗诱发的肺炎:结论:患有TS的女性即使没有Y染色体物质,也可能患上转移性胚胎发育不良瘤。结论:TS 女性患者即使没有 Y 染色体,也会发生转移性畸形精原细胞瘤,这对目前认为 Y 染色体是畸形性腺中性腺母细胞瘤恶性转化的必要条件这一观点提出了质疑。
{"title":"Rare Case of a Turner Syndrome Patient with Metastatic Dysgerminoma and No Y-Chromosomal Material with Pathogenic Variants Found in KIT and MTOR.","authors":"Camilla Mains Balle, Christine Gaasdal Kassentoft, Jolinda Iris van Heusden, Michael Knudsen, Line Raaby, Claus Højbjerg Gravholt","doi":"10.1159/000536236","DOIUrl":"10.1159/000536236","url":null,"abstract":"<p><strong>Introduction: </strong>The presence of Y-chromosomal material in females with Turner syndrome (TS) is a well-established risk factor for developing gonadoblastoma and malignant transformations thereof. However, these events are rarely seen in TS patients with no Y-chromosomal material. Thus, it is the current understanding that parts of the Y-chromosome are essential for the malignant transformation of gonadoblastoma in the dysgenetic gonad.</p><p><strong>Methods: </strong>We report a case of a TS female with an apparent 46,X,idic(Xq) karyotype, who was diagnosed with a metastatic dysgerminoma. Whole exome sequencing of the tumor and blood, along with RNA sequencing of the tumor, was performed to comprehensively search for cryptic Y-chromosomal material and pathogenic variants.</p><p><strong>Results: </strong>No Y-chromosomal material was detected in either tumor or blood. Whole exome-sequencing of DNA and RNA revealed a pathogenic somatic gain-of-function mutation in KIT and a pathogenic missense mutation in MTOR. The patient underwent total hysterectomy with bilateral salpingo-oophorectomy, followed by adjuvant chemotherapy. Unfortunately, she died due to chemotherapy-induced pneumonitis 7 months after the initial diagnosis.</p><p><strong>Conclusion: </strong>Females with TS can develop metastatic dysgerminoma even in the absence of Y-chromosomal material. This questions the current understanding of Y-chromosomal material being essential for the malignant transformation of a gonadoblastoma in the dysgenetic gonad.</p>","PeriodicalId":49536,"journal":{"name":"Sexual Development","volume":" ","pages":"203-210"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2023-09-12DOI: 10.1159/000534085
Sultana M H Faradz, Nurin Listyasari, Agustini Utari, Mahayu Dewi Ariani, Achmad Zulfa Juniarto, Ardy Santosa, Annastasia Ediati, Tuula K Rinne, Dineke Westra, Hedi Claahsen-van der Grinten, Frank H de Jong, Stenvert L S Drop, Katie Ayers, Andrew Sinclair
Background: Our multidisciplinary team (MDT) is a large specialized team based in Semarang, Indonesia, that cares for a wide variety of pediatric and adult individuals with differences of sex development (DSD) from across Indonesia. Here, we describe our work over the last 17 years.
Methods: We analyzed phenotypic, hormonal, and genetic findings from clinical records for all patients referred to our MDT during the period 2004-2020.
Results: Among 1,184 DSD patients, 10% had sex chromosome DSD, 67% had 46,XY DSD, and 23% had 46,XX DSD. The most common sex chromosome anomaly was Turner syndrome (45,X) (55 cases). For patients with 46,XY DSD under-masculinization was the most common diagnosis (311 cases), and for 46,XX DSD, a defect of Müllerian development was most common (131 cases) followed by congenital adrenal hyperplasia (CAH) (116 cases). Sanger sequencing, MLPA, and targeted gene sequencing of 257 patients with 46,XY DSD found likely causative variants in 21% (55 cases), with 13 diagnostic genes implicated. The most affected gene codes for the androgen receptor. Molecular analysis identified a diagnosis for 69 of 116 patients with CAH, with 62 carrying variants in CYP21A2 including four novel variants, and 7 patients carrying variants in CYP11B1. In many cases, these genetic diagnoses influenced the clinical management of patients and their families.
Conclusions: Our work has highlighted the occurrence of different DSDs in Indonesia. By applying sequencing technologies as part of our clinical care, we have delivered a number of genetic diagnoses and identified novel pathogenic variants in some genes, which may be clinically specific to Indonesia. Genetics can inform many aspects of DSD clinical management, and while many of our patients remain undiagnosed, we hope that future testing may provide answers for even more.
{"title":"Lessons Learned from 17 Years of Multidisciplinary Care for Differences of Sex Development Patients at a Single Indonesian Center.","authors":"Sultana M H Faradz, Nurin Listyasari, Agustini Utari, Mahayu Dewi Ariani, Achmad Zulfa Juniarto, Ardy Santosa, Annastasia Ediati, Tuula K Rinne, Dineke Westra, Hedi Claahsen-van der Grinten, Frank H de Jong, Stenvert L S Drop, Katie Ayers, Andrew Sinclair","doi":"10.1159/000534085","DOIUrl":"10.1159/000534085","url":null,"abstract":"<p><strong>Background: </strong>Our multidisciplinary team (MDT) is a large specialized team based in Semarang, Indonesia, that cares for a wide variety of pediatric and adult individuals with differences of sex development (DSD) from across Indonesia. Here, we describe our work over the last 17 years.</p><p><strong>Methods: </strong>We analyzed phenotypic, hormonal, and genetic findings from clinical records for all patients referred to our MDT during the period 2004-2020.</p><p><strong>Results: </strong>Among 1,184 DSD patients, 10% had sex chromosome DSD, 67% had 46,XY DSD, and 23% had 46,XX DSD. The most common sex chromosome anomaly was Turner syndrome (45,X) (55 cases). For patients with 46,XY DSD under-masculinization was the most common diagnosis (311 cases), and for 46,XX DSD, a defect of Müllerian development was most common (131 cases) followed by congenital adrenal hyperplasia (CAH) (116 cases). Sanger sequencing, MLPA, and targeted gene sequencing of 257 patients with 46,XY DSD found likely causative variants in 21% (55 cases), with 13 diagnostic genes implicated. The most affected gene codes for the androgen receptor. Molecular analysis identified a diagnosis for 69 of 116 patients with CAH, with 62 carrying variants in CYP21A2 including four novel variants, and 7 patients carrying variants in CYP11B1. In many cases, these genetic diagnoses influenced the clinical management of patients and their families.</p><p><strong>Conclusions: </strong>Our work has highlighted the occurrence of different DSDs in Indonesia. By applying sequencing technologies as part of our clinical care, we have delivered a number of genetic diagnoses and identified novel pathogenic variants in some genes, which may be clinically specific to Indonesia. Genetics can inform many aspects of DSD clinical management, and while many of our patients remain undiagnosed, we hope that future testing may provide answers for even more.</p>","PeriodicalId":49536,"journal":{"name":"Sexual Development","volume":" ","pages":"170-180"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10224139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The pathogenic variants in DEAH-box RNA helicase DHX37 are one of the major causes of 46,XY gonadal dysgenesis and testicular regression syndrome (TRS). To date, only 13 different missense variants have been reported. We report two additional cases with different clinical presentations carrying two novel variants in the DHX37 gene.
Case presentation and results: Case 1 (4.4-year-old boy) presented with significant micropenis and cryptorchidism and was diagnosed as TRS. Case 2 (13.5-year-old girl) had a 46,XY karyotype with female external genitalia and was diagnosed as GD. Two novel DHX37 variants affecting the RecA2 domain, p.G478R and p.L627F, were identified in these cases. Both variants identified in the probands were also present in their unaffected mother.
Conclusion: Our findings broaden the variant spectrum of DHX37 in 46,XY differences of sex development (DSD) individuals.
{"title":"Two Novel Heterozygous Variants in RecA2 Domain of DHX37 Cause 46,XY Gonadal Dysgenesis and Testicular Regression Syndrome.","authors":"Hao Yang, Xiuqi Ma, Hongjuan Tian, Jinna Yuan, Dehua Wu, Guanping Dong, Qian Liu, Junfen Fu","doi":"10.1159/000534086","DOIUrl":"10.1159/000534086","url":null,"abstract":"<p><strong>Introduction: </strong>The pathogenic variants in DEAH-box RNA helicase DHX37 are one of the major causes of 46,XY gonadal dysgenesis and testicular regression syndrome (TRS). To date, only 13 different missense variants have been reported. We report two additional cases with different clinical presentations carrying two novel variants in the DHX37 gene.</p><p><strong>Case presentation and results: </strong>Case 1 (4.4-year-old boy) presented with significant micropenis and cryptorchidism and was diagnosed as TRS. Case 2 (13.5-year-old girl) had a 46,XY karyotype with female external genitalia and was diagnosed as GD. Two novel DHX37 variants affecting the RecA2 domain, p.G478R and p.L627F, were identified in these cases. Both variants identified in the probands were also present in their unaffected mother.</p><p><strong>Conclusion: </strong>Our findings broaden the variant spectrum of DHX37 in 46,XY differences of sex development (DSD) individuals.</p>","PeriodicalId":49536,"journal":{"name":"Sexual Development","volume":" ","pages":"198-202"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10278413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2024-06-24DOI: 10.1159/000539511
Abstracts of the 11th I-DSD Symposium.
第 11 届国际可持续发展教育研讨会摘要。
{"title":"Abstracts of the 11th I-DSD Symposium.","authors":"","doi":"10.1159/000539511","DOIUrl":"https://doi.org/10.1159/000539511","url":null,"abstract":"<p><p>Abstracts of the 11th I-DSD Symposium.</p>","PeriodicalId":49536,"journal":{"name":"Sexual Development","volume":"17 Suppl 1 ","pages":"1-123"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}