Testis formation in XX individuals resulting from novel pathogenic variants in Wilms’ tumor 1 (WT1) geneMore about Open Access at the Crick
Authors listCaroline Eozenou Nitzan Gonen Maria Sol Touzon Anne Jorgensen Svetlana A Yatsenko Leila Fusee Alaa K Kamel Balazs Gellen Gabriela Guercio Priti Singh Selma Witchel Andrea J Berman Rana Mainpal Mehdi Totonchi Anahita Mohseni Meybodi Masomeh Askari Tiphanie Merel-Chali Joelle Bignon-Topalovic Roberta Migale Mariana Costanzo Roxana Marino Pablo Ramirez Natalia Perez Garrido Esperanza Berensztein Mona K Mekkawy John C Schimenti Rita Bertalan Inas Mazen Ken McElreavey Alicia Belgorosky Robin Lovell-Badge Aleksandar Rajkovic Anu Bashamboo
Toggle all authors (33)
Sex determination in mammals is governed by antagonistic interactions of two genetic pathways, imbalance in which may lead to disorders/differences of sex development (DSD) in human. Among 46,XX individuals with testicular DSD (TDSD) or ovotesticular DSD (OTDSD), testicular tissue is present in the gonad. Although the testis-determining gene SRY is present in many cases, the etiology is unknown in most SRY-negative patients. We performed exome sequencing on 78 individuals with 46,XX TDSD/OTDSD of unknown genetic etiology and identified seven (8.97%) with heterozygous variants affecting the fourth zinc finger (ZF4) of Wilms’ tumor 1 (WT1) (p.Ser478Thrfs*17, p.Pro481Leufs*15, p.Lys491Glu, p.Arg495Gln [x3], p.Arg495Gly). The variants were de novo in six families (P = 4.4 × 10−6), and the incidence of WT1 variants in 46,XX DSD is enriched compared to control populations (P < 1.8 × 10−4). The introduction of ZF4 mutants into a human granulosa cell line resulted in up-regulation of endogenous Sertoli cell transcripts and Wt1Arg495Gly/Arg495Gly XX mice display masculinization of the fetal gonads. The phenotype could be explained by the ability of the mutated proteins to physically interact with and sequester a key pro-ovary factor β-CATENIN, which may lead to up-regulation of testis-specific pathway. Our data show that unlike previous association of WT1 and 46,XY DSD, ZF4 variants of WT1 are a relatively common cause of 46,XX TDSD/OTDSD. This expands the spectrum of phenotypes associated with WT1 variants and shows that the WT1 protein affecting ZF4 can function as a protestis factor in an XX chromosomal context.
Issue number 24