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Characterizing Mutational Load and Clonal Composition of Human Blood
Published on: July 11, 2019
Phenotype and Molecular Characterizations of 30 Children From China With NR5A1 Mutations
Yanning Song1, Lijun Fan1, Chunxiu Gong1,2
1Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Insights
This study investigated NR5A1 gene mutations in 30 Chinese patients, revealing a wide spectrum of phenotypes and severe Sertoli cell impairment in 46, XY individuals. Common mutations like p.R87C and p.R313C were identified, along with 14 novel mutations.
Area of Science:
- Genetics
- Endocrinology
- Pediatrics
Background:
- Mutations in the NR5A1 gene are associated with diverse clinical presentations.
- Understanding genotype-phenotype correlations is crucial for managing patients with NR5A1-related disorders.
Purpose of the Study:
- To investigate the clinical phenotype of 30 Chinese patients with NR5A1 gene mutations.
- To compare clinical features between male and female patients with NR5A1 mutations.
- To identify common and novel NR5A1 mutations and analyze genotype-phenotype correlations.
Main Methods:
- Clinical data from 30 pediatric patients with NR5A1 mutations were analyzed.
- Patients were categorized into male and female groups for comparative analysis.
- Genotyping, ultrasound, and hormonal level assessments (LH, FSH, testosterone, INHB) were performed.
Main Results:
- Thirty patients (11 boys, 19 girls) aged 2 months to 17 years were studied, all with testes but without uterus/ovaries.
- Higher testes position observed in girls (p=0.013); no significant difference in Prader stage (p=0.086).
- Girls showed decreased basal FSH (p=0.002), LH/FSH ratio (p=0.001), and INHB (p=0.006).
- 80% of mutations were de novo; 14 novel mutations identified, with p.R87C and p.R313C being common.
Conclusions:
- 46, XY individuals with NR5A1 mutations exhibit a broad range of external genitalia characteristics and significant Sertoli cell dysfunction.
- The study identified common (p.R87C, p.R313C) and novel NR5A1 mutations, enhancing understanding of genotype-phenotype relationships.
- NR5A1 mutations present a complex spectrum of disorders requiring comprehensive clinical and genetic evaluation.
Abstract:
Background: Patients harboring NR5A1 mutations have a wide spectrum of phenotypes. Objective: To investigate the phenotype of patients with NR5A1 gene mutations from a 30 Chinese patient cohort. Methods: We reported the clinical features of children with NR5A1 gene mutations and compared them between two groups of patients with social genders of male (boys group) and female (girls group). Results: Thirty patients with NR5A1 mutations ranging from 2 months to 17 years of age were studied. There were 11 boys and 19 girls who were identified when they visited the hospital. The patients were verified as having testes without a uterus and ovaries by B-mode ultrasound. There was no difference between boys and girls in terms of the Prader stage (p = 0.086), but the position of the testes was higher in girls than in boys (p = 0.013). The patients' average height is -0.43 SDS according to the normal boys' height with SDS (while their average target height was 0.07 SDS). However, there was no such difference between boys and girls (p > 0.05). Although the basal LH and post-hCG testosterone (T) levels were not different (p > 0.05), but the basal FSH level, LH/FSH ratio, and INHB level were decreased in girls (p = 0.002; p = 0.001; p = 0.006). All of the mothers of the patients reported to have normal pregnancies. We found 24 patients (80%) with de novo mutations in the NR5A1 gene; 5 patients had inherited mutations from their mothers, and one inherited from the father. Only the mothers of patients 16 and 18 showed premature ovarian failure at the time of reporting. Among 26 disease associated mutations, 14 novel mutations that have been reported the first time and p.R87C is the most common Among the other 12 had had been reported,the p.R313C is the most common. Conclusion: Patients with 46, XY NR5A1 mutations presented a wide spectrum of external genitalia characteristics and severe Sertoli cell impairment. The p.R87C and p.R313C mutations appeared to be common (10%) in this group, and 14 new mutations were identified, improving our understanding the genotype phenotype correlations.
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