对核受体变体的功能和临床洞察力,以推进男性不孕症的精确诊断
Avinash S Gaikwad1, Margot J Wyrwoll1, Sophie A Koser1
1Institute of Reproductive Genetics, Centre of Medical Genetics, University of Münster, Münster, Germany.
EBioMedicine
|August 29, 2025
概括
这项研究评估了不孕男性的核受体,类固醇生成因子1 (NR5A1/SF1) 和雄激素受体 (AR) 的变异. 结合临床和实验数据改善了变种分类,帮助诊断和治疗男性不孕症.
科学领域:
- 遗传学和分子生物学
- 生殖医学
- 内分泌学
背景情况:
- 核受体,包括类固醇原因子1 (NR5A1/SF1) 和雄激素受体 (AR),对于繁殖至关重要.
- 这些受体中的致病变体会导致各种表型,从性发育差异到男性不孕症.
- 缺乏标准化方法来分类具有不确定的意义的变异 (VUS),这阻碍了准确的诊断和个性化治疗.
研究的目的:
- 在不孕男性中研究罕见的NR5A1和AR变异.
- 为NR5A1和AR分类VUS建立标准化方法.
- 改善因核受体变异而导致男性不孕症的患者的诊断和护理.
主要方法:
- 在2127名不育男性的外基因组/基因组测序.
- 临床表型和家族分离分析.
- 在的致病性预测和体外功能测试.
主要成果:
- 在不孕男性中发现了7种NR5A1和22种AR变异.
- 三种SF1和七种AR变体显示转录活性降低.
- 60% 的变体 (17/ 29) 被归类为致病或可能致病,包括VUS的重新分类.
结论:
- 结合临床,体和体外数据对于可靠的VUS评估至关重要.
- 精确的变种分类可以改善患者的诊断和管理.
- 这种方法有助于更好地了解受影响男性的精子发生障碍.
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