NR5A1 gene variants repress the ovarian-specific WNT signaling pathway in 46,XX disorders of sex development patients

Hum Mutat. 2019 Feb;40(2):207-216. doi: 10.1002/humu.23672. Epub 2018 Nov 30.

Abstract

Several recent reports have described a missense variant in the gene NR5A1 (c.274C>T; p.Arg92Trp) in a significant number of 46,XX ovotesticular or testicular disorders of sex development (DSDs) cases. The affected residue falls within the DNA-binding domain of the NR5A1 protein, however the exact mechanism by which it causes testicular development in 46,XX individuals remains unclear. We have screened a cohort of 26 patients with 46,XX (ovo)testicular DSD and identified three unrelated individuals with this NR5A1 variant (p.Arg92Trp), as well as one patient with a novel NR5A1 variant (c.779C>T; p.Ala260Val). We examined the functional effect of these changes, finding that while protein levels and localization were unaffected, variant NR5A1 proteins repress the WNT signaling pathway and have less ability to upregulate the anti-testis gene NR0B1. These findings highlight how NR5A1 variants impact ovarian differentiation across multiple pathways, resulting in a switch from ovarian to testis development in genetic females.

Keywords: 46,XX ovotesticular DSD; 46,XX testicular DSD; NR5A1; SF1; disorders of sex development.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 46, XX Disorders of Sex Development / genetics*
  • 46, XX Disorders of Sex Development / pathology
  • Adolescent
  • Adult
  • Child, Preschool
  • DNA-Binding Proteins / genetics
  • Disorders of Sex Development / genetics*
  • Disorders of Sex Development / pathology
  • Female
  • Humans
  • Infant
  • Male
  • Mutation, Missense / genetics
  • Pedigree
  • Phenotype
  • Protein Domains / genetics
  • Steroidogenic Factor 1 / genetics*
  • Testis / growth & development
  • Testis / pathology*
  • Wnt Signaling Pathway / genetics

Substances

  • DNA-Binding Proteins
  • NR5A1 protein, human
  • Steroidogenic Factor 1