Abstract
Objectives: To investigate the prevalence of genetic mutations in steroid 5α-reductase-2 (SRD5A2), androgen receptor (AR) and steroidogenic factor-1 (SF-1) in Chinese children with hypospadias, and to also explore the possible underlying molecular mechanisms of this disease.
Methods: A total of 52 boys with hypospadias were enrolled. Mutational analyses of the SRD5A2, AR and SF-1 genes were performed by direct sequencing.
Results: SRD5A2 gene mutations were found in 13.5% (7/52 cases), including five compound heterozygotic and two homozygotic mutations. One novel heterozygotic SF-1 gene mutation was identified in a patient with perineal hypospadias and cryptorchidism, the patient’s mother also had the same mutation. No mutation was found in the AR gene. The clinical manifestations of patients with mutations in SRD5A2 or SF-1 varied.
Conclusions: In Chinese patients, SRD5A2 gene mutations were, relatively, frequently associated with hypospadias. The SF-1 gene may be another candidate gene for hypospadias. In contrast, AR gene mutations are not commonly associated with this condition.
References
1. Jin L, Ye R, Zheng J, Hong S, Ren A. Secular trends of hypospadias prevalence and factors associated with it in southeast China during 1993–2005. Birth Defects Res A Clin Mol Teratol 2010;88:458–65.10.1002/bdra.20673Search in Google Scholar
2. Caione P. Prevalence of hypospadias in European countries: is it increasing? Eur Urol 2009;55:1027–9.10.1016/j.eururo.2009.01.051Search in Google Scholar
3. Sultan C, Paris F, Terouanne B, Balaguer P, Georget V, et al. Disorders linked to insufficient androgen action in male children. Hum Reprod Update 2001;7:314–22.10.1093/humupd/7.3.314Search in Google Scholar
4. Lin L, Achermann JC. Steroidogenic factor-1 (SF-1, Ad4BP, NR5A1) and disorders of testis development. Sex Dev 2008;2:200–9.10.1159/000152036Search in Google Scholar
5. Wang Y, Li Q, Xu J, Liu Q, Wang W, et al. Mutation analysis of five candidate genes in Chinese patients with hypospadias. Eur J Hum Genet 2004;12:706–12.10.1038/sj.ejhg.5201232Search in Google Scholar
6. Allali S, Muller JB, Brauner R, Lourenço D, Boudjenah R, et al. Mutation analysis of NR5A1 encoding steroidogenic factor 1 in 77 patients with 46, XY disorders of sex development (DSD) including hypospadias. PLoS One 2011;6:e24117.10.1371/journal.pone.0024117Search in Google Scholar
7. Vilchis F, Canto P, Chávez B, Ulloa-Aguirre A, Méndez JP. Molecular analysis of the 5 alpha-steroid reductase type 2 gene in a family with deficiency of the enzyme. Am J Med Genet 1997;69:69–72.10.1002/(SICI)1096-8628(19970303)69:1<69::AID-AJMG13>3.0.CO;2-MSearch in Google Scholar
8. Zhang M, Zhang H, Yang J, Gu L, Liu J, et al. Study on a novel androgen receptor gene mutation causing androgen insensitivity syndrome. Chin J Endocrinol Metab 2009;25: 58–61.Search in Google Scholar
9. Guoying C, Zhiya D, Wei W, Na L, Xiaoying L, et al. The analysis of clinical manifestations and genetic mutations in Chinese boys with primary adrenal insufficiency. J Pediatr Endocrinol Metab 2012;25:295–300.10.1515/jpem-2011-0362Search in Google Scholar
10. Makridakis NM, di Salle E, Reichardt JK. Biochemical and pharmacogenetic dissection of human steroid 5 alpha-reductase type II. Pharmacogenetics 2000;10:407–13.10.1097/00008571-200007000-00004Search in Google Scholar
11. Zhang M, Yang J, Zhang H, Ning G, Li X, et al. A Novel SRD5A2 Mutation with Loss of Function Identified in Chinese Patients with Hypospadias. Horm Res Paediatr 2011;76:44–9.10.1159/000324692Search in Google Scholar
12. Wigley WC, Prihoda JS, Mowszowicz I, Mendonca BB, New MI, et al. Natural mutagenesis study of the human steroid 5 alpha-reductase 2 isozyme. Biochemistry 1994;33:1265–70.10.1021/bi00171a029Search in Google Scholar
13. Chada M, Průsa R, Bronský J, Kotaska K, Sídlová K, et al. Inhibin B, follicle stimulating hormone, luteinizing hormone and testosterone during childhood and puberty in males: changes in serum concentrations in relation to age and stage of puberty. Physiol Res 2003;52:45–51.Search in Google Scholar
14. Soldin OP, Hoffman EG, Waring MA, Soldin SJ. Pediatric reference intervals for FSH, LH, estradiol, T3, free T3, cortisol, and growth hormone on the DPC IMMULITE 1000. Clin Chim Acta 2005;355:205–10.10.1016/j.cccn.2005.01.006Search in Google Scholar
15. Ardawi MS, Al-Kadi HA, Rouzi AA, Qari MH. Determinants of serum sclerostin in healthy pre- and postmenopausal women. J Bone Miner Res 2011;26:2812–22.10.1002/jbmr.479Search in Google Scholar
16. Hughes IA, Houk C, Ahmed SF, Lee PA, Lawson Wilkins Pediatric Endocrine Society/European Society for Paediatric Endocrinology Consensus Group. Consensus statement on management of intersex disorders. J Pediatr Urol 2006;2:148–62.10.1016/j.jpurol.2006.03.004Search in Google Scholar
17. Cheon CK. Practical approach to steroid 5alpha-reductase type 2 deficiency. Eur J Pediatr 2011;170:1–8.10.1007/s00431-010-1189-4Search in Google Scholar
18. Maimoun L, Philibert P, Cammas B, Audran F, Bouchard P, et al. Phenotypical, biological, and molecular heterogeneity of 5α-reductase deficiency: an extensive international experience of 55 patients. J Clin Endocrinol Metab 2011;96:296–307.10.1210/jc.2010-1024Search in Google Scholar
19. Sahakitrungruang T, Wacharasindhu S, Yeetong P, Snabboon T, Suphapeetiporn K, et al. Identification of mutations in the SRD5A2 gene in Thai patients with male pseudohermaphroditism. Fertil Steril 2008;90:2015.e11–5.10.1016/j.fertnstert.2008.01.019Search in Google Scholar
20. Sinnecker GH, Hiort O, Dibbelt L, Albers N, Dörr HG, et al. Phenotypic classification of male pseudohermaphroditism due to steroid 5-alpha-reductase 2 deficiency. Am J Med Genet 1996;63:223–30.10.1002/(SICI)1096-8628(19960503)63:1<223::AID-AJMG39>3.0.CO;2-OSearch in Google Scholar
21. Walter KN, Kienzle FB, Frankenschmidt A, Hiort O, Wudy SA, et al. Difficulties in diagnosis and treatment of 5alpha-reductase type 2 deficiency in a newborn with 46,XY DSD. Horm Res Paediatr 2010;74:67–71.10.1159/000313372Search in Google Scholar
22. Achermann JC, Ito M, Ito M, Hindmarsh PC, Jameson JL. A mutation in the gene encoding steroidogenic factor-1 causes XY sex reversal and adrenal failure in humans. Nat Genet 1999;22:125–6.10.1038/9629Search in Google Scholar
23. Köhler B, Lin L, Mazen I, Cetindag C, Biebermann H, et al. The spectrum of phenotypes associated with mutations in steroidogenic factor 1 (SF-1, NR5A1, Ad4BP) includes severe penoscrotal hypospadias in 46,XY males without adrenal insufficiency. Eur J Endocrinol 2009;161:237–42.10.1530/EJE-09-0067Search in Google Scholar PubMed PubMed Central
24. Köhler B, Lin L, Ferraz-de-Souza B, Wieacker P, Heidemann P, et al. Five novel mutations in steroidogenic factor 1 (SF1, NR5A1) in 46,XY patients with severe underandrogenization but without adrenal insufficiency. Hum Mutat 2008;29:59–64.10.1002/humu.20588Search in Google Scholar PubMed PubMed Central
25. Lourenço D, Brauner R, Lin L, De Perdigo A, Weryha G, et al. Mutations in NR5A1 associated with ovarian insufficiency. N Engl J Med 2009;360:1200–10.10.1056/NEJMoa0806228Search in Google Scholar PubMed PubMed Central
©2013 by Walter de Gruyter Berlin Boston
Articles in the same Issue
- Masthead
- Masthead
- Review article
- Tamoxifen therapy for the management of pubertal gynecomastia: a systematic review
- Images in pediatric endocrinology
- Solitary median maxillary central incisor, a clinical predictor of hypoplastic anterior pituitary, ectopic neurohypophysis and growth hormone deficiency
- A rare case of granuloma annulare in a 6-year-old child with type 1 diabetes
- Original articles
- The arginine stimulation test: timing of peak is not a helpful parameter in the diagnosis of growth hormone deficiency
- The relationship between adiposity and stature in prepubertal children with celiac disease
- Influence of micronutrient status and socioeconomic gradient on growth indices of 2–18-year-old Indian girls
- Phosphotyrosine phosphatases in GH-stimulated skin fibroblasts from children with idiopathic short stature
- The relation between salivary cortisol and the metabolic syndrome score in girls
- Association of vitamin D concentrations with adiposity indices among preadolescent children in Korea
- Association of serum resistin levels with metabolic syndrome and early atherosclerosis in obese Chinese children
- Characteristics of infants at risk of hypoglycaemia secondary to being ‘infant of a diabetic mother’
- Parental dyadic coping in families of children and adolescents with type 1 diabetes
- Pigmentary hypertrichosis and non-autoimmune insulin-dependent diabetes mellitus (PHID) syndrome is associated with severe chronic inflammation and cardiomyopathy, and represents a new monogenic autoinflammatory syndrome
- Effect of insulin therapy on IGF-1 level in children with new-onset type 1 diabetes mellitus: a comparison between DKA and non-DKA
- Mutation analysis of the SRD5A2, AR and SF-1 genes in 52 Chinese boys with hypospadias
- Sexual development in prepubertal obese boys: a 4-year longitudinal study
- Genetic diagnosis of one family with incomplete clinical data
- Patient reports
- Complete androgen insensitivity syndrome and discordant Müllerian remnants: two cases with novel mutation in the androgen receptor
- Psychosexual outcomes in three siblings with partial androgen insensitivity syndrome: impact of nature versus nurture
- Ambiguous genitalia in a 48, XXYY newborn: a casual relationship or a coincidence?
- Gonadal function of beta-thalassemics following stem cell transplantation conditioned with myeloablative and reduced intensity regimens
- Significant testicular enlargement in a 6.5-year-old boy with monorchism and testicular microlithiasis
- Report of the first case of precocious puberty in Rett syndrome
- Type II vitamin D-dependent rickets with diabetic ketoacidosis
- Pituitary gigantism presenting with depressive mood disorder and diabetic ketoacidosis in an Asian adolescent
- A rare association between Rathke’s cyst and hypophysitis in a patient with delayed sex development and growth failure
- Diabetes mellitus with Laron syndrome: case report
- Wegener granulomatosis as an uncommon cause of panhypopituitarism in childhood
- Rare cases of autoimmune hypothyroidism in young children
- Cushing syndrome related to leukemic infiltration of the central nervous system: a case report and a possible role of LIF
- Early presentation of bilateral gonadoblastomas in a Denys-Drash syndrome patient: a cautionary tale for prophylactic gonadectomy
- Identification of a novel homozygous mutation (S144I) in a Malay patient with maple syrup urine disease
- Virilization in two pre-pubertal children exposed to topical androgen
- A family with Camurati-Engelman disease. The role of the missense p.R218C mutation in TGFB1 in bones and endocrine glands
- Short communications
- Plasma ceramides are elevated in female children and adolescents with type 2 diabetes
- Assessment of contractility and myocardial function in small and appropriate for gestational age premature neonates using the stress-velocity relationship and tissue Doppler imaging immediately after birth
- Letter to the Editors
- Homeostasis model assessment of insulin resistance may not be reliable to evaluate insulin sensitivity in young obese children
- Type 1 diabetes in women with endometriosis: what is the risk of occurrence?
- How should we manage vitamin D-deficient adolescents?
- Should neonatal hyperparathyroidism associated with mucolipidosis II/III be treated pharmacologically?a
Articles in the same Issue
- Masthead
- Masthead
- Review article
- Tamoxifen therapy for the management of pubertal gynecomastia: a systematic review
- Images in pediatric endocrinology
- Solitary median maxillary central incisor, a clinical predictor of hypoplastic anterior pituitary, ectopic neurohypophysis and growth hormone deficiency
- A rare case of granuloma annulare in a 6-year-old child with type 1 diabetes
- Original articles
- The arginine stimulation test: timing of peak is not a helpful parameter in the diagnosis of growth hormone deficiency
- The relationship between adiposity and stature in prepubertal children with celiac disease
- Influence of micronutrient status and socioeconomic gradient on growth indices of 2–18-year-old Indian girls
- Phosphotyrosine phosphatases in GH-stimulated skin fibroblasts from children with idiopathic short stature
- The relation between salivary cortisol and the metabolic syndrome score in girls
- Association of vitamin D concentrations with adiposity indices among preadolescent children in Korea
- Association of serum resistin levels with metabolic syndrome and early atherosclerosis in obese Chinese children
- Characteristics of infants at risk of hypoglycaemia secondary to being ‘infant of a diabetic mother’
- Parental dyadic coping in families of children and adolescents with type 1 diabetes
- Pigmentary hypertrichosis and non-autoimmune insulin-dependent diabetes mellitus (PHID) syndrome is associated with severe chronic inflammation and cardiomyopathy, and represents a new monogenic autoinflammatory syndrome
- Effect of insulin therapy on IGF-1 level in children with new-onset type 1 diabetes mellitus: a comparison between DKA and non-DKA
- Mutation analysis of the SRD5A2, AR and SF-1 genes in 52 Chinese boys with hypospadias
- Sexual development in prepubertal obese boys: a 4-year longitudinal study
- Genetic diagnosis of one family with incomplete clinical data
- Patient reports
- Complete androgen insensitivity syndrome and discordant Müllerian remnants: two cases with novel mutation in the androgen receptor
- Psychosexual outcomes in three siblings with partial androgen insensitivity syndrome: impact of nature versus nurture
- Ambiguous genitalia in a 48, XXYY newborn: a casual relationship or a coincidence?
- Gonadal function of beta-thalassemics following stem cell transplantation conditioned with myeloablative and reduced intensity regimens
- Significant testicular enlargement in a 6.5-year-old boy with monorchism and testicular microlithiasis
- Report of the first case of precocious puberty in Rett syndrome
- Type II vitamin D-dependent rickets with diabetic ketoacidosis
- Pituitary gigantism presenting with depressive mood disorder and diabetic ketoacidosis in an Asian adolescent
- A rare association between Rathke’s cyst and hypophysitis in a patient with delayed sex development and growth failure
- Diabetes mellitus with Laron syndrome: case report
- Wegener granulomatosis as an uncommon cause of panhypopituitarism in childhood
- Rare cases of autoimmune hypothyroidism in young children
- Cushing syndrome related to leukemic infiltration of the central nervous system: a case report and a possible role of LIF
- Early presentation of bilateral gonadoblastomas in a Denys-Drash syndrome patient: a cautionary tale for prophylactic gonadectomy
- Identification of a novel homozygous mutation (S144I) in a Malay patient with maple syrup urine disease
- Virilization in two pre-pubertal children exposed to topical androgen
- A family with Camurati-Engelman disease. The role of the missense p.R218C mutation in TGFB1 in bones and endocrine glands
- Short communications
- Plasma ceramides are elevated in female children and adolescents with type 2 diabetes
- Assessment of contractility and myocardial function in small and appropriate for gestational age premature neonates using the stress-velocity relationship and tissue Doppler imaging immediately after birth
- Letter to the Editors
- Homeostasis model assessment of insulin resistance may not be reliable to evaluate insulin sensitivity in young obese children
- Type 1 diabetes in women with endometriosis: what is the risk of occurrence?
- How should we manage vitamin D-deficient adolescents?
- Should neonatal hyperparathyroidism associated with mucolipidosis II/III be treated pharmacologically?a