A genomics approach to females with infertility and recurrent pregnancy loss
HUMAN GENETICS
Authors: Maddirevula, Sateesh; Awartani, Khalid; Coskun, Serdar; AlNaim, Latifa F.; Ibrahim, Niema; Abdulwahab, Firdous; Hashem, Mais; Alhassan, Saad; Alkuraya, Fowzan S.
Abstract
Infertility affects 10% of reproductive-age women and is extremely heterogeneous in etiology. The genetic contribution to female infertility is incompletely understood, and involves chromosomal and single-gene defects. Our aim in this study is to decipher single-gene causes in infertile women in whom endocrinological, anatomical, and chromosomal causes have been excluded. Our cohort comprises women with recurrent pregnancy loss and no offspring from spontaneous pregnancies (RPL, n = 61) and those who never achieved clinical pregnancy and were referred for in vitro fertilization [primary infertility (PI), n = 14]. Whole-exome sequencing revealed candidate variants in 14, which represents 43% of those with PI and 13% of those with RPL. These include variants in previously established female infertility-related genes (TLE6, NLRP7, FSHR, and ZP1) as well as genes with only tentative links in the literature (NLRP5). Candidate variants in genes linked to primary ciliary dyskinesia (DNAH11 and CCNO) were identified in individuals with and without systemic features of the disease. We also identified variants in genes not previously linked to female infertility. These include one homozygous variant each in CCDC68, CBX3, CENPH, PABPC1L, PIF1, PLK1, and REXO4, which we propose as candidate genes for infertility based on their established biology or compatible animal models. Our study expands the contribution of single genes to the etiology of PI and RPL, improves the precision of disease classification at the molecular level, and offers the potential for future treatment and development of human genetics-inspired fertility regulators.
Mutations in CCNO result in congenital mucociliary clearance disorder with reduced generation of multiple motile cilia
NATURE GENETICS
Authors: Wallmeier, Julia; Al-Mutairi, Dalal A.; Chen, Chun-Ting; Loges, Niki Tomas; Pennekamp, Petra; Menchen, Tabea; Ma, Lina; Shamseldin, Hanan E.; Olbrich, Heike; Dougherty, Gerard W.; Werner, Claudius; Alsabah, Basel H.; Koehler, Gabriele; Jaspers, Martine; Boon, Mieke; Griese, Matthias; Schmitt-Grohe, Sabina; Zimmermann, Theodor; Koerner-Rettberg, Cordula; Horak, Elisabeth; Kintner, Chris; Alkuraya, Fowzan S.; Omran, Heymut
Abstract
Using a whole-exome sequencing strategy, we identified recessive CCNO (encoding cyclin O) mutations in 16 individuals suffering from chronic destructive lung disease due to insufficient airway clearance. Respiratory epithelial cells showed a marked reduction in the number of multiple motile cilia (MMC) covering the cell surface. The few residual cilia that correctly expressed axonemal motor proteins were motile and did not exhibit obvious beating defects. Careful subcellular analyses as well as in vitro ciliogenesis experiments in CCNO-mutant cells showed defective mother centriole generation and placement. Morpholino-based knockdown of the Xenopus ortholog of CCNO also resulted in reduced MMC and centriole numbers in embryonic epidermal cells. CCNO is expressed in the apical cytoplasm of multiciliated cells and acts downstream of multicilin, which governs the generation of multiciliated, cells. To our knowledge, CCNO is the first reported gene linking an inherited human disease to reduced MMC generation due to a defect in centriole amplification and migration.