Novel inactivating follicle-stimulating hormone receptor mutations in a patient with premature ovarian insufficiency identified by next-generation sequencing gene panel analysis
Asma Sassi, M.D.,
Julie Désir, M.D., Ph.D.,
Véronique Janssens, B.Sc.,
Martina Marangoni, M.Sc.,
Dorien Daneels, M.Sc.,
Alexander Gheldof, Ph.D.,
Maryse Bonduelle, M.D., Ph.D.,
Sonia Van Dooren, Ph.D.,
Sabine Costagliola, Ph.D.,
Anne Delbaere, M.D., Ph.D.
Affiliations
Asma Sassi, M.D.
Fertility Clinic, Department of Gynecology and Obstetrics, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
Julie Désir, M.D., Ph.D.
Department of Genetics, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
Véronique Janssens, B.Sc.
IRIBHM, Institute of Interdisciplinary Research in Human and Molecular Biology, Université Libre de Bruxelles, Brussels, Belgium
Martina Marangoni, M.Sc.
Department of Genetics, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
Dorien Daneels, M.Sc.
Brussels Interuniversity Genomics High Throughput Core (Bright Core), Brussels, Belgium; Centre for Medical Genetics, Reproduction and Genetics and Regenerative Medicine Research Cluster, Reproduction and Genetics Research Group, Vrije Universiteit Brussel–UZ Brussel, Brussels, Belgium
Alexander Gheldof, Ph.D.
Centre for Medical Genetics, Reproduction and Genetics and Regenerative Medicine Research Cluster, Reproduction and Genetics Research Group, Vrije Universiteit Brussel–UZ Brussel, Brussels, Belgium
Maryse Bonduelle, M.D., Ph.D.
Brussels Interuniversity Genomics High Throughput Core (Bright Core), Brussels, Belgium; Centre for Medical Genetics, Reproduction and Genetics and Regenerative Medicine Research Cluster, Reproduction and Genetics Research Group, Vrije Universiteit Brussel–UZ Brussel, Brussels, Belgium
Sonia Van Dooren, Ph.D.
Brussels Interuniversity Genomics High Throughput Core (Bright Core), Brussels, Belgium; Centre for Medical Genetics, Reproduction and Genetics and Regenerative Medicine Research Cluster, Reproduction and Genetics Research Group, Vrije Universiteit Brussel–UZ Brussel, Brussels, Belgium
Sabine Costagliola, Ph.D.
IRIBHM, Institute of Interdisciplinary Research in Human and Molecular Biology, Université Libre de Bruxelles, Brussels, Belgium
Anne Delbaere, M.D., Ph.D.
Fertility Clinic, Department of Gynecology and Obstetrics, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium; Reprint requests: Anne Delbaere, M.D.,Ph.D., Fertility Clinic, Department of Gynecology and Obstetrics, Erasme Hospital, 808 route de Lennik, 1070 Brussels, Belgium.
Objective: To find the genetic etiology of premature ovarian insufficiency (POI) in a patient with primary amenorrhea and hypergonadotropic hypogonadism. Design: Case report. Setting: University hospital. Patient(s): A Belgian woman aged 32 years with POI at the age of 17, her parents, and her sister whose POI was diagnosed at age 29. Intervention(s): Analysis of a panel of 31 genes implicated in POI (POIGP) using next-generation sequencing (NGS), Sanger sequencing, and in vitro functional study. Main Outcome Measure(s): Gene variants, family mutational segregation, and in vitro functional impact of the mutant proteins. Result(s): The analysis of the gene panel using NGS identified the presence of two novel follicle-stimulating hormone receptor (FSHR) missense mutations at a compound heterozygous state in the affected patient: c.646 G>A, p.Gly216Arg, and c.1313C>T, p.Thr438Ile. Sanger sequencing showed the presence of each mutation at heterozygous state in the patient’s parents and at heterozygous compound state in the affected sister. Both substituted amino acids (Gly216 and Thr438) were conserved in FSHR of several vertebrate species as well as in other glycoproteins receptors (TSHR and LHCGHR), suggesting a potentially important role in glycoprotein receptor function. An in vitro functional study showed similar results for both variants with more than 90% reduction of their cell surface expression and a 55% reduction of their FSH-induced cyclic adenosine 3′:5′ monophosphate (cAMP) production compared with the wild-type FSHR. Conclusion(s): The analysis of a gene panel of 31 genes implicated in POI allowed us to identify two novel partially inactivating mutations of FSHR that are likely responsible for the POI phenotype of the proband and of her affected sister.
