New mutations in non-syndromic primary ovarian insufficiency patients identified via whole-exome sequencing.

STUDY QUESTION: Is it possible to identify new mutations potentially associated with non-syndromic primary ovarian insufficiency (POI) via whole-exome sequencing (WES)? SUMMARY ANSWER: WES is an efficient tool to study genetic causes of POI as we have identified new mutations, some of which lead to protein destablization potentially contributing to the disease etiology. WHAT IS KNOWN ALREADY: POI is a frequently occurring complex pathology leading to infertility. Mutations in only few candidate genes, mainly identified by Sanger sequencing, have been definitively related to the pathogenesis of the disease. STUDY DESIGN, SIZE, DURATION: This is a retrospective cohort study performed on 69 women affected by POI. PARTICIPANTS/MATERIALS, SETTING, METHODS: WES and an innovative bioinformatics analysis were used on non-synonymous sequence variants in a subset of 420 selected POI candidate genes. Mutations in BMPR1B and GREM1 were modeled by using fragment molecular orbital analysis. MAIN RESULTS AND THE ROLE OF CHANCE: Fifty-five coding variants in 49 genes potentially related to POI were identified in 33 out of 69 patients (48%). These genes participate in key biological processes in the ovary, such as meiosis, follicular development, granulosa cell differentiation/proliferation and ovulation. The presence of at least two mutations in distinct genes in 42% of the patients argued in favor of a polygenic nature of POI. LIMITATIONS, REASONS FOR CAUTION: It is possible that regulatory regions, not analyzed in the present study, carry further variants related to POI. WIDER IMPLICATIONS OF THE FINDINGS: WES and the in silico analyses presented here represent an efficient approach for mapping variants associated with POI etiology. Sequence variants presented here represents potential future genetic biomarkers. STUDY FUNDING/COMPETING INTEREST(S): This study was supported by the Universidad del Rosario and Colciencias (Grants CS/CIGGUR-ABN062-2016 and 672-2014). Colciencias supported Liliana Catherine Patiño´s work (Fellowship: 617, 2013). The authors declare no conflict of interest.

A potential functional association between mutant BMPR2 and primary ovarian insufficiency.

Primary ovarian insufficiency (POI) affects ~1% of women in the general population. Despite numerous attempts at identifying POI genetic aetiology, coding mutations in only a few genes have been functionally related to POI pathogenesis. It has been suggested that mutant BMPR2 might contribute towards the phenotype. Several BMP15 (a BMPR2 ligand) coding mutations in human species have been related to POI pathogenesis. The BMPR2 p.Ser987Phe mutation, previously identified in a woman with POI, might therefore lead to cellular dysfunction contributing to the phenotype. To explore such an assumption, the present study assessed potential pathogenic subcellular localization/aggregation patterns associated with the p.Ser987Phe mutant form of BMPR2 in a relevant model for studying ovarian function. A significant increase in protein-like aggregation patterns was identified at the endoplasmic reticulum (ER) which permitted us to establish, for the first time, a potential functional association between mutant BMPR2 and POI aetiology. Since BMPR2 mutant forms were previously related to idiopathic pulmonary arterial hypertension, BMPR2 mutations may be related to an as-yet-to-be described syndromic form of POI involving pulmonary dysfunction. Additional assays are necessary to confirm that BMPR2 abnormal subcellular patterns are composed by aggregates. ABBREVIATIONS: POI: primary ovarian insufficiency; ER: endoplasmic reticulum; NGS: next generation sequencing.

Next generation sequencing in women affected by nonsyndromic premature ovarian failure displays new potential causative genes and mutations.

OBJECTIVE: To identify new molecular actors involved in nonsyndromic premature ovarian failure (POF) etiology. DESIGN: This is a retrospective case-control cohort study. SETTING: University research group and IVF medical center. PATIENT(S): Twelve women affected by nonsyndromic POF. The control group included 176 women whose menopause had occurred after age 50 and had no antecedents regarding gynecological disease. A further 345 women from the same ethnic origin (general population group) were also recruited to assess allele frequency for potentially deleterious sequence variants. INTERVENTION(S): Next generation sequencing (NGS), Sanger sequencing, and bioinformatics analysis. MAIN OUTCOME MEASURE(S): The complete coding regions of 70 candidate genes were massively sequenced, via NGS, in POF patients. Bioinformatics and genetics were used to confirm NGS results and to identify potential sequence variants related to the disease pathogenesis. RESULT(S): We have identified mutations in two novel genes, ADAMTS19 and BMPR2, that are potentially related to POF origin. LHCGR mutations, which might have contributed to the phenotype, were also detected. CONCLUSION(S): We thus recommend NGS as a powerful tool for identifying new molecular actors in POF and for future diagnostic/prognostic purposes.

Exome sequencing is an efficient tool for variant late-infantile neuronal ceroid lipofuscinosis molecular diagnosis.

The neuronal ceroid-lipofuscinoses (NCL) is a group of neurodegenerative disorders characterized by epilepsy, visual failure, progressive mental and motor deterioration, myoclonus, dementia and reduced life expectancy. Classically, NCL-affected individuals have been classified into six categories, which have been mainly defined regarding the clinical onset of symptoms. However, some patients cannot be easily included in a specific group because of significant variation in the age of onset and disease progression. Molecular genetics has emerged in recent years as a useful tool for enhancing NCL subtype classification. Fourteen NCL genetic forms (CLN1 to CLN14) have been described to date. The variant late-infantile form of the disease has been linked to CLN5, CLN6, CLN7 (MFSD8) and CLN8 mutations. Despite advances in the diagnosis of neurodegenerative disorders mutations in these genes may cause similar phenotypes, which rends difficult accurate candidate gene selection for direct sequencing. Three siblings who were affected by variant late-infantile NCL are reported in the present study. We used whole-exome sequencing, direct sequencing and in silico approaches to identify the molecular basis of the disease. We identified the novel c.1219T>C (p.Trp407Arg) and c.1361T>C (p.Met454Thr) MFSD8 pathogenic mutations. Our results highlighted next generation sequencing as a novel and powerful methodological approach for the rapid determination of the molecular diagnosis of NCL. They also provide information regarding the phenotypic and molecular spectrum of CLN7 disease.

BMP15 c.-9C>G promoter sequence variant may contribute to the cause of non-syndromic premature ovarian failure.

BMP15 has drawn particular attention in the pathophysiology of reproduction, as its mutations in mammalian species have been related to different reproductive phenotypes. In humans, BMP15 coding regions have been sequenced in large panels of women with premature ovarian failure (POF), but only some mutations have been definitely validated as causing the phenotype. A functional association between the BMP15 c.-9C>G promoter polymorphism and cause of POF have been reported. The aim of this study was to determine the potential functional effect of this sequence variant on specific BMP15 promoter transactivation disturbances. Bioinformatics was used to identify transcription factor binding sites located on the promoter region of BMP15. Reverse transcription polymerase chain reaction was used to study specific gene expression in ovarian tissue. Luciferase reporter assays were used to establish transactivation disturbances caused by the BMP15 c.-9C>G variant. The c.-9C>G variant was found to modify the PITX1 transcription factor binding site. PITX1 and BMP15 co-expressed in human and mouse ovarian tissue, and PITX1 transactivated both BMP15 promoter versions (-9C and -9G). It was found that the BMP15 c.-9G allele was related to BMP15 increased transcription, supporting c.-9C>G as a causal agent of POF.

Efecto del Mercurius-Heel®s sobre la citotoxicidad de fibroblastos gingivales humanos en un modelo in vitro / Effect of Mercurius-Heel®s on the cytotoxicity of human gingival fibroblasts in an in vitro model

La enfermedad periodontal es una patología de origen infeccioso, caracterizada por ocasionar secuelas destructivas al tejido de soporte del diente, y cuyo tratamiento va encaminado a la destrucción de los agentes etiológicos y a la regeneración periodontal. Una alternativa es el uso de agentes homeopáticos ya que son naturales y se administran a muy bajas concentraciones, uno de ellos es el Mercurius Heel® S como coadyuvante en enfermedades infecciosas. En este trabajo se presentan los resultados de una investigación cuyo objetivo fue evaluar el efecto del Mercurius Heel® S en la viabilidad de fibroblastos gingivales humanos, que fueron sometidos a tratamiento con Mercurius Heel® S durante 15 minutos y dos horas a concentraciones desde 300mg hasta 0.00006mg. Transcurridos esos tiempos, se retiró el tratamiento y las células fueron mantenidas durante 24, 48 y 72 horas más. Posteriormente se realizó un ensayo colorimétrico de viabilidad y proliferación celular denominado MTS de promega® Los fibroblastos gingivales humanos tratados con Mercurius Heel® S mostraron un aumento en la proliferación celular comparada con las células no tratadas. Bajas concentraciones del medicamento 0,0001mg y 0,00006mg mostraron una mayor proliferación observando diferencias estadísticamente significativas. El tratamiento a 15 minutos mostró mejores resultados con respecto al tratamiento de 2 horas con diferencias estadísticamente significativas también. Finalmente el efecto del Mercurius Heel® se mantuvo hasta las primeras 48 horas. Considerando lo anterior, el Mercurius Heel® no presentó ningún efecto citotóxico en los fibroblastos gingivales; por el contrario, las células proliferaron, lo que sugiere su utilidad como tratamiento complementario en la enfermedad periodontal.

Periodontal disease is pathology of infectious origin, characterized because it causes destructive consequences to the supporting tissue of the tooth, its treatment is aimed at the destruction of the etiologic agents and to the periodontal regeneration. An alternative is the use of homeopathic agents because they are natural and are managed to very low concentrations, one of them is the Mercurius Heel ® S as an adjunctive therapy in infectious diseases. In this work, we present the results of an investigation whose objective was to evaluate the effect of Mercurius Heel® S on the viability of human gingival fibroblasts, which were undergoing treatment with Mercurius Heel® S for 15 minutes and two hours to concentrations from 300mg to 0.00006mg. After these times, the treatment was removed and the cells were maintained for 24, 48, and 72 more hours. It was followed by a colorimetric assay for cell viability and proliferation called MTS of Promega ®. Human gingival fibroblasts treated with Mercurius Heel® S showed an increase in cell proliferation compared with the untreated cells. Low medication concentrations of 0.0001 mg and 0.00006 mg showed a greater proliferation showed greater statistically differences. Finally, the effect of Mercurius Heel® was maintained for the first 48 hours. Considering the above, the Mercurius Heel® did not provide any cytotoxic effect on human gingival fibroblasts; on the contrary, the cells proliferated, suggesting its usefulness as supplementary treatment for periodontal disease.

A novel familial case of diffuse leukodystrophy related to NDUFV1 compound heterozygous mutations.

NDUFV1 mutations have been related to encephalopathic phenotypes due to mitochondrial energy metabolism disturbances. In this study, we report two siblings affected by a diffuse leukodystrophy, who carry the NDUFV1 c.1156C>T (p.Arg386Cys) missense mutation and a novel 42-bp deletion. Bioinformatic and molecular analysis indicated that this deletion lead to the synthesis of mRNA molecules carrying a premature stop codon, which might be degraded by the nonsense-mediated decay system. Our results add information on the molecular basis and the phenotypic features of mitochondrial disease caused by NDUFV1 mutations.