title: Genetic insights into human isolated gonadotropin deficiency.
abstract: The identification of naturally occurring genetic mutations has provided unique insight into the current knowledge of the human hypothalamic-pituitary-gonadal axis. In the past decade, several monogenic causes have been reported in patients with isolated gonadotropin deficiency. Kallmann Syndrome is a clinically and genetically heterogeneous disorder, characterized by isolated hypogonadotropic hypogonadism and anosmia or hyposmia. To date, loss-of-function mutations in the genes encoding anosmin-1 (KAL1) and fibroblast growth factor receptor 1 (FGFR1) have been described in the X-linked and autosomal dominant forms of this syndrome, respectively. More recently, several heterozygous, homozygous or compound heterozygous mutations in the G protein-coupled prokineticin receptor-2 (PROKR2) and one of its ligands, prokineticin-2 (PROK2) were described in Kallmann syndrome. In addition, complex genetic transmission (digenic inheritance) was recently demonstrated in this condition. Regarding isolated hypogonadotropic hypogonadism without olfactory abnormalities, loss-of-function mutations in the Gonadotropin-releasing hormone (GnRH) receptor (GnRH-R) or the G-protein coupled receptor 54 (GPR54) genes, both encoding transmembrane receptors, have been described, as well as FGFR1 mutations. Finally, mutations of the beta sub-units of LH and FSH have been described in patients with selective gonadotropin deficiency. We review the role of these distinct genetic factors in human isolated hypogonadotropic hypogonadism.
authors.affiliation: Developmental Endocrinology Unit, Hormone and Molecular Genetic Laboratory LIM/42, Clinical Hospital, São Paulo University Medical School, Sao Paulo 05403-900, Brazil.
authors.forename: Ericka Barbosa
authors.initials: EB
authors.lastname: Trarbach
authors.forename: Leticia Gontijo
authors.initials: LG
authors.lastname: Silveira
authors.forename: Ana Claudia
authors.initials: AC
authors.lastname: Latronico
mesh_terms: D006062:Gonadotropins / Q000172:deficiency / Q000235:genetics*; D006801:Humans; D007006:Hypogonadism / Q000235:genetics* / Q000503:physiopathology*; D017436:Kallmann Syndrome / Q000235:genetics* / Q000503:physiopathology*
chemical_list: D006062:Gonadotropins