title: Loss-of-function mutation in the prokineticin 2 gene causes Kallmann syndrome and normosmic idiopathic hypogonadotropic hypogonadism.
abstract: Gonadotropin-releasing hormone (GnRH) deficiency in the human presents either as normosmic idiopathic hypogonadotropic hypogonadism (nIHH) or with anosmia [Kallmann syndrome (KS)]. To date, several loci have been identified to cause these disorders, but only 30% of cases exhibit mutations in known genes. Recently, murine studies have demonstrated a critical role of the prokineticin pathway in olfactory bulb morphogenesis and GnRH secretion. Therefore, we hypothesize that mutations in prokineticin 2 (PROK2) underlie some cases of KS in humans and that animals deficient in Prok2 would be hypogonadotropic. One hundred IHH probands (50 nIHH and 50 KS) with no known mutations were examined for mutations in the PROK2 gene. Mutant PROK2s were examined in functional studies, and the reproductive phenotype of the Prok2(-/-) mice was also investigated. Two brothers with KS and their sister with nIHH harbored a homozygous deletion in the PROK2 gene (p.[I55fsX1]+[I55fsX1]). Another asymptomatic brother was heterozygous for the deletion, whereas both parents (deceased) had normal reproductive histories. The identified deletion results in a truncated PROK2 protein of 27 amino acids (rather than 81 in its mature form) that lacks bioactivity. In addition, Prok2(-/-) mice with olfactory bulb defects exhibited disrupted GnRH neuron migration, resulting in a dramatic decrease in GnRH neuron population in the hypothalamus as well as hypogonadotropic hypogonadism. Homozygous loss-of-function PROK2 mutations cause both KS and nIHH.
authors.affiliation: Department of Medicine and Harvard Reproductive Endocrine Science Centers, Massachusetts General Hospital, Boston, MA 02114, USA. npitteloud@partners.org
authors.forename: Nelly
authors.initials: N
authors.lastname: Pitteloud
authors.forename: Chengkang
authors.initials: C
authors.lastname: Zhang
authors.forename: Duarte
authors.initials: D
authors.lastname: Pignatelli
authors.forename: Jia-Da
authors.initials: JD
authors.lastname: Li
authors.forename: Taneli
authors.initials: T
authors.lastname: Raivio
authors.forename: Lindsay W
authors.initials: LW
authors.lastname: Cole
authors.forename: Lacey
authors.initials: L
authors.lastname: Plummer
authors.forename: Elka E
authors.initials: EE
authors.lastname: Jacobson-Dickman
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Mellon
authors.forename: Qun-Yong
authors.initials: QY
authors.lastname: Zhou
authors.forename: William F
authors.initials: WF
authors.lastname: Crowley
mesh_terms: D000818:Animals; D001483:Base Sequence; D002465:Cell Movement; D005260:Female; D005768:Gastrointestinal Hormones / Q000172:deficiency / Q000235:genetics / Q000378:metabolism*; D017353:Gene Deletion; D005786:Gene Expression Regulation; D005838:Genotype; D007987:Gonadotropin-Releasing Hormone / Q000378:metabolism; D006801:Humans; D007006:Hypogonadism / Q000235:genetics / Q000378:metabolism* / Q000473:pathology*; D017436:Kallmann Syndrome / Q000235:genetics / Q000378:metabolism* / Q000473:pathology*; D008297:Male; D051379:Mice; D018345:Mice, Knockout; D009154:Mutation / Q000235:genetics; D009474:Neurons / Q000166:cytology / Q000378:metabolism; D009479:Neuropeptides / Q000172:deficiency / Q000235:genetics / Q000378:metabolism*; D010375:Pedigree; D010641:Phenotype; D012098:Reproduction
chemical_list: D005768:Gastrointestinal Hormones; D009479:Neuropeptides; C423608:PROK2 protein, human; C486586:Prok2 protein, mouse; D007987:Gonadotropin-Releasing Hormone