Oligogenic analysis across broad phenotypes of 46,XY differences in sex development associated with NR5A1/SF-1 variants: findings from the international SF1next study.
Background
Oligogenic inheritance has been suggested as a possible mechanism to explain the broad phenotype observed in individuals with differences of sex development (DSD) harbouring NR5A1/SF-1 variants.
Methods
We investigated genetic patterns of possible oligogenicity in a cohort of 30 individuals with NR5A1/SF-1 variants and 46,XY DSD recruited from the international SF1next study, using whole exome sequencing (WES) on family trios whenever available. WES data were analysed using a tailored filtering algorithm designed to identify rare variants in DSD and SF-1-related genes. Identified variants were subsequently tested using the Oligogenic Resource for Variant Analysis (ORVAL) bioinformatics platform for a possible combined pathogenicity with the individual NR5A1/SF-1 variant.
Findings
In 73% (22/30) of the individuals with NR5A1/SF-1 related 46,XY DSD, we identified one to seven additional variants, predominantly in known DSD-related genes, that might contribute to the phenotype. We found identical variants in eight unrelated individuals with DSD in DSD-related genes (e.g., TBCE, FLNB, GLI3 and PDGFRA) and different variants in eight genes frequently associated with DSD (e.g., CDH23, FLNB, GLI2, KAT6B, MYO7A, PKD1, SPRY4 and ZFPM2) in 15 index cases. Our study also identified combinations with NR5A1/SF-1 variants and variants in novel candidate genes.
Interpretation
These findings highlight the complex genetic landscape of DSD associated with NR5A1/SF-1, where in several cases, the use of advanced genetic testing and filtering with specific algorithms and machine learning tools revealed additional genetic hits that may contribute to the phenotype.
Funding
Swiss National Science Foundation and Boveri Foundation Zurich.
Copyright © 2025 The Author(s). Published by Elsevier B.V. All rights reserved.
Overview publication
| Title | Oligogenic analysis across broad phenotypes of 46,XY differences in sex development associated with NR5A1/SF-1 variants: findings from the international SF1next study. |
| Date | 2025-03-01 |
| Issue name | EBioMedicine |
| Issue number | v113:105624 |
| DOI | 10.1016/j.ebiom.2025.105624 |
| PubMed | 40037090 |
| Authors | |
| Info | SF1next study group, Abali S, Abali ZY, Ahmed SF, Akin L, Almaraz M, Audí L, Aydin M, Balsamo A, Baronio F, Bryce J, Busiah K, Caimari M, Camats-Tarruella N, Campos-Martorell A, Castaño L, Casteràs A, Çetinkaya S, Claahsen-van der Grinten HL, Cools M, Costa I, Darendeliler FF, Davies JH, Esteva I, Fabbri-Scallet H, Finlayson CA, Garcia E, Cuartero BG, German A, Globa E, Guerra-Junior G, Guerrero J, Guran T, Hannema SE, Hiort O, Hirsch J, Hughes I, Janner M, Kennedy U, Kolesinska Z, Lachlan K, Lauber-Biason A, Malikova JK, L'Allemand D, Lenhnerr-Taube N, Lucas-Herald A, Mammadova J, Mericq V, Mönig I, Moreno F, Mührer J, Niedziela M, Nordenstrom A, Orman B, Poyrazoglu S, Rial JM, Rutter MM, Rodríguez A, Schafer-Kalkhoff T, Seneviratne SN, Sredkova-Ruskova M, Tack LJW, Tadokoro-Cuccaro R, Thankamony A, Tomé M, Vela A, Wasniewska M, Zangen D, Zelinska N |
| Keywords | 46, XY DSD, Differences of sex development (DSD), Oligogenicity, Steroidogenic factor 1 (SF-1/NR5A1) |
| Read | Read publication |