Ovarian Dysgenesis and Premature Ovarian Failure (POF)
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The Genes Involved in Hearing and Endocrine Disorders A Thesis submitted to the University of Manchester for the degree of Doctor of Philosophy in the Faculty of Medical and Human Sciences. 2012 Emma Mary Jenkinson School of Medicine CONTENTS Content Page List of Tables 7 List of Figures 10 Abstract 16 Declaration 17 Copyright statement 17 Acknowledgment 19 Abbreviations 20 Chapter 1: Introduction 24 1. Introduction 25 1.1. Sensorineural Hearing Loss 25 1.1.1 Genes which Regulate Ion Homeostasis in the Cochlear 28 1.1.2 Genes Responsible for Formation and Maintenance of the 29 Hair bundles 1.1.3 Genes Responsible for Maintenance of the Extracellular 32 Matrix 1.1.4 Transcription Factor Genes 34 1.1.5 Genes of Poorly Established Function 35 1.1.6 The Need for Further Research in Deafness Genetics 37 1.2 Hypothalamic Pituitary Gonadal axis 37 1.2.1 Hypogonadotropic Hypogonadism 39 1.2.2 Hypergonadotropic Hypogonadism: Premature Ovarian 52 Failure (POF) and Ovarian Dysgenesis 1.2.3 Premature Ovarian Failure and Sensorineural Hearing 71 Loss: Perrault Syndrome 1.3 The Evolution of Techniques in Genetic Medicine 80 1.3.1 Linkage Mapping 80 1.3.2 From Locus to Gene Mutation 83 1.3.3 Next Generation Sequencing 84 1.4 Aim 89 Chapter 2: Materials and Methods 91 2.Materials and Methods 92 2 2.1 Suppliers 92 2.2 Nucleic Acid procedures 92 2.2.1 DNA Extraction 92 2.2.2 RNA Extraction 92 2.2.3 Quantification of Nucleic Acids 93 2.2.4 Standard PCR Reaction 93 2.2.5 Agarose Gel Electrophoresis 94 2.2.6 Purification of PCR Products 95 2.2.7 Sequencing Reactions 95 2.2.8 Purification of Sequencing Products 96 2.2.9 Whole Genome Amplification 96 2.2.10 Reverse Transcription 96 2.2.11 Affymetrix Genome-wide Human SNP Array V6.0/250K 96 2.2.12 Sybr Green 97 2.2.13 Copy Number assay 97 2.2.14 Whole exome sequencing 97 2.2.15 Expression array 98 2.3 Data Analysis 98 2.4 Protein Procedures 98 2.4.1 Extraction of Protein from Zebrafish Embryos 98 2.4.2 Extraction of Protein from Mammalian tissue 99 2.4.3 SDS Polyacrylamide Gel Electrophoresis (SDS-Page) 100 2.4.4 Western Blot Analysis 100 2.4.5 Developing Western Blot 101 2.4.6 Stripping Western Blots 103 2.5 Zebrafish Model Organism Techniques 103 2.5.1 Zebrafish Care and Breeding 103 2.5.2 De-chorination of Embryos 103 2.5.3 Procedure for de-yolking embryos 104 2.6 Immunohistochemistry Techniques 104 2.6.1 Sectioning and Mounting of Embryonic Tissue 104 3 2.6.2 Immunohistochemistry of Tissue Sections 105 Chapter 3. Clinical Details of Patients Involved in the Study 108 3. Clinical Details of Patients Involved in the Study 109 3.1 Aim 109 3.2 Clinical Descriptions 110 3.2.1 Perrault Syndrome Cohort 110 3.2.2 Family with Hypogonadotropic Hypogonadism syndrome 120 Chapter 4. Mutational Screening in HSD17B4 and HARS2 123 4. Mutational Screening in HSD17B4 and HARS2 124 4.1 Introduction 124 4.2 Aim 124 4.3 Results 125 4.4 Discussion 129 Chapter 5. Autozygosity Mapping 130 5. Autozygosity Mapping 131 5.1 Introduction 131 5.2 Aim 133 5.3 Results 133 5.3.1 Perrault Syndrome 134 5.3.1.1 Family P1 134 5.3.1.2 Family P2 142 5.3.1.3 Family P4 143 5.3.1.4 Family P5 144 5.3.1.5 Family P8 146 5.3.2 Hypogonadotropic Hypogonadism Syndrome: Family HH1 150 5.4 Discussion 155 5.4.1 Identification of a Perrault syndrome locus on 155 Chromosome 19 5.4.2 Identification of a Homozygous Deletion within the Perrault 157 syndrome locus 5.4.3 NOBOX Haploinsufficiency in Family P5 158 5.4.4 Identification of a locus for Hypogonadotropic 160 Hypogonadism syndrome on Chr3 4 5.5 Conclusions 160 Chapter 6. Copy Number Deletion Investigations 161 6. Copy Number Deletion Investigations 162 6.1 Introduction 162 6.2 Aim 164 6.3 Results 164 6.3.1 Investigation of the Chr19 Homozygous Deletion detected 164 in Family P1 6.3.2 Investigation of the Chr7 Heterozygous Deletion detected 186 in Family P5 6.4 Discussion 190 6.4.1 Sequencing of CDKN2D, KRI1, AP1M2 and SLC44A2 in 190 Perrault Syndrome cohort. 6.4.2 Expression analysis in Family P1 191 6.4.3 Confirmation of the heterozygous deletion on chromosome 194 7 in Family P5 6.5 Conclusions 196 Chapter 7. Perrault Syndrome Investigations 197 7. Perrault Syndrome Investigations 198 7.1 Introduction 198 7.2 Aim 198 7.3 Results 198 7.3.1 Sanger Sequencing of Candidate Genes in 19p13.3-13.11 198 locus 7.3.2 Next Generation Sequencing of Family P1 199 7.3.3 Expression Experiments for variants detected in Family P1 206 7.3.4 Next Generation Sequencing of additional Perrault 212 syndrome patients 7.4 Discussion 213 7.4.1 Next Generation Sequencing of Family P1 213 7.4.2 Expression Experiments in Family P1 217 7.4.3 Whole Exome Sequencing of Patients P6:II:1 and P2:II:2 219 7.5 Conclusion 220 5 Chapter 8. Hypogonadotropic Hypogonadism Investigations 221 8. Hypogonadotropic Hypogonadism Investigations 222 8.1 Introduction 222 8.2 Aim 223 8.3 Results 223 8.3.1 Sanger sequencing of candidate genes within the 3p22.1- 223 p21.2 locus. 8.3.2 Zebrafish BSN knockdown model 231 8.4 Discussion 244 8.4.1 Identification of BSN mutations in Family HH1 244 8.4.2 BSN knockdown zebrafish model 245 8.5 Conclusion 247 Chapter 9. Discussion 248 9.Discussion 249 9.1 Perrault Syndrome; Summary and final conclusions. 249 9.2 Perrault syndrome; Future work. 250 9.3 Hypogonadotropic Hypogonadism syndrome; Summary and 252 final conclusions. 9.4 Hypogonadotropic Hypogonadism syndrome; Future work. 254 9.5 Final conclusions 255 9.6 New Findings and Published Data since Submission of 256 Thesis Chapter 10. Appendix 257 10.Appendix 258 10.1 References 292 10.2 Publications 311 Final Word Count = 71,970 6 List of Tables Table Page 1.1. Table of known deafness genes. 36 1.2. Table of known hypogonadotropic hypogonadism genes 52 1.3. Table of known hypergonadotropic hypogonadism genes 71 1.4. Phenotypic features of reported Perrault syndrome patients. 73 2.1. Standard PCR reaction mixture. 93 2.2. Standard sequencing reaction mixture. 95 2.3. Primer sequences for SYBR green experiments. 97 2.4. Antibodies and conditions used in western blotting experiments. 102 2.5. Antibodies and conditions used for immunohistochemistry 106 experiments. 3.1. Clinical features for affected individuals from Perrault syndrome 117 cohort. 3.2. Features of affected individuals from Family HH1. 122 4.1. Common polymorphisms detected during mutational screening 126 of HARS2 and HSD17B4. 4.2. List of samples that were sequenced for HARS2 and HSD17B4 129 from Perrault syndrome cohort. 5.1. Data for 19p13.2 homozygous deletion as displayed in ChAS 139 software. 5.2. Data for 7q35 heterozygous deletion detected in affected 145 individual P5:II:1, as displayed in ChAS analysis software. 5.3. All homozygous regions over 2Mb detected in affected 148 individuals from Perrault syndrome families. 6.1. List of patients from Perrault syndrome cohort that were 165 sequenced for AP1M2, CDKN2D, KRI1 and SLC44A2 mutations. 6.2. Details of multi species alignment for the chromosome 19 166 homozygous region deleted in Family P1. 6.3. Efficiency of individual primer assays as calculated from 175 validation experiments. 6.4. Average assay efficiency based on validation experiments. 175 7 6.5 Triplicate Ct values for individuals from Family P1. 176 6.6. Results of the Comparative Ct method analysis of SYBR green 177 based qPCR data. 6.7. Results of the Pfaffl method analysis of SYBR green based 177 qPCR data. 6.8. Expression array data for 10 genes surrounding the19p13.2 182 intergenic deletion. 7.1 Candidate genes from locus 19p13.3-13.11 sequenced in 199 Family P1. 7.2 Variations detected in 19p13.3-13.11 locus after filtering using 201 predefined criteria. 7.3 Polyphen2 and SIFT in-silico predictions for variants detected 205 using whole exome sequencing. 7.4 Sequencing of ethnically matched control samples for novel 206 variants. 7.5 Next generation sequencing coverage data for Perrault 212 syndrome patients. 8.1. In silico predictions for the p.R3361W BSN mutation. 226 8.2. Coverage data for whole exome sequencing of sample 227 HH1:III:4. 8.3. Next Generation exome data for 3p22.1-p21.2 locus in affected 228 individual HH1:III:4. 8.4. Non-synonymous BSN variants detected in a cohort of IHH 230 patients. 10.1. Primer sequences for coding exons of HSD17B4. 259 10.2. Primer sequences for coding exons of HARS2. 260 10.3. Primer sequences for the confirmation and breakpoint 261 determination of Family P1 homozygous deletion. 10.4. Primer sequences for coding exons of AP1M2, SLC44A2, 262 CDKN2D and KRI1. 10.5. cDNA concentrations used in validation experiment 1. 263 10.6. Results of GAPDH assay efficiency validation experiment 1. 264 10.7. Results of CDKN2D assay efficiency validation experiment 1. 264 8 10.8. Results of KRI1 assay efficiency validation experiment 1. 265 10.9. Results of SLC44A2 assay efficiency validation experiment 1. 265 10.10. Results of AP1M2 assay efficiency validation experiment 1. 266 10.11. cDNA concentrations used in validation experiment 2.