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. 2014 Jun;99(6):E1097-103.
doi: 10.1210/jc.2013-3126. Epub 2014 Mar 14.

Central precocious puberty that appears to be sporadic caused by paternally inherited mutations in the imprinted gene makorin ring finger 3

Delanie B Macedo  1 , Ana Paula Abreu, Ana Claudia S Reis, Luciana R Montenegro, Andrew Dauber, Daiane Beneduzzi, Priscilla Cukier, Leticia F G Silveira, Milena G Teles, Rona S Carroll, Gil Guerra Junior, Guilherme Guaragna Filho, Zoran Gucev, Ivo J P Arnhold, Margaret de Castro, Ayrton C Moreira, Carlos Eduardo Martinelli Jr, Joel N Hirschhorn, Berenice B Mendonca, Vinicius N Brito, Sonir R Antonini, Ursula B Kaiser, Ana Claudia Latronico
Affiliations

Central precocious puberty that appears to be sporadic caused by paternally inherited mutations in the imprinted gene makorin ring finger 3

Delanie B Macedo et al. J Clin Endocrinol Metab. 2014 Jun.

Abstract

Context: Loss-of-function mutations in makorin ring finger 3 (MKRN3), an imprinted gene located on the long arm of chromosome 15, have been recognized recently as a cause of familial central precocious puberty (CPP) in humans. MKRN3 has a potential inhibitory effect on GnRH secretion.

Objectives: The objective of the study was to investigate potential MKRN3 sequence variations as well as copy number and methylation abnormalities of the 15q11 locus in patients with apparently sporadic CPP.

Setting and participants: We studied 215 unrelated children (207 girls and eight boys) from three university medical centers with a diagnosis of CPP. All but two of these patients (213 cases) reported no family history of premature sexual development. First-degree relatives of patients with identified MKRN3 variants were included for genetic analysis.

Main outcome measures: All 215 CPP patients were screened for MKRN3 mutations by automatic sequencing. Multiplex ligation-dependent probe amplification was performed in a partially overlapping cohort of 52 patients.

Results: We identified five novel heterozygous mutations in MKRN3 in eight unrelated girls with CPP. Four were frame shift mutations predicted to encode truncated proteins and one was a missense mutation, which was suggested to be deleterious by in silico analysis. All patients with MKRN3 mutations had classical features of CPP with a median age of onset at 6 years. Copy number and methylation abnormalities at the 15q11 locus were not detected in the patients tested for these abnormalities. Segregation analysis was possible in five of the eight girls with MKRN3 mutations; in all cases, the mutation was inherited on the paternal allele.

Conclusions: We have identified novel inherited MKRN3 defects in children with apparently sporadic CPP, supporting a fundamental role of this peptide in the suppression of the reproductive axis.

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Figures

Figure 1.
Figure 1.
Pedigrees of the patients with MKRN3 mutations. Squares indicate male family members, circles female members, black symbols clinically affected family members, symbols with black circles unaffected carriers, and question mark unknown phenotype. *, Unknown genotype. Arrows the proband in each family. The MKRN3 genotypes are shown for family members whose DNA was available for genetic studies. WT, wild-type. Families 1 and 8 are typical familial CPP cases. Patient II.2 from family 2 (4 y old) has not yet shown signs of puberty.
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