Precocious puberty is defined as the development of pubertal signs before the estimated age. It is characterised by testicular enlargement in boys, breast development in girls and bone growth acceleration. The onset of puberty is under the great influence of social and environmental factors; however, genetics and epigenetics are two fields of intensive research in central precocious puberty. This is a form of precocious puberty caused by premature activation of hypothalamic-pituitary-gonadal axis. In approximately quarter of cases the cause is genetic and that is why the application of molecular genetic assays is vital in the process of determining potential hereditary cause of the disease and for genetic counselling in patient’s relatives.
The aim of our study was to evaluate the presence of causative genetic variants in the MKRN3 gene in a group of sporadic patients, patients with familial central precocious puberty and their relatives. Nucleotide sequence of coding region was analysed using Sanger sequencing method. Patients with no identified genetic variants in target gene and family history consistent with paternal manner of inheritance were further analysed for copy number variations and changes in methylation pattern in genes MKRN3 and DLK1 using methylation-specific MLPA method.
We identified previously reported causative genetic variant in two pedigrees with familial central precocious puberty and novel potential candidate variant in another pedigree. The results of in silico predictive programs and segregation analysis are supporting evidence of pathogenic impact of this novel variant. We defined no genetic changes in coding sequence of the MKRN3 gene in sporadic patients. No large deletions/duplications and aberrant methylation changes were detected using methylation-specific MLPA assay. Therefore, the limitations of this method were discussed.
Sanger sequencing can be used for defining genetic variants in the MKRN3 gene. In our study we expanded the spectrum of variants implicated in central precocious puberty. Apart from this, identification of new target genes in reproductive axis will be of great importance.
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