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Aberrant DNA methylation in the PAX2 promoter is associated with Müllerian duct anomalies

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Abnormalities during Müllerian duct and female reproductive tract formation during embryonic development result in Müllerian duct anomalies (MDA). Previous studies have identified a role for mutations in related genes and DNA copy number variation (CNV). However, the correlation between gene methylation and MDA remains to be understood.

Methods

Endometrial tissues were collected from patients with septate (n = 23) or normal uterus (n = 28). We detected the methylation status of CpG sites and mRNA levels of nine candidate genes, including HOXA10, EMX2, TP63, ITGB3, PAX2, LHX1, GSC, WNT4, and H19, using MethyTarget and quantitative real-time polynucleotide chain reaction (qRT-PCR), respectively

Results

Compared with healthy controls, we detected three hypomethylated CpG sites (P < 0.05) and increased mRNA levels of PAX2 (P < 0.05) in individuals with MDA. HOXA10, EMX2, TP63, ITGB3, LHX1, and GSC had 1, 1, 2, 1, 5, and 2 differentially methylated CpG sites (P < 0.05), respectively, but there were no significant differences in their mRNA levels (P > 0.05). WNT4 and H19 did not show differences in methylation (P > 0.05) and mRNA levels (P > 0.05).

Conclusions

Aberrant DNA methylation within the promoter of PAX2 may contribute to the development of MDA by regulating its gene expression. However, the methylation status of HOXA10, EMX2, TP63, ITGB3, LHX1, GSC, WNT4, and H19, may not contribute to the development of MDA.

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References

  1. Moini A, Mohammadi S, Hosseini R, Eslami B, Ahmadi F (2013) Accuracy of three-dimensional sonography for diagnosis and classification of congenital uterine anomalies. J Ultrasound Med 32(6):923–927

    Article  Google Scholar 

  2. Dreisler E, Stampe Sorensen S (2014) Mullerian duct anomalies diagnosed by saline contrast sonohysterography: prevalence in a general population. Fertil Steril 102(2):525–529

    Article  Google Scholar 

  3. Ples L, Alexandrescu C, Ionescu CA, Arvatescu CA, Vladareanu S, Moga MA (2018) Three-dimensional scan of the uterine cavity of infertile women before assisted reproductive technology use. Medicine (Baltimore) 97(41):e12764

    Article  Google Scholar 

  4. Ugboaja JO, Oguejiofor CB, Igwegbe AO, Oranu EO (2019) Abnormal hysteroscopy findings among a cross section of infertile Nigerian women. Niger J Clin Pract 22(1):9–15

    CAS  PubMed  Google Scholar 

  5. Wani MM, Mir SA (2010) Chronic kidney disease in Mayer-Rokitansky-Kuster-Hauser syndrome. Indian J Nephrol 20(4):214–216

    Article  CAS  Google Scholar 

  6. Bjorsum-Meyer T, Herlin M, Qvist N, Petersen MB (2016) Vertebral defect, anal atresia, cardiac defect, tracheoesophageal fistula/esophageal atresia, renal defect, and limb defect association with Mayer-Rokitansky-Kuster-Hauser syndrome in co-occurrence: two case reports and a review of the literature. J Med Case Rep 10(1):374

    Article  Google Scholar 

  7. Bubishate S, Saleh I, Hasan RM (2018) A rare case of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome with solitary ectopic pelvic kidney and uretropelvic junction (UPJ) obstruction. Urol Case Rep 21:113–115

    Article  Google Scholar 

  8. Kang J, Mao M, Zhang Y, Ai FF, Zhu L (2018) Congenital anal atresia with rectovestibular fistula, scoliosis, unilateral renal agenesis, and finger defect (VACTERL association) in a patient with partial bicornuate uterus and distal vaginal atresia: a case report. Medicine (Baltimore) 97(45):e12822

    Article  Google Scholar 

  9. Gervasini C, Grati FR, Lalatta F, Tabano S, Gentilin B, Colapietro P, De Toffol S, Frontino G, Motta F, Maitz S, Bernardini L, Dallapiccola B, Fedele L, Larizza L, Miozzo M (2010) SHOX duplications found in some cases with type I Mayer-Rokitansky-Kuster-Hauser syndrome. Genet Med 12(10):634–640

    Article  Google Scholar 

  10. Bruce S, Hannula-Jouppi K, Peltonen J, Kere J, Lipsanen-Nyman M (2009) Clinically distinct epigenetic subgroups in Silver-Russell syndrome: the degree of H19 hypomethylation associates with phenotype severity and genital and skeletal anomalies. J Clin Endocrinol Metab 94(2):579–587

    Article  CAS  Google Scholar 

  11. Taylor HS, Vanden Heuvel GB, Igarashi P (1997) A conserved Hox axis in the mouse and human female reproductive system: late establishment and persistent adult expression of the Hoxa cluster genes. Biol Reprod 57(6):1338–1345

    Article  CAS  Google Scholar 

  12. Miyamoto N, Yoshida M, Kuratani S, Matsuo I, Aizawa S (1997) Defects of urogenital development in mice lacking Emx2. Development 124(9):1653–1664

    CAS  PubMed  Google Scholar 

  13. Troy PJ, Daftary GS, Bagot CN, Taylor HS (2003) Transcriptional repression of peri-implantation EMX2 expression in mammalian reproduction by HOXA10. Mol Cell Biol 23(1):1–13

    Article  CAS  Google Scholar 

  14. Liu S, Gao X, Qin Y, Liu W, Huang T, Ma J, Simpson JL, Chen Z (2015) Nonsense mutation of EMX2 is potential causative for uterus didelphysis: first molecular explanation for isolated incomplete mullerian fusion. Fertil Steril 103(3):769–774e762

    Article  CAS  Google Scholar 

  15. Ince TA, Cviko AP, Quade BJ, Yang A, McKeon FD, Mutter GL, Crum CP (2002) p63 Coordinates anogenital modeling and epithelial cell differentiation in the developing female urogenital tract. Am J Pathol 161(4):1111–1117

    Article  CAS  Google Scholar 

  16. Daftary GS, Troy PJ, Bagot CN, Young SL, Taylor HS (2002) Direct regulation of beta3-integrin subunit gene expression by HOXA10 in endometrial cells. Mol Endocrinol 16(3):571–579

    CAS  PubMed  Google Scholar 

  17. Xu Z, Wu S, Xing Q, Wang X, Xiang H, Xu Y, Wang J, He X, Wang B, Cao Y (2017) Genetic association between PAX2 and mullerian duct anomalies in Han Chinese females. J Assist Reprod Genet 34(1):125–129

    Article  Google Scholar 

  18. Roly ZY, Backhouse B, Cutting A, Tan TY, Sinclair AH, Ayers KL, Major AT, Smith CA (2018) The cell biology and molecular genetics of Mullerian duct development. Wiley Interdiscip Rev Dev Biol 7(3):e310

    Article  Google Scholar 

  19. Agulnick AD, Taira M, Breen JJ, Tanaka T, Dawid IB, Westphal H (1996) Interactions of the LIM-domain-binding factor Ldb1 with LIM homeodomain proteins. Nature 384(6606):270–272

    Article  CAS  Google Scholar 

  20. Grimbizis GF, Gordts S, Di Spiezio SA, Brucker S, De Angelis C, Gergolet M, Li TC, Tanos V, Brölmann H, Gianaroli L, Campo R (2013) The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod 28(8):2032–2044

    Article  CAS  Google Scholar 

  21. Sandbacka M, Bruce S, Halttunen M, Puhakka M, Lahermo P, Hannula-Jouppi K, Lipsanen-Nyman M, Kere J, Aittomäki K, Laivuori H (2011) Methylation of H19 and its imprinted control region (H19 ICR1) in Mullerian aplasia. Fertil Steril 95(8):2703–2706

    Article  CAS  Google Scholar 

  22. Eggermann T, Ledig S, Begemann M, Elbracht M, Kurth I, Wieacker P (2018) Search for altered imprinting marks in Mayer-Rokitansky-Kuster-Hauser patients. Mol Genet Genomic Med 6(6):1225–1228

    Article  CAS  Google Scholar 

  23. Rall K, Barresi G, Walter M, Poths S, Haebig K, Schaeferhoff K, Schoenfisch B, Riess O, Wallwiener D, Bonin M, Brucker S (2011) A combination of transcriptome and methylation analyses reveals embryologically-relevant candidate genes in MRKH patients. Orphanet J Rare Dis 6:32

    Article  Google Scholar 

  24. Zhu Y, Luo M, Huang H, Du X, Chen D, Xing Q, Wang B, Cao Y (2016) HOXA10, EMX2 and TENM1 expression in the mid-secretory endometrium of infertile women with a Mullerian duct anomaly. Reprod Biomed Online 32(4):388–393

    Article  CAS  Google Scholar 

  25. Xu B, Geerts D, Bu Z, Ai J, Jin L, Li Y, Zhang H, Zhu G (2014) Regulation of endometrial receptivity by the highly expressed HOXA9, HOXA11 and HOXD10 HOX-class homeobox genes. Hum Reprod 29(4):781–790

    Article  CAS  Google Scholar 

  26. Saare M, Krigul KL, Laisk-Podar T, Ponandai-Srinivasan S, Rahmioglu N, Lalit Kumar PG, Zondervan K, Salumets A, Peters M (2018) DNA methylation alterations-potential cause of endometriosis pathogenesis or a reflection of tissue heterogeneity? Biol Reprod 99(2):273–282

    Article  Google Scholar 

  27. Greenberg MVC, Bourc'his D (2019) The diverse roles of DNA methylation in mammalian development and disease. Nat Rev Mol Cell Biol 20(10):590–607

    Article  CAS  Google Scholar 

  28. Bell CG, Lowe R, Adams PD, Baccarelli AA, Beck S, Bell JT, Christensen BC, Gladyshev VN, Heijmans BT, Horvath S, Ideker T, Issa JJ, Kelsey KT, Marioni RE, Reik W, Relton CL, Schalkwyk LC, Teschendorff AE, Wagner W, Zhang K, Rakyan VK (2019) DNA methylation aging clocks: challenges and recommendations. Genome Biol 20(1):249

    Article  Google Scholar 

  29. Sanyanusin P, McNoe LA, Sullivan MJ, Weaver RG, Eccles MR (1995) Mutation of PAX2 in two siblings with renal-coloboma syndrome. Hum Mol Genet 4(11):2183–2184

    Article  CAS  Google Scholar 

  30. Porteous S, Torban E, Cho NP, Cunliffe H, Chua L, McNoe L, Ward T, Souza C, Gus P, Giugliani R, Sato T, Yun K, Favor J, Sicotte M, Goodyer P, Eccles M (2000) Primary renal hypoplasia in humans and mice with PAX2 mutations: evidence of increased apoptosis in fetal kidneys of Pax2(1Neu) +/- mutant mice. Hum Mol Genet 9(1):1–11

    Article  CAS  Google Scholar 

  31. Torres M, Gomez-Pardo E, Dressler GR, Gruss P (1995) Pax-2 controls multiple steps of urogenital development. Development 121(12):4057–4065

    CAS  PubMed  Google Scholar 

  32. Soofi A, Levitan I, Dressler GR (2012) Two novel EGFP insertion alleles reveal unique aspects of Pax2 function in embryonic and adult kidneys. Dev Biol 365(1):241–250

    Article  CAS  Google Scholar 

  33. Ranghini EJ, Dressler GR (2015) Evidence for intermediate mesoderm and kidney progenitor cell specification by Pax2 and PTIP dependent mechanisms. Dev Biol 399(2):296–305

    Article  CAS  Google Scholar 

  34. Wang P, Zhao H, Sun M, Li Y, Chen ZJ (2012) PAX2 in 192 Chinese women with Mullerian duct abnormalities: mutation analysis. Reprod Biomed Online 25(2):219–222

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The study was supported by grant 1708085QH201 of Natural Science Foundation of Anhui Province. We are very grateful for the technical support provided by Genesky Biotechnologies Inc., Shanghai.

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Authors

Contributions

CW: data collection, data analysis, manuscript writing; QX: sample collection, data collection, manuscript writing; BS: data collection; GL: data analysis, manuscript editing; ZX: sample collection; TW: data analysis, manuscript editing; YC: sample collection; YX: sample collection; YC: project development, manuscript editing.

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Correspondence to Yunxia Cao.

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Wang, C., Xing, Q., Song, B. et al. Aberrant DNA methylation in the PAX2 promoter is associated with Müllerian duct anomalies. Arch Gynecol Obstet 301, 1455–1461 (2020). https://doi.org/10.1007/s00404-020-05539-w

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  • DOI: https://doi.org/10.1007/s00404-020-05539-w

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