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Published-Ahead-of-Print April 3, 2008, DOI:10.2164/jandrol.107.004598
Journal of Andrology, Vol. 29, No. 4, July/August 2008
Copyright © American Society of Andrology
DOI: 10.2164/jandrol.107.004598

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Mutation Screening and Association Study of the TSSK4 Gene in Chinese Infertile Men With Impaired Spermatogenesis

DAN SU*,{dagger}, WEI ZHANG*,{dagger}, YUAN YANG*, YING DENG*, YONGXIN MA*, HONGXIA SONG* AND SIZHONG ZHANG*

From the * Department of Medical Genetics, West China Hospital, Sichuan University and the Division of Human Morbid Genomics, State Key Laboratory of Biotherapy, Chengdu, China.

Correspondence to: Dr Sizhong Zhang, Professor, Department of Medical Genetics, West China Hospital, Sichuan University, Renmin Nanlu, Section 3 #17 Chengdu, 610041, China (e-mail: szzhang{at}mcwcums.com).
Received for publication November 20, 2007; accepted for publication March 13, 2008.

   Abstract
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 Abstract
 Materials and Methods
 Results
 Discussion
 References
 
The testis-specific serine/threonine kinase (TSSK) family is a specific kinase group with exclusive or dominant expression in testis and involvement in spermatogenesis and male infertility. TSSK4 is a newly identified member of the TSSK family. In order to investigate the possible relationships between variations, including mutations and polymorphisms of the TSSK4 gene and impaired spermatogenesis in humans, mutation screening of this gene in 372 patients with azoospermia or severe oligospermia and 220 controls was performed. In total, 4 novel single nucleotide changes including c.679G>A, c.987+108G>A, c.-155C>G and c.765C>A were discovered. The latter 2 variations were found only in patients, not in controls. Bioinformatics analysis suggested that allele A of c.765C>A could decrease the activity of pre-mRNA splicing of TSSK4. The frequency of allele A of c.679G>A was significantly higher in controls than in patients. On the contrary, allele A of c.987+108G>A was remarkably increased in patients compared with controls. Our investigation of TSSK4, a potentially important testicular gene, in Chinese infertile and control men identified the association of some single nucleotide polymorphisms in this gene with male infertility.

     Key words: Male infertility, single nucleotide polymorphism



A significant proportion of idiopathic human male infertility, usually accompanied by azoospermia or severe oligospermia, has been considered to have certain genetic defects (de Kretser 1997; Matzuk et al, 2002). Although hundreds of genes have been reported as possible candidates, very few genetic causes have been confirmed. The majority of the defects still need to be tested in patients with impaired spermatogenesis. Besides mutation, other genetic variations including single nucleotide polymorphisms (SNPs) have been increasingly noted that may act as risk factors in modifying susceptibility to male infertility (Krausz et al, 2007).

During spermatogenesis, protein phosphorylation is essential for signaling pathways and regulation of protein activity. Among protein kinases catalyzing phosphorylation, the testis-specific serine/threonine kinase (TSSK) family is a particular one with exclusive or predominant expression in testis and functions in sperm differentiation, capacitation, and fertilization (Bielke et al, 1994; Kueng et al, 1997; Zuercher et al, 2000; Hao et al, 2004; Chen et al, 2005; Xu et al, 2007). To date, 5 members of the TSSK family have been reported, including TSSK1, TSSK2, TSSK3, TSSK4, and TSSK6, and all of the human homologs have been cloned. TSSK1 and TSSK2 are present in the stage of late spermatid to sperm (Kueng et al, 1997; Hao et al, 2004; Xu et al, 2007). Also, TSSK3 is exclusively expressed in human testis (Visconti et al, 2001), and in mature mice, TSSK3 may function in the differentiated Leydig cells (Zuercher et al, 2000). TSSK6, also named small serine/threonine kinase (SSTK), is found predominantly in the elongating spermatids and is involved in postmeiotic chromatin remodeling (Hao et al, 2004; Spiridonov et al, 2005). Male mice with deficient TSSK6 are infertile due to considerable sperm reduction and abnormal motility and morphology of spermatozoa (Spiridonov et al, 2005).

Recently, a new TSSK family member, TSSK4, initially named as TSSK5, has been identified. The TSSK4 gene, mapped to 14q11.2, contains 4 exons and encodes a protein of 328 amino acids with specific expression in testis (Chen et al, 2005; Xu et al, 2007). Further study shows that TSSK4 phosphorylates the cAMP responsive element binding protein (CREB) at Ser-133 and hence facilitates the binding of CREB to the specific cis cAMP responsive element (CRE), which is important for activating transcription of genes related to germ cell differentiation (Don et al, 2002; Chen et al, 2005). By stimulating the CRE/CREB pathway, TSSK4 may be involved in spermatogenesis, probably in the early stages of spermatid differentiation (Don et al, 2002; Chen et al, 2005). Moreover, autosomal aberration analysis in patients with spermatogenic arrest indicated that band 14q11, where TSSK4 is located, is highly linked with infertility, suggesting that certain genes in this region may be associated with impaired spermatogenesis (Guo et al, 2002; Chen et al, 2005).

Therefore, to investigate the possible association between TSSK4 and male infertility, we carried out a mutation screening of this gene in 372 infertile men with azoospermia or severe oligospermia and compared the results with those from 220 controls.


   Materials and Methods
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Subjects

The 372 infertile patients, aged 25 to 40 years, included 219 with azoospermia and 153 with severe oligospermia (sperm concentration < 5 x 106 sperm/mL) and were recruited from West China Hospital, Sichuan University. All of them underwent at least 2 semen analyses according to World Health Organization guidelines (1999). Also, these patients have no chromosomal abnormalities and microdeletions of the azoospermic factor (AZF) region on the Y chromosome since these changes had been tested and excluded by analysis of the cytogenetic and corresponding sequence tagged site (STS) (Simonim et al, 1999). The control group consisted of 220 fertile men with normospermia aged 25 to 50. All participants in this study were Chinese Hans from Southwest China and were genetically unrelated. The study was approved by the Institutional Ethic Review Board of West China Hospital, Sichuan University, and informed consent was obtained from all subjects.

Polymerase Chain Reaction Amplification

Genomic DNA was extracted from peripheral blood lymphocytes using standard phenol-chloroform procedures. Based on mRNA sequence (GenBank No. NM_174944.2) and genomic sequence, 4 pairs of primers were designed using PRIMER PREMIER 5.0 (Premier Biosoft International, Palo Alto, California) to amplify all 4 exons including intron/exon boundaries, 5' untranslated region (UTR) and 3' UTR (Table 1). Polymerase chain reactions (PCR) were carried out in a total volume of 50 µl containing 0.2 µg genomic DNA, 10 pmol of each primer, 10 pmol of dNTP, and 2 units Taq polymerase (TaKaRa, Shiga, Japan). The PCR profile was: predenaturation at 94°C for 5 minutes, followed by 35 amplification cycles comprising denaturation at 94°C for 30 seconds, annealing at a temperature between 53°C and 57°C for 30 seconds, extension at 72°C for 1 minute, with a final extra extension at 72°C for 10 minutes. Amplicons were resolved by 1.5% agarose gel electrophoresis to confirm the presence of specific PCR products.


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Table 1. The PCR amplified region, primer sequence, annealing temperature, product size, and the DHPLC melting temperature for mutation screening of the TSSK4 gene
 

Denaturing High-Performance Liquid Chromatography Analysis and DNA Sequencing

Mutation screening of TSSK4 was carried out using denaturing high-performance liquid chromatography (DHPLC) on an automated WAVE system (Transgenomic, Omaha, Nebraska). WAVEMAKER 4.1 software (Transgenomic) was used to determine the optimal melting temperature for tested fragments. Prior to DHPLC, the PCR products were denatured at 94°C for 5 minutes and cooled at room temperature for 45 minutes. Then, 6 µL products were injected into a high-throughput DNASep column and eluted with a linear acetonitrile gradient of 2% per minute at a flow rate of 0.9 mL/min. The elution profiles of heterozygous fragments were represented as aberrant shaped peaks, while the homozygous fragments were represented as single peaks. After DHPLC, heterozygous fragments were reamplified and purified with QIAquick PCR Purification Kit (Qiagen, Hilden, Germany) and sent for direct sequencing in both directions using an ABI 3100 DNA Sequencer (Applied Biosystems, Foster City, California).

Genotyping and Statistical Analysis

All participants were genotyped for identified variations including single nucleotide polymorphisms (SNPs) by PCR-restriction fragment length polymorphism (PCR-RFLP) analysis with corresponding restriction endonucleases (Dde I, Bsa HI, Tsp 45I, Dpn II; NEB, Beverly, Massachusetts). After endonuclease digestion, the products were electrophoresed on a 3% agarose gel and observed with a Gel Doc1000 system (Bio-Rad, Hercules, California).

Hardy-Weinberg equilibrium (HWE) was tested using an HWE program. Differences in genotypic and allelic frequencies between infertile patients and controls were assessed by {chi}2 test using SPSS 11.0 software (SPSS Inc, Chicago, Illinois).


   Results
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 Abstract
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 Discussion
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After screening of all 4 exons with their intron/exon boundaries, 5' UTR and 3' UTR of TSSK4 in 592 patients and controls, 4 single nucleotide changes were identified by DHPLC and DNA sequencing (Figure). According to the nomenclature recommendations of sequence variations (den Dunnen et al, 2000), they were named as c.-155C>G, c.679G>A, c.765C>A, and c.987+108G>A. None of these single nucleotide changes has been previously reported. As shown in the Figure, c.-155C>G and c.987+108G>A are located in the 5' UTR and the 3' UTR, respectively. In exon 3, c.679G>A results in an amino acid change of Val to Ile, whereas c.765C>A does not alter the amino acid sequence of TSSK4. Both c.-155C>G and c.765C>A were detected only in 5 infertile men each, more precisely, in 2 azoospermic and 3 oligospermic patients for c.-155C>G and in 5 patients with azoospermia for c.765C>A. No patient possessed both variations simultaneously. In contrast with the 2 rare variations, c.679G>A and c.987+108G>A, found in patients and controls, should be considered as SNPs since in both groups their minor allele frequencies were over 1%.

The genotypic distributions of the 2 SNPs were in HWE, and their genotype and allele frequencies are shown in Table 2. The 2 SNPs were found in both azoospermic and oligospermic patients without apparent differences in either genotype or allele frequencies between them (data not shown). As shown in Table 2, although no significant difference was observed among the 3 genotypes of c.679G>A, the frequency of allele A in controls was significantly higher than that in patients (3% vs 1.2%, P = .031) with an odds ratio (OR) of 0.400 (95% confidence interval [CI]: 0.170–0.944). At c.987+108G>A, only 2 genotypes, GG and GA, were identified in both groups. The frequencies of genotype GA and allele A decreased significantly in controls compared with patients (genotype GA: 15% vs 5.5%, P < .001; allele A: 7.5% vs 2.7%, P = .001), giving an OR of 3.057 (95% CI: 1.600–5.842) and 2.89 (95% CI: 1.531–5.453), respectively.Go


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Table 2. Genotype and allele frequencies of the four novel variations in the TSSK4 gene of infertile patients and controls
 

Figure 1
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Figure. The single nucleotide variations found in the TSSK4 gene. (A) Genomic structure of TSSK4 and the locations of the 4 variations. (B) DNA sequences of the 4 variations: the mutant sequences (upper panel) and the wild-type sequences (WT; lower panel). Arrows indicate the positions of the variations; codons are underlined by dark horizontal lines. The nomenclature of variations follows the recommendations of the web site http://www.hgvs.org/mutnomen/.

 


   Discussion
 Top
 Abstract
 Materials and Methods
 Results
 Discussion
 References
 
Although exact roles of the TSSKs are still unknown, a series of studies suggests that they are involved in postmeiotic germ cell differentiation (Xu et al, 2007). Therefore, it is reasonable to postulate that this kinase family may be associated with human male infertility, and mutation screening of the TSSK genes in patients with impaired spermatogenesis may contribute to the understanding of their roles. In the present study, we screened the TSSK4 variations and explored their possible association with spermatogenic impairment in humans. Similar work on the other 4 members of the TSSK family are in progress in our laboratory.

Four novel variations of TSSK4 were identified. Although c.765C>A did not change the amino acid sequence, the results from bioinformatics analysis with ESEfinder 3.0 (Exonic Splicing Enhancer [ESE]; Cartegni et al, 2003) showed that the substitution of C by A at c.765C>A would result in disappearance of the ESE sequence GGTCACTT, which could be recognized and bound by the splicing factor SC35, an important member of the serine/arginine-rich (SR) protein family that plays a essential role in pre-mRNA splicing (Cartegni et al, 2003; Sanford et al, 2005). Thus, compared with allele C, allele A may decrease the activity of pre-mRNA splicing and reduce the expression of TSSK4. However, since c.765C>A is found in a limited number of infertile men (5/372), whether it is related to impaired spermatogenesis still needs to be clarified by functional studies in more patients. Another rare variation, c.-155C>G, should not be considered a disease-causing mutation for the time being because its possible influence on gene function has not been studied.

At c.679G>A, a significant difference in allele A frequency was observed between patients with oligospermia/azoospermia and controls, suggesting that this SNP may be associated with impaired spermatogenesis. This SNP changes an amino acid, but no effect on pre-mRNA splicing could be predicted, so it is not clear whether this polymorphism is a functional one or only a genetic marker in linkage disequilibrium with other loci responsible for spematogenic impairment. The statistical analysis also showed that allele A of SNP c.987+ 108G>A was associated with an increased risk for male infertility, since the frequencies of allele A (OR: 2.89) and genotype GA (OR: 3.057) were significantly higher in patients than in controls. In addition, some researchers have suggested that SNPs in the UTRs may impact mRNA stability, translation efficiency, and gene expression (Miller et al, 2002; Kamiyama et al, 2007; Nief et al, 2007; Wang et al, 2007). Therefore, to further reveal the possible role of TSSK4 in male infertility, more deep functional study of c.987+108G>A on gene expression is necessary.

In conclusion, as the first mutational analysis of TSSK4 in infertile men with azoospermia or severe oligospermia, our investigation provided some preliminary results and suggestions for in-depth studies of this gene on male infertility in the future.


   Footnotes
 
Supported by the National Natural Science Foundation of China (Grant 30470960) and the China Medical Board Foundation of New York.

{dagger} These authors contributed equally to this article and share coauthorship. Back


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