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Androgens mediate sexual dimorphism in Pilarowski-Bjornsson syndrome

ABSTRACT: The effect of sex on the penetrance of autosomal dominant Mendelian conditions is an understudied area of research. Variants in CHD1 have previously been identified in females with Pilarowski-Bjornsson syndrome (PILBOS), a recently described cause of developmental delay. We now demonstrate that both sexes can show signs of PILBOS, although males are more likely to display PILBOS phenotypes when carrying more severe variants. A novel mouse model carrying a human-derived missense variant in the Chd1 gene (Chd1R616Q/+) shows female-restricted disease phenotypes including growth retardation, anxiety and hypotonia. Orchiectomy of male mice unmasks a growth retardation phenotype in Chd1R616Q/+ mutants compared to orchiectomized wild type (WT) littermates. Conversely, testosterone supplementation in female Chd1R616Q/+ mice and WT littermates rescues the growth phenotype, suggesting that androgens dictate PILBOS disease penetrance. On the human population level, we demonstrate a significant overrepresentation of healthy males carrying rare missense variants in CHD1 in the gnomAD database, further supporting a male protective effect against CHD1 variants. We further identify 212 other genes that show similar missense variant overrepresentation in males. Together our data suggests androgen-regulated sexual dimorphism in Pilarowski-Bjornsson syndrome and opens up novel avenues to understand the mechanistic basis of sexual dimorphism of autosomal Mendelian disorders.

ORGANISM(S): Mus musculus

PROVIDER: GSE281601 | GEO | 2025/05/22

REPOSITORIES: GEO

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Project description:We aimed to define a novel autosomal recessive neurodevelopmental disorder, characterize its clinical features, and identify the underlying genetic cause for this condition. Clinical and genetic data from affected individuals with neurological disorders were matched across families from five global sites. Here, we report five recessive CSPG4 (NM_001897) missense variants [three homozygous: c.A1370G (p.Asp457Gly), c.2627G>A (p.Arg876His) and c.3247C>A (p.Gln1083Lys), and two compound heterozygote: c.A1370G and c.5156A>G (p.Asp457Gly and p.Gln1719Arg) and c.658A>G and c.1220_1221delinsTG (p.(Thr220Ala and p.Pro407Leu)] by next-generation sequencing of five unrelated families with seven affected subjects. All subjects share a novel neurodevelopmental syndrome characterized by severe intellectual disability, global developmental delay, delayed ability to walk, speech and language delay, distinctive facial features, along with varying degrees of neurological impairment, including hypotonia, cerebellar hypoplasia, and/or seizures. All CSPG4 variants were predicted to be damaging using in silico tools, and three-dimensional molecular modeling suggested significant alterations in protein stability, compromising inter- and intra-molecular interactions. The impact on neurological and craniofacial development was analyzed in CRISPR/Cas9-mediated zebrafish models. CSPG4 variants affected notochord development, neuronal function, and cerebellar structure along with a disorganized head scaffold with anomalous skeletal and cartilage components. Two individuals metabolomics and crispant transcriptomics revealed significant perturbation of metabolites, extracellular matrix (ECM) regulating pathways, and genes previously described to cause mental retardation, dwarfism, and facial anomalies in humans. Our study links novel, rare, damaging variants of the ECM gene CSPG4 to a novel recessive Mendelian neurodevelopmental disorder in humans and supports the role of CSPG4 in early development.

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Androgens mediate sexual dimorphism in Pilarowski-Bjornsson syndrome

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