Brief report

Role of HOXA7 to HOXA13 and PBX1 genes in various forms of MRKH syndrome (congenital absence of uterus and vagina)

Agnès Burel¹ , Thomas Mouchel² , Sylvie Odent³ , Filiz Tiker⁴ , Bertrand Knebelmann⁵ , Isabelle Pellerin¹ and Daniel Guerrier¹

¹  CNRS UMR 6061, Génétique et Développement, Université de Rennes 1, Groupe IPD, IFR140 GFAS, Faculté de Médecine, Rennes, France

²  Service de Gynécologie Obstétrique, CHU de Rennes, Rennes, France

³  Unité de Génétique Médicale, Hôpital Sud, Rennes, France

⁴  Department of Pediatrics, Baskent University, Adana Hospital, Adana, Turkey

⁵  Service de Néphrologie, Hôpital Necker-Enfants-Malades, Paris, France

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Journal of Negative Results in BioMedicine 2006, 5:4doi:10.1186/1477-5751-5-4

Published:	23 March 2006

Abstract

The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome refers to the congenital absence or severe hypoplasia of the female genital tract, often described as uterovaginal aplasia which is the prime feature of the syndrome. It is the second cause of primary amenorrhea after gonadal dysgenesis and occurs in ~1 in 4500 women. Aetiology of this syndrome remains poorly understood. Frequent association of other malformations with the MRKH syndrome, involving kidneys, skeleton and ears, suggests the involvement of major developmental genes such as those of the HOX family. Indeed mammalian HOX genes are well known for their crucial role during embryogenesis, particularly in axial skeleton, hindbrain and limb development. More recently, their involvement in organogenesis has been demonstrated notably during urogenital differentiation. Although null mutations of HOX genes in animal models do not lead to MRKH-like phenotypes, dominant mutations in their coding sequences or aberrant expression due to mutated regulatory regions could well account for it. Sequence analysis of coding regions of HOX candidate genes and of PBX1, a likely HOX cofactor during Müllerian duct differentiation and kidney morphogenesis, did not reveal any mutation in patients showing various forms of MRKH syndrome. This tends to show that HOX genes are not involved in MRKH syndrome. However it does not exclude that other mechanisms leading to HOX dysfunction may account for the syndrome.