ANA CLAUDIA LATRONICO XAVIER
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/42 - Laboratório de Hormônios e Genética Molecular, Hospital das Clínicas, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/42 - Laboratório de Hormônios e Genética Molecular, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject X-Linked Central Precocious Puberty Associated with MECP2 defects(2022) CANTON, Ana; TINANO, Flavia; GUASTI, Leonardo; MONTENEGRO, Luciana; RYAN, Fiona; SHEARS, Deborah; MELO, Maria Edna; GOMES, Larissa; PIANA, Mariana; BRAUNER, Raja; ESPINO, Rafael; ESCRIBANO-MUNOZ, Arancha; PAGANONI, Alyssa; KORBONITS, Marta; SERAPHIM, Carlos Eduardo; FARIA, Aline; COSTA, Silvia; KREPISCHI, Ana Cristina; JORGE, Alexander; DAVID, Alessia; ARGENTE, Jesus; MENDONCA, Berenice; BRITO, Vinicius; HOWARD, Sasha; LATRONICO, Ana ClaudiaconferenceObject Genetic evaluation in children with self-limited pubertal delay discloses new candidate genes(2023) REZENDE, Raissa; SCHAFER, Evan; KAISINGER, Lena; HE, Wen; ANDRADE, Nathalia; DANTAS, Naiara; CELLIN, Laurana; QUEDAS, Elisangela; PERRY, John; HOWARD, Sasha; LATRONICO, Ana Claudia; CHAN, Yee-Ming; JORGE, Alexander- XAF1 as a modifier of p53 function and cancer susceptibility(2020) PINTO, Emilia M.; FIGUEIREDO, Bonald C.; CHEN, Wenan; GALVAO, Henrique C. R.; FORMIGA, Maria Nirvana; V, Maria Candida B. Fragoso; ASHTON-PROLLA, Patricia; RIBEIRO, Enilze M. S. F.; FELIX, Gabriela; COSTA, Tatiana E. B.; SAVAGE, Sharon A.; YEAGER, Meredith; I, Edenir Palmero; VOLC, Sahlua; SALVADOR, Hector; FUSTER-SOLER, Jose Luis; LAVARINO, Cinzia; CHANTADA, Guillermo; VAUR, Dominique; ODONE-FILHO, Vicente; BRUGIERES, Laurence; ELSE, Tobias; STOFFEL, Elena M.; MAXWELL, Kara N.; ACHATZ, Maria Isabel; KOWALSKI, Luis; ANDRADE, Kelvin C. de; PAPPO, Alberto; LETOUZE, Eric; LATRONICO, Ana Claudia; MENDONCA, Berenice B.; ALMEIDA, Madson Q.; BRONDANI, Vania B.; BITTAR, Camila M.; SOARES, Emerson W. S.; MATHIAS, Carolina; RAMOS, Cintia R. N.; MACHADO, Moara; ZHOU, Weiyin; JONES, Kristine; VOGT, Aurelie; KLINCHA, Payal P.; SANTIAGO, Karina M.; KOMECHEN, Heloisa; PARAIZO, Mariana M.; PARISE, Ivy Z. S.; V, Kayla Hamilton; WANG, Jinling; RAMPERSAUD, Evadnie; CLAY, Michael R.; MURPHY, Andrew J.; LALLI, Enzo; NICHOLS, Kim E.; RIBEIRO, Raul C.; RODRIGUEZ-GALINDO, Carlos; KORBONITS, Marta; ZHANG, Jinghui; THOMAS, Mark G.; CONNELLY, Jon P.; PRUETT-MILLER, Shondra; DIEKMANN, Yoan; NEALE, Geoffrey; WU, Gang; ZAMBETTI, Gerard P.Cancer risk is highly variable in carriers of the common TP53-R337H founder allele, possibly due to the influence of modifier genes. Whole-genome sequencing identified a variant in the tumor suppressor XAF1 (E134*/Glu134Ter/rs146752602) in a subset of R337H carriers. Haplotype-defining variants were verified in 203 patients with cancer, 582 relatives, and 42,438 newborns. The compound mutant haplotype was enriched in patients with cancer, conferring risk for sarcoma (P = 0.003) and subsequent malignancies (P = 0.006). Functional analyses demonstrated that wild-type XAF1 enhances transactivation of wild-type and hypomorphic TP53 variants, whereas XAF1-E134* is markedly attenuated in this activity. We propose that cosegregation of XAF1-E134* and TP53-R337H mutations leads to a more aggressive cancer phenotype than TP53-R337H alone, with implications for genetic counseling and clinical management of hypomorphic TP53 mutant carriers.
- An ancient founder mutation in PROKR2 impairs human reproduction(2012) STEFANIJA, Magdalena Avbelj; JEANPIERRE, Marc; SYKIOTIS, Gerasimos P.; YOUNG, Jacques; QUINTON, Richard; ABREU, Ana Paula; PLUMMER, Lacey; AU, Margaret G.; BALASUBRAMANIAN, Ravikumar; DWYER, Andrew A.; FLOREZ, Jose C.; CHEETHAM, Timothy; PEARCE, Simon H.; PURUSHOTHAMAN, Radhika; SCHINZEL, Albert; PUGEAT, Michel; JACOBSON-DICKMAN, Elka E.; TEN, Svetlana; LATRONICO, Ana Claudia; GUSELLA, James F.; DODE, Catherine; CROWLEY JR., William F.; PITTELOUD, NellyCongenital gonadotropin-releasing hormone (GnRH) deficiency manifests as absent or incomplete sexual maturation and infertility. Although the disease exhibits marked locus and allelic heterogeneity, with the causal mutations being both rare and private, one causal mutation in the prokineticin receptor, PROKR2 L173R, appears unusually prevalent among GnRH-deficient patients of diverse geographic and ethnic origins. To track the genetic ancestry of PROKR2 L173R, haplotype mapping was performed in 22 unrelated patients with GnRH deficiency carrying L173R and their 30 first-degree relatives. The mutations age was estimated using a haplotype-decay model. Thirteen subjects were informative and in all of them the mutation was present on the same approximate to 123 kb haplotype whose population frequency is 10. Thus, PROKR2 L173R represents a founder mutation whose age is estimated at approximately 9000 years. Inheritance of PROKR2 L173R-associated GnRH deficiency was complex with highly variable penetrance among carriers, influenced by additional mutations in the other PROKR2 allele (recessive inheritance) or another gene (digenicity). The paradoxical identification of an ancient founder mutation that impairs reproduction has intriguing implications for the inheritance mechanisms of PROKR2 L173R-associated GnRH deficiency and for the relevant processes of evolutionary selection, including potential selective advantages of mutation carriers in genes affecting reproduction.
- Prevalence of Deleterious Variants in MC3R in Patients With Constitutional Delay of Growth and Puberty(2023) DUCKETT, Katie; WILLIAMSON, Alice; KINCAID, John W. R.; RAINBOW, Kara; CORBIN, Laura J.; MARTIN, Hilary C.; EBERHARDT, Ruth Y.; HUANG, Qin Qin; HURLES, Matthew E.; HE, Wen; BRAUNER, Raja; DELANEY, Angela; DUNKEL, Leo; GRINSPON, Romina P.; HALL, Janet E.; HIRSCHHORN, Joel N.; HOWARD, Sasha R.; LATRONICO, Ana C.; JORGE, Alexander A. L.; MCELREAVEY, Ken; MERICQ, Veronica; MERINO, Paulina M.; PALMERT, Mark R.; PLUMMER, Lacey; REY, Rodolfo A.; REZENDE, Raissa C.; SEMINARA, Stephanie B.; SALNIKOV, Kathryn; BANERJEE, Indraneel; LAM, Brian Y. H.; PERRY, John R. B.; TIMPSON, Nicholas J.; CLAYTON, Peter; CHAN, Yee-Ming; ONG, Ken K.; O'RAHILLY, StephenContext The melanocortin 3 receptor (MC3R) has recently emerged as a critical regulator of pubertal timing, linear growth, and the acquisition of lean mass in humans and mice. In population-based studies, heterozygous carriers of deleterious variants in MC3R report a later onset of puberty than noncarriers. However, the frequency of such variants in patients who present with clinical disorders of pubertal development is currently unknown. Objective This work aimed to determine whether deleterious MC3R variants are more frequently found in patients clinically presenting with constitutional delay of growth and puberty (CDGP) or normosmic idiopathic hypogonadotropic hypogonadism (nIHH). Methods We examined the sequence of MC3R in 362 adolescents with a clinical diagnosis of CDGP and 657 patients with nIHH, experimentally characterized the signaling properties of all nonsynonymous variants found and compared their frequency to that in 5774 controls from a population-based cohort. Additionally, we established the relative frequency of predicted deleterious variants in individuals with self-reported delayed vs normally timed menarche/voice-breaking in the UK Biobank cohort. Results MC3R loss-of-function variants were infrequent but overrepresented in patients with CDGP (8/362 [2.2%]; OR = 4.17; P = .001). There was no strong evidence of overrepresentation in patients with nIHH (4/657 [0.6%]; OR = 1.15; P = .779). In 246 328 women from the UK Biobank, predicted deleterious variants were more frequently found in those self-reporting delayed (aged & GE;16 years) vs normal age at menarche (OR = 1.66; P = 3.90E-07). Conclusion We have found evidence that functionally damaging variants in MC3R are overrepresented in individuals with CDGP but are not a common cause of this phenotype.
conferenceObject Several new candidate genes for self-limited delayed puberty revealed by whole exome sequencing(2023) REZENDE, Raissa; SCHAFER, Evan; KAISINGER, Lena; DANTAS, Naiara; ANDRADE, Nathalia; CELLIN, Laurana; QUEDAS, Elisangela; HE, Wen; PERRY, John; XAVIER, Ana Claudia Latronico; HOWARD, Sasha; CHAN, Yee-Ming; JORGE, Alexander- Expanding the Spectrum of Founder Mutations Causing Isolated Gonadotropin-Releasing Hormone Deficiency(2015) CHOI, Jin-Ho; BALASUBRAMANIAN, Ravikumar; LEE, Phil H.; SHAW, Natalie D.; HALL, Janet E.; PLUMMER, Lacey; BUCK, Cassandra L.; KOTTLER, Marie-Laure; JARZABEK, Katarzyna; WOLCZYNSKI, Slawomir; QUINTON, Richard; LATRONICO, Ana Claudia; DODE, Catherine; OGATA, Tsutomu; KIM, Hyung-Goo; LAYMAN, Lawrence C.; GUSELLA, James F.; CROWLEY JR., William F.Context: Loss of function (LoF) mutations in more than 20 genes are now known to cause isolated GnRH deficiency (IGD) in humans. Most causal IGD mutations are typically private, ie, limited to a single individual/pedigree. However, somewhat paradoxically, four IGD genes (GNRH1, TAC3, PROKR2, and GNRHR) have been shown to harbor LoF founder mutations that are shared by multiple unrelated individuals. It is not known whether similar founder mutations occur in other IGD genes. Objective: The objective of the study was to determine whether shared deleterious mutations in IGD-associated genes represent founder alleles. Setting: This study was an international collaboration among academic medical centers. Methods: IGD patients with shared mutations, defined as those documented in three or more unrelated probands in 14 IGD-associated genes, were identified from various academic institutions, the Human Gene Mutation Database, and literature reports by other international investigators. Haplotypes of single-nucleotide polymorphisms and short tandem repeats surrounding the mutations were constructed to assess genetic ancestry. Results: A total of eight founder mutations in five genes, GNRHR (Q106R, R262Q, R139H), TACR3 (W275X), PROKR2 (R85H), FGFR1 (R250Q, G687R), and HS6ST1 (R382W) were identified. Most founder alleles were present at low frequency in the general population. The estimated age of these mutant alleles ranged from 1925 to 5600 years and corresponded to the time of rapid human population expansion. Conclusions: We have expanded the spectrum of founder alleles associated with IGD to a total of eight founder mutations. In contrast to the approximately 9000-year-old PROKR2 founder allele that may confer a heterozygote advantage, the rest of the founder alleles are relatively more recent in origin, in keeping with the timing of recent human population expansion and any selective heterozygote advantage of these alleles requires further evaluation.
- DLK1 Is a Novel Link Between Reproduction and Metabolism(2019) GAMES, Larissa G.; CUNHA-SILVA, Marina; CRESPO, Raiane P.; RAMOS, Carolina O.; MONTENEGRO, Luciana R.; CANTON, Ana; LEES, Melissa; SPOUDEAS, Helen; DAUBER, Andrew; MACEDO, Delanie B.; BESSA, Danielle S.; MACIEL, Gustavo A.; BARACAT, Edmund C.; JORGE, Alexander A. L.; MENDONCA, Berenice B.; BRITO, Vinicius N.; LATRONICO, Ana ClaudiaBackground: Delta-like homolog 1 (DLK1), also called preadipocyte factor 1, prevents adipocyte differentiation and has been considered a molecular gatekeeper of adipogenesis. A DLK1 complex genomic defect was identified in five women from a single family with central precocious puberty (CPP) and increased body fat percentage. Methods: We studied 60 female patients with a diagnosis of CPP or history of precocious menarche. Thirty-one of them reported a family history of precocious puberty. DLK1 DNA sequencing was performed in all patients. Serum DLK1 concentrations were measured using an ELISA assay in selected cases. Metabolic and reproductive profiles of adult women with CPP caused by DLK1 defects were compared with those of 20 women with idiopathic CPP. Results: We identified three frameshift mutations of DLK1 (p.Gly199Alafs*11, p.Va1271Cysfs*14, and p.Pro160Leufs*50) in five women from three families with CPP. Segregation analysis was consistent with the maternal imprinting of DLK1. Serum DLK1 concentrations were undetectable in three affected women. Metabolic abnormalities, such as overweight/obesity, early-onset glucose intolerance/type 2 diabetes mellitus, and hyperlipidemia, were more prevalent in women with the DLK1 mutation than in the idiopathic CPP group. Notably, the human metabolic alterations were similar to the previously described dlk1-null mice phenotype. Two sisters who carried the p.Gly199Alafs*11 mutation also exhibited polycystic ovary syndrome and infertility. Conclusions: Loss-of-function mutations of DLK1 are a definitive cause of familial CPP. The high prevalence of metabolic alterations in adult women who experienced CPP due to DLK1 defects suggests that this antiadipogenic factor represents a link between reproduction and metabolism.
- Applying precision medicine to the diagnosis and management of endocrine disorders(2022) BIDLINGMAIER, Martin; GLEESON, Helena; LATRONICO, Ana-Claudia; SAVAGE, Martin O.Precision medicine employs digital tools and knowledge of a patient's genetic makeup, environment and lifestyle to improve diagnostic accuracy and to develop individualised treatment and prevention strategies. Precision medicine has improved management in a number of disease areas, most notably in oncology, and it has the potential to positively impact others, including endocrine disorders. The accuracy of diagnosis in young patients with growth disorders can be improved by using biomarkers. Insulin-like growth factor I (IGF-I) is the most widely accepted biomarker of growth hormone secretion, but its predictive value for recombinant human growth hormone treatment response is modest and various factors can affect the accuracy of IGF-I measurements. These factors need to be taken into account when considering IGF-I as a component of precision medicine in the management of growth hormone deficiency. The use of genetic analyses can assist with diagnosis by confirming the aetiology, facilitate treatment decisions, guide counselling and allow prompt intervention in children with pubertal disorders, such as central precocious puberty and testotoxicosis. Precision medicine has also proven useful during the transition of young people with endocrine disorders from paediatric to adult services when patients are at heightened risk of dropping out from medical care. An understanding of the likelihood of ongoing GH deficiency, using tools such as MRI, detailed patient history and IGF-I levels, can assist in determining the need for continued recombinant human growth hormone treatment during the process of transitional care.
- Molecular basis of normal and pathological puberty: from basic mechanisms to clinical implications(2023) ARGENTE, Jesus; DUNKEL, Leo; KAISER, Ursula B.; LATRONICO, Ana C.; LOMNICZI, Alejandro; SORIANO-GUILLEN, Leandro; TENA-SEMPERE, ManuelPuberty is a major maturational event; its mechanisms and timing are driven by genetic determinants, but also controlled by endogenous and environmental cues. Substantial progress towards elucidation of the neuroendocrine networks governing puberty has taken place. However, key aspects of the mechanisms responsible for the precise timing of puberty and its alterations have only recently begun to be deciphered, propelled by epidemiological data suggesting that pubertal timing is changing in humans, via mechanisms that are not yet understood. By integrating basic and clinical data, we provide a comprehensive overview of current advances on the physiological basis of puberty, with a particular focus on the roles of kisspeptins and other central transmitters, the underlying molecular and endocrine mechanisms, and the pathways involved in pubertal modulation by nutritional and metabolic cues. Additionally, we have summarised molecular features of precocious and delayed puberty in both sexes, as revealed by clinical and genetic studies. This Review is a synoptic up-to-date view of how puberty is controlled and of the pathogenesis of major pubertal alterations, from both a clinical and translational perspective. We also highlight unsolved challenges that will seemingly concentrate future research efforts in this active domain of endocrinology.