[PDF][PDF] Bi-allelic DNAH8 variants lead to multiple morphological abnormalities of the sperm flagella and primary male infertility

C Liu, H Miyata, Y Gao, Y Sha, S Tang, Z Xu… - The American Journal of …, 2020 - cell.com
C Liu, H Miyata, Y Gao, Y Sha, S Tang, Z Xu, M Whitfield, C Patrat, H Wu, E Dulioust, S Tian
The American Journal of Human Genetics, 2020cell.com
Sperm malformation is a direct factor for male infertility. Multiple morphological abnormalities
of the flagella (MMAF), a severe form of asthenoteratozoospermia, are characterized by
immotile spermatozoa with malformed and/or absent flagella in the ejaculate. Previous
studies indicated genetic heterogeneity in MMAF. To further define genetic factors
underlying MMAF, we performed whole-exome sequencing in a cohort of 90 Chinese MMAF-
affected men. Two cases (2.2%) were identified as carrying bi-allelic missense DNAH8 …
Sperm malformation is a direct factor for male infertility. Multiple morphological abnormalities of the flagella (MMAF), a severe form of asthenoteratozoospermia, are characterized by immotile spermatozoa with malformed and/or absent flagella in the ejaculate. Previous studies indicated genetic heterogeneity in MMAF. To further define genetic factors underlying MMAF, we performed whole-exome sequencing in a cohort of 90 Chinese MMAF-affected men. Two cases (2.2%) were identified as carrying bi-allelic missense DNAH8 variants, variants which were either absent or rare in the control human population and were predicted to be deleterious by multiple bioinformatic tools. Re-analysis of exome data from a second cohort of 167 MMAF-affected men from France, Iran, and North Africa permitted the identification of an additional male carrying a DNAH8 homozygous frameshift variant. DNAH8 encodes a dynein axonemal heavy-chain component that is expressed preferentially in the testis. Hematoxylin-eosin staining and electron microscopy analyses of the spermatozoa from men harboring bi-allelic DNAH8 variants showed a highly aberrant morphology and ultrastructure of the sperm flagella. Immunofluorescence assays performed on the spermatozoa from men harboring bi-allelic DNAH8 variants revealed the absent or markedly reduced staining of DNAH8 and its associated protein DNAH17. Dnah8-knockout male mice also presented typical MMAF phenotypes and sterility. Interestingly, intracytoplasmic sperm injections using the spermatozoa from Dnah8-knockout male mice resulted in good pregnancy outcomes. Collectively, our experimental observations from humans and mice demonstrate that DNAH8 is essential for sperm flagellar formation and that bi-allelic deleterious DNAH8 variants lead to male infertility with MMAF.
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