11
views
0
recommends
+1 Recommend
2 collections
    0
    shares

          The flagship journal of the Society for Endocrinology. Learn more

      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      New developments and future trajectories in supernumerary sex chromosome abnormalities: a summary of the 2022 3rd International Workshop on Klinefelter Syndrome, Trisomy X, and XYY

      review-article

      Read this article at

      ScienceOpenPublisherPMC
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          The 3rd International Workshop on Klinefelter Syndrome, Trisomy X, and 47,XYY syndrome was held in Leiden, the Netherlands, on September 12–14, 2022.

          Here, we review new data presented at the workshop and discuss scientific and clinical trajectories. We focus on shortcomings in knowledge and therefore point out future areas for research.

          We focus on the genetics and genomics of supernumerary sex chromosome syndromes with new data being presented. Most knowledge centre specifically on Klinefelter syndrome, where aspects on testosterone deficiency and the relation to bone, muscle and fat were discussed, as was infertility and the treatment thereof. Both trisomy X and 47,XYY syndrome are frequently affected by infertility.

          Transitioning of males with Klinefelter syndrome was addressed, as this seemingly simple process in practise is often difficult.

          It is now realized that neurocognitive changes are pervasive in all supernumerary sex chromosome syndromes, which were extensively discussed. New intervention projects were also described, and exciting new data concerning these were presented.

          Advocacy organizations were present, describing the enormous burden carried by parents when having to explain their child’s specific syndrome to most professionals whenever in contact with health care and education systems. It was also pointed out that most countries do not have health care systems that diagnose patients with supernumerary sex chromosome syndromes, thus pinpointing a clear deficiency in the current genetic testing and care models.

          At the end of the workshop, a roadmap towards the development of new international clinical care guidelines for Klinefelter syndrome was decided.

          Related collections

          Most cited references85

          • Record: found
          • Abstract: found
          • Article: not found

          Klinefelter Syndrome: Integrating Genetics, Neuropsychology, and Endocrinology

          Although first identified over 70 years ago, Klinefelter syndrome (KS) continues to pose substantial diagnostic challenges, as many patients are still misdiagnosed, or remain undiagnosed. In fact, as few as 25% of patients with KS are accurately diagnosed and most of these diagnoses are not made until adulthood. Classic characteristics of KS include small testes, infertility, hypergonadothropic hypogonadism, and cognitive impairment. However, the pathophysiology behind KS is not well understood, although genetic effects are also thought to play a role. For example, recent developments in genetics and genomics point to a fundamental change in our understanding of KS, with global epigenetic and RNA expression changes playing a central role for the phenotype. KS is also associated with more general health markers, including higher morbidity and mortality rates and lower socioeconomic status (which likely affect both morbidity and mortality). In addition, hypogonadism is associated with greater risk of metabolic syndrome, type 2 diabetes, cardiovascular disease, breast cancer, and extragonadal germ cell tumors. Medical treatment typically focuses on testosterone replacement therapy (TRT), although the effects of this therapy have not been studied rigorously, and future studies need to evaluate the effects of TRT on metabolic risk and neurocognitive outcomes. This review presents a comprehensive interdisciplinary examination of recent developments in genetic, endocrine, and neurocognitive science, including the study of animal models. It provides a number of recommendations for improving the effectiveness of research and clinical practice, including neonatal KS screening programs, and a multidisciplinary approach to KS treatment from childhood until senescence.
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Single-cell analysis of developing and azoospermia human testicles reveals central role of Sertoli cells

            Clinical efficacy of treatments against non-obstructive azoospermia (NOA), which affects 1% of men, are currently limited by the incomplete understanding of NOA pathogenesis and normal spermatogenic microenvironment. Here, we profile >80,000 human testicular single-cell transcriptomes from 10 healthy donors spanning the range from infant to adult and 7 NOA patients. We show that Sertoli cells, which form the scaffold in the testicular microenvironment, are severely damaged in NOA patients and identify the roadmap of Sertoli cell maturation. Notably, Sertoli cells of patients with congenital causes (Klinefelter syndrome and Y chromosome microdeletions) are mature, but exhibit abnormal immune responses, while the cells in idiopathic NOA (iNOA) are physiologically immature. Furthermore, we find that inhibition of Wnt signaling promotes the maturation of Sertoli cells from iNOA patients, allowing these cells to regain their ability to support germ cell survival. We provide a novel perspective on the development of diagnostic methods and therapeutic targets for NOA.
              • Record: found
              • Abstract: found
              • Article: not found

              Morbidity in Klinefelter syndrome: a Danish register study based on hospital discharge diagnoses.

              Klinefelter syndrome (KS) is the most prevalent sex chromosome disorder in man; it affects approximately one in 660 men and is a common cause of hypogonadism and infertility. Our current knowledge of morbidity in KS is based on observational studies and case reports and therefore is limited. We used Danish registers to obtain dates of hospital admissions and discharge diagnoses in a cohort of all males diagnosed with KS in Denmark and a randomly selected, age-matched control group. Our cohort consisted of 832 KS subjects and 4033 control subjects, contributing with a total of approximately 100,000 person years. We used stratified Cox regression analysis on main groups of diagnoses. Where significant results were found, subsequent analyses were performed on subgroups of diagnoses. We found a significantly increased risk of being hospitalized among the KS subjects [hazard ratio (HR), 1.69; 95% confidence interval, 1.54-1.86]. The increased admission risk was present in all but one of the main diagnosis groups, with the highest HRs for congenital malformations (HR, 10.7), psychiatric disorders (HR, 3.7), and endocrine and metabolic disorders (HR, 3.2). We compared hospitalization rates before and after the diagnosis of KS and found that the increased rate was present even before the diagnosis of KS. Males suffering from KS experienced an increased hospitalization rate from a variety of disorders. Some are likely to be caused by hypogonadism, and some may be linked to the syndrome per se, whereas others are not readily explained. However, other factors, e.g. socioeconomic, may be involved.

                Author and article information

                Journal
                Endocr Connect
                Endocr Connect
                EC
                Endocrine Connections
                Bioscientifica Ltd (Bristol )
                2049-3614
                04 January 2023
                01 March 2023
                : 12
                : 3
                : e220500
                Affiliations
                [1 ]Department of Endocrinology , Aarhus University Hospital, Aarhus, Denmark
                [2 ]Department of Molecular Medicine , Aarhus University Hospital, Aarhus, Denmark
                [3 ]Department of Clinical Medicine , Aarhus University, Aarhus, Denmark
                [4 ]Department of Medicine , Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy
                [5 ]Centre of Reproductive Medicine and Andrology , Münster, Germany
                [6 ]Department of Growth and Reproduction Copenhagen University Hospital - Rigshospitalet , Copenhagen, Denmark
                [7 ]Department of Clinical Medicine , Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
                [8 ]Section on Developmental Neurogenomics , National Institute of Mental Health Intramural Research Program, National Institutes of Health, Bethesda, Maryland, USA
                [9 ]Clinical Neurodevelopmental Sciences , Leiden University, Leiden, The Netherlands and TRIXY Center of Expertise, Leiden University Treatment and Expertise Centre (LUBEC), Leiden, The Netherlands
                [10 ]Department of Pediatrics , University of Virginia, Charlottesville, Virginia, USA
                [11 ]Department of Clinical Genetics , Aarhus University Hospital, Aarhus, Denmark
                [12 ]Department of Pediatrics , Developmental Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
                Author notes
                Correspondence should be addressed to C H Gravholt: claus.gravholt@ 123456clin.au.dk
                Author information
                http://orcid.org/0000-0001-5924-1720
                http://orcid.org/0000-0002-0534-4350
                http://orcid.org/0000-0002-9179-7515
                http://orcid.org/0000-0002-7526-3142
                http://orcid.org/0000-0001-9178-4901
                Article
                EC-22-0500
                10.1530/EC-22-0500
                9986408
                36598290
                c211361c-e6ef-459c-b719-3ad7087909a6
                © The authors

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 01 December 2022
                : 04 January 2023
                Categories
                Review

                klinefelter syndrome,testosterone,anti-mullerian hormone,trisomy x syndrome,47,xyy syndrome

                Comments

                Comment on this article

                Related Documents Log