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      Androgen Receptor Mutations Associated with Androgen Insensitivity Syndrome: A High Content Analysis Approach Leading to Personalized Medicine

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          Abstract

          Androgen insensitivity syndrome (AIS) is a rare disease associated with inactivating mutations of AR that disrupt male sexual differentiation, and cause a spectrum of phenotypic abnormalities having as a common denominator loss of reproductive viability. No established treatment exists for these conditions, however there are sporadic reports of patients (or recapitulated mutations in cell lines) that respond to administration of supraphysiologic doses (or pulses) of testosterone or synthetic ligands. Here, we utilize a novel high content analysis (HCA) approach to study AR function at the single cell level in genital skin fibroblasts (GSF). We discuss in detail findings in GSF from three historical patients with AIS, which include identification of novel mechanisms of AR malfunction, and the potential ability to utilize HCA for personalized treatment of patients affected by this condition.

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          Most cited references35

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          Androgen receptor defects: historical, clinical, and molecular perspectives.

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            Polyglutamine-expanded androgen receptors form aggregates that sequester heat shock proteins, proteasome components and SRC-1, and are suppressed by the HDJ-2 chaperone.

            Spinal bulbar muscular atrophy is a neurodegenerative disorder caused by a polyglutamine expansion in the androgen receptor (AR). We show in transiently transfected HeLa cells that an AR containing 48 glutamines (ARQ48) accumulates in a hormone-dependent manner in both cytoplasmic and nuclear aggregates. Electron microscopy reveals both types of aggregates to have a similar ultrastructure. ARQ48 aggregates sequester mitochondria and steroid receptor coactivator 1 and stain positively for NEDD8, Hsp70, Hsp90 and HDJ-2/HSDJ. Co-expression of HDJ-2/HSDJ significantly represses aggregate formation. ARQ48 aggregates also label with antibodies recognizing the PA700 proteasome caps but not 20S core particles. These results suggest that ARQ48 accumulates due to protein misfolding and a breakdown in proteolytic processing. Furthermore, the homeostatic disturbances associated with aggregate formation may affect normal cell function.
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              Gender dysphoria and gender change in androgen insensitivity or micropenis.

              Tom Mazur (2005)
              This review article answers three questions relevant to the medical management and care of individuals born with complete androgen insensitivity syndrome (CAIS), partial androgen insensitivity syndrome (PAIS), or a micropenis: (1) Do any of these individuals reassign themselves from their initial gender assignment? (2) Do more reassign than the ones who do not? (3) Is there evidence of gender dysphoria in those who do not self-initiate reassignment? Reviewed were all articles on CAIS, PAIS, and micropenis cited in K. J. Zucker (1999) plus articles published through 2004. There were no documented cases of gender change in individuals with CAIS (N= 156 females) or micropenis (N= 89: 79 males, 10 females). Nine (9.1%) out of 99 individuals with PAIS changed gender. Thus, self-initiated gender reassignment was rare. Gender dysphoria also appears to be a rare occurrence. The best predictor of adult gender identity in CAIS, PAIS, and micropenis is initial gender assignment.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2009
                9 December 2009
                : 4
                : 12
                : e8179
                Affiliations
                [1 ]Department of Molecular and Cellular Biology and Medicine, Baylor College of Medicine, Houston, Texas, United States of America
                [2 ]Michael E. DeBakey VA Medical Center and Department of Medicine, Baylor College of Medicine, Houston, Texas, United States of America
                [3 ]Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
                [4 ]Department of Internal Medicine, Division of Endocrinology and Metabolism, The University of Texas Southwestern Medical School, Dallas, Texas, United States of America
                Brunel University, United Kingdom
                Author notes

                Conceived and designed the experiments: ATS MAM MM. Performed the experiments: ATS SMH HS IPU MS YNS SNM. Analyzed the data: ATS HS IPU MS SNM MAM MM. Contributed reagents/materials/analysis tools: ATS SMH JJB MJM MAM MM. Wrote the paper: ATS MAM MM.

                Article
                09-PONE-RA-11244R1
                10.1371/journal.pone.0008179
                2785468
                20011049
                cd3e8c84-58ff-4019-bb9a-537c7e916b05
                Szafran et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 24 June 2009
                : 28 September 2009
                Page count
                Pages: 13
                Categories
                Research Article
                Cell Biology
                Cell Biology/Cell Growth and Division
                Cell Biology/Cell Signaling
                Cell Biology/Developmental Molecular Mechanisms
                Cell Biology/Gene Expression
                Cell Biology/Morphogenesis and Cell Biology
                Cell Biology/Nuclear Structure and Function
                Genetics and Genomics/Gene Expression
                Genetics and Genomics/Genetics of Disease
                Genetics and Genomics/Nuclear Structure and Function

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