ANAPC13双等位基因突变导致人类和小鼠卵母细胞成熟阻滞
该研究对3例卵母细胞成熟阻滞患者行全外显子测序,发现ANAPC13双等位基因突变,并在敲入小鼠模型中重现成熟阻滞表型;机制上突变ANAPC13通过异常亚基互作损害APC/C功能,干扰MI至AI转换的蛋白组成;显微注射Anapc13 mRNA可部分 rescue 第一极体排出。
要点
- ANAPC13双等位基因突变(c.6C>A和c.71T>G)见于3例MI期卵母细胞成熟阻滞患者。
- Anapc13M/M小鼠卵母细胞成熟比例极低,超排后1.66%±3.34% vs 对照96.63%±3.40%(P<0.001)。
- 显微注射Anapc13 mRNA可部分(49.20%±3.60%)恢复突变卵母细胞第一极体排出。
核心结论
- ANAPC13突变与人类和小鼠卵母细胞成熟阻滞存在因果关系。
- 突变ANAPC13通过异常亚基互作损害APC/C功能,干扰MI至AI转换的蛋白组成。
- 显微注射Anapc13 mRNA为ANAPC13突变患者提供了初步的潜在治疗证据。
研究设计与样本
- 研究纳入辅助生殖治疗中经形态学评估诊断为卵母细胞成熟阻滞的患者,行全外显子测序。
- 在3例患者中鉴定出ANAPC13突变,并将复发突变c.6C>A构建敲入小鼠模型(Anapc13M/M),以野生型(Anapc13+/+)为对照。
- 进一步开展小鼠卵母细胞表型实验、人类卵母细胞蛋白质组分析及细胞系和质粒分子实验。
- 探索性 rescue 治疗采用Anapc13 mRNA显微注射。
主要发现
- 3例不孕女性携带ANAPC13双等位基因突变(NM_001242374.1: c.6C>A; p.D2E 和 c.71T>G; p.L24R),表现为 metaphase I 期卵母细胞成熟阻滞。
- Anapc13M/M雌鼠超排后成熟卵母细胞比例极低(Anapc13+/+: 96.63% ± 3.40% vs Anapc13M/M: 1.66% ± 3.34%,P<0.001)。
- Anapc13M/M雌鼠体外成熟后成熟卵母细胞比例亦极低(Anapc13+/+: 70.30% ± 1.10% vs Anapc13M/M: 0.83% ± 1.66%,P<0.001)。
- 突变ANAPC13通过损害APC/C功能,在MI至AI转换期扰乱卵母细胞蛋白组成,但不改变纺锤体组装检查点动态。
- 显微注射Anapc13 mRNA可使Anapc13突变卵母细胞部分(49.20% ± 3.60%)恢复第一极体排出。
临床怎么用
- 对反复辅助生殖失败且表现为卵母细胞成熟阻滞的患者,可考虑ANAPC13基因检测。
- ANAPC13突变患者可探索性尝试Anapc13 mRNA显微注射,但需在充分知情同意和研究框架下进行。
局限性
- 研究仅基于3例患者,样本量有限。
- 显微注射 rescue 仅为探索性初步证据,尚未转化为临床常规治疗。
以上解读依据论文摘要(全文未开放获取或许可不允许翻译转载)。
原文
BACKGROUND: Oocyte maturation arrest is an intractable clinical problem, resulting in recurrent failure of assisted reproductive treatments. The anaphase-promoting complex or cyclosome orchestrates a series of proteolytic events to ensure proper cell cycle progression of mitosis in somatic cell proliferation and meiosis during oocyte maturation. Defects in anaphase-promoting complex or cyclosome subunits, such as ANAPC8 and ANAPC12, have been demonstrated linked to oocyte maturation arrest. However, the roles of other anaphase-promoting complex or cyclosome subunits in oocyte maturation remain unclear. OBJECTIVE: This study aimed to reveal the causal relationship between ANAPC13 mutations and oocyte maturation arrest, while elucidating the pathogenic mechanism to provide a theoretical basis for clinical diagnosis and treatment. STUDY DESIGN: Patients diagnosed with oocyte maturation arrest by morphologic assessment during assisted reproductive treatments were recruited and underwent whole-exome sequencing. Mutations in ANAPC13 were identified in 3 patients and screened out as the candidate. The recurrent mutation c.6C>A was recapitulated in a knock-in mouse model (Anapc13M/M mice) to clarify its association with oocyte maturation arrest, with wild-type mice (Anapc13+/+ mice) serving as controls. Further phenotyping experiments with mouse oocytes, proteomic analysis of human oocytes, and molecular experiments with cell lines and plasmids were conducted to determine the role of ANAPC13 in oocyte maturation. Anapc13 mRNA microinjection was performed as an exploratory rescue treatment. RESULTS: We identified 2 biallelic ANAPC13 mutations (NM_001242374.1: c.6C>A; p.D2E and c.71T>G; p.L24R) in 3 infertile females with oocyte maturation arrest at metaphase I. Oocytes from the Anapc13M/M female mice similarly displayed an extremely low proportion of mature oocytes, whether obtained after superovulation (Anapc13+/+: 96.63% ± 3.40% vs Anapc13M/M: 1.66% ± 3.34%, P<0.001) or in vitro maturation (Anapc13+/+: 70.30% ± 1.10% vs Anapc13M/M: 0.83% ± 1.66%, P<0.001). An in-depth study of oocytes demonstrated that mutant ANAPC13 disrupts the protein composition of oocytes during metaphase I-to-anaphase I transition by impairing anaphase-promoting complex or cyclosome function, without changing the spindle assembly checkpoint dynamics. Furthermore, a molecular mechanistic study revealed that anaphase-promoting complex or cyclosome dysfunction resulted from abnormal subunit interaction. Moreover, Anapc13-mutant oocytes can be partially (49.20% ± 3.60%) rescued to extrude the first polar body by microinjection of Anapc13 mRNA. CONCLUSION: Our study demonstrated the critical role of ANAPC13 in human and mouse oocyte maturation, established a causal relationship between ANAPC13 mutations and oocyte maturation arrest, and further provided preliminary evidence that microinjection may serve as a potential treatment for these patients with ANAPC13 mutations.
引用
- Wang Y, Ding Z, Liu X, et al. Biallelic mutations in ANAPC13 cause female infertility characterized by oocyte maturation arrest both in humans and mice. Am J Obstet Gynecol. 2026. PMID: 41997520. doi:10.1016/j.ajog.2026.04.017
供执业医师工作参考,不替代临床判断;数值与分级以指南原文为准。