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Decreased FGF8 signaling causes deficiency of gonadotropin-releasing hormone in humans and mice
John Falardeau, Wilson C.J. Chung, Andrew Beenken, Taneli Raivio, Lacey Plummer, Yisrael Sidis, Elka E. Jacobson-Dickman, Anna V. Eliseenkova, Jinghong Ma, Andrew Dwyer, Richard Quinton, Sandra Na, Janet E. Hall, Celine Huot, Natalie Alois, Simon H.S. Pearce, Lindsay W. Cole, Virginia Hughes, Moosa Mohammadi, Pei Tsai, Nelly Pitteloud
John Falardeau, Wilson C.J. Chung, Andrew Beenken, Taneli Raivio, Lacey Plummer, Yisrael Sidis, Elka E. Jacobson-Dickman, Anna V. Eliseenkova, Jinghong Ma, Andrew Dwyer, Richard Quinton, Sandra Na, Janet E. Hall, Celine Huot, Natalie Alois, Simon H.S. Pearce, Lindsay W. Cole, Virginia Hughes, Moosa Mohammadi, Pei Tsai, Nelly Pitteloud
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Research Article Reproductive biology

Decreased FGF8 signaling causes deficiency of gonadotropin-releasing hormone in humans and mice

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Abstract

Idiopathic hypogonadotropic hypogonadism (IHH) with anosmia (Kallmann syndrome; KS) or with a normal sense of smell (normosmic IHH; nIHH) are heterogeneous genetic disorders associated with deficiency of gonadotropin-releasing hormone (GnRH). While loss-of-function mutations in FGF receptor 1 (FGFR1) cause human GnRH deficiency, to date no specific ligand for FGFR1 has been identified in GnRH neuron ontogeny. Using a candidate gene approach, we identified 6 missense mutations in FGF8 in IHH probands with variable olfactory phenotypes. These patients exhibited varied degrees of GnRH deficiency, including the rare adult-onset form of hypogonadotropic hypogonadism. Four mutations affected all 4 FGF8 splice isoforms (FGF8a, FGF8b, FGF8e, and FGF8f), while 2 mutations affected FGF8e and FGF8f isoforms only. The mutant FGF8b and FGF8f ligands exhibited decreased biological activity in vitro. Furthermore, mice homozygous for a hypomorphic Fgf8 allele lacked GnRH neurons in the hypothalamus, while heterozygous mice showed substantial decreases in the number of GnRH neurons and hypothalamic GnRH peptide concentration. In conclusion, we identified FGF8 as a gene implicated in GnRH deficiency in both humans and mice and demonstrated an exquisite sensitivity of GnRH neuron development to reductions in FGF8 signaling.

Authors

John Falardeau, Wilson C.J. Chung, Andrew Beenken, Taneli Raivio, Lacey Plummer, Yisrael Sidis, Elka E. Jacobson-Dickman, Anna V. Eliseenkova, Jinghong Ma, Andrew Dwyer, Richard Quinton, Sandra Na, Janet E. Hall, Celine Huot, Natalie Alois, Simon H.S. Pearce, Lindsay W. Cole, Virginia Hughes, Moosa Mohammadi, Pei Tsai, Nelly Pitteloud

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Figure 3

Response to GnRH therapy in 3 probands harboring an FGF8 mutation.

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Response to GnRH therapy in 3 probands harboring an FGF8 mutation.
   
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(A) Pulsatile GnRH was administered at a dose of 100 ng/kg i.v. at a physiologic frequency to the proband described in case 1, demonstrating a normal increase in LH and FSH, an increase in E2 consistent with development of 2 follicles, and an increase in progesterone (Prog) consistent with ovulation. Data are centered to the day of ovulation (0 d); for E2, follicle diameters are indicated; shaded areas represent mean ± 1 SD hormone levels in 109 control women; boxed regions at top denote GnRH pulse frequency. (B) LH, FSH, and T responses to GnRH therapy in 2 male patients (cases 2 and 6). Horizontal lines denote lowest value of the normal range for adult serum T levels. To convert serum T values from ng/dl to nmol/l, divide by 28.84.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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