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SRY interference of normal regulation of the RET gene suggests a potential role of the Y-chromosome gene in sexual dimorphism in Hirschsprung disease.
[hirschsprung disease]
The
Hirschsprung
disease
(
HSCR
)
is
a
complex
congenital
disorder
,
arising
from
abnormalities
in
enteric
nervous
system
(
ENS
)
development
.
There
is
a
gender
disparity
among
the
patients
,
with
the
male
to
female
ratio
as
high
as
5
:
1
.
Loss
-of-function
mutations
of
HSCR
genes
and
haploinsufficiency
of
their
gene
products
are
the
primary
pathogenic
mechanisms
for
disease
development
.
Recent
studies
identified
over
half
of
the
HSCR
disease
susceptibility
genes
as
targets
for
the
sex-determining
factor
SRY
,
suggesting
that
this
Y-
encoded
transcription
factor
could
be
involved
in
sexual
dimorphism
in
HSCR
.
Among
the
SRY
targets
,
the
tyrosine
kinase
receptor
RET
represents
the
most
important
disease
gene
,
whose
mutations
account
for
half
of
the
familial
and
up
to
one
-
third
of
the
sporadic
forms
of
HSCR
.
RET
is
regulated
by
a
distal
and
a
proximal
enhancer
at
its
promoter
,
in
which
PAX
3
and
NKX
2
-
1
are
the
resident
transcription
factors
respectively
.
We
show
that
the
SRY
-box
10
(
SOX
10
)
co
-activator
interacts
and
forms
transcriptional
complexes
with
PAX
3
and
NKX
2
-
1
in
a
sequence-independent
manner
and
exacerbates
their
respective
transactivation
activities
on
the
RET
promoter
.
SRY
competitively
displaces
SOX
10
in
such
transcription
complexes
and
represses
their
regulatory
functions
on
RET
.
Hence
SRY
could
be
a
Y-
located
negative
modifier
of
RET
expression
;
and
if
it
is
ectopically
expressed
during
ENS
development
,
such
SRY
repression
could
result
in
RET
protein
haploinsufficiency
and
promotion
of
HSCR
development
,
thereby
contributing
to
sexual
dimorphism
in
HSCR
.
Diseases
Validation
Diseases presenting
"loss-of-function mutations"
symptom
achondroplasia
alpha-thalassemia
aromatase deficiency
child syndrome
cowden syndrome
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erythropoietic protoporphyria
esophageal adenocarcinoma
familial hypocalciuric hypercalcemia
harlequin ichthyosis
hirschsprung disease
kallmann syndrome
kindler syndrome
lamellar ichthyosis
neonatal adrenoleukodystrophy
pendred syndrome
werner syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated