Genetics of Male Infertility: A Marker of Overall Health

摘要：总体而言 无精子症影响着全球1%的男性，这意味着全球有645，000名年龄在20至50岁之间的男性， 美国的据估计，遗传原因解释了50%的不孕症。流行病学数据表明 生育状况可能是整体健康的标志，但遗传基础才刚刚开始 明白提高对不孕症遗传基础和相关整体健康的认识 合并症将有助于不孕夫妇的咨询;证明诊断的发展是合理的 屏幕;并可能导致患者特定的治疗选择。在当前的个性化医疗时代， 降低成本的全基因组测序和简便的基因组编辑技术， 不孕症和整体健康共病的遗传基础，并开发有针对性的治疗方法。项目我 将发现无精子症男性的遗传变异，以确定临床诊断发展的目标 或者心理治疗项目I将使用Charlson Comorbidity Index问卷来确定不孕患者是否 或其家庭成员有其他总体健康共病史。项目二将验证不孕症- 项目I中确定的相关遗传变异，并表征生育力和总体健康表型。 项目II还将与项目III合作，确定表观遗传扰动对 精原干细胞功能项目III将开发小鼠支持细胞和生殖细胞基因疗法 无精子症的模型，并将产生关键的安全性和可行性数据，以告知公众对话， 基因治疗在生殖系内和生殖系周围的风险和益处。试点项目将发现表观遗传 生殖细胞和体细胞的景观从睾丸的生育与不育的男子。核心A将提供 行政监督，促进项目和核心之间的通信和数据交换，以确保 这个P50计划的影响力大于其各个部分的总和。教育和推广 核心将通过开发实践教学模块来教育中等教育， 学校和高中学生以及服务不足社区的成年人了解生殖医学 和不育的遗传学。模块将在皮特移动的科学实验室进行测试和验证， 部署到圣路易斯、匹兹堡、伊萨卡和纽约的教师讲习班， 在他们的教室里。以男性为重点的教学模块也将与P50中心共享， 俄勒冈州和西北大学，以补充他们现有的女性为重点的动手模块。

Abstract: Overall Azoospermia impacts 1% of men globally, which translates to 645,000 men between the ages of 20 and 50 in the United States. It is estimated that genetic causes explain 50% of infertility. Epidemiological data suggest that fertility status may be a marker of overall health, but the genetic underpinnings are just beginning to be understood. Improved knowledge about the genetic basis of infertility and associated overall health comorbidities will aid in the counseling of infertile couples; justify the development of diagnostic screens; and may lead to patient-specific treatment options. In the current personalized medicine era with reduced cost whole genome sequencing and facile genome editing technologies, it is feasible to discover genetic underpinnings of infertility and overall health comorbidities and develop targeted therapies. Project I will discover genetic variants in men with azoospermia to identify targets for development of clinical diagnostics or therapy. Project I will use Charlson Comorbidity Index questionnaires to determine whether infertile patients or their family members have histories of other overall health comorbidities. Project II will validate infertility- associated genetic variants identified in Project I and characterize the fertility and overall health phenotypes. Project II will also work collaborate with Project III to determine the impact of epigenetic perturbations on spermatogonial stem cell function. Project III will develop Sertoli cell and germ cell gene therapies in mouse models of azoospermia and will produce critical safety and feasibility data to inform the public dialogue on the risks and benefits of gene therapy in and around the germline. The Pilot project will discover the epigenetic landscape of germ cells and somatic cells from the testes of fertile versus infertile men. Core A will provide the administrative oversight and facilitate communications and data exchange among projects and cores to ensure that this P50 program achieves an impact that is greater than the sum of its parts. The Education and Outreach Core will maximize the public impact of this P50 by developing hands-on teaching modules to educate middle school and high school students as well as adults in underserved communities about reproductive medicine and the genetics of infertility. Modules will be tested and validated in the Pitt Mobile Science lab before deploying to teacher workshops in St. Louis, Pittsburgh, Ithaca and New York allowing teachers to implement the modules in their classrooms. Male focused teaching modules will also be shared with P50 centers in Oregon and at Northwestern to complement their existing female-focused hands-on modules.