Skip to main content
Log in

The role of the sex-determining region of the Y chromosome (SRY) in the etiology of 46,XX true hermaphroditism

  • Original Investigations
  • Published:
Human Genetics Aims and scope Submit manuscript

Summary

The syndrome of 46,XX true hermaphroditism is a clinical condition in which both ovarian and testicular tissue are found in one individual. Both Mullerian and Wolffian structures are usually present, and external genitalia are often ambiguous. Two alternative mechanisms have been proposed to explain the development of testicular tissue in these subjects: (1) translocation of chromosomal material encoding the testicular determination factor (TDF) from the Y to the X chromosome or to an autosome, or (2) an autosomal dominant mutation that permits testicular determination in the absence of TDF. We have investigated five subjects with 46,XX true hermaphroditism. Four individuals had a normal 46,XX karyotype; one subject (307) had an apparent terminal deletion of the short arm of one X chromosome. Genomic DNA was isolated from these individuals and subjected to Southern blot analysis. Only subject 307 had Y chromosomal sequences that included the pseudoautosomal boundary, SRY (sex-determining region of Y), ZFY (Y gene encoding a zinc finger protein), and DXYS5 (an anonymous locus on the distal short arm of Y) but lacked sequences for DYZ5 (proximal short arm of Y) and for the long arm probes DYZ1 and DYZ2. The genomic DNA of the other four subjects lacked detectable Y chromosomal sequences when assayed either by Southern blotting or after polymerase chain reaction amplification. Our data demonstrate that 46,XX true hermaphroditism is a genetically heterogeneous condition, some subjects having TDF sequences but most not. The 46,XX subjects without SRY may have a mutation of an autosomal gene that permits testicular determination in the absence of TDF.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Abbas NE, Toublanc JE, Boucekkine C, Toublanc M, Affara NA, Job J-C, Fellous M (1990) A possible common origin of “Y-negative” human XX males and XX true hermaphrodites. Hum Genet 84:356–360

    Article  CAS  PubMed  Google Scholar 

  • Berkovitz GD, Rock JA, Urban MD, Migeon CJ (1982) True hermaphroditism. Johns Hopkins Med J 151:290–297

    CAS  PubMed  Google Scholar 

  • Bernstein R, Koo GC, Wachtel SS (1980) Abnormality of the X chromosome in human 46,XY female siblings with dysgenetic ovaries. Science 207:768–769

    CAS  PubMed  Google Scholar 

  • Berta P, Hawkins JR, Sinclair AH, Taylor A, Griffiths BL, Goodfellow PN, Fellous M (1990) Genetic evidence equating SRY and the testis-determining factor. Nature 348:448–450

    Article  CAS  PubMed  Google Scholar 

  • Chapelle A de la (1987) The Y-chromosomal and autosomal testis-determining genes. Development 101 [Suppl]:33–38

    PubMed  Google Scholar 

  • Chen H, Cutley L (1991) Molecular studies of Y chromosome using polymerase chain reaction (PCR). Pediatr Res 29:128A

    Google Scholar 

  • Damiani D, Billerbeck AEC, Goldberg ACK, Setian N, Fellous M, Kalil J (1990) Investigation of the ZFY gene in XX true hermaphroditism and Swyer syndrome. Hum Genet 85:85–88

    Article  CAS  PubMed  Google Scholar 

  • Disteche CM, Brown L, Saal H, Friedman C, Thuline HC, Hoar DI, Pagon RA, Page DC (1986) Molecular detection of a translocation (Y;15) in a 45,X male. Hum Genet 74:372–377

    Article  CAS  PubMed  Google Scholar 

  • Donohoue PA, Van Dop C, McLean RH, White PC, Jospe N, Migeon CJ (1986) Gene conversion in salt-losing congenital adrenal hyperplasia with absent complement C4B protein. J Clin Endocrinol Metab 62:995–1002

    CAS  PubMed  Google Scholar 

  • Eicher EM, Beamer WG, Washburn LL, Whitten WR (1980) A cytogenetic investigation of inherited true hermaphroditism in BALB/cwt mice. Cytogenet Cell Genet 28:104–115

    CAS  PubMed  Google Scholar 

  • Ellis NA, Goodfellow PJ, Pym B, Smith M, Palmer M, Frischauf A-M, Goodfellow PN (1989) The pseudoautosomal boundary in man is defined by an Alu repeat sequence inserted on the Y chromosome. Nature 337:81–84

    Article  CAS  PubMed  Google Scholar 

  • Espiner EA, Veale AMO, Sands VE, Fitzgerald PH (1970) Familial syndrome of streak gonads and normal male karyotype in five phenotypic females. N Engl J Med 283:6–11

    CAS  PubMed  Google Scholar 

  • Feinberg AP, Vogelstein B (1982) A technique for radiolabeling DNA restriction endonuclease fragments to high specific activity. Anal Biochem 132:6–13

    Google Scholar 

  • Ferguson-Smith MA (1966) X-Y chromosomal interchange in the aetiology of true hermaphroditism and of XX Klinefelter's syndrome. Lancet II:1953–1956

    Google Scholar 

  • Ferguson-Smith MA, Cooke A, Affara NA, Boyd E, Tolmie JL (1990a) Genotype-phenotype correlations in XX males and the bearing on current theories of sex determination. Hum Genet 84:198–202

    Article  CAS  PubMed  Google Scholar 

  • Ferguson-Smith MA, North MA, Affara NA, Briggs H (1990b) The secret of sex. Lancet 336:809–810

    CAS  PubMed  Google Scholar 

  • Ford CE, Miller OJ, Polani PE, Alemeida JC de, Briggs JH (1959) A sex-chromosome anomaly in a case of gonadal dysgenesis (Turner syndrome). Lancet I:711

    Google Scholar 

  • Geldwerth D, Bishop C, Guellaen G, Koenig M, Vergnaud G, Mandel J-L, Weissenbach JC (1985) Extensive DNA sequence homologies between the human Y and the long arm of the X chromosome. EMBO J 4:1739–1743

    CAS  PubMed  Google Scholar 

  • German J, Simpson JL, Chaganti RSK, Summitt RL, Reid LB, Merkatz IR (1978) Genetically determined sex-reversal in 46,XY humans. Science 202:53–56

    CAS  PubMed  Google Scholar 

  • Gessler M, Thomas GH, Couillin P, Junien C, McGillivray BC, Hayden M, Jaschek G, Bruns GAP (1989) A deletion map of the WAGR region of chromosome 11. Am J Hum Genet 44:486–495

    CAS  PubMed  Google Scholar 

  • Hall BD, Spranger NW (1980) Campomelic dysplasia: further elucidation of a distinct entity. Am J Dis Child 134:285–289

    CAS  PubMed  Google Scholar 

  • Jacobs PA (1969) The chromosomal basis of some types of intersexuality in man. J Reprod Fertil 7 [Suppl]:73–78

    Google Scholar 

  • Jacobs PA, Strong JA (1959) A case of human intersexuality having a possible XXY sex-determining mechanism. Nature 183:302–303

    CAS  PubMed  Google Scholar 

  • Jager RJ, Anvret M, Hall K, Scherer G (1990a) A human XY female with a frame shift mutation in the candidate testis-determining gene SRY. Nature 348:452–454

    CAS  PubMed  Google Scholar 

  • Jager RJ, Ebensperger C, Fraccaro M, Scherer G (1990b) A ZFY-negative 46,XX true hermaphrodite is positive for the Y pseudoautosomal boundary. Hum Genet 85:666–668

    CAS  PubMed  Google Scholar 

  • Koopman P, Muslerberg A, Capel B, Vivian N, Lovell-Badge R (1990) Expression of a candidate sex-determining gene during mouse testis determination. Nature 348:450–452

    Article  CAS  PubMed  Google Scholar 

  • Koopman P, Gubbay J, Vivian N, Goodfellow P, Lovell-Badge R (1991) Male development of chromosomally female mice transgenic for SRY. Nature 351:117–121

    Article  CAS  PubMed  Google Scholar 

  • Lyons J (1990) Analysis of ras gene point mutations by PCR and oligonucleotide hybridization. In: Innis MA, Gelfand DM, Shinsky JJ, White TJ (eds) PCR protocols: a guide to methods and applications. Academic Press, San Diego, pp 386–391

    Google Scholar 

  • Migeon BR, Axelman J, Stetten G (1988) Clonal evolution in human lymphoblast cultures. Am J Hum Genet 42:742–747

    CAS  PubMed  Google Scholar 

  • Muller U, Donion T, Schmid M, Fitch N, Richer C-L, Lalande M, Latt SA (1986) Deletion mapping of the testis-determining locus with DNA probes in 46,XX males and in 46,XY and 46X,dic(Y) females. Nucleic Acids Res 14:6489–6505

    CAS  PubMed  Google Scholar 

  • Muller U, Donlon TA, Kunkel SM, Lalande M, Latt SA (1987) Y-190, a DNA probe for the sensitive detection of Y derived marker chromosomes and mosaicism. Hum Genet 75:109–113

    CAS  PubMed  Google Scholar 

  • Niekerk WA van (1981) True hermaphroditism. In: Josso N (eds) The intersex child. Karger, Basel, pp 80–99

    Google Scholar 

  • Page DC, Brown LG, Chapelle A de la (1987a) Exchange of terminal portions of X and Y chromosomal short arms in human XX males. Nature 328:437–440

    Article  CAS  PubMed  Google Scholar 

  • Page DC, Mosher R, Simpson EM, Fisher EMC, Mardon G, Pollack J, McGillivray B, Chapelle A de la, Brown LG (1987b) The sex-determining region of the human Y chromosome. Cell 51:1091–1104

    Article  CAS  PubMed  Google Scholar 

  • Pai GS, Thomas GH (1980) A new R-banding technique in clinical cytogenetics. Hum Genet 54:41–45

    Article  CAS  PubMed  Google Scholar 

  • Palmer MS, Sinclair AH, Berta P, Ellis NA, Goodfellow PN, Abbas NE, Fellous M (1989) Genetic evidence that ZFY is not the testis-determining factor. Nature 342:937–939

    Article  CAS  PubMed  Google Scholar 

  • Petit C, Chapelle A de la, Levilliers J, Castillo S, Noel B, Weissenbach J (1987) An abnormal terminal X-Y interchange accounts for most but not all cases of human XX maleness. Cell 49:595–602

    Article  CAS  PubMed  Google Scholar 

  • Raine J, Robertson ME, Malcolm S, Hoey H, Grant DB (1989) Absence of Y specific DNA sequences in two siblings with 46,XX hermaphroditism. Arch Dis Child 64:1185–1187

    CAS  PubMed  Google Scholar 

  • Ramsay M, Bernstein R, Zware E, Page DC, Jenkins T (1988) XX true hermaphroditism in Southern African Blacks: an enigma of primary sexual differentiation. Am J Hum Genet 43:4–13

    CAS  PubMed  Google Scholar 

  • Rouyer F, Simmler M-C, Page DC, Weissenbach J (1987) A sex chromosome rearrangement in a human XX male caused by Alu-Alu recombination. Cell 51:417–425

    Article  CAS  PubMed  Google Scholar 

  • Sambrook J, Fritsch EF, Maniatis T (1989) Molecular cloning: a laboratory manual, 2nd edn. Cold Spring Harbor Laboratory, Cold Spring Harbor, NY

    Google Scholar 

  • Sinclair AH, Berta P, Palmer MS, Hawkins JR, Griffiths BL, Smith MJ, Foster JW, Frischauf AM, Lovell-Badge R, Good-fellow PN (1990) A gene from the human sex determining region encodes a protein with homology to a conserved DNA-binding motif. Nature 346:240–244

    Article  CAS  PubMed  Google Scholar 

  • Smith KD, Young KE, Talbot CC Jr, Schmeckpeper BJ (1987) Repeated DNA of the human Y chromosome. Development 101 [Suppl]:77–92

    CAS  PubMed  Google Scholar 

  • Vernaud G, Page DC, Simmler MC, Brown L, Rouyer F, Noel B, Botstein D, Chapelle A de la, Weissenbach J (1986) A deletion map of the human Y chromosome based on DNA hybridization. Am J Hum Genet 38:109–124

    Google Scholar 

  • Waibel F, Scherer G, Fraccaro M, Hustinx TWJ, Weissenbach J, Wieland J, Meyerova A, Back E, Wolf U (1987) Absence of Y specific DNA sequences in human 46,XX true hermaphrodites and in 45,X mixed gonadal dysgenesis. Hum Genet 76:332–336

    Article  CAS  PubMed  Google Scholar 

  • Washburn LL, Eicher EM (1983) Sex reversal in XY caused by dominant mutation on chromosome 17. Nature 303:338–340

    Article  CAS  PubMed  Google Scholar 

  • Weissenbach J, Goodfellow PN, Smith KD (1989) Report of the committee on the genetic constitution of the Y chromosome. Cytogenet Cell Genet 51:438–449

    CAS  PubMed  Google Scholar 

  • Welshons WJ, Russel LB (1959) The Y chromosome as the bearer of male determining factors in the mouse. Proc Natl Acad Sci USA 45:560–566

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Berkovitz, G.D., Fechner, P.Y., Marcantonio, S.M. et al. The role of the sex-determining region of the Y chromosome (SRY) in the etiology of 46,XX true hermaphroditism. Hum Genet 88, 411–416 (1992). https://doi.org/10.1007/BF00215675

Download citation

  • Received:

  • Revised:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00215675

Keywords

Navigation