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    Current understanding holds that Klinefelter syndrome (KS) is not inherited, but arises randomly during meiosis. Whether there is any genetic basis for the origin of KS is unknown. Here, guided by our identification of some USP26 variations apparently associated with KS, we found that knockout of Usp26 in male mice resulted in the production of 41, XXY offspring. USP26 protein is localized at the XY body, and the disruption of Usp26 causes incomplete sex chromosome pairing by destabilizing TEX11. The unpaired sex chromosomes then result in XY aneuploid spermatozoa. Consistent with our mouse results, a clinical study shows that some USP26 variations increase the proportion of XY aneuploid spermatozoa in fertile men, and we identified two families with KS offspring wherein the father of the KS patient harbored a USP26-mutated haplotype, further supporting that paternal USP26 mutation can cause KS offspring production. Thus, some KS should originate from XY spermatozoa, and paternal USP26 mutations increase the risk of producing KS offspring. © 2021 The Authors.

    Citation

    Chao Liu, Hongbin Liu, Haobo Zhang, Lina Wang, Mengjing Li, Feifei Cai, Xiuge Wang, Li Wang, Ruidan Zhang, Sijie Yang, Wenwen Liu, Yu Liang, Liying Wang, Xiaohui Song, Shizhen Su, Hui Gao, Jing Jiang, Jinsong Li, Mengcheng Luo, Fei Gao, Qi Chen, Wei Li, Zi-Jiang Chen. Paternal USP26 mutations raise Klinefelter syndrome risk in the offspring of mice and humans. The EMBO journal. 2021 Jul 01;40(13):e106864

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    PMID: 33978233

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