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Haploinsufficiency at the Protein Kinase A RI Gene Locus Leads to Fertility Defects in Male Mice and Men

Department of Pharmacology (K.A.B., M.N.P., M.A.N., G.S.M.), University of Washington School of Medicine, Seattle, Washington 98195-7750; and Greenberg Division of Cardiology, Department of Medicine (D.A.M., D.W., C.T.B.), and Department of Reproductive Medicine and Urology (M.G.), Weill Medical College of Cornell University, New York, New York 10021

Address all correspondence and requests for reprints to: G. S. McKnight, Department of Pharmacology, University of Washington School of Medicine, Box 357750, Seattle, Washington 98195-7750. E-mail: mcknight{at}u.washington.edu.

Carney complex (CNC) is a familial multiple neoplasia syndrome characterized by spotty skin pigmentation, cardiac and cutaneous myxomas, and endocrine tumors. CNC is inherited as an autosomal dominant trait and is transmitted with greater frequency by women vs. men. Nearly two thirds of CNC patients are heterozygous for inactivating mutations in the gene encoding the protein kinase A (PKA) type I regulatory subunit (RI), PRKAR1. We report here that male mice heterozygous for the Prkar1a gene have severely reduced fertility. Sperm from Prkar1a heterozygous mice are morphologically abnormal and reduced in number. Genetic rescue experiments reveal that this phenotype results from elevated PKA catalytic activity in germ cells as early as the pachytene stage of spermatogenesis. Consistent with this defect in the male mutant mice, sperm from CNC patients heterozygous for PRKAR1A mutations were also found to be morphologically aberrant and decreased in number. We conclude that unregulated PKA activity in male meiotic or postmeiotic germ cells leads to structural defects in mature sperm and results in reduced fertility in mice and humans, contributing to the strikingly reduced transmission of PRKAR1A inactivating mutations by male patients with CNC.

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