SummaryDAX1 (NR0B1) is a nuclear receptor with a characteristic C-terminal ligand binding domain, but an atypical DNA binding domain. Mutations in the DAX1 gene cause adrenal hypoplasia congenita (AHC) establishing its biological importance. Recent studies highlight the complexities of DAX1 regulation and function. There is considerable phenotypic variability in AHC suggesting the existence of DAX1 modifier genes and environmental influences on DAX1 function. The findings of an alternatively spliced DAX1A, more common than DAX1 in all tissues except testis, of DAX1 homodimers, and of DAX1 heterodimers with a number of transcription factor partners including DAX1A and SHP point to an expanded transcription regulatory network under DAX1 control. Model organisms (mice and zebrafish) are being used to identify other DAX1 functions and modifier genes to understand the pathogenesis of AHC and the lack of genotype-phenotype correlation.
KeywordsDAX1; NR0B1; Adrenal hypoplasia congenital; DAX1A; DAX1 homodimerization; DAX1 modifier genes
DAX1 and Adrenal Hypoplasia Congenita (AHC)Mutations in DAX1 (NR0B1), which is encoded in the Xp21 chromosomal region a, can lead to adrenal insufficiency with glucocorticoid and mineralocorticoid deficiency (McCabe, 2001). These mutations are responsible for many, but not all, patients with the cytomegalic form of adrenal hypoplasia congenita (AHC). These mutations also cause hypogonadotropic hypogonadism (HH) which is consistent with the expression of DAX1 in the hypothalamus and pituitary.Duplications of the region of the X chromosome containing DAX1 cause dosage sensitive sex reversal (Bardoni et al., 1994;McCabe, 2001). Transgenic XY mice with additional copies of the mouse DAX1 ortholog expressed at high levels do not have male to female sex reversal, but do show delayed testicular development (Swain et al., 1998). When these investigators crossed the transgenic female mice with poschiavinus males who have a weaker male sex determining Sry allele, they did observe complete sex reversal.