A mutation in the NOBOX gene is associated with
premature ovarian failure (POF), also known as premature ovarian insufficiency (POI). It is a condition which ovaries loss its normal function before the age of 40. It is a heritable disease in up to 30% of patients which is characterised by secondary infertility, amenorrhea, hypoestrogenism, and elevated
follicle-stimulating hormone levels in the serum (FSH>40IU/liter). It affects ≈1% of women below 40 years old. A study conducted on 96 white women with POF revealed one case of
heterozygous mutation in the NOBOX homeodomain, p.Arg355His, in one patient. These results suggest that
NOBOX gene is a strong autosomal candidate for POF and its genetic mechanism involves haploinsufficiency. However, these mutations were not found in Chinese and Japanese women making it a less common explanation for POF in the region. The POF syndrome is a highly heterogenous clinical disorder but a recent study showed the first
homozygous mutation associated with NOBOX loss-of-function. One patient out of 96 population diagnosed with POF in China was found with one novel homozygous truncating variant in the
NOBOX gene. This truncated variant caused a defective transcriptional activation of
GDF9, a well-known target of NOBOX, which led to the lost ability of NOBOX to induce
G2/M arrest. This finding disagrees that mutation is a less common explanation for POF in Asian population. Understanding the mutations in NOBOX homeodomain is important to researchers and clinicians to develop diagnostic and therapeutic approaches for POF such as genetic control of mammalian reproductive life-span, regulation of fertility, and generation of mature eggs in the lab. == Interactions ==