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Department of Paediatrics, University of Cambridge, Addenbrookes Hospital, Cambridge CB2 2QQ, United Kingdom
Address all correspondence and requests for reprints to: Ieuan A. Hughes, University of Cambridge School of Clinical Medicine, Addenbrookes Hospital, Department of Pediatrics, Hills Road, Box 116, Cambridge CB2 2QQ, United Kingdom. E-mail: iah1000{at}cam.ac.uk
Mammalian sex differentiation is a hormone-dependent process in the male following the determination of a testis from the indifferent gonad through a cascade of genetic events. Female sex differentiation is not dependent on ovarian hormones, yet there is evidence that members of the Wnt family of developmental signaling molecules play a role in Müllerian duct development and in suppressing Leydig cell differentiation in the ovary. The testis induces male sex differentiation (including testis descent) through a time-dependent production of optimal concentrations of anti-Müllerian hormone, insulin-like factor(s) and androgens. Observations in several human syndromes of disordered fetal sex development corroborate findings in murine embryo studies, although there are exceptions in some gene knockout models. The ubiquitously expressed AR interacts in a ligand-dependent manner with coregulators to control the expression of androgen-responsive genes. Preliminary studies suggest the possibility of hormone resistance syndromes associated with coregulator dysfunction. Polymorphic variants in genes controlling androgen synthesis and action may modulate androgenic effects on sex differentiation.
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