Distal-less homeobox genes Dlx5/6 regulate Müllerian duct regression

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This study investigates the role of Distal-less homeobox genes Dlx5 and Dlx6 in anti-Müllerian hormone-induced regression of the Müllerian duct during male mouse development. The authors demonstrate that AMH signaling is necessary for the expression of these genes, which act redundantly to facilitate duct regression; loss of either gene causes variable persistence of Müllerian tissue, while double mutants show more severe retention. The paper explicitly discusses Persistent Müllerian Duct Syndrome, a condition where males retain female reproductive structures like the uterus due to defects in this pathway, linking the molecular findings directly to the pathology of Müllerian duct remnants often associated with endometriosis research contexts.

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Abstract

Dlx5 and Dlx6 encode distal-less homeodomain transcription factors that are present in the genome as a linked pair at a single locus. Dlx5 and Dlx6 have redundant roles in craniofacial, skeletal, and uterine development. Previously, we performed a transcriptome comparison for anti-Müllerian hormone (AMH)-induced genes expressed in the Müllerian duct mesenchyme of male and female mouse embryos. In that study, we found that Dlx5 transcripts were nearly seven-fold higher in males compared to females and Dlx6 transcripts were found only in males, suggesting they may be AMH-induced genes. Therefore, we investigated the role of Dlx5 and Dlx6 during AMH-induced Müllerian duct regression. We found that Dlx5 was detected in the male Müllerian duct mesenchyme from E14.5 to E16.5. In contrast, in female embryos Dlx5 was detected in the Müllerian duct epithelium. Dlx6 expression in Müllerian duct mesenchyme was restricted to males. Dlx6 expression was not detected in female Müllerian duct mesenchyme or epithelium. Genetic experiments showed that AMH signaling is necessary for Dlx5 and Dlx6 expression. Müllerian duct regression was variable in Dlx5 homozygous mutant males at E16.5, ranging from regression like controls to a block in Müllerian duct regression. In E16.5 Dlx6 homozygous mutants, Müllerian duct tissue persisted primarily in the region adjacent to the testes. In Dlx5-6 double homozygous mutant males Müllerian duct regression was also found to be incomplete but more severe than either single mutant. These studies suggest that Dlx5 and Dlx6 act redundantly to mediate AMH-induced Müllerian duct regression during male differentiation.
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Distal-less homeobox genes Dlx5/6 regulate Müllerian duct regression | bioRxiv /* */ /* */ <!-- <!-- /*! * yepnope1.5.4 * (c) WTFPL, GPLv2 */ (function(a,b,c){function d(a){return"[object Function]"==o.call(a)}function e(a){return"string"==typeof a}function f(){}function g(a){return!a||"loaded"==a||"complete"==a||"uninitialized"==a}function h(){var a=p.shift();q=1,a?a.t?m(function(){("c"==a.t?B.injectCss:B.injectJs)(a.s,0,a.a,a.x,a.e,1)},0):(a(),h()):q=0}function i(a,c,d,e,f,i,j){function k(b){if(!o&&g(l.readyState)&&(u.r=o=1,!q&&h(),l.onload=l.onreadystatechange=null,b)){"img"!=a&&m(function(){t.removeChild(l)},50);for(var d in y[c])y[c].hasOwnProperty(d)&&y[c][d].onload()}}var j=j||B.errorTimeout,l=b.createElement(a),o=0,r=0,u={t:d,s:c,e:f,a:i,x:j};1===y[c]&&(r=1,y[c]=[]),"object"==a?l.data=c:(l.src=c,l.type=a),l.width=l.height="0",l.onerror=l.onload=l.onreadystatechange=function(){k.call(this,r)},p.splice(e,0,u),"img"!=a&&(r||2===y[c]?(t.insertBefore(l,s?null:n),m(k,j)):y[c].push(l))}function j(a,b,c,d,f){return q=0,b=b||"j",e(a)?i("c"==b?v:u,a,b,this.i++,c,d,f):(p.splice(this.i++,0,a),1==p.length&&h()),this}function k(){var a=B;return a.loader={load:j,i:0},a}var l=b.documentElement,m=a.setTimeout,n=b.getElementsByTagName("script")[0],o={}.toString,p=[],q=0,r="MozAppearance"in l.style,s=r&&!!b.createRange().compareNode,t=s?l:n.parentNode,l=a.opera&&"[object Opera]"==o.call(a.opera),l=!!b.attachEvent&&!l,u=r?"object":l?"script":"img",v=l?"script":u,w=Array.isArray||function(a){return"[object Array]"==o.call(a)},x=[],y={},z={timeout:function(a,b){return b.length&&(a.timeout=b[0]),a}},A,B;B=function(a){function b(a){var a=a.split("!"),b=x.length,c=a.pop(),d=a.length,c={url:c,origUrl:c,prefixes:a},e,f,g;for(f=0;f<d;f++)g=a[f].split("="),(e=z[g.shift()])&&(c=e(c,g));for(f=0;f<b;f++)c=x[f](c);return c}function g(a,e,f,g,h){var i=b(a),j=i.autoCallback;i.url.split(".").pop().split("?").shift(),i.bypass||(e&&(e=d(e)?e:e[a]||e[g]||e[a.split("/").pop().split("?")[0]]),i.instead?i.instead(a,e,f,g,h):(y[i.url]?i.noexec=!0:y[i.url]=1,f.load(i.url,i.forceCSS||!i.forceJS&&"css"==i.url.split(".").pop().split("?").shift()?"c":c,i.noexec,i.attrs,i.timeout),(d(e)||d(j))&&f.load(function(){k(),e&&e(i.origUrl,h,g),j&&j(i.origUrl,h,g),y[i.url]=2})))}function h(a,b){function c(a,c){if(a){if(e(a))c||(j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}),g(a,j,b,0,h);else if(Object(a)===a)for(n in m=function(){var b=0,c;for(c in a)a.hasOwnProperty(c)&&b++;return b}(),a)a.hasOwnProperty(n)&&(!c&&!--m&&(d(j)?j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}:j[n]=function(a){return function(){var b=[].slice.call(arguments);a&&a.apply(this,b),l()}}(k[n])),g(a[n],j,b,n,h))}else!c&&l()}var h=!!a.test,i=a.load||a.both,j=a.callback||f,k=j,l=a.complete||f,m,n;c(h?a.yep:a.nope,!!i),i&&c(i)}var i,j,l=this.yepnope.loader;if(e(a))g(a,0,l,0);else if(w(a))for(i=0;i (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0];var j=d.createElement(s);var dl=l!='dataLayer'?'&l='+l:'';j.src='//www.googletagmanager.com/gtm.js?id='+i+dl;j.type='text/javascript';j.async=true;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-M677548'); Skip to main content Home About Submit ALERTS / RSS Search for this keyword Advanced Search New Results Distal-less homeobox genes Dlx5/6 regulate Müllerian duct regression Rachel D. Mullen , Brice Bellessort , View ORCID Profile Giovanni Levi , Richard R. Behringer doi: https://doi.org/10.1101/2022.04.08.487506 Rachel D. Mullen 1 Department of Genetics, University of Texas MD Anderson Cancer Center , Houston, Texas, U.S.A Find this author on Google Scholar Find this author on PubMed Search for this author on this site Brice Bellessort 2 Physiologie Moléculaire et Adaptation, CNRS UMR7221, Muséum National d’Histoire Naturelle, Département AVIV , Paris, France Find this author on Google Scholar Find this author on PubMed Search for this author on this site Giovanni Levi 2 Physiologie Moléculaire et Adaptation, CNRS UMR7221, Muséum National d’Histoire Naturelle, Département AVIV , Paris, France Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Giovanni Levi Richard R. Behringer 1 Department of Genetics, University of Texas MD Anderson Cancer Center , Houston, Texas, U.S.A Find this author on Google Scholar Find this author on PubMed Search for this author on this site For correspondence: rrb{at}mdanderson.org Abstract Full Text Info/History Metrics Preview PDF Abstract Dlx5 and Dlx6 encode distal-less homeodomain transcription factors that are present in the genome as a linked pair at a single locus. Dlx5 and Dlx6 have redundant roles in craniofacial, skeletal, and uterine development. Previously, we performed a transcriptome comparison for anti-Müllerian hormone (AMH)-induced genes expressed in the Müllerian duct mesenchyme of male and female mouse embryos. In that study, we found that Dlx5 transcripts were nearly seven-fold higher in males compared to females and Dlx6 transcripts were found only in males, suggesting they may be AMH-induced genes. Therefore, we investigated the role of Dlx5 and Dlx6 during AMH-induced Müllerian duct regression. We found that Dlx5 was detected in the male Müllerian duct mesenchyme from E14.5 to E16.5. In contrast, in female embryos Dlx5 was detected in the Müllerian duct epithelium. Dlx6 expression in Müllerian duct mesenchyme was restricted to males. Dlx6 expression was not detected in female Müllerian duct mesenchyme or epithelium. Genetic experiments showed that AMH signaling is necessary for Dlx5 and Dlx6 expression. Müllerian duct regression was variable in Dlx5 homozygous mutant males at E16.5, ranging from regression like controls to a block in Müllerian duct regression. In E16.5 Dlx6 homozygous mutants, Müllerian duct tissue persisted primarily in the region adjacent to the testes. In Dlx5-6 double homozygous mutant males Müllerian duct regression was also found to be incomplete but more severe than either single mutant. These studies suggest that Dlx5 and Dlx6 act redundantly to mediate AMH-induced Müllerian duct regression during male differentiation. Introduction The male reproductive tract organs include the vas deferentia, epididymides, and seminal vesicles. These structures provide the conduit for movement and maturation of spermatozoa from the testes for sexual reproduction. While formation and differentiation of these male reproductive tract organs are essential for reproduction, another process which eliminates a progenitor organ system termed Müllerian duct regression is also required for male development ( 1 ). These developmental processes are regulated by the presence or absence of fetal hormones ( 2 ). The reproductive tract organs of mammals are derived from two pairs of epithelial tubes surrounded by mesenchyme called the Wolffian ducts (progenitor male reproductive tract) and Müllerian ducts (progenitor female reproductive tract). The Wolffian ducts differentiate into the vas deferentia, epididymides, and seminal vesicles. The oviducts, uterus and upper vagina are derived from the Müllerian ducts. Interestingly, both the Wolffian and Müllerian ducts are formed regardless of the genetic sex of the embryo. Differential hormone signaling after the formation of these genital ducts results in Wolffian duct loss in female embryos and Müllerian duct regression in male embryos. Müllerian duct regression is mediated by the TGF-β family member anti-Müllerian hormone (AMH) secreted by Sertoli cells of the fetal testes ( 3 ). AMH signaling acts in the Müllerian duct mesenchyme through ACVR1 or BMPR1A type 1 receptors (shared with the bone morphogenetic protein (BMP) signaling pathway) and a sole anti-Müllerian hormone type 2 receptor (AMHR2) ( 4 , 5 ). Amhr2 is expressed in the Müllerian duct mesenchyme and in the somatic cells of the gonads ( 6 ). In the Mullerian duct mesenchyme, AMH binds AMHR2 which then activates its type 1 receptors. This AMH ligand receptor complex subsequently phosphorylates R-SMAD1, 5 and 8 (also shared with the BMP signaling pathway) ( 4 ). These redundant phosphorylated R-SMADs then presumably activate downstream effectors of AMH signaling. Amh and Amhr2 are each required for Müllerian duct regression. Male mice homozygous for either Amh or Amhr2 null alleles retain Müllerian duct derived structures, including a uterus and oviducts ( 7 , 8 ). Further, mutations of either the AMH or AMHR2 genes in human males result in Persistent Mullerian Duct Syndrome (PMDS). Like mouse models with Amh and Amhr2 loss, patients with PMDS have testes and male secondary sex characteristics but retain female reproductive tract organs associated with their male reproductive tract ( 9 – 11 ). A mutation in Amhr2 in dogs is also known to result in PMDS ( 12 ). Males of these species with loss of either AMH or AMHR2 also have subfertility likely due to a combination of the effects of cryptorchidism (observed in humans and dogs) and the presence of superimposed Müllerian duct tissues impeding sperm passage (mouse, human and dog) ( 9 , 12 ). AMH alone is also sufficient for Müllerian duct regression in female embryos. Transgenic female mice with widespread expression of human AMH have complete regression of the Müllerian ducts and lack a uterus and oviducts ( 13 ). Few downstream effectors of AMH have been identified. In mice, loss of the signaling molecule beta-catenin encoded by Ctnnb1 in the Müllerian duct mesenchyme results in the complete retention of the Müllerian duct in newborn males ( 14 ). In a recent RNA-seq study we compared male and female mouse Müllerian duct mesenchyme transcriptomes soon after the initiation of AMH signaling in males to identify potential AMH-induced target genes. In that study we identified the BMP target Osterix/Sp7 (Osx) ( 15 , 16 ). We found that AMH signaling is necessary and sufficient for Osx expression. Osx null male mice have a delay in Müllerian duct regression but later Müllerian duct derived tissues are eliminated ( 16 ). This transcriptome analysis also revealed differential upregulation of BMP target genes Dlx5 and Dlx6 in the Müllerian mesenchyme of males in comparison to females. Based on this transcriptome data and that the BMP pathway shares multiple signaling components with the AMH signaling pathway, we further characterize Dlx5 and Dlx6 expression and function during Müllerian regression. We show that AMH signaling is necessary for Dlx5 and Dlx6 expression in Müllerian duct mesenchyme. Loss of Dlx5 or Dlx6 results in partial retention of the Müllerian ducts in male mice, whereas double mutant males consistently retain more Müllerian tissue. This study identifies Dlx5 and Dlx6 as redundant downstream effectors of AMH signaling for Müllerian regression. Materials and Methods Mice Swiss outbred mice were obtained from Taconic Biosciences. C57BL/6J mice were obtained from the Jackson Laboratory. Dlx6 tm1Jlr mice were obtained from the MMRRC (Mutant Mouse Resource and Research Center). Amhr2 tm3(cre)Bhr (Amhr2-Cre, ( 17 )), Amhr2 tm2Bhr (Amhr2-lacZ, ( 18 )), Dlx5 tm1Levi (Dlx5-lacZ, ( 19 )) , Dlx6 tm1Jlr (Dlx6-lacZ, ( 20 )), Dlx5/Dlx6 tm1Levi ( Dlx5-6 , ( 21 )) mice were maintained on a predominantly C57BL/6J genetic background. Amhr2-Cre, Amhr2-lacZ, Dlx5-lacZ, Dlx6-lacZ, and Dlx5-6 mice were genotyped by PCR as described previously. All animal procedures were approved by the Institutional Animal Care and Use Committee of the University of Texas MD Anderson Cancer Center. Studies were performed consistent with the National Institutes of Health Guide for the Care and Use of Laboratory Animals. β-galactosidase staining Dlx5-lacZ and Dlx6-lacZ heterozygous males were bred with Swiss females to establish timed matings for β-galactosidase (β-gal) staining as previously described ( 16 ). Immunofluorescence Immunofluorescence was performed as previously described ( 22 ). Rabbit anti-DLX5 polyclonal antibody (Sigma-Aldrich Cat# HPA005670, RRID:AB_1078681, 1:50). Rabbit anti-PAX2 polyclonal antibody (Thermo Fisher Scientific Cat# 71-6000, RRID:AB_2533990, 1:100). Primary antibodies were detected with goat anti-rabbit IgG (H+L) Alexa Fluor Plus 488 rabbit (Thermo Fisher Scientific Cat# A32731TR, RRID:AB_2866491, 1:200). At least three specimens of each genotype were analyzed. Results Dlx5 and Dlx6 expression in the developing reproductive organs is sexually dimorphic Previously, we generated transcriptomes by RNA-seq of FACS-purified Müllerian duct mesenchyme cells from E14.5 male and female embryos to identify candidate genes induced by AMH that mediate Müllerian duct regression ( 16 ). At this stage of development, male mesenchymal cells are responding to AMH secreted by the testes, whereas in female embryos these cells are naïve to AMH because the fetal ovaries do not express AMH. Analysis of the bulk RNA-seq results showed that Dlx5 transcripts were 6.7-fold higher in males compared to females and Dlx6 transcripts were found only in males, suggesting these genes may respond to AMH signaling to mediate Müllerian duct regression. Previous studies in the mouse showed that Dlx5 is expressed in the epithelium of the E18.5 uterus and subsequently in the luminal and glandular epithelia of the postnatal and adult uterus ( 23 ). In that study, expression was also detected earlier in the Müllerian ducts at E15.5 and E16.5. We examined DLX5 expression in the Müllerian ducts of E14.5 male and female embryos by immunofluorescence ( Fig. 1 ). In males, DLX5 was detected in the mesenchymal cells surrounding the Müllerian duct epithelium ( Fig. 1A ). In contrast, but consistent with previous studies ( 23 ), DLX5 expression was detected in the epithelial cells of the Müllerian duct of E14.5 female embryos ( Fig. 1B ). Download figure Open in new tab Fig. 1. DLX5 and Dlx5-lacZ expression in the Müllerian duct. Immunofluorescent staining of DLX5 in cross sections of the mesonephros from E14.5 male ( A ) and female ( B ) embryos. Dotted lines surround the Müllerian duct (MD) and Wolffian duct (WD) epithelium. Scale bars = 50 μm. Dlx5-lacZ expression during Müllerian duct development. Wholemount β-gal-stained urogenital organs from E14.5 to 16.5 Dlx5-lacZ heterozygous male ( C, E, G ) and female ( D, F, H ) embryos. Arrowheads, Müllerian ducts. B, bladder; K, kidney; O, ovary; T, testis. Scale bars = 500 μm. We also used a Dlx5-lacZ knock-in allele to examine Dlx5 expression in the developing reproductive organs ( 19 , 20 ). Dlx5-lacZ expression was detected at E14.5 in the Müllerian ducts of both male and female embryos ( Fig. 1C, D ). In male and female embryos, β-gal staining was observed throughout the entire length of the Müllerian ducts. At E15.5 and E16.5, Dlx5-lacZ expression persisted in the residual Müllerian ducts of male embryos ( Fig. 1E, G ). Consistent with earlier studies, in Dlx5-lacZ female embryos at E15.5 and E16.5, β-gal staining was detected throughout the entire length of the Müllerian ducts with strongest staining caudally ( Fig. 1E, G ) ( 23 ). These data indicate that Dlx5 is expressed in the male Müllerian duct mesenchyme and female Müllerian duct epithelium. Thus, Dlx5 exhibits a sexually dimorphic pattern of expression in the developing Müllerian system. We used a Dlx6-lacZ knock-in allele ( 20 ) to examine Dlx6 expression in the developing reproductive organs ( Fig. 2 ). Dlx6-lacZ expression in male embryos was detected at E14.5 and E15.5 throughout the entire length of the Müllerian ducts and later at E16.5 as the Müllerian duct was regressing ( Fig. 2A-C ). Histological analysis showed that β-gal expression was localized to the Müllerian duct mesenchyme ( Fig. 2B’ ). No β-gal staining was detected in the Müllerian ducts of female embryos at each time point examined (E14.5 to E16.5) ( Fig. 2D-F ). These results show that Dlx6 is expressed in the male Müllerian duct mesenchyme. The male-specific expression of Dlx6 in the developing reproductive organs demonstrates that it is expressed in a sexually dimorphic pattern. These findings also show that Dlx5 and Dlx6 are co-expressed in the male Müllerian duct mesenchyme at the initiation and during ductal regression. Download figure Open in new tab Fig. 2. Dlx6-lacZ expression during Müllerian duct development. Wholemount β-gal-stained urogenital organs from E14.5 to 16.5 Dlx6-lacZ heterozygous male ( A-C ) and female ( D-F ) embryos. Yellow arrowheads, Müllerian ducts. MD, Müllerian ducts; O, ovary; T, testis. Scale bars = 500 μm. Eosin counterstained paraffin section (10 μm) of wholemount β-gal-stained E15.5 Dlx6-lacZ heterozygous male ( B’ ). Dotted lines surround the Müllerian duct and Wolffian duct epithelium. Arrowheads, Müllerian duct, Wolffian duct. MD, Müllerian duct; WD, Wolffian duct. Scale bars = 50 μm. AMH is necessary for Dlx5 and Dlx6 expression in the Müllerian duct mesenchyme The temporal and spatial patterns of expression for Dlx5 and Dlx6 in the developing male Müllerian duct mesenchyme are consistent with the idea that they are induced by AMH signaling. To test this idea, we performed genetic experiments examining Dlx5 and Dlx6 expression in the absence of AMH signaling in male embryos. To determine if AMH signaling is required for Dlx5 expression, we performed DLX5 immunostaining of the Müllerian ducts of Amhr2 Cre/lacZ mutant males at E14.5 ( Fig. 3 ). Amhr2-Cre and Amhr2-lacZ are knock-in alleles that are also loss-of-function alleles ( 17 , 18 ). Thus, Amhr2 Cre/lacZ mutants lack Amhr2 function, blocking AMH signaling, resulting in males with a retained and fully developed Müllerian system ( 8 ). DLX5 positive Müllerian duct mesenchyme cells were detected in wild-type male controls ( Fig. 3A ). No DLX5 immunostaining was detected in the Müllerian duct mesenchyme of Amhr2 Cre/lacZ mutant males ( Fig. 3B ). This suggests that DLX5 expression requires AMH signaling. Download figure Open in new tab Fig. 3. AMH signaling is required for DLX5 expression. Immunofluorescent staining of DLX5 in cross sections of the mesonephros from E14.5 wild type ( A ) and Dlx5-lacZ/+; Amhr2-Cre/lacZ ( B ) male embryos. DLX5 is not expressed in Amhr2-Cre/lacZ males, indicating AMH signaling is required for DLX5 expression in the male Müllerian duct (MD). Yellow dotted lines surround the MD epithelium; white dotted lines surround the Wolffian duct (WD). MD, Müllerian duct; WD, Wolffian duct. Scale bars = 50 μm. To determine if AMH signaling was required for Dlx6 expression, we generated E15.5 Dlx6-lacZ/+; Amhr2-Cre/Cre male embryos ( Fig. 4 ). β-gal staining was detected in the residual Müllerian duct tissue of Dlx6-lacZ/+ embryos ( Fig. 4A ). However, no β-gal staining was observed in the Müllerian ducts of E15.5 Dlx6-lacZ/+; Amhr2-Cre/Cre male embryos that retained a complete Müllerian system due to the block in AMH signaling ( Fig. 4B ). This suggests that Dlx6-lacZ expression requires AMH signaling. Download figure Open in new tab Fig. 4. AMH signaling is required for Dlx6-lacZ expression in the Müllerian duct. Wholemount β-gal-stained urogenital organs from E15.5 Dlx6-lacZ/+ ( A ) and Dlx6-lacZ/+; Amhr2-Cre/Cre ( B ) male embryos. Arrow in A , residual β-gal-stained Müllerian duct (MD) tissue. Arrow in B , absence of β-gal-stained Müllerian duct tissue in fully retained Müllerian duct caused by loss of Amhr2 . MD, Müllerian duct; T, testis. Scale bars=1000 μm. Dlx5 and Dlx6 regulate Müllerian duct regression Dlx5-lacZ homozygotes die shortly after birth with craniofacial defects ( 19 ). In wild-type male embryos, most of the Müllerian duct is regressed at E16.5 and regression is complete by E18.5. We initially screened for the presence of residual Müllerian duct-derived tissues (uterus) by histological analysis of Dlx5-lacZ homozygous mutants at E18.5 ( Fig. 5A, B ). None of the 4 Dlx5-lacZ homozygous mutant males screened by histological sectioning had uterine tissue ( Fig. 5B ). We next examined Müllerian duct regression in Dlx5-lacZ homozygous mutant males and controls at E16.5, using lacZ expression to mark the Müllerian duct. Five of 6 Dlx5-lacZ homozygous mutant males analyzed had Müllerian duct regression like controls ( Fig. 5C ). However, one of the mutants retained a significant amount of Müllerian duct ( Fig. 5D ). These results indicate that Dlx5 contributes to Müllerian duct regression. Download figure Open in new tab Fig. 5. Müllerian duct regression in Dlx5 mutant males. Hematoxylin (H) and Eosin (E) stained cross sections of the vas deferens (v) adjacent to the testis (T) from E18.5 Dlx5-lacZ/+ ( A ) and Dlx5-lacZ/Dlx5-lacZ ( B ) male embryos. Yellow dotted lines surround the vas deferens epithelium. v, vas deferens; T, testis. Scale = 100 μm. Wholemount β-gal-stained urogenital organs from E16.5 Dlx5-lacZ/+ ( C ) and Dlx5-lacZ/Dlx5-lacZ ( D ) male embryos. Yellow arrowheads, Müllerian ducts. T, testis; MD, Müllerian duct. Scale bars = 500 μm. Dlx6-lacZ homozygous mutants die within a day after birth also with craniofacial abnormalities ( 20 ). Like the Dlx5-lacZ mutants, we examined Müllerian duct regression by lacZ expression in mutants and controls at E16.5 and E18.5. At E16.5, control males showed very small β-gal positive regions, indicating residual Müllerian duct tissue ( Fig. 6A ). In contrast, in E16.5 Dlx6-lacZ homozygous mutant male embryos there were still significant stretches of β-gal staining notably in the Müllerian ducts adjacent to the testes ( Fig. 6B ). However, by E18.5, Müllerian duct regression in Dlx6-lacZ homozygous mutant male embryos was comparable to control males ( Fig. 6C, D ) . These results suggest that loss of Dlx6 results in a delay in Müllerian duct regression and Dlx6 contributes to Müllerian duct regression. Download figure Open in new tab Fig. 6. Müllerian duct regression in Dlx6 mutant males. Wholemount β-gal-stained urogenital organs from E16.5 Dlx6-lacZ/+ ( A ) and Dlx6-lacZ/Dlx6-lacZ ( B ) male embryos and E18.5 Dlx6-lacZ/+ ( C ) and Dlx6-lacZ/Dlx6-lacZ ( D ) male embryos. Yellow arrowheads, Müllerian ducts ( A, B ) and uterus ( C, D ). T, testis; MD, Müllerian duct; u, uterus. Scale bars = 500 μm. Müllerian duct regression in Dlx5 male homozygous mutants was variable, whereas in Dlx6 male homozygous mutants it was delayed. Dlx5 and Dlx6 are co-expressed in the male Müllerian duct mesenchyme, suggesting that they may act together for Müllerian duct regression. Therefore, we examined Müllerian duct regression in Dlx5-6 homozygous mutant males. The Dlx5-6 allele ( Dlx5/Dlx6 tm1Levi ) is a deletion of both Dlx5 and Dlx6 coding regions that also contains a lacZ reporter ( 21 ). However, the lacZ reporter in this allele is not functional. Pax2 is expressed in the developing Müllerian duct epithelium ( 24 ). Therefore, we followed Müllerian duct regression by wholemount immunostaining for PAX2. At E16.5, much like the Dlx5 male homozygous mutants, one Dlx5-6 homozygous mutants had near complete retention of the Müllerian duct epithelium while others were comparable to wild type ( Fig. 7A, B ). To quantify the portion of Müllerian duct epithelium retained in Dlx5-6 homozygous mutants and controls we calculated the ratio of the length of retained Müllerian duct epithelium to Wolffian duct epithelium from the whole mount images. Ratios for Dlx5-6 homozygous mutants were 0.70 ( Fig. 7B ), 0.32 and 0.27 in comparison to ratios of controls 0.30, 0.25 and 0.19 ( Fig. 7A ). At E18.5 significant portions of uterine epithelium were retained in all Dlx5-6 homozygous mutants examined in comparison to controls ( Fig. 7C, D ). Ratios of retained uterine epithelium to vas deferens epithelium for Dlx5-6 homozygous mutants were 0.53, 0.48 and 0.39 ( Fig. 7D ), in comparison to ratios of controls 0.03 ( Fig. 7C ) and 0.04. Consistent with these results, initial histology at E18.5 detected retained uterine tissue in 1 of 4 Dlx5-6 homozygous mutant males examined ( Fig. 7E, F ). These results suggest that Dlx5 and Dlx6 contribute to Müllerian duct regression and may be functioning redundantly. Download figure Open in new tab Fig. 7. Müllerian duct regression in Dlx5-6 mutant males. Wholemount PAX2 immunofluorescent staining of E16.5 Dlx5-6/ + ( A ) and Dlx5-6/Dlx5-6 ( B ) male embryos and E18.5 Dlx5-6/ + ( C ) and Dlx5-6/Dlx5-6 ( D ) male embryos. Yellow arrowheads, Müllerian ducts ( A, B ) and uterus ( C, D ). White arrowheads, Wolffian ducts ( A, B ) and vas deferens ( C, D ). MD, Müllerian duct; WD, Wolffian duct; T, testis; v, vas deferens; u, uterus. Scale bars = 500 μm. Hematoxylin (H) and Eosin (E) stained cross sections of the vas deferens (v) adjacent to the testis (T) from E18.5 Dlx5-6/ + ( E ) and Dlx5-6/Dlx5-6 ( F ) male embryos. T, testis; v, vas deferens; u, uterus. Scale bars =100 μm. Discussion Previously, we compared the transcriptomes of FACS-isolated E14.5 male and female Müllerian duct mesenchyme cells in a screen for AMH-induced genes that mediate Müllerian duct regression during male differentiation ( 16 ). In our initial analysis, we identified Osx as an AMH-induced gene that is expressed in the male Müllerian duct mesenchyme to regulate Müllerian duct regression. Upon further analysis of the transcriptomes, we found that the distal-less homeobox genes Dlx5 and Dlx6 were upregulated in males relative to females. We found that both genes are expressed in the male Müllerian duct mesenchyme and are dependent on AMH signaling. The Dlx5 -null and Dlx6 -null male embryos ( 19 , 20 ) showed variable retention of the Müllerian ducts and a delay in Müllerian duct regression, whereas the Dlx5-6 -null male embryos ( 21 ) retained more Müllerian duct tissue compared to each single mutant. These findings place a new pair of transcription factors that act together in the gene regulatory network to mediate AMH-induced Müllerian duct regression during male differentiation ( 25 ). AMH signaling is required for Dlx5 and Dlx6 expression in the male Müllerian duct mesenchyme We found that both Dlx5 and Dlx6 are expressed in the male Müllerian duct mesenchyme during the embryonic stages coinciding with the initiation and progression of Müllerian duct regression. Dlx genes are organized as linked pairs in the mammalian genome ( 26 ). These Dlx gene pairs are typically co-expressed in various tissues, suggesting common cis regulation. Perhaps Dlx5 and Dlx6 share Müllerian duct mesenchyme-specific regulatory elements that respond to AMH signaling. Previously, we discovered that Osx was expressed in the male but not in female Müllerian duct mesenchyme ( 16 ). Our observations of Dlx5 and Dlx6 expression add to a growing list of genes that exhibit sexually dimorphic patterns of expression in the Müllerian ducts. We found that the expression of Dlx5 , and Dlx6 in the Müllerian duct mesenchyme was dependent upon AMH signaling through AMHR2. Similar results were found for Osterix expression ( 16 ). Amhr2 is expressed in the Müllerian duct mesenchyme of both male and female embryos ( 6 , 17 , 18 ). The female Müllerian duct mesenchyme is competent to respond to AMH because ectopic AMH can induce Müllerian duct regression, eliminating the development of the uterus and oviducts ( 13 ). Thus, the sexually dimorphic expression of Osx , Dlx5, and Dlx6 expression in the Müllerian duct mesenchyme mirrors the sexually dimorphic expression of fetal AMH. Interestingly, Dlx5 is also expressed in the Müllerian duct of female embryos. However, in contrast to mesenchymal expression in male embryos, expression in female embryos was localized to the Müllerian duct epithelium. This epithelial expression persists at later stages of embryogenesis and postnatally in the luminal and glandular epithelium of the uterus ( 23 ). We found that Dlx6 expression in the Müllerian duct was only in male embryos; no expression was detected in female embryos. However, Dlx6 expression is detected later in the postnatal uterine epithelium ( 23 ). These observations suggest that the expression of Dlx5 in the epithelium of the female Müllerian duct is independent of AMH signaling, suggesting that other factors direct expression in this tissue compartment. Dlx5 and Dlx6 mediate Müllerian duct regression Simultaneous deletion of Dlx5 and Dlx6 in the postnatal uterus leads to alterations in uterine adenogenesis and infertility, suggesting that they act redundantly for epithelial morphogenesis in the uterus ( 23 ). In addition to the postnatal uterus, redundant functions for Dlx5 and Dlx6 have also been reported for limb and craniofacial development ( 19 – 21 , 27 , 28 ). The overlapping expression patterns of Dlx5 and Dlx6 suggested that they functioned redundantly in the male Müllerian duct mesenchyme. Male homozygotes for each single mutation retain variable amounts of Müllerian tissue and male homozygous double mutants retain more Müllerian tissue. Interestingly, the Dlx5-6 double mutant males did not show complete retention and differentiation of the Müllerian system like Amh and Amhr2 mutant males ( 7 , 8 ). The incompletely penetrant Müllerian duct regression phenotypes in the Dlx5-6 double mutant male embryos suggests that there are other mediators of AMH-induced Müllerian duct regression that act together with Dlx5-6 (e.g. Osx ). Previous studies suggest that there are significantly excess levels of AMH produced for Müllerian duct regression because Amh levels must be reduced to ~10% of wild type to uncover partial Müllerian duct regression phenotypes ( 18 ). Perhaps downstream target genes of AMH signaling must be collectively inactivated for a complete block to Müllerian duct regression ( 29 , 30 ). Dlx genes are known targets of BMP signaling ( 26 ). Interestingly, AMH signal transduction shares receptors (BMPR1A and ACVR1) and downstream R-SMAD proteins (SMAD1, 5, 8) with BMP signaling (Jamin et al., 2002; Orvis et al., 2008). Osx was discovered as a BMP-induced gene ( 15 ). Osx , Dlx5, and Dlx6 each have roles in skeleton development and Müllerian duct regression ( 15 , 16 , 19 – 21 , 27 , 28 ). Do these transcription factor genes regulate the same downstream effectors in skeleton-forming and Müllerian duct mesenchyme cells, or do they regulate different sets of target genes? This question can be addressed by identifying tissue specific cis regulatory elements that are bound by OSX, DLX5, and DLX6 and regulate transcription. Conflict of Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Author Contributions R.D.M. and R.R.B. conceived the study and designed experiments. 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