Genotype-specific differences in infertile men due to loss-of-function variants in M1AP or ZZS genes

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Abstract

Male infertility and meiotic arrest have been linked to M1AP , the gene encoding meiosis I associated protein. In mice, M1AP interacts with the ZZS proteins SHOC1, TEX11, and SPO16, which promote DNA class I crossover formation during meiosis. To determine whether M1AP and ZZS proteins are involved in human male infertility by disrupting class I crossover formation, we screened for biallelic or hemizygous loss-of-function (LoF) variants in the encoding human genes to select men with a presumed protein deficiency; we compiled N=10 men for M1AP , N=4 for SHOC1 , N=9 for TEX11, and the first homozygous LoF variant in SPO16 in an infertile man. After in-depth characterisation of the testicular phenotype of these men, we identified gene-specific meiotic impairments: men with SHOC1, TEX11, or SPO16 deficiency shared an early meiotic arrest lacking haploid germ cells. All men with LoF variants in M1AP exhibited a predominant metaphase I arrest with rare haploid round spermatids, and six men even produced sporadic elongated spermatids. These differences were explained by different recombination failures: abrogated SHOC1, TEX11, or SPO16 led to incorrect synapsis of homologous chromosomes and unrepaired DNA double-strand breaks (DSB). On the contrary, abolished M1AP did not affect synapsis and DSB repair but led to a reduced number of class I crossover events. Notably, medically assisted reproduction resulted in the birth of a healthy child, offering the possibility of fatherhood to men with LoF variants in M1AP . Our study establishes M1AP as an important, but not essential, functional enhancer in the network of ZZS-mediated meiotic recombination.

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    Reviewer #1 (Evidence, reproducibility and clarity):

    This manuscript compiles LoF variants of M1AP and ZZS proteins (i.e., SHOC1, TEX11 and SPO16) that almost certainly underlie infertility and reports the first case of an infertile man homozygous for a variant in SPO16. The authors validated interactions between human M1AP and ZZS that were found in mice. Analyzing testicular samples from infertile men revealed that those with deficiencies in SHOC1, TEX11 or SPO16 exhibited early meiotic arrest without haploid germ cells, whereas those with M1AP variants displayed a predominant metaphase I arrest with rare haploid germ cells. Further investigations showed that disrupted SHOC1, TEX11 or SPO16 led to defective synapsis and pairing of homologous chromosomes and unpaired DNA DSBs, while M1AP mutations reduced CO events. Importantly, men with LoF variants in M1AP can father healthy children by medically assisted reproduction. Overall, the results are clear and convincing in defining likely causative variants in infertility patients.

    Response: We thank reviewer #1 for the appreciation of our work. We already addressed the suggestions raised by reviewer# 1 to improve our manuscript.

    I have a few minor comments for improving the manuscript:
    • No statistical analyses were performed. The meaning of error bars was not mentioned. It is essential to specify the minimum number of seminiferous tubules counted for each patient.

    Response: We added the statistical analysis. We described now in more clarity that all round tubules in a patient's testicular section were counted (l. 646-653).

    • Allele frequencies of variants are not provided.

    Response: We added the allele frequencies from gnomAD v4.1.0 (SNVs) and gnomAD SVs v2.1 (CNVs) in Table 1.

    • Figure 4 should clearly label the representations of each color channel.

    Response: Thanks for this suggestion. We labelled each color channel accordingly.

    • The authors should clearly label the bands of SPO16 in the right panel of Figure 1B.

    Response: We labelled the SPO16 band in Figure 1B more clearly.

    • Appendix Figure S1B and S2B, what does "rat" mean in "rat Ins2 Ex3/4/"?

    Response: In the minigene assay, an artificial gene was constructed with exon 3 and 4 from the insulin 2 gene of the species rat (Rattus norvegicus). We described this in more detail in the Appendix methods section (l. 119) and in the Figure legend S1B and S2B.

    Reviewer #1 (Significance):

    Overall, this study significantly contributes to the understanding of some genetic causes of human infertility and offers a potential avenue to treat patients with M1AP variants/ mutants. Since no knock-in animal model was applied to mimic the subtle phenotype variations observed in patients, the functionality of truncated proteins remains unexplored. For example, it is unclear why the germ cells in patient M3260 with the SHOC1 variant can progress to round spermatids (Fig. 2C), while those in Shoc1 KO mice (10.1093/molehr/gaac015) and other patients cannot. However, this is a minor concern.

    Response: Thanks for this comment. SHOC1 variant c.1939+2T>C present in M3260 is a predicted splice site variant. In vitro it results in an in-frame exon skipping as shown by the minigene assay (Appendix Figure S2) that is predicted to lead to a loss of only 4% of the protein. We assume that this does not result in a complete loss but only in an impaired protein function enabling significantly reduced progression of spermatogenesis up to the round spermatid stage in few cells (l. 354-360). We addressed this in more detail in the results section (l. 145ff and l. 189ff) and in the Appendix Figure S2 legend. Accordingly, SHOC1 variant c.1939+2T>C is not a LoF variant and we excluded it from the quantification of subsequent analyses. Immunohistological staining of this patients was excluded from Appendix Figure S6, S7, S9, S10, and S11 and incorporated into Appendix Figure S2.

    In addition, the recurrent M1AP c.676dup was functionally analysed in our previous work (Wyrwoll et al., 2020, PMID: 32673564). We detected M1AP mRNA in a testicular biopsy from one patient showing that this variant leads not to degradation of the mRNA. Furthermore heterologous expression of the mutant M1AP cDNA in HEK293T cells led to the production of a truncated protein that presumably leads to loss of protein function. We added this information in l. 136. Furthermore, our preliminary experiments of co-immunoprecipitation of truncated M1AP with TEX11 hint to an abolished protein-protein interaction caused by M1AP c.676dup and thus a loss of protein function.

    Our field of expertise is gametogenesis and meiosis in mice.

    Reviewer #2 (Evidence, reproducibility and clarity):

    Summary:
    This interesting manuscript provides evidence for the biological and clinical relevance in human males of mutations in genes encoding M1AP and other related proteins. In mice, M1AP, "meiosis 1 associated protein," is known to associate with several proteins (SHOC1, TEX11, and SPO16) in the ZZS complex that promotes DNA recombination and crossover formation during meiosis I prophase. Mutation of these proteins in model organisms disrupts the process of recombination and cause arrest of spermatocytes prior to the first meiotic division. Here the authors took advantage of their MERGE (Male Reproductive Genomics) cohort to screen for human loss-of-function (LoF) mutations in the relevant ZZS complex and M1AP genes and to associate these with human male reproductive phenotypes. They found that men with deficiency of ZZS proteins SHOC1, TEX11 or SPO16 genes were infertile, exhibiting arrest of germ cell development early in meiotic prophase, with aberrations of chromosome synapsis and failure to repair DNA double-strand breaks (DSBs). In interesting contrast, men with M1AP mutations exhibited metaphase arrest, and indeed, in some cases, produced haploid spermatids, which in medically assisted reproduction (ICSI), led to the birth of offspring. Because they demonstrate that M1AP interacts with the other proteins, the authors conclude that M1AP is a "catalyzer," but not essential, for the processes of synapsis, recombination, and formation of haploid gametes.

    Major Comments:
    The work is clearly presented with detailed methods that should allow adaptation in other laboratories.
    Overall, this study is a tour de force with what was no doubt difficult archival samples. The histology is generally of good quality, supporting the conclusions about progress of meiotic prophase in the mutant samples. The images of H&E-stained tissue are particularly striking, especially those in supplemental figures.

    Response: We thank Reviewer #2 for the appreciation of our work and the suggestions to improve our manuscript. To provide transparency of our work, we plan to upload each (immuno-) histologically stained testicular section shown in the Main and Appendix Figures in the microscopy image repository OMERO/Open Microscopy Environment (OME).

    That said, and with particular reference to Fig. 3A, it is difficult to sub-stage meiotic prophase by immunocytochemistry, even in optimal samples, with only one marker (in this case gH2AX). The staging here is also at odds with the statement in the subsequent section (and Fig. 4B) on absence of pachytene cells in men with mutation of SHOC1, TEX11, or SPO16.

    Because precise stages of arrest probably cannot be determined in these samples, the authors would be wiser to use phrases such as "zygotene-like"

    Response: We agree with the reviewer that it is indeed difficult to sub-stage meiotic prophase based on IHC for one marker. A precise sub-staging of the meiotic prophase would require identifying the stage of the seminiferous epithelium. The cycle of the human seminiferous epithelium has been subdivided into 12 stages based on the acrosomal development made visible by immunohistochemistry for acrosin. However, in order to properly evaluate the human germ cell associations, only seminiferous tubules showing a well-preserved seminiferous epithelium with no apparent damage to the epithelium and the peritubular wall can be considered. In addition, all the different generations of germ cells have to be present as well as at least six spermatids (Muciaccia et al., 2013, PMID: 23946533). As these requirements cannot be fulfilled in the testicular tissue of men with a meiotic arrest as due to LoF variants in M1AP or the ZZS genes, we followed the reviewer's suggestion and have modified the respective phrases throughout the text, e.g. to 'zygotene-like'.

    The authors should also clarify how it was confirmed that the metaphase-like cells were spermatocytes and not spermatogonia (given that gH2AX signal is weak or unclear in some such nuclei). Readers with a focus on the more regularly staged mouse or rat tubules would appreciate a few more guidelines to criteria for staging human tubules.

    Response: We thank the reviewer for raising this point. In order to confirm that the metaphase-like cells were indeed spermatocytes we will perform additional IHC staining for γH2AX and MAGEA4 on sequential testis sections (distance 3 µm) on representative samples of the patient cohort as well as controls as the hosts of both antibodies are mice. For a few more guidelines on the criteria for staging human tubules, please refer to the response to the previous point.

    Evidence for the birth of a (healthy) child from one individual with M1AP mutation verges on the anecdotal (N=1). It is interesting but raises multiple questions and concerns about both the frequency of chromosomal abnormalities in such individuals and the transmission of the mutant alleles.

    Response: We understand very well, that the evidence based on N=1 seems to be sparse. Nevertheless, if it is in principle possible for a man affected by bi-allelic M1AP LoF variants to conceive a child by ICSI then it could be also possible for other couples with a similar genetic condition (M1AP LoF), and thus providing a proof-of-principle (l. 417f). Reviewer #2 is completely right with the concerns regarding chromosomal aberrations and the transmission of the mutant allele. Thus, it is essential for clinicians/geneticists to counsel the affected couple carefully about the small but existed chance to have a biological own child and the accompanied potential but so far unexplored risks as outlined in l. 435ff. Our future research project will address this open and highly relevant question.

    The authors conclude that the M1AP protein is an essential "catalyzer" in the meiotic recombination pathway. However, it is not clear from the data presented that M1AP in fact has enzymatic catalysis activity or exactly when and how it participates. Because the word "catalyzer" is not buttressed with hard or convincing evidence, the authors should consider other ways to describe the proposed role of M1AP, perhaps as a "putative component" and/or "modifier" of the recombination pathway.

    Response: We appreciate the reviewer's advice, and changed the wording to "functional enhancer".

    Minor comments:
    Fig. 1A - these are nice illustrations, but overly simplified with respect to timing (synapsis is not completed in zygonema)

    Response: We completely agree that Figure 1A is a simplified depiction that could not reflect the temporally and spatially highly complex processes of meiosis. By adding a second dotted box and describing the process in the Figure legend in more detail, we tried to reduce the simplification. Nonetheless, we believe that this simplified schematic help readers, who are less familiar with the progression of meiosis to contextualise the described processess.

    Fig. 1B - greater clarity in legend would be appreciated

    Response: We described Figure 1B in more detail.

    Figs. 2A & 3A - colors in bar graphs are difficult to discriminate

    Response: We improved the discrimination of bar graphs accordingly.

    Fig. 4A - with full appreciation for the difficulty with this material, the images are of low contrast and require considerable enlargement

    Response: We agree with this opinion; and we increased the contrast. In addition, we will improve the way of representation in a revised Figure 4 in the complete revision of the manuscript in accordance with the suggestions of all three Reviewers.

    Reviewer #2 (Significance):

    This is a very interesting paper, which I evaluated from the perspective of a reproductive geneticist with expertise in meiosis and interest in infertility. I think this report will be of interest to clinicians because it identifies a gene possibly linked to marginal fertility and establishes human protein interactions similar to those previously identified in mice. It reinforces the importance of ZZS genes in humans. The contributions of this report to the field of meiosis confirm previous evidence on M1AP, including mutant phenotypes and protein interactions, extending them to humans. We can thus appreciate the conserved function of the mammalian M1AP protein, but as yet the molecular mechanisms of M1AP are not clarified.

    Response: We gratefully thank Reviewer #2 for the thorough evaluation of our work and appreciate the recognition of the significance. Indeed, it was not possible to clarify the molecular mechanisms of M1AP that, hopefully, could be identified as soon as human specific antibodies, which will function in the needed applications, will be available. Additionally, we will perform further experiments as suggested by Reviewer #3 to gain a better understanding of the processess involved. Clarifying the underlying molecular mechanism is not only one of our highest interest but will also be important for the scientific community.

    Reviewer #3 (Evidence, reproducibility and clarity):

    In this manuscript, Rotte et al. investigate the meiotic molecular function in human of the M1AP protein and of the ZZS complex (SCHOC1, TEX11 and SPO16 proteins). The ZSS complex is a key player of meiotic recombination. It is a sub-complex of the conserved family of the ZMM proteins, essential for the formation of class I crossovers, a proper chromosomes segregation and fertility. Understanding its mode of action, regulation and conservation in human is thus a crucial issue in the fields of meiosis and human reproduction, with potential implications for patients. In that context, the recent identification of the protein M1AP as a partner of the ZSS proteins raise the question of its role, function and conservation. The aim of this study is thus of primary importance.
    To perform this molecular characterization, the authors made a cohort (24 total) of men carrying LoF variants in M1AP and ZSS genes. They performed a molecular biology analysis to assess the physical interaction between the human M1AP protein and the three components of the ZSS complex. Their results confirm a previous work performed in mice, mentioned by the authors.
    Then, they took advantage of available biopsies from different mutant men to perform a histological and cytological analysis of the impact of the different mutations on meiosis. The main conclusions are that in human, similarly to what is known in different organisms (ranging from yeast to mice), the ZSS complex is essential for crossover formation, synapsis and spermatogenesis, and that defect in the genes is associated with a premature prophase I arrest and no sperm formation. The authors also showed that M1AP protein plays a role in meiotic progression, but to a lesser extend compare to the ZSS proteins, with a metaphase I arrest, an undetectable recombination phenotype, apart of a reduced crossover number and, spermatozoa can form in its absence.

    Major points:
    The authors investigate the physical interaction between M1AP and the ZSS members through a single approach: Co-IP of tagged proteins after expression in human HEK293T cells. This approach is informative, but to reinforce the conclusions the authors should provide data from independent approaches: yeast two hybrid, expression of recombinant proteins followed by pull down, co-immunostaining (TEX11 antibodies were used in the study and M1AP antibody is present in the literature) are possible non-exclusive approaches to decipher, more in details, the interaction. Moreover, understanding the hierarchy of interactions appears important to understand its rational, regulation and function. What is the meaning of a M1AP interaction with all the members of the complex? Remains an open question.

    Response: We thank Reviewer #3 for this comment. In an independent approach we aimed to specify the interaction of M1AP to the ZZS proteins. Thus, we already cloned truncated versions of M1AP to refine the binding site of M1AP to the ZZS proteins (Figure R1). In a preliminary experiment, we co-transfected full-length as well as truncated forms of M1AP with TEX11 and showed via Co-IP that the interaction is only possible with full-length M1AP. Within the full-revision, we plan to finalise these experiments and thus validate the specifity of the interaction between M1AP and TEX11 and thereby gain more insight into the interaction/hierarchy of the interaction of M1AP with the ZZS complex.

    Figure R****1 Tolerance landscape of M1AP NM_001321739.2 illustrating the respective regions selected for mutagenesis of truncated M1AP constructs. Adapted from MetaDome.

    Moreover, in the last couple of years, we spent enormous resources (personnel, time, financial) to get a functional antibody against human M1AP, including testing of different commercial (and already published) antibodies, creating three customised antibodies against different M1AP polypeptides, a nanobody raised against the complete M1AP protein (failed because of the impossibility to purify the protein), and contacting the authors of previously published customised M1AP antibodies (Arango et al., 2013/PMID 23269666 and Li et al. 2023/PMID 36440627). Figure R2 recapitulates some of our attempts. Moreover, we published the initial attempts of establishing an M1AP antibody in Wyrwoll et al., 2020/PMID 32673564. Unfortunately, no human M1AP-specific antibody is available.

    Additionally, we tested different TEX11, SHOC1 and SPO16 antibodies in immunohistochemistry and SHOC1 and SPO16 antibodies in immunofluorescence of spermatocyte spreads, which did not result in a specific staining (Figure R3). Due to the lack of a human specific antibody against M1AP as well as antibodies against SHOC1 and SPO16, we are not able to localise these proteins in patient testicular sections to address this highly interesting research question that remains of great interest within our work on M1AP.

    Figure R2. Attempts to locate M1AP in the human testis. Previous attempts to identify a commercially available antibody that reliably detects M1AP in the human testis have not been successful (Wyrwoll et al., 2020/ PMID 32673564). Accordingly, we tried to produce a human-specific antibody in cooperation with companies specified in antibody customisation (Eurogentec, Biotem). The last attempt, conducted with Biotem, is exemplarily shown in this figure. A. Human M1AP protein sequence (NP_620159.2) highlighting the antibody epitopes (orange) that were selected so that in men carrying the M1AP LoF variant c.676dup p.Trp226Leufs*4 in a homozygous state, the respective antibody should not be able to bind due to the protein truncation. For rabbit immunisation, both epitopes were pooled. B. HEK293T cells were transfected with DYK-tagged M1AP plasmids, either expressing the wildtype (WT) or the truncated protein (W226L). Sera of day (D) 28 and 42 of the immunised rabbit as well as the purified antibody product, a commercially available anti-M1AP antibody (HPA), and anti-DYK control antibody specificity was confirmed by Western blotting. C. Customised anti-M1AP antibody validation in human testicular control and D. M1AP-deficient tissue did not yield in a reliable staining. Various protocol optimisations were tested (different antigen retrieval, adapted blocking and antibody dilution solution, various primary and secondary antibody concentrations). Date shown represents the best result, respectively. The application of both sera and the purified antibody for spermatocyte spreading was tested in parallel and has not been successful either (data not shown). SC: Sertoli cells, SPC: spermatocytes, M-I: metaphase I cells, RS: round spermatids, ES: elongated spermatids. The scale bar represents 100 µm and 10 µm.

    Figure R3. Efforts to identify human-specific antibodies for ZZS localisation. A. Commercially available antibodies for ZZS were tested via Western blotting, aiming to reliably detect SHOC1, SPO16, and TEX11 in human testicular biopsies. HA-tagged wildtype plasmid DNA (WT) was transfected in HEK293T cells and the anti-HA antibody was used as a positive control. Only one antibody detected TEX11 reliable in the purified lysates (anti-TEX11: HPA002950). B.-D. Immunohistochemical staining was performed with all antibodies on human testicular and is representatively shown for anti-SHOC1: #BS155344-R, anti-SPO16: #BS15024-R, and anti-TEX11: HPA002950. Only the anti-TEX11 (#HPA002950) was found to be specific. However, presumably due to the fixation with Bouin's solution, staining could not reliably be repeated in all samples and was not implied in this study. Various protocol optimisations were tested (different antigen retrieval, adapted blocking and antibody dilution solution, various primary and secondary antibody concentrations). Date shown represents the best result, respectively. The application of all antibodies for spermatocyte spreading was tested in parallel and have not been successful (data not shown), except for anti-TEX11 (#HPA002950, Appendix Figure S13). SC: Sertoli cells, SPC: spermatocytes, RS: round spermatids, ES: elongated spermatids. The scale bar represents 100 µm and 10 µm.

    The ZZS mutants have a defect in gH2AX pattern, a defect in synapsis and no MLH1 foci, associated to apoptosis and prophase I arrest. M1AP mutation has a minor impact. The characterization of the effect of the different mutations (in particular M1AP) on the recombination process should be addressed further, by cytological means. For example, effect on strand invasion and ssDNA production should be monitored using RPA, DMC1 and RAD51 antibodies. The impact on alternative resolution pathway (e.g. BLOOM dependent) should be tested as well as the effect on other ZMM proteins, in particular MSH4-5, should be investigated. These experiments are essential to characterize, at the molecular level, the function of the different proteins during recombination.

    Response: We thank the reviewer for this suggestion and highly appreciate to investigate the different pathways in more depth. We plan to perform additional immunofluorescence staining of spermatocyte spreads of identified patients compared to the control in the planned revision for a better understanding of M1AP within human recombination. We already ordered the antibodies against meiotic marker proteins as suggested by the Reviewer.

    We would like to take the opportunity to refer to the extremely limited access to cryopreserved testicular material of the patients presented in this manuscript: for each gene (M1AP, SHOC1, TEX11, SPO16) we were lucky to get one testicular biopsy specimen from one man for only one preparation of spermatocyte spreads. We hope for the Reviewer's understanding that we cannot address each requested staining albeit this would be of highest interest. However, we are very confident that we will provide additional staining added to the yet shown to improve the understanding of M1AP's function on human male meiotic recombination.

    In the same line, TEX11 staining in M1AP mutant should be more documented and in particular the different stages shown, as well as the foci counting, to have a quantitative result, that can be compared to MLH1. Moreover, co-immunostaining of different markers with TEX11: RPA, DMC1, MSH and MLH1 are also important to understand how the pathway is perturbed and the recruitment delayed/affected.

    Response: In the planned revision, we will include the TEX11 foci counting using the acquired images that will be compared to MLH1 foci quantification. In addition, we plan additional co-immunostaining of TEX11 with different markers dependent on the availability of testicular material. Due to the limited resources of cryopreserved material, we cannot repeat the TEX11 staining in the patients with M1AP LoF variant for documentation of different stages. Slides that have already been stained are unfortunately bleached and cannot be re-analysed.

    The published M1AP antibody should be tested to investigate its perturbation in the absence of the ZZS proteins and the hierarchy of event.

    Response: As already outlined above, we tried to get any functional M1AP antibody for several years, which was not possible (Figure R2). Thus, we unfortunately cannot address this comment via this approach albeit this research question remains of great interest within our work on M1AP.

    OPTIONAL: the obligatory crossover was measured, a comment or calculation of interference would be very interesting, and it seems doable using the MLH1 counting, to test whether thses mutants have an effect on this process.

    Response: We thank Reviewer #3 for the suggestion of this interesting question that was not within our focus so far. Due to the limited material and the small number of cells from which we could digitally separate the chromosomes, we believe that the sample size is insufficient to obtain a statistically significant result.

    Minor comments
    As written, the title is misleading, the paper does not investigate the impact of M1AP in ZSS recombination. Such study implies to study genetic interactions or the genetic dependency between the different proteins, which is not the case here.

    Response: Thanks for this comment. We changed the title to "Genotype-specific differences in infertile men due to loss-of-function variants in M1AP or ZZS genes".

    Labelled on histological images is not clear. The authors should clearly explain to what marker each staining correspond.

    Response: We changed the labelling accordingly.

    L67 to 72: the authors should update and use more accurate citations for meiotic recombination.

    Response: Thanks for this suggestion. In this section, we have described the fundamental processes of meiosis, which have been repeatedly reviewed by renowned scientists. We have therefore chosen four well-cited expert reviews from different groups as references (PMID: 29385397, 24050176, 27648641, 35613017).

    L76: the ZMM are specifically involved in the resolution of class I crossover. Please rephrase.

    Response: We rephrased the sentence and changed it throughout the manuscript.

    L94: Strictly, the author identified an interaction, they didn't establish how the interaction takes place.

    Response: We rephrased the sentence.

    FigS13: TEX11 staining should be presented with foci counting as a main figure.

    Response: We plan to restructure Figure 4 along with the new meiosis specific markers and will consider this comment.

    L255: MLH1 does not quantify homologous recombination but, class I crossovers.

    Response: We rephrased the sentence.

    L352: The sentence is hard to understand, rephrase please.

    Response: We rephrased the sentence.

    Reviewer #3 (Significance):

    In general, the paper is well written and easy to follow. However, in light of the importance of the questions for the field of meiosis, it currently seems a little superficial, in particular if the authors aim at addressing the molecular function of the different proteins. The role of the ZSS proteins and M1AP in the control of meiotic recombination, at the molecular level is very important to decipher and additional experiments might help to better address this question. In addition, the functional links between M1AP and ZSS remains unclear and to investigate further.
    This study gives information for human process, and can be compared to more advanced work done with mice.
    This study will be important for the community working on meiosis in mammals, but also for people interested in reproduction.

    Response: We thank Reviewer #3 for the thorough evaluation and acknowledgment of the significance of our work. We appreciate the suggestion of performing additional experiments to gain a better and more in depth understanding of the molecular pathways involved. We hope for the Reviewer's understanding that we cannot address all raised comments due to the limited material and the difficulty to get human specific antibodies in a research field that primarily works with highly valuable mouse models.

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    Referee #3

    Evidence, reproducibility and clarity

    In this manuscript, Rotte et al. investigate the meiotic molecular function in human of the M1AP protein and of the ZZS complex (SCHOC1, TEX11 and SPO16 proteins). The ZSS complex is a key player of meiotic recombination. It is a sub-complex of the conserved family of the ZMM proteins, essential for the formation of class I crossovers, a proper chromosomes segregation and fertility. Understanding its mode of action, regulation and conservation in human is thus a crucial issue in the fields of meiosis and human reproduction, with potential implications for patients. In that context, the recent identification of the protein M1AP as a partner of the ZSS proteins raise the question of its role, function and conservation. The aim of this study is thus of primary importance.

    To perform this molecular characterization, the authors made a cohort (24 total) of men carrying LoF variants in M1AP and ZSS genes. They performed a molecular biology analysis to assess the physical interaction between the human M1AP protein and the three components of the ZSS complex. Their results confirm a previous work performed in mice, mentioned by the authors.

    Then, they took advantage of available biopsies from different mutant men to perform a histological and cytological analysis of the impact of the different mutations on meiosis. The main conclusions are that in human, similarly to what is known in different organisms (ranging from yeast to mice), the ZSS complex is essential for crossover formation, synapsis and spermatogenesis, and that defect in the genes is associated with a premature prophase I arrest and no sperm formation. The authors also showed that M1AP protein plays a role in meiotic progression, but to a lesser extend compare to the ZSS proteins, with a metaphase I arrest, an undetectable recombination phenotype, apart of a reduced crossover number and, spermatozoa can form in its absence.

    Major points:

    The authors investigate the physical interaction between M1AP and the ZSS members through a single approach: Co-IP of tagged proteins after expression in human HEK293T cells. This approach is informative, but to reinforce the conclusions the authors should provide data from independent approaches: yeast two hybrid, expression of recombinant proteins followed by pull down, co-immunostaining (TEX11 antibodies were used in the study and M1AP antibody is present in the literature) are possible non-exclusive approaches to decipher, more in details, the interaction. Moreover, understanding the hierarchy of interactions appears important to understand its rational, regulation and function. What is the meaning of a M1AP interaction with all the members of the complex? Remains an open question.

    The ZZS mutants have a defect in H2AX pattern, a defect in synapsis and no MLH1 foci, associated to apoptosis and prophase I arrest. M1AP mutation has a minor impact. The characterization of the effect of the different mutations (in particular M1AP) on the recombination process should be addressed further, by cytological means. For example, effect on strand invasion and ssDNA production should be monitored using RPA, DMC1 and RAD51 antibodies. The impact on alternative resolution pathway (e.g. BLOOM dependent) should be tested as well as the effect on other ZMM proteins, in particular MSH4-5, should be investigated. These experiments are essential to characterize, at the molecular level, the function of the different proteins during recombination.

    In the same line, TEX11 staining in M1AP mutant should be more documented and in particular the different stages shown, as well as the foci counting, to have a quantitative result, that can be compared to MLH1. Moreover, co-immunostaining of different markers with TEX11: RPA, DMC1, MSH and MLH1 are also important to understand how the pathway is perturbed and the recruitment delayed/affected.

    The published M1AP antibody should be tested to investigate its perturbation in the absence of the ZZS proteins and the hierarchy of event.

    OPTIONAL: the obligatory crossover was measured, a comment or calculation of interference would be very interesting, and it seems doable using the MLH1 counting, to test whether thses mutants have an effect on this process.

    Minor comments

    As written, the title is misleading, the paper does not investigate the impact of M1AP in ZSS recombination. Such study implies to study genetic interactions or the genetic dependency between the different proteins, which is not the case here.

    Labelled on histological images is not clear. The authors should clearly explain to what marker each staining correspond.
    L67 to 72: the authors should update and use more accurate citations for meiotic recombination.

    L76: the ZMM are specifically involved in the resolution of class I crossover. Please rephrase.

    L94: Strictly, the author identified an interaction, they didn't establish how the interaction takes place.

    FigS13: TEX11 staining should be presented with foci counting as a main figure.

    L255: MLH1 does not quantify homologous recombination but, class I crossovers.

    L352: The sentence is hard to understand, rephrase please.

    Significance

    In general, the paper is well written and easy to follow. However, in light of the importance of the questions for the field of meiosis, it currently seems a little superficial, in particular if the authors aim at addressing the molecular function of the different proteins. The role of the ZSS proteins and M1AP in the control of meiotic recombination, at the molecular level is very important to decipher and additional experiments might help to better address this question. In addition, the functional links between M1AP and ZSS remains unclear and to investigate further.

    This study gives information for human process, and can be compared to more advanced work done with mice.
    This study will be important for the community working on meiosis in mammals, but also for people interested in reproduction.

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    Referee #2

    Evidence, reproducibility and clarity

    Summary:

    This interesting manuscript provides evidence for the biological and clinical relevance in human males of mutations in genes encoding M1AP and other related proteins. In mice, M1AP, "meiosis 1 associated protein," is known to associate with several proteins (SHOC1, TEX11, and SPO16) in the ZZS complex that promotes DNA recombination and crossover formation during meiosis I prophase. Mutation of these proteins in model organisms disrupts the process of recombination and cause arrest of spermatocytes prior to the first meiotic division. Here the authors took advantage of their MERGE (Male Reproductive Genomics) cohort to screen for human loss-of-function (LoF) mutations in the relevant ZZS complex and M1AP genes and to associate these with human male reproductive phenotypes. They found that men with deficiency of ZZS proteins SHOC1, TEX11 or SPO16 genes were infertile, exhibiting arrest of germ cell development early in meiotic prophase, with aberrations of chromosome synapsis and failure to repair DNA double-strand breaks (DSBs). In interesting contrast, men with M1AP mutations exhibited metaphase arrest, and indeed, in some cases, produced haploid spermatids, which in medically assisted reproduction (ICSI), led to the birth of offspring. Because they demonstrate that M1AP interacts with the other proteins, the authors conclude that M1AP is a "catalyzer," but not essential, for the processes of synapsis, recombination, and formation of haploid gametes.

    Major Comments:

    The work is clearly presented with detailed methods that should allow adaptation in other laboratories.
    Overall, this study is a tour de force with what was no doubt difficult archival samples. The histology is generally of good quality, supporting the conclusions about progress of meiotic prophase in the mutant samples. The images of H&E-stained tissue are particularly striking, especially those in supplemental figures. That said, and with particular reference to Fig. 3A, it is difficult to sub-stage meiotic prophase by immunocytochemistry, even in optimal samples, with only one marker (in this case gH2AX). The staging here is also at odds with the statement in the subsequent section (and Fig. 4B) on absence of pachytene cells in men with mutation of SHOC1, TEX11, or SPO16. Because precise stages of arrest probably cannot be determined in these samples, the authors would be wiser to use phrases such as "zygotene-like." The authors should also clarify how it was confirmed that the metaphase-like cells were spermatocytes and not spermatogonia (given that gH2AX signal is weak or unclear in some such nuclei). Readers with a focus on the more regularly staged mouse or rat tubules would appreciate a few more guidelines to criteria for staging human tubules.
    Evidence for the birth of a (healthy) child from one individual with M1AP mutation verges on the anecdotal (N=1). It is interesting but raises multiple questions and concerns about both the frequency of chromosomal abnormalities in such individuals and the transmission of the mutant alleles.
    The authors conclude that the M1AP protein is an essential "catalyzer" in the meiotic recombination pathway. However, it is not clear from the data presented that M1AP in fact has enzymatic catalysis activity or exactly when and how it participates. Because the word "catalyzer" is not buttressed with hard or convincing evidence, the authors should consider other ways to describe the proposed role of M1AP, perhaps as a "putative component" and/or "modifier" of the recombination pathway.

    Minor comments:

    Fig. 1A - these are nice illustrations, but overly simplified with respect to timing (synapsis is not completed in zygonema)

    Fig. 1B - greater clarity in legend would be appreciated

    Figs. 2A & 3A - colors in bar graphs are difficult to discriminate

    Fig. 4A - with full appreciation for the difficulty with this material, the images are of low contrast and require considerable enlargement

    Significance

    This is a very interesting paper, which I evaluated from the perspective of a reproductive geneticist with expertise in meiosis and interest in infertility. I think this report will be of interest to clinicians because it identifies a gene possibly linked to marginal fertility and establishes human protein interactions similar to those previously identified in mice. It reinforces the importance of ZZS genes in humans. The contributions of this report to the field of meiosis confirm previous evidence on M1AP, including mutant phenotypes and protein interactions, extending them to humans. We can thus appreciate the conserved function of the mammalian M1AP protein, but as yet the molecular mechanisms of M1AP are not clarified.

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    Referee #1

    Evidence, reproducibility and clarity

    This manuscript compiles LoF variants of M1AP and ZZS proteins (i.e., SHOC1, TEX11 and SPO16) that almost certainly underlie infertility and reports the first case of an infertile man homozygous for a variant in SPO16. The authors validated interactions between human M1AP and ZZS that were found in mice. Analyzing testicular samples from infertile men revealed that those with deficiencies in SHOC1, TEX11 or SPO16 exhibited early meiotic arrest without haploid germ cells, whereas those with M1AP variants displayed a predominant metaphase I arrest with rare haploid germ cells. Further investigations showed that disrupted SHOC1, TEX11 or SPO16 led to defective synapsis and pairing of homologous chromosomes and unpaired DNA DSBs, while M1AP mutations reduced CO events. Importantly, men with LoF variants in M1AP can father healthy children by medically assisted reproduction. Overall, the results are clear and convincing in defining likely causative variants in infertility patients.

    I have a few minor comments for improving the manuscript:

    • No statistical analyses were performed. The meaning of error bars was not mentioned. It is essential to specify the minimum number of seminiferous tubules counted for each patient.
    • Allele frequencies of variants are not provided.
    • Figure 4 should clearly label the representations of each color channel.
    • The authors should clearly label the bands of SPO16 in the right panel of Figure 1B.
    • Appendix Figure S1B and S2B, what does "rat" mean in "rat Ins2 Ex3/4/"?

    Significance

    Overall, this study significantly contributes to the understanding of some genetic causes of human infertility and offers a potential avenue to treat patients with M1AP variants/ mutants. Since no knock-in animal model was applied to mimic the subtle phenotype variations observed in patients, the functionality of truncated proteins remains unexplored. For example, it is unclear why the germ cells in patient M3260 with the SHOC1 variant can progress to round spermatids (Fig. 2C), while those in Shoc1 KO mice (10.1093/molehr/gaac015) and other patients cannot. However, this is a minor concern.

    Our field of expertise is gametogenesis and meiosis in mice.