Fig. 2. WT1 acts at multiple steps during gonad formation and sex determination.
WT1(-KTS) variants can transactivate Sf1. Both WT1 and Sf1 are required for
survival of the bi-potential gonads. WT1(+KTS) products are necessary for the
expression of high levels of the sex-determining gene Sry. Sry
directly or indirectly leads to the activation of Sox9, which in turn
stimulates the expression of the anti-Mullerian hormone MIS (AMH).
Furthermore, WT1(-KTS) can directly transactivate MIS, Dax1 and at
least indirectly Wnt-4. Transactivation of the MIS promoter is
achieved through the direct interaction of WT1(-KTS) with SF1 protein. This
transactivation of the MIS promoter, but also the Dax1
promoter is increased through interaction of WT1 with the LIM-only
co-activator FHL2. Dax1, a gene that can interfere with male sexual
development is a repressor of the MIS promoter.