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Levaillant L, Bouhours-Nouet N, Illouz F, Amsellem Jager J, Bachelot A, Barat P, Baron S, Bensignor C, Brac De La Perriere A, Braik Djellas Y, Caillot M, Caldagues E, Campas MN, Caquard M, Cartault A, Cheignon J, Decrequy A, Delemer B, Dieckmann K, Donzeau A, Doye E, Fradin M, Gaudillière M, Gatelais F, Gorce M, Hazart I, Houcinat N, Houdon L, Ister-Salome M, Jozwiak L, Jeannoel P, Labarthe F, Lacombe D, Lambert AS, Lefevre C, Leheup B, Leroy C, Maisonneuve B, Marchand I, Marquant E, Muszlak M, Pantalone L, Pochelu S, Quelin C, Radet C, Renoult-Pierre P, Reynaud R, Rouleau S, Teinturier C, Thevenon J, Turlotte C, Valle A, Vierge M, Villanueva C, Ziegler A, Dieu X, Bouzamondo N, Rodien P, Prunier-Mirebeau D, Coutant R. The Severity of Congenital Hypothyroidism With Gland-In-Situ Predicts Molecular Yield by Targeted Next-Generation Sequencing. J Clin Endocrinol Metab 2023; 108:e779-e788. [PMID: 36884306 PMCID: PMC10438870 DOI: 10.1210/clinem/dgad119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 02/07/2023] [Accepted: 02/23/2023] [Indexed: 03/09/2023]
Abstract
INTRODUCTION Congenital hypothyroidism with gland-in-situ (CH-GIS) is usually attributed to mutations in the genes involved in thyroid hormone production. The diagnostic yield of targeted next-generation sequencing (NGS) varied widely between studies. We hypothesized that the molecular yield of targeted NGS would depend on the severity of CH. METHODS Targeted NGS was performed in 103 CH-GIS patients from the French national screening program referred to the Reference Center for Rare Thyroid Diseases of Angers University Hospital. The custom targeted NGS panel contained 48 genes. Cases were classified as solved or probably solved depending on the known inheritance of the gene, the classification of the variants according to the American College of Medical Genetics and Genomics, the familial segregation, and published functional studies. Thyroid-stimulating hormone at CH screening and at diagnosis (TSHsc and TSHdg) and free T4 at diagnosis (FT4dg) were recorded. RESULTS NGS identified 95 variants in 10 genes in 73 of the 103 patients, resulting in 25 solved cases and 18 probably solved cases. They were mainly due to mutations in the TG (n = 20) and TPO (n = 15) genes. The molecular yield was, respectively, 73% and 25% if TSHsc was ≥ and < 80 mUI/L, 60% and 30% if TSHdg was ≥ and < 100 mUI/L, and 69% and 29% if FT4dg was ≤ and > 5 pmol/L. CONCLUSION NGS in patients with CH-GIS in France found a molecular explanation in 42% of the cases, increasing to 70% when TSHsc was ≥ 80 mUI/L or FT4dg was ≤ 5 pmol/L.
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Affiliation(s)
- Lucie Levaillant
- Department of Pediatric Endocrinology and Diabetology, University Hospital of Angers, 49000 Angers, France
- Reference Center for Rare Diseases of Thyroid and Hormone Receptivity, University Hospital of Angers, 49000 Angers, France
| | - Natacha Bouhours-Nouet
- Department of Pediatric Endocrinology and Diabetology, University Hospital of Angers, 49000 Angers, France
- Reference Center for Rare Diseases of Thyroid and Hormone Receptivity, University Hospital of Angers, 49000 Angers, France
| | - Frédéric Illouz
- Reference Center for Rare Diseases of Thyroid and Hormone Receptivity, University Hospital of Angers, 49000 Angers, France
- Department of Endocrinology, Diabetes and Nutrition, University Hospital of Angers, 49000 Angers, France
| | - Jessica Amsellem Jager
- Department of Pediatric Endocrinology and Diabetology, University Hospital of Angers, 49000 Angers, France
- Reference Center for Rare Diseases of Thyroid and Hormone Receptivity, University Hospital of Angers, 49000 Angers, France
| | - Anne Bachelot
- Department of Endocrinology and Reproductive Medicine, Hôpital Pitié-Salpêtrière, ICAN, 75651 Paris, France
| | - Pascal Barat
- Pediatric Endocrinology, CHU de Bordeaux, 33000 Bordeaux, France
| | - Sabine Baron
- Pediatrics Department, CHU Nantes, 44000 Nantes, France
| | | | - Aude Brac De La Perriere
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service d'Endocrinologie Pédiatrique, 69677 Bron, France
| | - Yasmine Braik Djellas
- Department of Endocrinology and Reproductive Medicine, Hôpital Pitié-Salpêtrière, ICAN, 75651 Paris, France
| | - Morgane Caillot
- Pediatrics Department, CH de Martigues, 13500 Martigues, France
| | | | | | | | - Audrey Cartault
- Endocrine, Genetics, Bone Diseases, and Paediatric Gynecology Unit, Children's Hospital, CHU Toulouse, 31059 Toulouse, France
| | - Julie Cheignon
- Department of Pediatric Endocrinology and Diabetology, University Hospital of Angers, 49000 Angers, France
| | - Anne Decrequy
- Department of Pediatric Endocrinology and Diabetology, University Hospital of Angers, 49000 Angers, France
| | - Brigitte Delemer
- Department of Endocrinology, Diabetes and Nutrition, CHU de Reims-Hôpital Robert-Debré, 51100 Reims, France
| | | | - Aurélie Donzeau
- Department of Pediatric Endocrinology and Diabetology, University Hospital of Angers, 49000 Angers, France
| | | | - Mélanie Fradin
- Service de Génétique, CLAD Ouest, CHU Rennes, 35200 Rennes, France
| | - Mélanie Gaudillière
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service d'Endocrinologie Pédiatrique, 69677 Bron, France
| | | | - Magali Gorce
- Service de Génétique, 49000 Angers Cedex 9, France
| | | | - Nada Houcinat
- CHU Dijon, Centre de référence maladies rares Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD, CHU Dijon Bourgogne 21000, France
| | - Laure Houdon
- Pediatric Diabetology, University Hospital, St Pierre de la Reunion 97410, France
| | | | - Lucie Jozwiak
- Pediatrics Department, CH de Roubaix, 59100 Roubaix, France
| | | | - Francois Labarthe
- Reference Center for Inborn Errors of Metabolism, Tours University Hospital, 37044 Tours, France
| | - Didier Lacombe
- Department of Medical Genetics, CHU Bordeaux INSERM U1211, Université de Bordeaux, 33076 Bordeaux, France
| | - Anne-Sophie Lambert
- AP-HP, Bicêtre Paris Saclay Hospital, DMU SEA, Endocrinology and Diabetes for Children, Le Kremlin Bicêtre 94270, France
| | - Christine Lefevre
- Pediatric Endocrinology, Jeanne de Flandre Hospital, 59037 Lille, France
| | - Bruno Leheup
- Service de Génétique clinique, Höpital Brabois, Centre Hospitalier Universitaire de Nancy, Nancy, Lorraine 54500, France
| | - Clara Leroy
- Service d'Endocrinologie et Maladies Métaboliques, Centre Hospitalier Régional Universitaire de Lille, Hôpital Huriez, 59037 Lille, France
| | | | - Isis Marchand
- Pediatrics Department, CHI de Créteil, 94010 Créteil, France
| | - Emeline Marquant
- Assistance-Publique des Hôpitaux de Marseille, Department of Pediatrics, Hôpital de la Timone Enfants, 13005 Marseille, France
| | | | | | - Sandra Pochelu
- Pediatric Endocrinology, CHU de Bordeaux, 33000 Bordeaux, France
| | - Chloé Quelin
- Service de Génétique, CLAD Ouest, CHU Rennes, 35200 Rennes, France
| | | | - Peggy Renoult-Pierre
- Service de Médecine Interne, Unité d'Endocrinologie Diabétologie et Nutrition, Centre Hospitalier Universitaire et Faculté de Médecine, Université de Tours, 37044 Tours, France
| | - Rachel Reynaud
- Assistance-Publique des Hôpitaux de Marseille, Department of Pediatrics, Hôpital de la Timone Enfants, 13005 Marseille, France
| | - Stéphanie Rouleau
- Department of Pediatric Endocrinology and Diabetology, University Hospital of Angers, 49000 Angers, France
| | - Cécile Teinturier
- AP-HP, Bicêtre Paris Saclay Hospital, DMU SEA, Endocrinology and Diabetes for Children, Le Kremlin Bicêtre 94270, France
| | - Julien Thevenon
- Inserm UMR 1231 GAD Team, Genetics of Developmental Anomalies, and FHU-TRANSLAD, CHU/Université de Bourgogne-Franche Comté, 21000 Dijon, France
| | | | - Aline Valle
- Pediatrics Department, CH de Douai, 59187 Douai, France
| | - Melody Vierge
- Assistance-Publique des Hôpitaux de Marseille, Department of Pediatrics, Hôpital de la Timone Enfants, 13005 Marseille, France
| | - Carine Villanueva
- Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Service d'Endocrinologie Pédiatrique, 69677 Bron, France
| | | | - Xavier Dieu
- Reference Center for Rare Diseases of Thyroid and Hormone Receptivity, University Hospital of Angers, 49000 Angers, France
- Biochemistry and Molecular Biology Laboratory, University Hospital of Angers, 49000 Angers, France
| | - Nathalie Bouzamondo
- Reference Center for Rare Diseases of Thyroid and Hormone Receptivity, University Hospital of Angers, 49000 Angers, France
- Biochemistry and Molecular Biology Laboratory, University Hospital of Angers, 49000 Angers, France
| | - Patrice Rodien
- Reference Center for Rare Diseases of Thyroid and Hormone Receptivity, University Hospital of Angers, 49000 Angers, France
- Department of Endocrinology, Diabetes and Nutrition, University Hospital of Angers, 49000 Angers, France
| | - Delphine Prunier-Mirebeau
- Reference Center for Rare Diseases of Thyroid and Hormone Receptivity, University Hospital of Angers, 49000 Angers, France
- Biochemistry and Molecular Biology Laboratory, University Hospital of Angers, 49000 Angers, France
| | - Régis Coutant
- Department of Pediatric Endocrinology and Diabetology, University Hospital of Angers, 49000 Angers, France
- Reference Center for Rare Diseases of Thyroid and Hormone Receptivity, University Hospital of Angers, 49000 Angers, France
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Li L, Li X, Wang X, Han M, Zhao D, Wang F, Liu S. Mutation screening of eight genes and comparison of the clinical data in a Chinese cohort with congenital hypothyroidism. Endocrine 2023; 79:125-134. [PMID: 36125728 DOI: 10.1007/s12020-022-03188-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/30/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Congenital hypothyroidism (CH) is a common neonatal endocrine disorder, characterized by irreversible intellectual disability and short stature if left untreated. It can be divided into thyroid dysgenesis (TD), including athyreosis, ectopy and hypoplasia, and dyshormonogenesis (DH), also referring to gland in situ (GIS), in which patients have eutopic thyroids with normal size or goiter. This study aims to analyze the clinical and genetic data of 375 Chinese CH patients without DUOX2 and thyroid transcription factor (TTF) variants, and to explore the mutation frequencies of the eight genes and the inheritance pattern of CH. METHODS Targeted next generation sequencing (NGS) and statistical analysis were performed for mutation screening on eight CH-related genes and the comparison of clinical data in a cohort of 606 Chinese CH patients from Henan Province. RESULTS A total of 104 variants were detected in genes required for thyroid formation (TSHR, GLIS3, BOREALIN, NTN1, JAG1 and TUBB1) and thyroid hormone synthesis (TG and TPO) in 83 subjects. Monogenic variants were the most prevalent with a percentage of 75.00% (78/104) followed by oligogenic variants (25.00%, 26/104). No differences were found in various clinical data between patients with and without variants. However, it should be noted that only initial L-T4 dose was statistically different between patients with monogenic variants and oligogenic variants. CONCLUSIONS Our results suggested that apart from Mendelian monogenic inheritance, oligogenic inheritance of CH could not be excluded and also involves other factors, such as penetrance, epigenetic mechanisms and environmental factors.
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Affiliation(s)
- Liangshan Li
- Medical Genetic Department, the Affiliated Hospital of Qingdao University, Qingdao, China
- Department of Clinical Laboratory, Huadong Hospital affiliated to Fudan University, Shanghai, China
| | - Xiaole Li
- Department of Henan Newborn Screening Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoyu Wang
- Medical Genetic Department, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mengmeng Han
- Medical Genetic Department, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Dehua Zhao
- Department of Henan Newborn Screening Center, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fang Wang
- Endocrinology Department, the Affiliated Hospital of Qingdao University, Qingdao, China.
| | - Shiguo Liu
- Medical Genetic Department, the Affiliated Hospital of Qingdao University, Qingdao, China.
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Molina MF, Pio MG, Scheps KG, Adrover E, Abelleyro MM, Targovnik HM, Rivolta CM. Curating the gnomAD database: Report of novel variants in the thyroid peroxidase gene using in silico bioinformatics algorithms and a literature review. Mol Cell Endocrinol 2022; 558:111748. [PMID: 35995307 DOI: 10.1016/j.mce.2022.111748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/31/2022] [Accepted: 08/01/2022] [Indexed: 12/15/2022]
Abstract
Thyroid peroxidase (TPO) is a membrane-bound glycoprotein located at the apical side of the thyroid follicular cells that catalyzes both iodination and coupling of iodotyrosine residues within the thyroglobulin molecule, leading to the synthesis of thyroid hormone. Variants in TPO cause congenital hypothyroidism (CH) by iodide organification defect and are commonly inherited in an autosomal recessive fashion. In the present work, we report a detailed population analysis and bioinformatic prediction of the TPO variants indexed in the Genome Aggregation Database (gnomAD) v2.1.1. The proportion of missense cysteine variants and nonsense, frameshift, and splice acceptor/donor variants were analyzed in each ethnic group (European (Non-Finnish), European (Finnish), African/African Americans, Latino/Admixed American, East Asian, South Asian, Ashkenazi Jewish, Other). The results showed a clear predominance of frameshift variants in the East Asian (82%) and European (Finnish) (75%) population, whereas the splice site variants predominate in African/African Americans (99.46%), Other (96%), Latino/Admixed American (94%), South Asian (86%), European (Non-Finnish) (56%) and Ashkenazi Jewish (56%) populations. The analysis of the distribution of the variants indexed in gnomAD v2.1.1 database revealed that most missense variants identified in the An peroxidase domain map in exon 8, followed by exons 11, 7 and 9, and finally in descending order by exons 10, 6, 12 and 5. In total, 183 novel TPO variants were described (13 missense cysteine's variants, 158 missense variants involving the An peroxidase domain and 12 splicing acceptor or donor sites variants) which were not reported in the literature and that would have deleterious effects on prediction programs. In the gnomAD v2.1.1 population, the estimated prevalence of heterozygous carriers of the potentially damaging variants was 1:77. In conclusion, we provide an updated and curated reference source of new TPO variants for application in clinical diagnosis and genetic counseling. Also, this work contributes to elucidating the molecular basis of CH associated with TPO defects.
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Affiliation(s)
- Maricel F Molina
- Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología, Biotecnología y Genética/Cátedra de Genética, Buenos Aires, Argentina; CONICET-Universidad de Buenos Aires, Instituto de Inmunología, Genética y Metabolismo (INIGEM), Buenos Aires, Argentina
| | - Mauricio Gomes Pio
- Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología, Biotecnología y Genética/Cátedra de Genética, Buenos Aires, Argentina; CONICET-Universidad de Buenos Aires, Instituto de Inmunología, Genética y Metabolismo (INIGEM), Buenos Aires, Argentina
| | - Karen G Scheps
- Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología, Biotecnología y Genética/Cátedra de Genética, Buenos Aires, Argentina; CONICET-Universidad de Buenos Aires, Instituto de Inmunología, Genética y Metabolismo (INIGEM), Buenos Aires, Argentina
| | - Ezequiela Adrover
- Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología, Biotecnología y Genética/Cátedra de Genética, Buenos Aires, Argentina; CONICET-Universidad de Buenos Aires, Instituto de Inmunología, Genética y Metabolismo (INIGEM), Buenos Aires, Argentina
| | - Miguel M Abelleyro
- CONICET-Academia Nacional de Medicina, Instituto de Medicina Experimental (IMEX), Buenos Aires, Argentina
| | - Héctor M Targovnik
- Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología, Biotecnología y Genética/Cátedra de Genética, Buenos Aires, Argentina; CONICET-Universidad de Buenos Aires, Instituto de Inmunología, Genética y Metabolismo (INIGEM), Buenos Aires, Argentina
| | - Carina M Rivolta
- Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Microbiología, Inmunología, Biotecnología y Genética/Cátedra de Genética, Buenos Aires, Argentina; CONICET-Universidad de Buenos Aires, Instituto de Inmunología, Genética y Metabolismo (INIGEM), Buenos Aires, Argentina.
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Abstract
Thyroid diseases in children and adolescents include acquired or congenital conditions, including genetic disorders either isolated or part of a syndrome. Briefly, we will review the physiology and pathophysiology of the thyroid gland and its disorders. The aim of this chapter is to describe genetic abnormalities of the thyroid gland.
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Batjargal K, Tajima T, Fujita-Jimbo E, Yamaguchi T, Nakamura A, Yamagata T. Functional analysis of <i>PAX8</i> variants identified in patients with congenital hypothyroidism <i>in situ</i>. Clin Pediatr Endocrinol 2022; 31:234-241. [DOI: 10.1297/cpe.2021-0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 06/08/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
| | - Toshihiro Tajima
- Department of Pediatrics, Jichi Medical University, Tochigi, Japan
| | | | - Takeshi Yamaguchi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Akie Nakamura
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Pio MG, Siffo S, Scheps KG, Molina MF, Adrover E, Abelleyro MM, Rivolta CM, Targovnik HM. Curating the gnomAD database: Report of novel variants in the thyrogobulin gene using in silico bioinformatics algorithms. Mol Cell Endocrinol 2021; 534:111359. [PMID: 34119605 DOI: 10.1016/j.mce.2021.111359] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 01/09/2023]
Abstract
Thyroglobulin (TG) is a large glycosylated protein of 2767 amino acids, secreted by the thyrocytes into the follicular lumen. It plays an essential role in the process of thyroid hormone synthesis. TG gene variants lead to permanent congenital hypothyroidism. In the present work, we report a detailed population and bioinformatic prediction analyses of the TG variants indexed in the Genome Aggregation Database (gnomAD). The results showed a clear predominance of nonsense variants in the European (Finnish), European (Non-Finnish) and Ashkenazi Jewish ethnic groups, whereas the splice site variants predominate in South Asian and African/African-American populations. In total, 282 novel TG variants were described (47 missense involving the wild-type cysteine residues, 177 missense located in the ChEL domain and 58 splice site variants) which were not reported in the literature and that would have deleterious effects in prediction programs. In the gnomAD population, the estimated prevalence of heterozygous carriers of the potentially damaging variants was 1:320. In conclusion, we provide an updated and curated reference source for the diagnosis of thyroid disease, mainly to congenital hypothyroidism due to TG deficiency. The identification and characterization of TG variants is undoubtedly a valuable approach to study the TG structure/function relations and an important tool for clinical diagnosis and genetic counseling.
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Affiliation(s)
- Mauricio Gomes Pio
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Microbiología, Inmunología, Biotecnología y Genética/Cátedra de Genética, Buenos Aires, Argentina; CONICET-Universidad de Buenos Aires, Instituto de Inmunología, Genética y Metabolismo (INIGEM), Buenos Aires, Argentina
| | - Sofia Siffo
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Microbiología, Inmunología, Biotecnología y Genética/Cátedra de Genética, Buenos Aires, Argentina; CONICET-Universidad de Buenos Aires, Instituto de Inmunología, Genética y Metabolismo (INIGEM), Buenos Aires, Argentina
| | - Karen G Scheps
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Microbiología, Inmunología, Biotecnología y Genética/Cátedra de Genética, Buenos Aires, Argentina; CONICET-Universidad de Buenos Aires, Instituto de Inmunología, Genética y Metabolismo (INIGEM), Buenos Aires, Argentina
| | - Maricel F Molina
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Microbiología, Inmunología, Biotecnología y Genética/Cátedra de Genética, Buenos Aires, Argentina; CONICET-Universidad de Buenos Aires, Instituto de Inmunología, Genética y Metabolismo (INIGEM), Buenos Aires, Argentina
| | - Ezequiela Adrover
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Microbiología, Inmunología, Biotecnología y Genética/Cátedra de Genética, Buenos Aires, Argentina; CONICET-Universidad de Buenos Aires, Instituto de Inmunología, Genética y Metabolismo (INIGEM), Buenos Aires, Argentina
| | - Miguel M Abelleyro
- CONICET-Academia Nacional de Medicina, Instituto de Medicina Experimental (IMEX), Buenos Aires, Argentina
| | - Carina M Rivolta
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Microbiología, Inmunología, Biotecnología y Genética/Cátedra de Genética, Buenos Aires, Argentina; CONICET-Universidad de Buenos Aires, Instituto de Inmunología, Genética y Metabolismo (INIGEM), Buenos Aires, Argentina
| | - Héctor M Targovnik
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Microbiología, Inmunología, Biotecnología y Genética/Cátedra de Genética, Buenos Aires, Argentina; CONICET-Universidad de Buenos Aires, Instituto de Inmunología, Genética y Metabolismo (INIGEM), Buenos Aires, Argentina.
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Xue P, Yang Y, Yun Q, Cui Y, Yu B, Long W. Variant of TSHR is Not a Frequent Cause of Congenital Hypothyroidism in Chinese Han Patients. Int J Gen Med 2021; 14:4135-4143. [PMID: 34377013 PMCID: PMC8349214 DOI: 10.2147/ijgm.s322726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/16/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To screen variants of the thyroid stimulating hormone receptor (TSHR) gene among congenital hypothyroidism (CH) patients. PATIENTS AND METHODS We conducted a genetic screening of the TSHR gene in a cohort of 125 Chinese CH patients. Variants were detected by customized targeted next-generation sequencing. RESULTS A total of 11 TSHR missense heterozygous variants were identified in 14 CH patients. Six variants were in the transmembrane domains, four variants were in the leucine-rich repeats and one variant was located in the hinge region of the TSHR protein. p.F525S was the most prevalent variant with an allele frequency of 0.016, followed by p.R450H with an allele frequency of 0.012. The allele frequency of most variants was higher in our cohort than those of other populations. CONCLUSION The prevalence of TSHR variants was 11.2%. Variant p.F525S was the most prevalent variant with an allele frequency of 0.016. The prevalence of TSHR variants was different from other populations.
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Affiliation(s)
- Peng Xue
- Department of Pediatrics, Changzhou Children’s Hospital, Changzhou, People’s Republic of China
| | - Yuqi Yang
- Department of Medical Genetics, Affiliated Changzhou Women and Children’s Hospital, Nanjing Medical University, Changzhou, People’s Republic of China
| | - Qi Yun
- Department of Pediatrics, Changzhou Children’s Hospital, Changzhou, People’s Republic of China
| | - Yue Cui
- Department of Pediatrics, Changzhou Children’s Hospital, Changzhou, People’s Republic of China
| | - Bin Yu
- Department of Medical Genetics, Affiliated Changzhou Women and Children’s Hospital, Nanjing Medical University, Changzhou, People’s Republic of China
| | - Wei Long
- Department of Medical Genetics, Affiliated Changzhou Women and Children’s Hospital, Nanjing Medical University, Changzhou, People’s Republic of China
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Alcántara-Ortigoza MA, Sánchez-Verdiguel I, Fernández-Hernández L, Enríquez-Flores S, González-Núñez A, Hernández-Martínez NL, Sánchez C, González-del Angel A. Further Evidence That Defects in Main Thyroid Dysgenesis-Related Genes Are an Uncommon Etiology for Primary Congenital Hypothyroidism in Mexican Patients: Report of Rare Variants in FOXE1, NKX2-5 and TSHR. CHILDREN-BASEL 2021; 8:children8060457. [PMID: 34070861 PMCID: PMC8227333 DOI: 10.3390/children8060457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 11/18/2022]
Abstract
Mexico shows a high birth prevalence of congenital hypothyroidism (CH) due to thyroid dysgenesis (TD). PAX8 defects underlie only 1% of these cases and NKX2-1 does not seem to be involved. Here, we analyzed other TD-related genes in 128 non-related Mexican patients (females 77.3%; 6 months to 16.6 years) with non-syndromic CH-TD diagnosis established by clinical evaluation, thyroid hormone serum profiling, and scintigraphy (74%) or ultrasonography (26%). We performed Sanger sequencing of FOXE1, NKX2-5, and TSHR and evaluated copy number variations (CNVs) in TSHR, FOXE1, PAX8, and NKX2-1 by multiplex ligation-dependent probe amplification. Odds ratios for TD risk were explored for FOXE1 polyalanine stretches [polyAla-rs71369530] in cases and controls (N = 116). Five rare missense changes cataloged as benign (NKX2-5:p.(Ala119Ser)-rs137852684), of unknown significance (FOXE1:p.(Ala335Gly)-rs543372757; TSHR:p.(Asp118Asn)-rs1414102266), and likely pathogenic (FOXE1:p.(Gly124Arg)-rs774035532; TSHR:p.(Trp422Arg)-rs746029360) accounted for 1.5% (N = 2/128) of clinically relevant genotypes (supported in part by protein modeling) in CH-TD. No CNVs were identified, nor did polyAla > 14 alanines in FOXE1 significantly protect against TD. The present and previously published data collectively show that small clinically relevant germline variants in PAX8, FOXE1, and TSHR are found in only a very small proportion (2.5%) of isolated CH-TD Mexican patients.
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Affiliation(s)
- Miguel Angel Alcántara-Ortigoza
- Laboratorio de Biología Molecular, Subdirección de Investigación Médica, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de Mexico CP 04530, Mexico; (M.A.A.-O.); (L.F.-H.); (N.L.H.-M.)
| | - Iraís Sánchez-Verdiguel
- Consulta Externa, Instituto Nacional de Pediatría, Secretaría de Salud, Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de la Salud, UNAM, Ciudad de Mexico CP 04530, Mexico;
| | - Liliana Fernández-Hernández
- Laboratorio de Biología Molecular, Subdirección de Investigación Médica, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de Mexico CP 04530, Mexico; (M.A.A.-O.); (L.F.-H.); (N.L.H.-M.)
| | - Sergio Enríquez-Flores
- Grupo de Investigación en Biomoléculas y Salud Infantil, Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatría, Ciudad de Mexico CP 04530, Mexico;
| | - Aidy González-Núñez
- Hospital Regional Materno Infantil de Alta Especialidad de Nuevo León, Guadalupe CP 67140, Mexico;
| | - Nancy Leticia Hernández-Martínez
- Laboratorio de Biología Molecular, Subdirección de Investigación Médica, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de Mexico CP 04530, Mexico; (M.A.A.-O.); (L.F.-H.); (N.L.H.-M.)
| | - Carmen Sánchez
- Laboratorio de Seguimiento del Neurodesarrollo, Instituto Nacional de Pediatría, Ciudad de Mexico CP 04530, Mexico;
| | - Ariadna González-del Angel
- Laboratorio de Biología Molecular, Subdirección de Investigación Médica, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de Mexico CP 04530, Mexico; (M.A.A.-O.); (L.F.-H.); (N.L.H.-M.)
- Correspondence: ; Tel.: +52-55-1084-0900 (ext. 1306)
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9
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Guideline Adherence and Registry Recruitment of Congenital Primary Hypothyroidism: Data from the German Registry for Congenital Hypothyroidism (HypoDok). Int J Neonatal Screen 2021; 7:ijns7010010. [PMID: 33673307 PMCID: PMC8006240 DOI: 10.3390/ijns7010010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/02/2021] [Accepted: 02/07/2021] [Indexed: 12/19/2022] Open
Abstract
Neonatal screening for congenital primary hypothyroidism (CH) is mandatory in Germany but medical care thereafter remains inconsistent. Therefore, the registry HypoDok of the German Society of Pediatric Endocrinology and Diabetology (DGKED) was analyzed to evaluate the implementation of evidence-based guidelines and to assess the number of included patients. Inclusion criteria were (i) date of birth between 10/2001 and 05/2020 and (ii) increased thyroid-stimulating hormone (TSH) at screening and/or confirmation. The cohort was divided into before (A) and after (B) guideline publication in 02/2011, to assess the guideline's influence on medical care. A total of 659 patients were analyzed as group A (n = 327) and group B (n = 332) representing 17.5% and 10.3% of CH patients identified in the German and Austrian neonatal screening program during the respective time period. Treatment start and thyroxine doses were similar in both groups and consistent with recommendations. Regular follow-ups were documented. In the first three years of life, less than half of the patients underwent audiometry; developmental assessment was performed in 49.3% (A) and 24.8% (B) (p < 0.01). Documentation of CH patient care by pediatric endocrinologists seemed to be established, however, it reflected only a minority of the affected patients. Therefore, comprehensive documentation as an important instrument of quality assurance and evidence-based medicine should be legally enforced and officially funded in order to record, comprehend, and optimize care and outcome in patients with rare diseases such as CH.
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10
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Rodrigues TMB, Silva MMDC, Freitas MM, Duarte ZMC, Frutuoso VS, Rodrigues MT, Rubio IGS. Case Report: Functional Analysis and Neuropsychological Evaluation of Dyshormonogenetic Fetal Goiter in Siblings Caused by Novel Compound Hyterozygous TPO Gene Mutations. Front Endocrinol (Lausanne) 2021; 12:671659. [PMID: 34220711 PMCID: PMC8251258 DOI: 10.3389/fendo.2021.671659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/21/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION It is rare for a euthyroid mother to carry a child with a fetal goiter. However, cases of congenital hypothyroidism (CH) caused by thyroid dyshormonogenesis have been reported. Even though gene mutations associated with fetal goiter have been reported in a few studies, the effects on intellectual development have not been investigated. This study aimed to characterize and investigate the underlying genetic mechanism of CH and neuropsychological development and growth of two siblings with CH-induced fetal goiters. CASE REPORT Two male siblings from a non-consanguineous marriage with CH and fetal goiter were diagnosed by ultrasonography at 32- and 26-weeks of gestation. This condition was confirmed by cordocentesis in the first pregnancy (TSH: 135 μIU/ml). The mother was euthyroid, and no intra-amniotic levothyroxine treatment was performed. Peripheral blood DNA was screened for TPO mutations. The new deletion p.Cys296Alafs*21 and the p.Arg665Trp mutation, inherited from heterozygous parents, were identified in both patients. Functional analysis showed both mutations reduced the TPO enzyme activity and impaired the membrane localization. The p.Cys296Alafs*21 mutation produces a protein product with a drastically reduced molecular weight. Additionally, a complete clinical and neuropsychological evaluation was also performed. The WISC IV test was employed to provide an overall measure of the siblings' cognitive and intellectual abilities. No growth retardation was detected in either child. In general, both children showed normal neuropsychological development; however, they exhibited slight reduction of Processing Speed Index scores, which are sensitive to neurological and attentional factors and motor maturation activity. Notably, the younger sibling obtained significantly low scores in the Operational Memory Index, a measure of attention capacity and psychoneurological immaturity. CONCLUSION We described a new TPO compound heterozygosity that severely impaired the TPO activity and membrane localization leading to severe CH and fetal goiter. This is the first report showing the neuropsychological evaluation in patients with dyshormonogenetic fetal goiter. More studies are needed to understand the neurodevelopmental outcomes of neonates with CH-induced fetal goiters.
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Affiliation(s)
| | - Marlon Messias da Conceição Silva
- Thyroid Molecular Science Laboratory, Department of Biological Sciences, Federal University of São Paulo, Federal University of São Paulo (UNIFESP), Diadema, Brazil
- Structural and Functional Biology Program, Federal University of São Paulo, UNIFESP, São Paulo, Brazil
| | - Magali Maciel Freitas
- Thyroid Molecular Science Laboratory, Department of Biological Sciences, Federal University of São Paulo, Federal University of São Paulo (UNIFESP), Diadema, Brazil
| | - Zélia Maria Costa Duarte
- Thyroid Molecular Science Laboratory, Department of Biological Sciences, Federal University of São Paulo, Federal University of São Paulo (UNIFESP), Diadema, Brazil
| | - Vitória Sousa Frutuoso
- Thyroid Molecular Science Laboratory, Department of Biological Sciences, Federal University of São Paulo, Federal University of São Paulo (UNIFESP), Diadema, Brazil
| | - Mariana Teixeira Rodrigues
- Thyroid Molecular Science Laboratory, Department of Biological Sciences, Federal University of São Paulo, Federal University of São Paulo (UNIFESP), Diadema, Brazil
- Structural and Functional Biology Program, Federal University of São Paulo, UNIFESP, São Paulo, Brazil
| | - Ileana Gabriela Sanchez Rubio
- Thyroid Molecular Science Laboratory, Department of Biological Sciences, Federal University of São Paulo, Federal University of São Paulo (UNIFESP), Diadema, Brazil
- Structural and Functional Biology Program, Federal University of São Paulo, UNIFESP, São Paulo, Brazil
- *Correspondence: Ileana Gabriela Sanchez Rubio,
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11
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Koracin V, Mlinaric M, Baric I, Brincat I, Djordjevic M, Drole Torkar A, Fumic K, Kocova M, Milenkovic T, Moldovanu F, Mulliqi Kotori V, Nanu MI, Remec ZI, Repic Lampret B, Platis D, Savov A, Samardzic M, Suzic B, Szatmari I, Toromanovic A, Zerjav Tansek M, Battelino T, Groselj U. Current Status of Newborn Screening in Southeastern Europe. Front Pediatr 2021; 9:648939. [PMID: 34026686 PMCID: PMC8138576 DOI: 10.3389/fped.2021.648939] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 04/08/2021] [Indexed: 12/30/2022] Open
Abstract
Significant part of Southeastern Europe (with a population of 76 million) has newborn screening (NBS) programs non-harmonized with developed European countries. Initial survey was conducted in 2013/2014 among 11 countries from the region (Albania, Bulgaria, Bosnia and Herzegovina (BIH), Croatia, Kosovo, Macedonia, Moldova, Montenegro, Romania, Serbia, and Slovenia) to assess the main characteristics of their NBS programs and their future plans. Their cumulative population at that time was ~52,5 million. At that time, none of the countries had an expanded NBS program, while phenylketonuria screening was not introduced in four and congenital hypothyroidism in three of 11 countries. We repeated the survey in 2020 inviting the same 11 countries, adding Cyprus, Greece, Hungary, and Malta (due to their geographical position in the wider region). The aims were to assess the current state, to evaluate the change in the period, and to identify the main obstacles impacting the implementation of expanded NBS and/or reaching a wider population. Responses were collected from 12 countries (BIH-Federation of BIH, BIH-Republic of Srpska, Bulgaria, Croatia, Greece, Hungary, Kosovo, North Macedonia, Malta, Montenegro, Romania, Serbia, Slovenia) with a population of 68.5 million. The results of the survey showed that the regional situation regarding NBS only modestly improved in this period. All of the surveyed countries except Kosovo screened for at least congenital hypothyroidism, while phenylketonuria was not screened in four of 12 countries. Croatia and Slovenia implemented an expanded NBS program using tandem mass spectrometry from the time of last survey. In conclusion, the current status of NBS programs in Southeastern Europe is very variable and is still underdeveloped (or even non-existent) in some of the countries. We suggest establishing an international task-force to assist with implementation and harmonization of basic NBS services where needed.
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Affiliation(s)
| | - Matej Mlinaric
- University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Ivo Baric
- Department of Pediatrics, School of Medicine, University Hospital Center Zagreb and University of Zagreb, Zagreb, Croatia
| | | | - Maja Djordjevic
- Department of Metabolism and Clinical Genetics, Institute for Mother and Child Health Care of Serbia, Belgrade, Serbia
| | - Ana Drole Torkar
- University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Ksenija Fumic
- Department of Laboratory Diagnostics, University Hospital Center Zagreb, Zagreb, Croatia
| | - Mirjana Kocova
- Department of Endocrinology and Genetics, University Pediatric Clinic, Skopje, Macedonia
| | - Tatjana Milenkovic
- Department of Pediatric Endocrinology, Institute for Mother and Child Health Care of Serbia, Belgrade, Serbia
| | - Florentina Moldovanu
- Department of Pediatrics, National Institute for Mother and Child Health, Alessandrescu-Rusescu, Bucharest, Romania
| | | | - Michaela Iuliana Nanu
- Department of Pediatrics, National Institute for Mother and Child Health, Alessandrescu-Rusescu, Bucharest, Romania
| | - Ziga Iztok Remec
- Clinical Institute for Special Laboratory Diagnostics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Barbka Repic Lampret
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Clinical Institute for Special Laboratory Diagnostics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Dimitrios Platis
- Department of Neonatal Screening, Institute of Child Health, Athens, Greece
| | - Alexey Savov
- National Genetic Laboratory, University Hospital of Obstetrics and Gynecology, Medical University Sofia, Sofia, Bulgaria
| | - Mira Samardzic
- Institute for Sick Children, Clinical Center of Montenegro, Podgorica, Montenegro
| | - Biljana Suzic
- Children Hospital Banja Luka, Banja Luka, Bosnia and Herzegovina
| | | | - Alma Toromanovic
- Department of Pediatrics, University Clinical Center, Tuzla, Bosnia and Herzegovina
| | - Mojca Zerjav Tansek
- University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tadej Battelino
- University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Urh Groselj
- University Children's Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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12
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Da DZ, Wang Y, Wang M, Long Z, Wang Q, Liu J. Congenital Hypothyroidism Patients With Thyroid Hormone Receptor Variants Are Not Rare: A Systematic Review. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211067943. [PMID: 34919466 PMCID: PMC8721697 DOI: 10.1177/00469580211067943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Primary congenital hypothyroidism (CH) is a common endocrine and metabolic disease. Various genetic factors, including the thyroid hormone receptor (TSHR), play an important role in CH. Aim To explore the occurrence of pathogenic TSHR variants in CH. Methods We searched published articles in PubMed, Web of Science, and Cochrane Library databases, from the establishment of the database to September 26, 2021. Studies with sequencing partial or full exons of TSHR in CH patients were included. Gene polymorphism was excluded. Results A total of 66 articles (44 case-control studies and 22 case reports) were selected from the database. Though case-control studies, we found the incidence of pathogenic TSHR variants were not rare (range from 0% to 30.6%) and varied greatly in different countries and race. The pathogenic genotypes varied in different regions. All the variants were “loss-of-function” mutations, in which the p.(Arg450His) variant was the most common variant. In addition, we analyzed the case reports and found that CH patients with a family genetic background expressed homozygous genotypes. Homozygotes had more obvious symptoms of hypothyroidism and higher risk of comorbidities than heterozygotes. Conclusion Pathogenic TSHR variants are not uncommon cause of the CH, especially in the Arabs. The role of TSHR gene detection in the treatment of children with CH needs to be further studied.
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Affiliation(s)
- Dong-Zhu Da
- Department of Breast-Thyroid-Vascular Surgery, Shanghai General Hospital, Shanghai, China.,Department of Breast and Thyroid Surgery, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, China
| | - Ye Wang
- Department of Breast-Thyroid-Vascular Surgery, Shanghai General Hospital, Shanghai, China
| | - Min Wang
- Department of Breast-Thyroid-Vascular Surgery, Shanghai General Hospital, Shanghai, China
| | - Zhi Long
- Department of Pediatrics, Shanghai General Hospital, Shanghai, China
| | - Qian Wang
- Department of Pediatrics, Shanghai General Hospital, Shanghai, China
| | - Jun Liu
- Department of Breast-Thyroid-Vascular Surgery, Shanghai General Hospital, Shanghai, China
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