1
|
Iwahashi-Odano M, Kitamura M, Narumi S. A case of syndromic congenital hypothyroidism with a 15.2 Mb interstitial deletion on 2q12.3q14.2 involving PAX8. Clin Pediatr Endocrinol 2023; 32:65-71. [PMID: 36761496 PMCID: PMC9887295 DOI: 10.1297/cpe.2022-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/03/2022] [Indexed: 11/05/2022] Open
Abstract
Paired box 8 (PAX8) mutations are an established genetic cause of congenital hypothyroidism (CH). The majority of these mutations are found in the protein-coding exons of the gene. The proband, a 3-yr-old girl, had tetralogy of Fallot and polydactyly soon after birth. She was diagnosed with CH in the newborn screening for CH. She had a high serum TSH level (239 mU/L) and low free T4 level (0.7 ng/dL). Ultrasonography revealed thyroid hypoplasia. We performed array comparative genomic hybridization because the patient exhibited a variety of symptoms across multiple organ systems. The analysis revealed a novel heterozygous deletion that spanned a 15.2 Mb region in 2q12.3q14.3 (GRCh37; chr2:109,568,260-124,779,449). There were 71 protein-coding genes in this region, including two genes (PAX8 and GLI2) associated with congenital endocrine disorders. The common clinical features of the two previously reported patients with a total PAX8 deletion and our case were CH, short stature and intellectual disability, but the severity of hypothyroidism and other clinical features were variable. In conclusion, we describe a syndromic CH patient with a novel 2q12.3q14.3 deletion involving PAX8. Patients with CH, whose unifying diagnosis is not obvious, could have a genomic deletion involving PAX8.
Collapse
Affiliation(s)
- Megumi Iwahashi-Odano
- Department of Molecular Endocrinology, National Research
Institute for Child Health and Development, Tokyo, Japan,Department of Pediatrics, The Jikei University School of
Medicine, Tokyo, Japan
| | - Miyuki Kitamura
- Department of Pediatrics and Child Health, Kurume University
School of Medicine, Fukuoka, Japan
| | - Satoshi Narumi
- Department of Molecular Endocrinology, National Research
Institute for Child Health and Development, Tokyo, Japan
| |
Collapse
|
2
|
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
| | | |
Collapse
|
3
|
Tanase-Nakao K, Muroya K, Adachi M, Abe K, Hasegawa T, Narumi S. A patient with congenital hypothyroidism due to a <i>PAX8</i> frameshift variant accompanying a urogenital malformation. Clin Pediatr Endocrinol 2022; 31:250-255. [DOI: 10.1297/cpe.2022-0030] [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: 04/18/2022] [Accepted: 06/15/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kanako Tanase-Nakao
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Koji Muroya
- Department of Endocrinology and Metabolism, Kanagawa Children’s Medical Center, Yokohama, Japan
| | - Masanori Adachi
- Department of Endocrinology and Metabolism, Kanagawa Children’s Medical Center, Yokohama, Japan
| | - Kiyomi Abe
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Tomonobu Hasegawa
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Narumi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
4
|
Watanabe D, Yagasaki H, Narusawa H, Saito T, Mitsui Y, Miyake K, Ohta M, Inukai T. Screening of frequent variants associated with congenital hypothyroidism: a comparison with next generation sequencing. Endocr J 2021; 68:1411-1419. [PMID: 34234053 DOI: 10.1507/endocrj.ej21-0353] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Congenital hypothyroidism (CH) is considered the most common congenital endocrine disorder of genetic origin. Next generation sequencing (NGS) is the standard method for identifying genetic mutations, but it is an expensive and complex technique. Therefore, we propose to use Sanger sequencing to identify selected variants of the four most common CH-causative genes: DUOX2, TG, TSHR, and PAX8. To analyze the performance of Sanger sequencing, we compared its variant detection ability with that of a CH NGS panel containing 53 genes. We performed Sanger sequencing of selected variants and panel NGS analysis of 25 Japanese patients with CH. Sanger sequencing identified nine variants in seven patients, while NGS identified 24 variants in 14 patients. Of these, eight, five, eight, two, and one were found to be potentially pathogenic in DUOX2, TSHR, TG, UBR1, and TPO genes, respectively. The percentage of detectable variants using Sanger sequencing compared with NGS was 37.5% (9/24 variants), whereas the percentage of detectable cases carrying variants using Sanger sequencing compared with NGS was 50% (7/14 patients). We proposed a system for screening commonly identified CH-related variants by Sanger sequencing. Sanger sequencing could therefore identify about a third of CH-causative variants, so is considered an effective and efficient form of pre-screening before NGS.
Collapse
Affiliation(s)
- Daisuke Watanabe
- Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Hideaki Yagasaki
- Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Hiromune Narusawa
- Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Tomohiro Saito
- Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Yumiko Mitsui
- Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Kunio Miyake
- Department of Health Sciences, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Masanori Ohta
- Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Takeshi Inukai
- Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| |
Collapse
|
5
|
Camats N, Baz-Redón N, Fernández-Cancio M, Clemente M, Campos-Martorell A, Jaimes N, Antolín M, Garcia-Arumí E, Blasco-Pérez L, Paramonov I, Mogas E, Soler-Colomer L, Yeste D. Phenotypic Variability of Patients With PAX8 Variants Presenting With Congenital Hypothyroidism and Eutopic Thyroid. J Clin Endocrinol Metab 2021; 106:e152-e170. [PMID: 33029631 DOI: 10.1210/clinem/dgaa711] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/05/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE Thyroid dyshormonogenesis is a heterogeneous group of hereditary diseases produced by a total/partial blockage of the biochemical processes of thyroid-hormone synthesis and secretion. Paired box 8 (PAX8) is essential for thyroid morphogenesis and thyroid hormone synthesis. We aimed to identify PAX8 variants in patients with thyroid dyshormonogenesis and to analyze them with in vitro functional studies. PATIENTS AND METHODS Nine pediatric patients with a eutopic thyroid gland were analyzed by the Catalan screening program for congenital hypothyroidism. Scintigraphies showed absent, low, or normal uptake. Only one patient had a hypoplastic gland. On reevaluation, perchlorate discharge test was negative or compatible with partial iodine-organization deficit. After evaluation, 8 patients showed permanent mild or severe hypothyroidism. Massive-sequencing techniques were used to detect variants in congenital hypothyroidism-related genes. In vitro functional studies were based on transactivating activity of mutant PAX8 on a TG-gene promoter and analyzed by a dual-luciferase assays. RESULTS We identified 7 heterozygous PAX8 exonic variants and 1 homozygous PAX8 splicing variant in 9 patients with variable phenotypes of thyroid dyshormonogenesis. Five were novel and 5 variants showed a statistically significant impaired transcriptional activity of TG promoter: 51% to 78% vs the wild type. CONCLUSIONS Nine patients presented with PAX8 candidate variants. All presented with a eutopic thyroid gland and 7 had deleterious variants. The phenotype of affected patients varies considerably, even within the same family; but, all except the homozygous patient presented with a normal eutopic thyroid gland and thyroid dyshormonogenesis. PAX8 functional studies have shown that 6 PAX8 variants are deleterious. Our studies have proven effective in evaluating these variants.
Collapse
Affiliation(s)
- Núria Camats
- Growth and Development group, Vall d'Hebron Research Institute (VHIR), Hospital Universitari Vall d'Hebron, Barcelona, Spain
- CIBERER, ISCIII, Madrid, Spain
| | - Noelia Baz-Redón
- Growth and Development group, Vall d'Hebron Research Institute (VHIR), Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Pediatrics, Obstetrics and Gynecology and Preventive Medicine Department, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Mónica Fernández-Cancio
- Growth and Development group, Vall d'Hebron Research Institute (VHIR), Hospital Universitari Vall d'Hebron, Barcelona, Spain
- CIBERER, ISCIII, Madrid, Spain
| | - María Clemente
- Growth and Development group, Vall d'Hebron Research Institute (VHIR), Hospital Universitari Vall d'Hebron, Barcelona, Spain
- CIBERER, ISCIII, Madrid, Spain
- Pediatrics, Obstetrics and Gynecology and Preventive Medicine Department, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Pediatric Endocrinology Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ariadna Campos-Martorell
- Growth and Development group, Vall d'Hebron Research Institute (VHIR), Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Pediatrics, Obstetrics and Gynecology and Preventive Medicine Department, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Pediatric Endocrinology Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Nadya Jaimes
- Department of Pediatric Endocrinology, Hospital Fundación la Misericordia HOMI, Bogotá, Colombia
| | - María Antolín
- Department of Clinical and Molecular Genetics and Rare Disease, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Medicine Genetics Group, VHIR, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Elena Garcia-Arumí
- Department of Clinical and Molecular Genetics and Rare Disease, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Medicine Genetics Group, VHIR, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Research Group on Neuromuscular and Mitochondrial Disorders, VHIR, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Laura Blasco-Pérez
- Department of Clinical and Molecular Genetics and Rare Disease, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Medicine Genetics Group, VHIR, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ida Paramonov
- Department of Clinical and Molecular Genetics and Rare Disease, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Eduard Mogas
- Pediatric Endocrinology Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Laura Soler-Colomer
- Pediatric Endocrinology Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Diego Yeste
- Growth and Development group, Vall d'Hebron Research Institute (VHIR), Hospital Universitari Vall d'Hebron, Barcelona, Spain
- CIBERER, ISCIII, Madrid, Spain
- Pediatrics, Obstetrics and Gynecology and Preventive Medicine Department, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Pediatric Endocrinology Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| |
Collapse
|
6
|
Sorapipatcharoen K, Tim-Aroon T, Mahachoklertwattana P, Chantratita W, Iemwimangsa N, Sensorn I, Panthan B, Jiaranai P, Noojarern S, Khlairit P, Pongratanakul S, Suprasongsin C, Korwutthikulrangsri M, Sriphrapradang C, Poomthavorn P. DUOX2 variants are a frequent cause of congenital primary hypothyroidism in Thai patients. Endocr Connect 2020; 9:1121-1134. [PMID: 33310921 PMCID: PMC7774760 DOI: 10.1530/ec-20-0411] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To identify the genetic etiologies of congenital primary hypothyroidism (CH) in Thai patients. DESIGN AND METHODS CH patients were enrolled. Clinical characteristics including age, signs and symptoms of CH, pedigree, family history, screened thyroid-stimulating hormone results, thyroid function tests, thyroid imaging, clinical course and treatment of CH were collected. Clinical exome sequencing by next-generation sequencing was performed. In-house gene list which covered 62 potential candidate genes related to CH and thyroid disorders was developed for targeted sequencing. Sanger sequencing was performed to validate the candidate variants. Thyroid function tests were determined in the heterozygous parents who carried the same DUOX2 or DUOXA2 variants as their offsprings. RESULTS There were 118 patients (63 males) included. Mean (SD) age at enrollment was 12.4 (7.9) years. Forty-five of 118 patients (38%) had disease-causing variants. Of 45 variants, 7 genes were involved (DUOX2, DUOXA2, TG, TPO, SLC5A5, PAX8 and TSHR). DUOX2, a gene causing thyroid dyshormonogenesis, was the most common defective gene (25/45, 56%). The most common DUOX2 variant found in this study was c.1588A>T. TG and TPO variants were less common. Fourteen novel variants were found. Thyroid function tests of most parents with heterozygous state of DUOX2 and DUOXA2 variants were normal. CONCLUSIONS DUOX2 variants were most common among Thai CH patients, while TG and TPO variants were less common. The c.1588A>T in DUOX2 gene was highly frequent in this population.
Collapse
Affiliation(s)
- Kinnaree Sorapipatcharoen
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Thipwimol Tim-Aroon
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pat Mahachoklertwattana
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wasun Chantratita
- Center for Medical Genomics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nareenart Iemwimangsa
- Center for Medical Genomics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Insee Sensorn
- Center for Medical Genomics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Bhakbhoom Panthan
- Center for Medical Genomics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poramate Jiaranai
- Center for Medical Genomics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Saisuda Noojarern
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Patcharin Khlairit
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sarunyu Pongratanakul
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chittiwat Suprasongsin
- Research Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Chutintorn Sriphrapradang
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Preamrudee Poomthavorn
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Correspondence should be addressed to P Poomthavorn:
| |
Collapse
|
7
|
Iwahashi-Odano M, Nagasaki K, Fukami M, Nishioka J, Yatsuga S, Asakura Y, Adachi M, Muroya K, Hasegawa T, Narumi S. Congenital Hypothyroidism Due to Truncating PAX8 Mutations: A Case Series and Molecular Function Studies. J Clin Endocrinol Metab 2020; 105:5897054. [PMID: 32841355 DOI: 10.1210/clinem/dgaa584] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/20/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT PAX8 is a transcription factor required for thyroid development, and its mutation causes congenital hypothyroidism (CH). More than 20 experimentally verified loss-of-function PAX8 mutations have been described, and all but one were located in the DNA-binding paired domain. OBJECTIVE We report the identification and functional characterization of 3 novel truncating PAX8 mutations located outside the paired domain. METHODS Three CH probands, diagnosed in the frame of newborn screening, had thyroid hypoplasia and were treated with levothyroxine. Next-generation sequencing-based mutation screening was performed. Functionality of the identified mutations were verified with Western blotting, intracellular localization assays, and transactivation assays with use of HeLa cells. Luciferase complementation assays were used to evaluate the effect of mutations on the interaction between PAX8 and its partner, NKX2-1. RESULTS Each proband had novel truncating PAX8 mutations that were I160Sfs*52, Q213Efs*27, and F342Rfs*85. Western blotting showed destabilization of the I160fs-PAX8 protein. Q213fs-PAX8 and F342fs-PAX8 showed normal protein expression levels and normal nuclear localization, but showed loss of transactivation of the luciferase reporter. By luciferase complementation assays, we showed that PAX8-NKX2-1 interaction was defective in Q213fs-PAX8. We also characterized the recombinant PAX8 proteins, and found that the protein sequence corresponding to exon 10 (363-400 aa residues) was essential for the PAX8-NKX2-1 interaction. CONCLUSIONS Clinical and molecular findings of 3 novel truncating PAX8 mutations located outside the paired domain were reported. Experiments using cultured cells and recombinant proteins showed that the C-terminal portion (ie, 363-400 aa) of PAX8 is required for the PAX8-NKX2-1 interaction.
Collapse
Affiliation(s)
- Megumi Iwahashi-Odano
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
- Department of Pediatrics, The Jikei University School of Medicine, Tokyo, Japan
| | - Keisuke Nagasaki
- Division of Pediatrics, Department of Homeostatic Regulation and Development, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Maki Fukami
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Junko Nishioka
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Shuichi Yatsuga
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Yumi Asakura
- Department of Endocrinology and Metabolism, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Masanori Adachi
- Department of Endocrinology and Metabolism, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Koji Muroya
- Department of Endocrinology and Metabolism, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Tomonobu Hasegawa
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Narumi
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
8
|
Iwahashi-Odano M, Fujisawa Y, Ogata T, Nakashima S, Muramatsu M, Narumi S. Identification and functional characterization of a novel PAX8 mutation (p.His39Pro) causing familial thyroid hypoplasia. Clin Pediatr Endocrinol 2020; 29:173-178. [PMID: 33088016 PMCID: PMC7534521 DOI: 10.1297/cpe.29.173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 07/04/2020] [Indexed: 11/24/2022] Open
Abstract
Mutations in PAX8, the gene for a thyroid-specific transcription factor,
causes congenital hypothyroidism (CH) with autosomal dominant inheritance. All previously
detected PAX8 mutations except one are located in the DNA-binding paired
domain. The proband, a 1-yr-old boy, was diagnosed with CH in the frame
of newborn screening. He had high serum TSH level (180 mU/L) and low serum free
T4 level (0.4 ng/dL). Ultrasonography revealed that the proband had thyroid
hypoplasia. Importantly, he had a family history of CH, i.e., his mother
also had CH and hypoplasia. Next generation sequencing-based mutation screening revealed a
novel heterozygous PAX8 mutation (c.116A>C, p.His39Pro) that was
transmitted to the proband from the mother. Expression experiments with HeLa cells
confirmed that His39Pro-PAX8 exhibited defective transactivation of the
TG promoter–luciferase reporter. In conclusion, we identified and
described a novel loss-of-function PAX8 mutation in a family with thyroid
hypoplasia. Patients with dominantly inherited CH and no extrathyroidal abnormalities
could have PAX8 mutations.
Collapse
Affiliation(s)
- Megumi Iwahashi-Odano
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Yasuko Fujisawa
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tsutomu Ogata
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Shinichi Nakashima
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Mayumi Muramatsu
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Satoshi Narumi
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| |
Collapse
|
9
|
Stoupa A, Al Hage Chehade G, Chaabane R, Kariyawasam D, Szinnai G, Hanein S, Bole-Feysot C, Fourrage C, Nitschke P, Thalassinos C, Pinto G, Mnif M, Baron S, De Kerdanet M, Reynaud R, Barat P, Hachicha M, Belguith N, Polak M, Carré A. High Diagnostic Yield of Targeted Next-Generation Sequencing in a Cohort of Patients With Congenital Hypothyroidism Due to Dyshormonogenesis. Front Endocrinol (Lausanne) 2020; 11:545339. [PMID: 33692749 PMCID: PMC7937947 DOI: 10.3389/fendo.2020.545339] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 12/15/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To elucidate the molecular cause in a well-characterized cohort of patients with Congenital Hypothyroidism (CH) and Dyshormonogenesis (DH) by using targeted next-generation sequencing (TNGS). STUDY DESIGN We studied 19 well-characterized patients diagnosed with CH and DH by targeted NGS including genes involved in thyroid hormone production. The pathogenicity of novel mutations was assessed based on in silico prediction tool results, functional studies when possible, variant location in important protein domains, and a review of the recent literature. RESULTS TNGS with variant prioritization and detailed assessment identified likely disease-causing mutations in 10 patients (53%). Monogenic defects most often involved TG, followed by DUOXA2, DUOX2, and NIS and were usually homozygous or compound heterozygous. Our review shows the importance of the detailed phenotypic description of patients and accurate analysis of variants to provide a molecular diagnosis. CONCLUSIONS In a clinically well-characterized cohort, TNGS had a diagnostic yield of 53%, in accordance with previous studies using a similar strategy. TG mutations were the most common genetic defect. TNGS identified gene mutations causing DH, thereby providing a rapid and cost-effective genetic diagnosis in patients with CH due to DH.
Collapse
Affiliation(s)
- Athanasia Stoupa
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- IMAGINE Institute affiliate, Paris, France
- Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Ghada Al Hage Chehade
- Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Rim Chaabane
- Laboratory of Human Molecular Genetics, Medicine School, University of Sfax, Sfax, Tunisia
| | - Dulanjalee Kariyawasam
- Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Gabor Szinnai
- Pediatric Immunology, Department of Biomedicine, University of Basel, Basel, Switzerland
- Pediatric Endocrinology, University Children’s Hospital Basel, University of Basel, Basel, Switzerland
| | - Sylvain Hanein
- INSERM U1163, IMAGINE Institute, Translational Genetics, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Christine Bole-Feysot
- Genomics Platform, INSERM UMR 1163, Paris Descartes Sorbonne Paris Cite University, Imagine Institute, Paris, France
| | - Cécile Fourrage
- Bioinformatics Platform, Paris Descartes University, IMAGINE Institute, Paris, France
| | - Patrick Nitschke
- Bioinformatics Platform, Paris Descartes University, IMAGINE Institute, Paris, France
| | - Caroline Thalassinos
- Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Graziella Pinto
- Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
| | - Mouna Mnif
- Endocrinology Department, CHU Hedi Chaker, Sfax, Tunisia
| | - Sabine Baron
- Pediatrics Department, CHU Nantes, Nantes, France
| | | | | | - Pascal Barat
- CHU de Bordeaux, Pediatric Endocrinology, Bordeaux, France
| | | | - Neila Belguith
- Laboratory of Human Molecular Genetics, Medicine School, University of Sfax, Sfax, Tunisia
- Medical Genetics Department, CHU Hedi Chaker, Sfax, Tunisia
| | - Michel Polak
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- IMAGINE Institute affiliate, Paris, France
- Pediatric Endocrinology, Gynecology and Diabetology Unit, Hôpital Universitaire Necker-Enfants Malades, AP-HP, Paris, France
- Centre de Référence des Maladies Endocriniennes Rares de la Croissance et du Développement, Necker-Enfants Malades University Hospital, Paris, France
- Centre Régional de Dépistage Néonatal (CRDN) Ile de France, Paris, France
- *Correspondence: Michel Polak, ; Aurore Carré,
| | - Aurore Carré
- INSERM U1016, Cochin Institute, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- IMAGINE Institute affiliate, Paris, France
- *Correspondence: Michel Polak, ; Aurore Carré,
| |
Collapse
|
10
|
Smol T, Ribero-Karrouz W, Edery P, Gorduza DB, Catteau-Jonard S, Manouvrier-Hanu S, Ghoumid J. Mayer-Rokitansky-Künster-Hauser syndrome due to 2q12.1q14.1 deletion: PAX8 the causing gene? Eur J Med Genet 2019; 63:103812. [PMID: 31731040 DOI: 10.1016/j.ejmg.2019.103812] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 11/05/2019] [Accepted: 11/11/2019] [Indexed: 11/19/2022]
Abstract
Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) is a rare malformative disorder, characterized by congenital aplasia of the uterus and the upper two thirds of the vagina (MIM #277000). For a majority of patients, the disorder remained without identified genetic cause. However, four recurrent microdeletions, i.e. 1q21.1-16p11.2-17q12 and 22q11.21, as well as variants in genes contained in these loci, have been identified in a small number of cases. We describe an additional patient with 2q12.1q14.1 microdeletion, showing MRKH and congenital hypothyroidism due to thyroid gland hypoplasia. The patient received a dual diagnosis with microdeletion of SHOX locus in addition to the 2q12.1q14.1 microdeletion. Literature review and database analysis has enabled us to identify 5 OMIM morbid genes: CKAP2L, IL1B, IL1RN, IL36RN and PAX8. Among these, PAX8 (Paired Box Gene 8), a transcriptional factor part of the paired-box family, plays a key role in the development of the thyroid gland, kidneys and Müllerian derivatives. We discuss here the role of PAX8 and speculate on the possible involvement of PAX8 in MRKH. In this study, we report a second case of 2q12.1q14.1 microdeletion, involving PAX8 as a gene associated with Müllerian agenesis in a MRKH I and hypothyroidism. Further studies will confirm the direct participation of PAX8 in gene target sequencing in a population of MRKH with hypothyroidism.
Collapse
Affiliation(s)
- Thomas Smol
- Univ. Lille, EA 7364, RADEME, Maladies RAres Du Developpement Embryonnaire et Du Metabolisme, F-59000, Lille, France; CHU Lille, Institut de Génétique Médicale, F-59000, Lille, France
| | | | - Patrick Edery
- CHU Lyon, Genetics Service and National Reference Centre for Developmental Anomalies, F-69000, Lyon, France; Lyon Neuroscience Research Centre, GENDEV Team, Inserm U1028, CNRS UMR 5292, UCB Lyon1, Lyon, France
| | | | | | - Sylvie Manouvrier-Hanu
- Univ. Lille, EA 7364, RADEME, Maladies RAres Du Developpement Embryonnaire et Du Metabolisme, F-59000, Lille, France; CHU Lille, Clinique de Génétique - Guy Fontaine, F-59000, Lille, France
| | - Jamal Ghoumid
- CHU Lille, Institut de Génétique Médicale, F-59000, Lille, France; CHU Lille, Clinique de Génétique - Guy Fontaine, F-59000, Lille, France.
| |
Collapse
|
11
|
Abstract
Resistance to thyrotropin (RTSH) is broadly defined as reduced sensitivity of thyroid follicle cells to stimulation by biologically active TSH due to genetic defects. Affected individuals have elevated serum TSH in the absence of goiter, with the severity ranging from nongoitrous isolated hyperthyrotropinemia to severe congenital hypothyroidism with thyroid hypoplasia. Conceptually, defects leading to RTSH impair both aspects of TSH-mediated action, namely thyroid hormone synthesis and gland growth. These include inactivating mutations in the genes encoding the TSH receptor and the PAX8 transcription factor. A common third cause has been genetically mapped to a locus on chromosome 15, but the underlying pathophysiology has not yet been elucidated. This review provides a succinct overview of currently defined causes of nonsyndromic RTSH, their differential diagnoses (autoimmune; partial iodine organification defects; syndromic forms of RTSH) and implications for the clinical approach to patients with RTSH.
Collapse
Affiliation(s)
- Helmut Grasberger
- University of Michigan, 6504 MSRB I, 1150 West Medical Center Drive, Ann Arbor, MI 48109, USA.
| | - Samuel Refetoff
- The University of Chicago, MC3090, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
| |
Collapse
|
12
|
PAX8 pathogenic variants in Chinese patients with congenital hypothyroidism. Clin Chim Acta 2015; 450:322-6. [DOI: 10.1016/j.cca.2015.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 09/05/2015] [Accepted: 09/05/2015] [Indexed: 11/22/2022]
|
13
|
Ma D, Marion R, Punjabi NP, Pereira E, Samanich J, Agarwal C, Li J, Huang CK, Ramesh KH, Cannizzaro LA, Naeem R. A de novo 10.79 Mb interstitial deletion at 2q13q14.2 involving PAX8 causing hypothyroidism and mullerian agenesis: a novel case report and literature review. Mol Cytogenet 2014; 7:85. [PMID: 25484916 PMCID: PMC4256837 DOI: 10.1186/s13039-014-0085-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 11/04/2014] [Indexed: 11/17/2022] Open
Abstract
Reports of interstitial deletions involving proximal long arm of chromosome 2 are limited. Based on early chromosomal analysis studies, the phenotypic consequence of deletions at the ancestral chromosome fusion site at chromosome 2q13q14.1 remains unclear. A recurrent 1.71 Mb deletion at 2q13 has recently been proposed as a new genomic disorder, associated with an increased risk of intellectual disability and craniofacial dysmorphism. Herein, we report the case of a 12 year-old girl with unique clinical features including global developmental delay, mullerian agenesis, and hypothyroidism associated with a normal size and position of the thyroid gland, as well as negative thyroid antibodies. Microarray-based comparative genomic hybridization study revealed a de novo 10.79 Mb deletion at 2q13q14.2 (111,548,932–122,336,492), which involves more than 88 UCSC genes, 38 of which are OMIM genes, 7 of which are disease-causing and 3 of which (including GLI2, IL1B and PAX8) show a dominant inheritance pattern.. Interestingly, PAX8 (chr2:113,973,574–114,036,498), a member of the paired-box gene family, is essential for the formation of thyroxine-producing follicular cells. Autosomal dominant transmission of congenital thyroid hypoplasia due to loss-of-function mutation of PAX8 suggests a possible haploinsufficiency effect. Additionally, PAX8 is also expressed in the tissue primordia that form both the mullerian duct derivatives and the upper urinary tracts. A recent study has associated a novel PAX8 mutation with a severe form of hypothyroidism and abnormalities in the urogenital tract. Taken together, the unique clinical manifestation seen in this patient could be attributed to the heterozygous deletion of PAX8 gene. A prospective investigation is merited to fully evaluate the pathogenic effect of the interstitial deletion of 2q13q14.2.
Collapse
Affiliation(s)
- Deqiong Ma
- Molecular Pathology and Cytogenetics Lab, Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, 1635 Poplar Street, Bronx, NY 10461 USA
| | - Robert Marion
- Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY USA
| | | | - Elaine Pereira
- Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY USA
| | - Joy Samanich
- Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY USA
| | - Chhavi Agarwal
- Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY USA
| | - Jianli Li
- Molecular Pathology and Cytogenetics Lab, Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, 1635 Poplar Street, Bronx, NY 10461 USA
| | - Chih-Kang Huang
- Molecular Pathology and Cytogenetics Lab, Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, 1635 Poplar Street, Bronx, NY 10461 USA
| | - K H Ramesh
- Molecular Pathology and Cytogenetics Lab, Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, 1635 Poplar Street, Bronx, NY 10461 USA
| | - Linda A Cannizzaro
- Molecular Pathology and Cytogenetics Lab, Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, 1635 Poplar Street, Bronx, NY 10461 USA
| | - Rizwan Naeem
- Molecular Pathology and Cytogenetics Lab, Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, 1635 Poplar Street, Bronx, NY 10461 USA
| |
Collapse
|
14
|
Vincenzi M, Camilot M, Ferrarini E, Teofoli F, Venturi G, Gaudino R, Cavarzere P, De Marco G, Agretti P, Dimida A, Tonacchera M, Boner A, Antoniazzi F. Identification of a novel pax8 gene sequence variant in four members of the same family: from congenital hypothyroidism with thyroid hypoplasia to mild subclinical hypothyroidism. BMC Endocr Disord 2014; 14:69. [PMID: 25146893 PMCID: PMC4142740 DOI: 10.1186/1472-6823-14-69] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 07/25/2014] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Congenital hypothyroidism is often secondary to thyroid dysgenesis, including thyroid agenesis, hypoplasia, ectopic thyroid tissue or cysts. Loss of function mutations in TSHR, PAX8, NKX2.1, NKX2.5 and FOXE1 genes are responsible for some forms of inherited congenital hypothyroidism, with or without hypoplastic thyroid. The aim of this study was to analyse the PAX8 gene sequence in several members of the same family in order to understand whether the variable phenotypic expression, ranging from congenital hypothyroidism with thyroid hypoplasia to mild subclinical hypothyroidism, could be associated to the genetic variant in the PAX8 gene, detected in the proband. METHODS We screened a hypothyroid child with thyroid hypoplasia for mutations in PAX8, TSHR, NKX2.1, NKX2.5 and FOXE1 genes. We studied the inheritance of the new variant R133W detected in the PAX8 gene in the proband's family, and we looked for the same substitution in 115 Caucasian European subjects and in 26 hypothyroid children. Functional studies were performed to assess the in vitro effect of the newly identified PAX8 gene variant. RESULTS A new heterozygous nucleotide substitution was detected in the PAX8 DNA-binding motif (c.397C/T, R133W) in the proband, affected by congenital hypothyroidism with thyroid hypoplasia, in his older sister, displaying a subclinical hypothyroidism associated with thyroid hypoplasia and thyroid nodules, in his father, affected by hypothyroidism with thyroid hypoplasia and thyroid nodules, and his first cousin as well, who revealed only a subclinical hypothyroidism. Functional studies of R133W-PAX8 in the HEK293 cells showed activation of the TG promoter comparable to the wild-type PAX8. CONCLUSIONS In vitro data do not prove that R133W-PAX8 is directly involved in the development of the thyroid phenotypes reported for family members carrying the substitution. However, it is reasonable to conceive that, in the cases of transcriptions factors, such as Pax8, which establish several interactions in different protein complexes, genetic variants could have an impact in vivo.
Collapse
Affiliation(s)
- Monica Vincenzi
- Department of Life and Reproduction Sciences, University of Verona, Piazzale Scuro 10, 37126 Verona, Italy
| | - Marta Camilot
- Department of Life and Reproduction Sciences, University of Verona, Piazzale Scuro 10, 37126 Verona, Italy
- Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Eleonora Ferrarini
- Department of Endocrinology, Centro di Eccellenza AmbiSEN, University of Pisa, Pisa, Italy
| | - Francesca Teofoli
- Department of Life and Reproduction Sciences, University of Verona, Piazzale Scuro 10, 37126 Verona, Italy
- Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Giacomo Venturi
- Department of Life and Reproduction Sciences, University of Verona, Piazzale Scuro 10, 37126 Verona, Italy
| | - Rossella Gaudino
- Department of Life and Reproduction Sciences, University of Verona, Piazzale Scuro 10, 37126 Verona, Italy
- Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Paolo Cavarzere
- Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Giuseppina De Marco
- Department of Endocrinology, Centro di Eccellenza AmbiSEN, University of Pisa, Pisa, Italy
| | - Patrizia Agretti
- Department of Endocrinology, Centro di Eccellenza AmbiSEN, University of Pisa, Pisa, Italy
| | - Antonio Dimida
- Department of Endocrinology, Centro di Eccellenza AmbiSEN, University of Pisa, Pisa, Italy
| | - Massimo Tonacchera
- Department of Endocrinology, Centro di Eccellenza AmbiSEN, University of Pisa, Pisa, Italy
| | - Attilio Boner
- Department of Life and Reproduction Sciences, University of Verona, Piazzale Scuro 10, 37126 Verona, Italy
- Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Franco Antoniazzi
- Department of Life and Reproduction Sciences, University of Verona, Piazzale Scuro 10, 37126 Verona, Italy
- Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| |
Collapse
|
15
|
Abstract
The most frequent cause of congenital hypothyroidism is thyroid dysgenesis. Thyroid dysgenesis summarizes a spectrum of developmental abnormalities of the embryonic thyroid ranging from complete absence of the thyroid gland (athyreosis), to a normally located but too small thyroid (hypoplasia), or an abnormally located thyroid gland (ectopy). Although considered a sporadic disease, distinct genetic forms of isolated or syndromic thyroid dysgenesis have been described in recent years. However, genetics of thyroid dysgenesis (TD) are mostly not following simple Mendelian patterns, and beside monogenic, multigenic and epigenetic mechanisms need to be considered. The review will highlight the molecular mechanisms of thyroid organogenesis, clinical and genetic features of the different monogenetic forms of thyroid dysgenesis, the aspects relevant for diagnosis and counseling of affected families and current research strategies to get more insight into the non-Medelian mechanisms of normal and abnormal thyroid development.
Collapse
Affiliation(s)
- Gabor Szinnai
- Division of Paediatric Endocrinology and Diabetology, University Children's Hospital Basel UKBB, Spitalstrasse 33, CH-4031 Basel, Switzerland; Department of Biomedicine, University Basel, Spitalstrasse 33, CH-4031 Basel, Switzerland.
| |
Collapse
|
16
|
Wei W, Wang Y, Dong J, Wang Y, Min H, Song B, Shan Z, Teng W, Xi Q, Chen J. Hypothyroxinemia induced by mild iodine deficiency deregulats thyroid proteins during gestation and lactation in dams. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:3233-45. [PMID: 23917811 PMCID: PMC3774435 DOI: 10.3390/ijerph10083233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 07/24/2013] [Accepted: 07/26/2013] [Indexed: 11/17/2022]
Abstract
The main object of the present study was to explore the effect on thyroidal proteins following mild iodine deficiency (ID)-induced maternal hypothyroxinemia during pregnancy and lactation. In the present study, we established a maternal hypothyroxinemia model in female Wistar rats by using a mild ID diet. Maternal thyroid iodine content and thyroid weight were measured. Expressions of thyroid-associated proteins were analyzed. The results showed that the mild ID diet increased thyroid weight, decreased thyroid iodine content and increased expressions of thyroid transcription factor 1, paired box gene 8 and Na+/I- symporter on gestational day (GD) 19 and postpartum days (PN) 21 in the maternal thyroid. Moreover, the up-regulated expressions of type 1 iodothyronine deiodinase (DIO1) and type 2 iodothyronine deiodinase (DIO2) were detected in the mild ID group on GD19 and PN21. Taken together, our data indicates that during pregnancy and lactation, a maternal mild ID could induce hypothyroxinemia and increase the thyroidal DIO1 and DIO2 levels.
Collapse
Affiliation(s)
- Wei Wei
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, 92 North 2nd Road, Shenyang 110001, China; E-Mails: (W.W.); (Y.W.); (J.D.); (Y.W.); (H.M.); (B.S.); (Q.X.)
- Liaoning Provincial Key Laboratory of Endocrine Diseases, the First Hospital of China Medical University, Shenyang 110001, China; E-Mails: (Z.S.); (W.T.)
| | - Yi Wang
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, 92 North 2nd Road, Shenyang 110001, China; E-Mails: (W.W.); (Y.W.); (J.D.); (Y.W.); (H.M.); (B.S.); (Q.X.)
- Liaoning Provincial Key Laboratory of Endocrine Diseases, the First Hospital of China Medical University, Shenyang 110001, China; E-Mails: (Z.S.); (W.T.)
| | - Jing Dong
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, 92 North 2nd Road, Shenyang 110001, China; E-Mails: (W.W.); (Y.W.); (J.D.); (Y.W.); (H.M.); (B.S.); (Q.X.)
- Liaoning Provincial Key Laboratory of Endocrine Diseases, the First Hospital of China Medical University, Shenyang 110001, China; E-Mails: (Z.S.); (W.T.)
| | - Yuan Wang
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, 92 North 2nd Road, Shenyang 110001, China; E-Mails: (W.W.); (Y.W.); (J.D.); (Y.W.); (H.M.); (B.S.); (Q.X.)
| | - Hui Min
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, 92 North 2nd Road, Shenyang 110001, China; E-Mails: (W.W.); (Y.W.); (J.D.); (Y.W.); (H.M.); (B.S.); (Q.X.)
| | - Binbin Song
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, 92 North 2nd Road, Shenyang 110001, China; E-Mails: (W.W.); (Y.W.); (J.D.); (Y.W.); (H.M.); (B.S.); (Q.X.)
| | - Zhongyan Shan
- Liaoning Provincial Key Laboratory of Endocrine Diseases, the First Hospital of China Medical University, Shenyang 110001, China; E-Mails: (Z.S.); (W.T.)
| | - Weiping Teng
- Liaoning Provincial Key Laboratory of Endocrine Diseases, the First Hospital of China Medical University, Shenyang 110001, China; E-Mails: (Z.S.); (W.T.)
| | - Qi Xi
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, 92 North 2nd Road, Shenyang 110001, China; E-Mails: (W.W.); (Y.W.); (J.D.); (Y.W.); (H.M.); (B.S.); (Q.X.)
- Department of Physiology, the University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Jie Chen
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, 92 North 2nd Road, Shenyang 110001, China; E-Mails: (W.W.); (Y.W.); (J.D.); (Y.W.); (H.M.); (B.S.); (Q.X.)
- Liaoning Provincial Key Laboratory of Endocrine Diseases, the First Hospital of China Medical University, Shenyang 110001, China; E-Mails: (Z.S.); (W.T.)
| |
Collapse
|
17
|
Hermanns P, Grasberger H, Cohen R, Freiberg C, Dörr HG, Refetoff S, Pohlenz J. Two cases of thyroid dysgenesis caused by different novel PAX8 mutations in the DNA-binding region: in vitro studies reveal different pathogenic mechanisms. Thyroid 2013; 23:791-6. [PMID: 23308388 PMCID: PMC3704082 DOI: 10.1089/thy.2012.0141] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Mutations in PAX8, a transcription factor gene, cause thyroid dysgenesis (TD). The extreme variability of the thyroid phenotype makes it difficult to identify individuals harboring PAX8 gene mutations. Here we describe two patients with TD and report two novel PAX8 gene mutations (S54R and R133Q). We performed in vitro studies to functionally characterize these mutations. METHODS Using PAX8 expression vectors, we investigated whether the PAX8 mutants localized correctly to the nucleus. To analyze the DNA-binding properties of S54R and R133Q, electrophoretic mobility shift assays were performed. Furthermore, we measured whether the mutant PAX8 proteins were able to activate the thyroglobulin (TG)- and the thyroperoxidase (TPO)-promoters. RESULTS S54R had an impaired binding to DNA and a negligible activity on the TG- and the TPO-promoters. The DNA-binding property of R133Q, which is located in the highly conserved terminal portion of the PAX8 DNA-binding domain, was normal. Interestingly, it also exhibited dramatically impaired activation of the TG- and TPO-promoters. However, R133Q has no dominant negative effect on the WT protein in vitro. Thus, the underlying molecular mechanism by which the function of R133Q is impaired remains to be elucidated. CONCLUSIONS We identified and functionally characterized two novel mutations of the PAX8 gene that lead to TD by distinct mechanisms. A structural defect of the mutant R133Q leading to a reduced capability for induced fit upon DNA interaction might explain the disparity between its apparently normal binding to DNA, but lack of promoter activation.
Collapse
Affiliation(s)
- Pia Hermanns
- Department of Pediatrics, Johannes Gutenberg University Medical School, Mainz, Germany
| | - Helmut Grasberger
- Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Ronald Cohen
- Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Clemens Freiberg
- Department of Pediatrics and Pediatric Neurology, Georg August University Medical School, Göttingen, Germany
| | - Helmuth-Günther Dörr
- Division of Pediatric Endocrinology, Hospital for Children and Adolescents, Friedrich-Alexander–University of Erlangen-Nuremberg, Erlangen, Germany
| | - Samuel Refetoff
- Department of Medicine, The University of Chicago, Chicago, Illinois
- Department of Pediatrics, The University of Chicago, Chicago, Illinois
- Department of Genetics, The University of Chicago, Chicago, Illinois
| | - Joachim Pohlenz
- Department of Pediatrics, Johannes Gutenberg University Medical School, Mainz, Germany
| |
Collapse
|
18
|
Liu SG, Zhang SS, Zhang LQ, Li WJ, Zhang AQ, Lu KN, Wang MJ, Yan SL, Ma X. Screening of PAX8 mutations in Chinese patients with congenital hypothyroidism. J Endocrinol Invest 2012; 35:889-92. [PMID: 22293317 DOI: 10.3275/8239] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Congenital hypothyroidism (CH) is a neonatal endocrine disease with an incidence of 1:2000 to 1:4000 worldwide. In about 85% of patients CH is secondary to thyroid dysgenesis, but its pathogenesis remains unclear. Thyroid transcription factors, such as paired box transcription factor 8 (PAX8), play an important role in thyroid organogenesis and development. AIM To screen PAX8 mutations in Chinese CH patients and characterize the features of PAX8 mutations in China. MATERIALS AND METHODS Blood samples were collected from 300 CH patients in Shandong Province, China, and genomic DNA was extracted from peripheral blood leukocytes. Using PCR and direct sequencing, exon 3 and exon 4 of PAX8 were analyzed. RESULTS Analysis of PAX8 in 300 CH patients revealed heterozygous missense mutations or variations in two unrelated patients; one was a known missense mutation G92A, resulting in an arginine to histidine substitution at codon 31, the other was a missense variation G122T, resulting in the substitution of a glycine at position 41 by a valine residue. The patient with the R31H mutation had CH with thyroid hypoplasia, while the patient with the G41V variation had CH with a eutopic and normal-sized thyroid gland. CONCLUSION We report a heterozygous missense mutation and a variation in PAX8 in two out of 300 unrelated Chinese CH patients, showing that the PAX8 mutation rate is very low in CH patients in China.
Collapse
Affiliation(s)
- S G Liu
- Shandong Provincial Key Laboratory of Metabolic Disease, The Affiliated Hospital of Medical College, Qingdao University, Qingdao, China
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Hashemipour M, Hovsepian S, Kelishadi R. High prevalence of congenital hypothyroidism in Isfahan: Do familial components have a role? Adv Biomed Res 2012; 1:37. [PMID: 23326768 PMCID: PMC3544130 DOI: 10.4103/2277-9175.100130] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Accepted: 03/15/2012] [Indexed: 12/05/2022] Open
Abstract
Background: Despite elimination of iodine deficiency, the rates of both permanent and transient congenital hypothyroidism (CH) in our study were higher than the comparable worldwide rates, which emphasize the major role of genetic factors in the pathogenesis of CH and many studies in this regard confirm this possibility. Materials and Methods: In this review, we report all studies that established during CH screening program regarding familial and genetic component of the disease. Results: Although we could not entirely ignore the possible role of environmental and autoimmune factors in the development and function of thyroid gland, our findings strongly suggest the role of genetic factors as dominant etiologic factor in CH. Conclusion: The studies support the existence of a familial component of CH involving dominant genetic predisposition factors with a low penetrance. Considering the polygenic/multifactorial basis of CH, they suggest the possible involvement of other unknown genes in the pathogenesis of the disease, which may also follow non-Mendelian pattern of inheritance.
Collapse
Affiliation(s)
- Mahin Hashemipour
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | | |
Collapse
|
20
|
Alcántara-Ortigoza MA, González-del Angel A, Martínez-Cruz V, Vela-Amieva M, Sánchez-Pérez C, Moreno-Rojas R, Estandía-Ortega B, Hernández-Martínez N. Molecular analysis of the PAX8 gene in a sample of Mexican patients with primary congenital hypothyroidism: identification of the recurrent p.Arg31His mutation. Clin Endocrinol (Oxf) 2012; 76:148-50. [PMID: 21689132 DOI: 10.1111/j.1365-2265.2011.04153.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
21
|
Affiliation(s)
- Syed Ahmed Zaki
- Department of Pediatrics, Lokmanya Tilak Municipal General Hospital and Medical College, Sion, Mumbai, Maharashtra, India
| | | |
Collapse
|
22
|
Hermanns P, Grasberger H, Refetoff S, Pohlenz J. Mutations in the NKX2.5 gene and the PAX8 promoter in a girl with thyroid dysgenesis. J Clin Endocrinol Metab 2011; 96:E977-81. [PMID: 21450989 PMCID: PMC3100746 DOI: 10.1210/jc.2010-2341] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Screening of the known candidate genes involved in thyroid organogenesis has revealed mutations in a small subset of patients with congenital hypothyroidism due to thyroid dysgenesis (TD). OBJECTIVE We studied a girl with TD who had mutations in two transcription factors involved in thyroid development. RESULTS Sequencing analysis of candidate genes involved in thyroid gland development revealed a new paternally inherited heterozygous mutation in the NKX2.5 gene (S265R) and a new maternally inherited heterozygous mutation in the PAX8 promoter region (-456C>T). Both parents and a brother, who was also heterozygous for both mutations, were phenotypically normal. Immunofluorescence microscopy showed a correct nuclear localization of both wild-type (WT) and mutant NKX2.5 proteins. EMSA demonstrated that the mutant NKX2.5 binds to the NKE_2, DIO2, TG, and TPO promoter elements equally well as the WT protein. However, the mutant NKX2.5 protein showed a 30-40% reduced transactivation of the thyroglobulin and the thyroid peroxidase promoters and a dominant-negative effect of the mutant NKX2.5. EMSA studies of the WT and mutant PAX8 promoter sequences incubated with nuclear extracts from PCCL3 cells exhibited a loss of protein binding capacity of the mutant promoter. In addition, the mutant PAX8 promoter showed a significantly reduced transcriptional activation of a luciferase reporter gene in vitro. Thus, this promoter mutation is expected to lead to reduced PAX8 expression. CONCLUSIONS We identified new heterozygous mutations in both NKX2.5 and PAX8 genes of a girl with TD. Both defects might contribute to the phenotype.
Collapse
Affiliation(s)
- Pia Hermanns
- Department of Pediatrics, Johannes Gutenberg University Medical School, Langenbeckstrasse 1, D-55101 Mainz, Germany
| | | | | | | |
Collapse
|