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DIO3 protects against thyrotoxicosis-derived cranio-encephalic and cardiac congenital abnormalities
M. Elena Martinez, … , Thomas Gridley, Arturo Hernandez
M. Elena Martinez, … , Thomas Gridley, Arturo Hernandez
Published September 27, 2022
Citation Information: JCI Insight. 2022;7(21):e161214. https://doi.org/10.1172/jci.insight.161214.
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Research Article Development Endocrinology

DIO3 protects against thyrotoxicosis-derived cranio-encephalic and cardiac congenital abnormalities

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Abstract

Maternal hyperthyroidism is associated with an increased incidence of congenital abnormalities at birth, but it is not clear which of these defects arise from a transient developmental excess of thyroid hormone and which depend on pregnancy stage, antithyroid drug choice, or unwanted subsequent fetal hypothyroidism. To address this issue, we studied a mouse model of comprehensive developmental thyrotoxicosis secondary to a lack of type 3 deiodinase (DIO3). Dio3–/– mice exhibited reduced neonatal viability on most genetic backgrounds and perinatal lethality on a C57BL/6 background. Dio3–/– mice exhibited severe growth retardation during the neonatal period and cartilage loss. Mice surviving after birth manifested brain and cranial dysmorphisms, severe hydrocephalus, choanal atresia, and cleft palate. These abnormalities were noticeable in C57BL/6J Dio3–/– mice at fetal stages, in addition to a thyrotoxic heart with septal defects and thin ventricular walls. Our findings stress the protecting role of DIO3 during development and support the hypothesis that human congenital abnormalities associated with hyperthyroidism during pregnancy are caused by transient thyrotoxicosis before clinical intervention. Our results also suggest thyroid hormone involvement in the etiology of idiopathic pathologies including cleft palate, choanal atresia, Chiari malformations, Kaschin-Beck disease, and Temple and other cranio-encephalic and heart syndromes.

Authors

M. Elena Martinez, Ilka Pinz, Marilena Preda, Christine R. Norton, Thomas Gridley, Arturo Hernandez

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Figure 6

Altered gene expression in the heart of Dio3–/– fetuses.

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Altered gene expression in the heart of Dio3–/– fetuses.
(A) Volcano plo...
(A) Volcano plot of gene expression in the Dio3–/– E14.5 fetal heart. (B) Heatmap of 364 differentially expressed genes (P < 0.05) in the E14.5 fetal heart (n = 4, values for each gene were normalized to 1 as the mean of all samples). (C) Top upstream regulators (based on P values and activation scores) whose pathways are altered in Dio3–/– E14.5 fetal heart as determined by Ingenuity analyses. Dotted lines indicate the threshold established by the software to indicate substantial activation/inactivation (D) qPCR validation of differentially expressed genes in independent RNA samples isolated from E14.5 fetal hearts (n = 8, 6). (E) Expression of the same genes in E18.5 fetal hearts (n = 11, 8). *** indicates P < 0.001, as determined by the Student’s 2-tailed t test.

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