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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 8

Palate and cardiac defects and altered fetal growth trajectories.

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Palate and cardiac defects and altered fetal growth trajectories.
(A) Re...
(A) Representative MR images (n = 5, 10, 4) illustrating craniofacial, palate, and cardiac defects (yellow arrows) in littermate E14.5 fetuses of the 3 genotypes. (B) Correlation of cranial length and weight in E14.5 fetuses and association with congenital defects. Data included E14.5 fetuses of all genotypes and also fetuses generated by wild-type parents. (C) Photograph illustrating growth retardation in a Dio3–/– E10.5 embryos compared to a Dio3+/+ littermate. (D and E) E13.5 and E18.5 weight, respectively, of fetuses of different genotypes and generated by heterozygous crosses or by WT crosses (n = 6–43). (F and G) E13.5 and E18.5 weight, respectively, of placentas from fetuses of different genotypes and by heterozygous crosses or by WT crosses (n = 6–24). **, *** indicate P < 0.01 and 0.001, respectively, as determined by 1-way ANOVA and Tukey’s post hoc test.

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