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Hypothyroidism impairs skeletal muscle regeneration after injury by altering myogenic and nonmyogenic pathways
Paola Aguiari, Valentina Villani, Yan-Yun Liu, Gianni Carraro, Gregory A. Brent, Laura Perin, Anna Milanesi
Paola Aguiari, Valentina Villani, Yan-Yun Liu, Gianni Carraro, Gregory A. Brent, Laura Perin, Anna Milanesi
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Research Article Cell biology Endocrinology Muscle biology

Hypothyroidism impairs skeletal muscle regeneration after injury by altering myogenic and nonmyogenic pathways

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Abstract

Thyroid hormone signaling is an essential regulator of skeletal muscle development, function, and metabolism, yet the specific signaling pathways required for muscle regeneration are not yet defined. We used scRNA-seq and the FUCCI (fluorescent ubiquitination-based cell cycle indicator) reporter mouse model to examine how hypothyroidism impacts repair processes after cardiotoxin-induced injury in mice. During regeneration, and up to 2 months after injury, hypothyroid muscles displayed smaller myofibers and a shift to slower oxidative fiber types. scRNA-seq of tibialis anterior muscle during regeneration revealed that hypothyroidism reduced myogenic-lineage diversity. Cell cycle analysis confirmed delayed cell cycle progression at 5 and 14 days after injury, with skeletal muscle stem cells stalled at the G1/S transition, hindering differentiation. Transcriptomic data revealed altered nonmyogenic dynamics, including elevated activated fibro-adipogenic progenitors (FAPs) early in repair and persistent proinflammatory macrophages. Integrative regulon and ligand-receptor analysis further demonstrated that triiodothyronine acted through dual modes: a direct transcriptional control of myogenic cell cycle and oxidative programs and an indirect paracrine remodeling mediated by FAP and immune signaling networks. This study identified what we believe to be novel effects of hypothyroidism on myogenic heterogeneity and impaired tissue repair, offering insights into muscle-wasting mechanisms relevant to hypothyroidism-associated myopathy and sarcopenia.

Authors

Paola Aguiari, Valentina Villani, Yan-Yun Liu, Gianni Carraro, Gregory A. Brent, Laura Perin, Anna Milanesi

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Figure 2

scRNA-seq of TAM shows different muscle-resident cell dynamics in response to injury in hypothyroid versus control mice.

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scRNA-seq of TAM shows different muscle-resident cell dynamics in respon...
(A) Experimental design overview. Single cells were collected from TAMs isolated from control and hypothyroid mice before injury and 5 and 14 days after cardiotoxin-induced injury, and subjected to scRNA-seq followed by downstream analysis. Created in BioRender (Aguiari P, 2026, https://BioRender.com/rz1yprc). (B) t-SNE embedding of integrated dataset from control and hypothyroid muscle scRNA-seq datasets from all the time points, colored by population. (C) Bubble plot showing the expression of canonical markers in each population. Average gene expression values are scaled. (D) t-SNE embedding of integrated dataset from control and hypothyroid scRNA-seq data colored by population and grouped by time point. (E) Graph showing the relative proportion of each cell type in control and hypothyroid regenerating muscles at the different time points, shown as a percentage. Number of cells for each sample: CTRL NI, 2,303; CTRL 5d, 4,852; CTRL 14d, 6,588; HYPO NI, 1,055; HYPO 5d, 4,312; HYPO 14d, 3,299.

Copyright © 2026 American Society for Clinical Investigation
ISSN 2379-3708

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