Go to The Journal of Clinical Investigation
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Transfers
  • Advertising
  • Job board
  • Contact
  • Physician-Scientist Development
  • Current issue
  • Past issues
  • By specialty
    • COVID-19
    • Cardiology
    • Immunology
    • Metabolism
    • Nephrology
    • Oncology
    • Pulmonology
    • All ...
  • Videos
  • Collections
    • In-Press Preview
    • Resource and Technical Advances
    • Clinical Research and Public Health
    • Research Letters
    • Editorials
    • Perspectives
    • Physician-Scientist Development
    • Reviews
    • Top read articles

  • Current issue
  • Past issues
  • Specialties
  • In-Press Preview
  • Resource and Technical Advances
  • Clinical Research and Public Health
  • Research Letters
  • Editorials
  • Perspectives
  • Physician-Scientist Development
  • Reviews
  • Top read articles
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Transfers
  • Advertising
  • Job board
  • Contact
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
View: Text | PDF
Research Article Cell biology Endocrinology Muscle biology

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

  • Text
  • PDF
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

×

Figure 5

Hypothyroidism impairs muscle stem cell cycle progression and fiber type regeneration following injury.

Options: View larger image (or click on image) Download as PowerPoint
Hypothyroidism impairs muscle stem cell cycle progression and fiber type...
(A) Pax7-Fucci2aR mice are generated by crossing of Fucci2aR and mice expressing Cre recombinase under the Pax7 promoter (Pax7-Cre). (B) Immunofluorescence images of uninjured and injured TAM 3 days after muscle injury, showing expression of the Fucci2aR reporter fluorophores mCherry (red) and mVenus (green). Nuclei in blue. Scale bars: 50 μm. (C) Experimental design overview. Primary cells were collected from TAMs isolated from control and hypothyroid mice before injury and 5, 7, and 14 days after cardiotoxin injury (n = 3 for each group) and subjected to flow cytometry analysis. Created in BioRender (Aguiari P, 2026, https://BioRender.com/dshnhgx). (D) Representative graphs showing selection of CD31–CD45–SCA1–VCAM1+ population by flow cytometry. (E) Representative quadrant of Fucci2aR reporter mVenus and mCherry expression in the VCAM1+ population: mVenus+ (M/G2, green), mCherry+ (G1, red), mVenus+mCherry+ (G1/S, yellow), and mVenus–mCherry– (G0). (F) Superimposed dot plot graph showing proportion of MuSCs in different phases of the cell cycle in control and hypothyroid myogenic muscles before and 5, 7, and 14 dpi, as identified by flow cytometry analysis. *P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001. (G) Experimental design overview. TAMs were isolated from control and hypothyroid mice before injury and 5, 7, 14, and 28 days after cardiotoxin injury (n = 3 for each group) and subjected to histological analysis. Created in BioRender (Aguiari P, 2026, https://BioRender.com/ksp4qn5). (H) Immunofluorescence of TAM sections from control and hypothyroid mice at different time points before and after injury: myosin type I (MYH7, magenta), type IIa (MYH2, yellow), type IIb (MYH4, green), and laminin (white). Type IIx (MYH1) unstained. Scale bars: 100 μm. (I) Histogram plot showing proportion of different fiber types in TAM during regeneration at 0, 7, 14, and 28 days after cardiotoxin-induced injury. Data are presented as mean ± SEM. n = 3. Two-way ANOVA was used for statistical analysis. ***P < 0.001, ****P < 0.0001, in hypothyroid compared with time point–matched control fibers. The experiment was repeated 3 times independently under identical conditions. C, control; H, hypothyroid; CTRL, control; HYPO, hypothyroid.

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

Sign up for email alerts