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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 7

Thyroid hormone (T3) signaling and downstream regulatory programs during muscle regeneration.

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Thyroid hormone (T3) signaling and downstream regulatory programs during...
(A) Percentage of cells in each population expressing Thra, Thrb, Dio2, and Dio3. (B) Temporal modeling of Thra/b activity (generalized additive model [GAM], k = 3). GAM-like fits of VIPER-inferred normalized enrichment scores (NESs; mean ± SEM) for Thra (top) and Thrb (bottom). Lines show temporal trends; ribbons denote ± SEM. Asterisks indicate statistically significant divergence between CTRL and HYPO trajectories (**P < 0.01, ***P < 0.001, ANOVA comparing GAM smooths). (C) Line plots show CollecTRI-VIPER NESs for proliferative (Myc/E2f) and oxidative (Foxo/Ppargc1a) transcriptional programs across cells. Each line represents the average program activity per condition and time point. In FAPs, hypothyroidism suppressed the Myc/E2f cycling module at baseline and 5 days post-injury (dpi) but reactivated it at 14 dpi, while the oxidative Foxo/Ppargc1a program showed the opposite trend: early induction and late repression. Myogenic cells showed a similar inversion of proliferative and oxidative trajectories, whereas myeloid populations exhibited only a transient oxidative increase at 5 dpi. (D and E) Tile heatmap displaying hypothyroid-induced changes in LR interactions stratified by sender (rows) and receiver (columns) for each pathway family across the 3 regeneration stages. The color scale encodes the effect size (HYPO – CTRL). This figure resolves the directionality of communication. Asterisks indicate FDR-adjusted Wilcoxon’s P values (*P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001). (F) CollecTRI-VIPER transcriptional modeling and LR pathway analysis were integrated to compare direct (Thr regulon) and indirect (ECM, IGF-1, IL-6, Notch) effects across myogenic, FAP, and myeloid lineages. β-Coefficients were summarized as qualitative activation (arrow up), repression (arrow down), or weak effects at early and late stages of regeneration.

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