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A Mouse Model Demonstrates a Multigenic Origin of Congenital Hypothyroidism

Stazione Zoologica A. Dohrn (E.A., P.D.L., A.A., R.D.L., M.D.F.), Laboratorio di Genetica Animale at CEINGE, 80145 Naples, Italy; Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica (P.E.M.) and Dipartimento di Biologia e Patologia Cellulare e Molecolare (D.T., V.M., R.D.L.), Università Federico II, and Biogem at CEINGE (A.R.), Naples, Italy; Instituto Nazionale Tumori Fondazione Pascale (G.C., C.A.), 80131 Naples, Italy; Laboratory of Metabolism (S.K.), National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892; and Max Planck Institute für Biophysikalische Chemie (A.M.), Abteilung Molekulare Zellbiologie, 37077 Göttingen, Germany

Address all correspondence and requests for reprints to: Prof. Roberto Di Lauro, Laboratory of Animal Genetics, Stazione Zoologica Anton Dohrn, at CEINGE Via Comunale Margherita no. 482, 80145 Napoli, Italy. E-mail: rdilauro{at}unina.it.

Congenital hypothyroidism with thyroid dysgenesis (TD) is a frequent human condition characterized by elevated levels of TSH in response to reduced thyroid hormone levels. Congenital hypothyroidism is a genetically heterogeneous disease. In the majority of cases studied, no causative mutations have been identified and very often the disease does not show a Mendelian transmission. However, in approximately 5% of cases, it can be a consequence of mutations in genes encoding the TSH receptor or the transcription factors TITF1, FOXE1, or PAX8. We report here that in mouse models, the combination of partial deficiencies in the Titf1 and Pax8 genes results in an overt TD phenotype that is absent in either of the singly deficient, heterozygous mice. The disease is characterized by a small thyroid gland, elevated levels of TSH, reduced thyroglobulin biosynthesis, and high occurrence of hemiagenesis. The observed phenotype is strain specific, and the pattern of transmission indicates that at least two other genes, in addition to Titf1 and Pax8, are necessary to generate the condition. These results show that TD can be of multigenic origin in mice and strongly suggest that a similar pathogenic mechanism may be observed in humans.

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