J Clin Invest. 1994 Aug;94(2):506-15. doi: 10.1172/JCI117362.

Genetic analysis of 29 kindreds with generalized and pituitary resistance to thyroid hormone. Identification of thirteen novel mutations in the thyroid hormone receptor beta gene.

The Journal of clinical investigation

M Adams, C Matthews, T N Collingwood, Y Tone, P Beck-Peccoz, K K Chatterjee

PMID: 8040303 PMCID: PMC296123 DOI: 10.1172/JCI117362
Free PMC Article

Abstract

Resistance to thyroid hormone (RTH), with elevated serum free thyroid hormones and nonsuppressed thyrotropin levels, is either relatively asymptomatic, suggesting a generalized disorder (GRTH) or associated with thyrotoxic features, indicating possible selective pituitary resistance (PRTH). 20 GRTH and 9 PRTH cases, sporadic or dominantly inherited, were analyzed. Affected individuals were heterozygous for single nucleotide substitutions in the thyroid hormone receptor beta gene, except for a single case of a seven nucleotide insertion. With one exception, the corresponding 13 novel and 7 known codon changes localized to and extended the boundaries of two mutation clusters in the hormone-binding domain of the receptor. 15 kindreds shared 6 different mutations, and haplotype analyses of the mutant allele showed that they occurred independently. The majority (14 out of 19) of the recurrent but a minority (1 out of 10) of unique mutations were transitions of CpG dinucleotides. Mutant receptor binding to ligand was moderately or severely impaired and did not correlate with the magnitude of thyroid dysfunction. There was no association between clinical features and the nature or location of a receptor mutation. These observations suggest that GRTH and PRTH are phenotypic variants of the same genetic disorder, whose clinical expression may be modulated by other non-mutation-related factors.

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Substances

• Receptors, Thyroid Hormone
• Thyroid Hormones

MeSH terms

• Adolescent
• Adult
• Amino Acid Sequence
• Base Sequence
• Child
• Child, Preschool
• Drug Resistance
• Female
• Haplotypes
• Humans
• Male
• Middle Aged
• Molecular Sequence Data
• Mutation*
• Pituitary Gland / drug effects
• Receptors, Thyroid Hormone / chemistry
• Receptors, Thyroid Hormone / genetics
• Receptors, Thyroid Hormone / metabolism
• Structure-Activity Relationship
• Thyroid Hormones / pharmacology

Publication Types

• Journal Article
• Research Support, Non-U.S. Gov't

Grant support

• Wellcome Trust/United Kingdom

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