The length of FOXE1 polyalanine tract in congenital hypothyroidism: Evidence for a pathogenic role from familial, molecular and cohort studies

Front Endocrinol (Lausanne). 2023 Mar 16:14:1127312. doi: 10.3389/fendo.2023.1127312. eCollection 2023.

Abstract

Introduction: FOXE1 is required for thyroid function and its homozygous mutations cause a rare syndromic form of congenital hypothyroidism (CH). FOXE1 has a polymorphic polyalanine tract whose involvement in thyroid pathology is controversial. Starting from genetic studies in a CH family, we explored the functional role and involvement of FOXE1 variations in a large CH population.

Methods: We applied NGS screening to a large CH family and a cohort of 1752 individuals and validated these results by in silico modeling and in vitro experiments.

Results: A new heterozygous FOXE1 variant segregated with 14-Alanine tract homozygosity in 5 CH siblings with athyreosis. The p.L107V variant demonstrated to significantly reduce the FOXE1 transcriptional activity. The 14-Alanine-FOXE1 displayed altered subcellular localization and significantly impaired synergy with other transcription factors, when compared with the more common 16-Alanine-FOXE1. The CH group with thyroid dysgenesis was largely and significantly enriched with the 14-Alanine-FOXE1 homozygosity.

Discussion: We provide new evidence that disentangle the pathophysiological role of FOXE1 polyalanine tract, thereby significantly broadening the perspective on the role of FOXE1 in the complex pathogenesis of CH. FOXE1 should be therefore added to the group of polyalanine disease-associated transcription factors.

Keywords: FOXE1; athyreosis; congenital hypothyroidism; forkhead transcription factor; next generation sequencing; polyalanine tracts.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Congenital Hypothyroidism* / genetics
  • Forkhead Transcription Factors / genetics
  • Humans
  • Peptides / genetics
  • Transcription Factors / genetics

Substances

  • polyalanine
  • Peptides
  • Transcription Factors
  • FOXE1 protein, human
  • Forkhead Transcription Factors

Grants and funding

The study was partially supported by the Italian Ministry of Health, Rome, Italy (grants: RF-2010–2309484 and 05C002_2010 to LP). RC-B and MB were supported by the National Health and Medical Research Council, Australia (grant: 1061941). We acknowledge funding from Human Technopole and from the European Research Council (ERC-2021-STG Thyromol #101041298) to FC.