Ho Sin Yee, Stella. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1997. / Includes bibliographical references (leaves 94-105). / Background --- p.1 / Chapter Chapter 1 --- Introduction / Thyrotoxicosis --- p.3 / Graves' Disease --- p.5 / Laboratory Assessment of the Mothers --- p.7 / Placental Transfer --- p.10 / Effects of Maternal Thyroid and Antithyroid Agents on the Fetus --- p.13 / Diagnostic and Screening Tests for Fetal Thyroid Dysfunction --- p.19 / Fetal Treatment --- p.21 / Aims and Objectives of the Research --- p.24 / Chapter Chapter 2 --- Subjects and Methods / Patients' Profile --- p.26 / Categorization of the Thyrotoxic Population --- p.28 / Intraobserver Error --- p.30 / Pilot Study --- p.31 / Equipment --- p.31 / Measurements --- p.32 / Growth Charts employed --- p.32 / Imaging Technique --- p.33 / Calculations --- p.39 / Gestational Age of the Fetus --- p.41 / Analytical Methods --- p.43 / Chapter Chapter 3 --- Results / Intraobserver Error --- p.45 / Pilot Study --- p.45 / Maternal Thyroid Status (Thyrotoxic Population) --- p.48 / Fetal Thyroid Volume --- p.49 / Rate of Fetal Thyroid Growth --- p.59 / Fetal Thyroid Volume to Estimated Fetal Weight Ratios (V/W) --- p.60 / Birthweight of the Infants --- p.63 / Chapter Chapter 4 --- Discussion / Methodology --- p.64 / Findings and Observations --- p.71 / Chapter Chapter 5 --- Conclusions --- p.92 / References --- p.94 / Appendix I --- p.106

"Publication authorized September 2, 1943." / Includes bibliographical references (p. 69-75).

Congenital hypothyroidism (CH) is the most frequent of the rare endocrine diseases (e.g. Addison's disease, Cushing's syndrome, Congenital adrenal hyperplasia.), which affects 1:2000 – 4000 newborns. If not immediately diagnosed after birth, thyroid hormones deficiency causes severe defects in brain and skeletal development leading to a complex clinical scenario called cretinism. CH can be due to a defective synthesis of thyroid hormones (dyshormonogenesis) or an abnormal embryonic development of the gland. Data obtained using knockout mouse models have shown the pivotal role of four specific transcription factors (NKX2.1, PAX8, FOXE1 and HHEX) for the correct organogenesis or function of the gland. Although mutations in those genes have been identified in few cases of CH patients, the pathogenetic mechanisms remain still elusive in the vast majority of CH cases (95%).<p>For the identification of new genes and molecular events controlling thyroid organogenesis it would be useful to develop an in vitro cellular model to recapitulate thyroid embryogenesis in a dish. Embryonic Stem Cells (ESCs) have recently emerged as system model to recapitulate the embryogenesis of several tissues in vitro.<p>Induced overexpression of defined transcription factors has been shown to have a directing effect on the differentiation of pluripotent stem cells into specific cell types. In this thesis I show that a transient overexpression of the transcription factors NKX2.1 and PAX8 is sufficient to direct the differentiation of murine ESCs into thyroid follicular cells (TFC) and promotes in vitro self- assembly of TFC into three-dimensional follicular structures, when associated to a subsequent thyrotropin (TSH) treatment. Cells differentiated by this protocol showed significant iodide organification activity, a hallmark of thyroid tissue function. Importantly, athyroid mice grafted with mESC-derived thyroid follicles show normalization of plasma T4 levels with concomitant decrease of plasma TSH. In addition, a full normalization of body temperature at 4 weeks after transplantation was observed. Together, these data clearly demonstrate that grafting of our mESC-derived thyroid cells rescues the hypothyroid state and triggers symptomatic recovery along with the normalization of plasma hormone concentrations. The high efficiency of TFC differentiation and follicle morphogenesis in our system will provide an unprecedented opportunity for future studies to decipher regulatory mechanisms involved in embryonic thyroid development, a major research need towards an improved understanding of the molecular mechanisms underlying congenital hypothyroidism, the most common congenital endocrine disorder in humans. / Doctorat en Sciences biomédicales et pharmaceutiques / info:eu-repo/semantics/nonPublished

Congenital Hypothyroidism (CH) is the most common endocrine disorder, affecting one out of 2000-4000 newborns. Most CH are due to a defect in thyroid embryonic development and they can lead to severe phenotypes if not treated correctly. Multiple observations argue in favor of a genetic cause in a minority of thyroid dysgenesis, but to date, only few cases could be explained by a mutation in one of the genes coding for the factors known to be important in thyroid development and/or function (NKX2-1, PAX8, FOXE1, TSHR). This is the reason why it was important to develop new models allowing the discovery of new genes/mechanisms potentially implicated in the gland organogenesis. To that purpose, we set up in the laboratory a structure enabling the use of zebrafish as an animal model. The latter is indeed more and more used by developmental biologists, including by scientists interested in thyroid development.<p><p>The first step of our project consisted in a deeper characterization of the model, notably by the study of the expression patterns of the thyroid functional differentiation markers. Furthermore, the exact role of the Tsh/Tshr signaling – main regulator of thyroid growth and function in mammals – was dissected. In a second part of the project, we generated a stable transgenic line (tg(tg:mCherry)) allowing the visualization of thyroid development in living embryos and in a dynamic manner, thanks to real-time imaging techniques. On the one hand, this tool enabled us to better understand the morphological aspect of the different stages of thyroid development, such as the budding, evagination, relocalization or folliculogenesis. On the other hand, the use of double transgenic fishes obtained by crossing tg(tg:mCherry) with other lines expressing GFP in surrounding structures of interest, allowed us to highlight the contacts between the cardiovascular system and thyroid, and this along the whole gland development. The introduction of this model within the laboratory paves the way for the discovery and the study of thyroid intrinsic and extrinsic genes/mechanisms which might play a role on its development.<p><p>L’hypothyroïdie congénitale (HC) est une maladie relativement fréquente, touchant un nouveau-né sur 2000-4000. La majorité des HC sont dues à un défaut dans le développement embryonnaire de la glande, et peuvent mener à des phénotypes sévères si elles ne sont pas correctement traitées. Il existe plusieurs arguments en faveur d’une cause génétique dans une minorité de ces dysgénésies thyroïdiennes mais, à ce jour, seuls quelques cas ont pu être reliés à une mutation dans un des gènes codant pour des facteurs connus pour être importants dans le développement/la fonction de la glande (NKX2-1, PAX8, FOXE1, TSHR). C’est pour cette raison qu’il est important de développer de nouveaux modèles pouvant permettre la découverte de nouveaux gènes/mécanismes potentiellement impliqués dans l’organogénèse de la glande. A cette fin, nous avons mis en place au sein du laboratoire une structure permettant l’utilisation du poisson-zèbre comme modèle animal. Ce dernier est en effet de plus en plus utilisé par les biologistes du développement, y compris par les scientifiques qui s’intéressent au développement thyroïdien.<p><p>La première étape de notre travail a consisté en une caractérisation approfondie du modèle, notamment par l’étude du réseau d’expression des marqueurs de différenciation fonctionnelle de la glande. En outre, le rôle exact de la signalisation par la TSH – principal régulateur de la croissance et de la fonction de la thyroïde des mammifères – a été étudié. Dans la deuxième partie du projet, nous avons généré une ligne transgénique stable (tg(tg:mCherry)) permettant la visualisation du développement thyroïdien dans des embryons vivants et ce, de manière dynamique, grâce au principe d’imagerie en temps réel. D’une part, cet outil nous a permis de mieux comprendre l’aspect morphologique des différentes étapes du développement thyroïdien, telles que la formation du bourgeon, l’invagination, la relocalisation ou la folliculogénèse. D’autre part, l’utilisation de poissons doublement transgéniques obtenus par le croisement de tg(tg:mCherry) avec d’autres lignées où les structures environnantes d’intérêt expriment la GFP nous a permis de mettre en avant les contacts entre le système cardiovasculaire et la thyroïde, et ce, tout au long de son développement. La mise en place de ce modèle au sein de notre laboratoire ouvre la voie à la découverte et à l’étude de mécanismes/gènes extrinsèques à la thyroïde mais pouvant jouer un rôle sur son développement. / Doctorat en Sciences agronomiques et ingénierie biologique / info:eu-repo/semantics/nonPublished