Indiana University-Purdue University Indianapolis (IUPUI) / LHX3 is a LIM-homeodomain transcription factor that has essential roles in pituitary and nervous system development in mammals. Children who are homozygous for recessive mutations in the LHX3 gene present with combined pituitary hormone deficiency disease (CPHD) characterized by deficits of multiple anterior pituitary hormones. Most LHX3 patients also present with additional defects associated with the nervous system including a characteristic limited head rotation and sometimes deafness. However, of the 10 types of LHX3 mutation described to date, one mutation type (W224ter) does not result in the limited head rotation, defining a new form of the disease. W224ter patients have CPHD but do not have nervous system symptoms. Whereas other mutations in LHX3 cause loss of the entire protein or its activity, the W224ter mutation causes specific loss of the carboxyl terminal of the LHX3 protein—a region that we have shown to contain critical regulatory domains for pituitary gene activation. To better understand the molecular and cellular etiology of CPHD associated with LHX3 gene mutations, I have generated knock-in mice that model the human LHX3 W224ter disease. The resulting mice display marked dwarfism, thyroid disease, female infertility, and reduced male fertility. Immunohistochemistry, real-time quantitative polymerase chain reaction (PCR), and enzyme-linked immunosorbant assays (ELISA) were used to measure hormones and regulatory factor protein and RNA levels, an approach which is not feasible with human patients. We have generated a novel mouse model of human pediatric CPHD. Our findings are consistent with the hypothesis that the actions of the LHX3 factor are molecularly separable in the nervous system and pituitary gland.

Chez la souris, Six6 et Lhx2 sont exprimés dans l'œil et la glande pituitaire en développement. Par une approche "gènes candidats", les ADN de patients avec un phénotype proche de celui de souris invalidées pour ces gènes ont été séquencés. Aucune mutation a été mise en évidence pour SIX6. Deux variations hétérozygotes faux-sens de LHX2 ont été identifiées mais n'ont pas d'effet (tests in vitro). LHX2 a un rôle régulateur transcriptionnel in vitro sur deux gènes pituitaires (PRL, POU1F1), et en action synergique avec POU1F1. Deux mutations hétérozygotes composites de LHX3 chez un patient non consanguin ont permis d'assigner à ce gène un syndrome décrit uniquement chez des patients consanguins. Une de ces mutations a un effet dominant négatif. POU1F1, impliqué dans la différenciation pituitaire terminale, est associé en pathologie humaine à un déficit en hormone de croissance (GH), PRL et TSHβ. L'expression de GH est régulée par la fixation de POU1F1 sur son promoteur et sur un " Locus Control Region " mais ses cofacteurs ne sont pas connus. Deux mutations faux-sens identifiées dans le domaine de transactivation (TAD) de POU1F1 sont associées à un déficit isolé en GH. La résonnance plasmonique de surface a permis de définir les interactions de POU1F1 (normal et mutés) sur ses séquences cibles ; des extraits nucléaires sont passés avec POU1F1 (normal et mutés) afin d'identifier (par spectrométrie de masse) ses partenaires au locus GH. Une cristallographie du TAD a débuté pour analyser sa structure tridimensionnelle qui est probablement altéré par les mutations identifiées

Indiana University-Purdue University Indianapolis (IUPUI) / LHX3 is a transcription factor important in pituitary and nervous system development. Patients with mutations in coding regions of the gene have combined pituitary hormone deficiency (CPHD) that causes growth, fertility, and metabolic problems. Promoter and intronic elements of LHX3 important for basal gene expression in vitro have been identified, but the key regulatory elements necessary for in vivo expression were unknown. With these studies, I sought to elucidate how LHX3 gene expression is regulated in vivo. Based on sequence conservation between species in non-coding regions, I identified a 7.9 kilobase (kb) region 3' of the human LHX3 gene as a potential regulatory element. In a beta galactosidase transgenic mouse model, this region directed spatial and temporal expression to the developing pituitary gland and spinal cord in a pattern consistent with endogenous LHX3 expression. Using a systematic series of deletions, I found that the conserved region contains multiple nervous system enhancers and a minimal 180 base pair (bp) enhancer that direct expression to both the pituitary and spinal cord in transgenic mice. Within this minimal enhancer, TAAT/ATTA sequences that are characteristic of homeodomain protein binding sites are required to direct expression. I performed DNA binding experiments and chromatin immunoprecipitation assays to reveal that the ISL1 and PITX1 proteins specifically recognize these elements in vitro and in vivo. Based on in vivo mutational analyses, two tandem ISL1 binding sites are required for enhancer activity in the pituitary and spine and a PITX1 binding site is required for spatial patterning of gene expression in the pituitary. Additional experiments demonstrated that these three elements cannot alone direct gene expression, suggesting a combination of factors is required for enhancer activity. This study reveals that the key regulatory elements guiding developmental regulation of the human LHX3 gene lie in this conserved downstream region. Further, this work implicates ISL1 as a new transcriptional regulator of LHX3 and describes a possible mechanism for the regulation of LHX3 by a known upstream factor, PITX1. Identification of important regulatory regions will also enable genetic screening in candidate CPHD patients and will thereby facilitate patient treatment and genetic counseling.

In den letzten fünf Jahren gelang es, drei neue genetische Krankheitsbilder aus dem Kreis der pädiatrischen Endokrinologie klinisch zu beschreiben und deren genetische Grundlage aufzuklären. Hierbei waren vor allem die klinischen Erscheinungsbilder ungewöhnlicher Patienten, die neben bekannten hormonellen Ausfällen durch assoziierte Defekte auffielen, für die gezielte Suche nach genetischen Defekten ausschlaggebend. In allen drei Fällen konnten die assoziierten Symptome durch den primären genetischen Defekt molekular geklärt werden. Mittlerweile ist bei weiteren Patienten ein Mutationsnachweis gelungen und der zuerst von uns beschriebene Phänotyp konnte jeweils bestätigt werden. Bei den beschriebenen defekten handelt es sich um den POMC Gendefekt (klinisches Bild: Adipositas, rote Haarfarbe und Hypocortisolismus), den LHX3 gendefekt (klinisches Bild: Hypopituitarismus und Enschränkung der Haslrotation) und den NKX2.1 Gendefekt (klinisches Bild: Angeborene Hypothyreose und Choreoathetose). / In the last few years'' three new genetic syndromes were described which affect diseases within the field of paediatric endocrinology. The clinical picture of uncommon patients, which are affected beside known endocrine defects by additional associated symptoms, led to the molecular differential diagnosis which resulted in the description of new mutations. In all three cases the additional symptoms could be explained by the identified genetic defect. Meanwhile additional patients were identified with mutations in the affected genes, which confirmed the initial description of the new clinical diseases. The identified syndromes are: POMC gene defect (clinical picture: obesity, red hair, hypocortisolism), LHX3 gene defect (clinical picture: hypopituitarism and decreased neck movement) and NKX2.1 gene defect (clinical picture: congenital hypothyroidism and choreoathetosis).

Le récepteur hypophysaire de la GnRH (RGnRH) joue un rôle crucial dans le contrôle de la fonctionde reproduction. Dans le promoteur distal du Rgnrh, j'ai caractérisé un élément de réponsebifonctionnel répondant aux protéines LIM à homéodomaine ISL1/LHX3 et à GATA2. D'autre part,deux motifs TAAT situés dans la région plus proximale confèrent à ce gène la capacité de répondreaux facteurs Paired-like PROP1 et OTX2. Tous ces facteurs, exprimés précocement au cours del'ontogenèse hypophysaire, pourraient participer à l'émergence de l'expression du Rgnrh. Hors del'hypophyse, j'ai découvert que le Rgnrh est exprimé au cours du développement postnatal dansl'hippocampe de rat, où il module la plasticité synaptique. Par ailleurs, j'ai identifié deux nouveauxsites d'expression, la rétine et la glande pinéale. Ces résultats mettent en lumière l'importancefonctionnelle de ce récepteur et de son ligand et les rôles multiples qu'il ont acquis au cours del'évolution des Vertébrés.

Le récepteur hypophysaire de la GnRH (RGnRH) joue un rôle crucial dans le contrôle de la fonctionde reproduction. Dans le promoteur distal du Rgnrh, j’ai caractérisé un élément de réponsebifonctionnel répondant aux protéines LIM à homéodomaine ISL1/LHX3 et à GATA2. D’autre part,deux motifs TAAT situés dans la région plus proximale confèrent à ce gène la capacité de répondreaux facteurs Paired-like PROP1 et OTX2. Tous ces facteurs, exprimés précocement au cours del’ontogenèse hypophysaire, pourraient participer à l’émergence de l’expression du Rgnrh. Hors del’hypophyse, j’ai découvert que le Rgnrh est exprimé au cours du développement postnatal dansl’hippocampe de rat, où il module la plasticité synaptique. Par ailleurs, j’ai identifié deux nouveauxsites d’expression, la rétine et la glande pinéale. Ces résultats mettent en lumière l’importancefonctionnelle de ce récepteur et de son ligand et les rôles multiples qu’il ont acquis au cours del’évolution des Vertébrés. / In the pituitary, the GnRH receptor (GnRHR) plays a crucial role in the neuroendocrine control ofreproductive function. Within the distal region of the Gnrhr promoter, I have characterized abifunctional response element modulated by the LIM homeodomain proteins ISL1/LHX3 and byGATA2. Besides, in the proximal region of the promoter, two TAAT motifs conferred response toPaired-like factors PROP1 and OTX2. All these factors are expressed during pituitary ontogenesis andcould participate in the onset and regulation of Gnrhr expression. Outside of the pituitary, I havediscovered that the Gnrhr was expressed during postnatal development in the rat hippocampus, whereit modulated synaptic plasticity. Furthermore, I have identified two novel sites of Gnrhr expression, theretina and the pineal gland. Altogether, these data highlight the functional importance of this receptorand its ligand as well as the multiple roles they have acquired during vertebrate evolution.

Indiana University-Purdue University Indianapolis (IUPUI) / The LHX3 transcription factor is essential for pituitary gland and nervous system development in mammals. In humans, mutations in the LHX3 gene underlie combined pituitary hormone deficiency (CPHD) disease featuring deficits in anterior pituitary hormones and defects in the nervous system. The mechanisms that control temporal and spatial expression of the LHX3 gene are poorly understood. The proximal promoters of the human LHX3 gene are insufficient to guide expression in vivo and downstream elements including a conserved 7.9 kilobase (kb) enhancer region appear to play a role in tissue-specific expression in the pituitary and nervous system. In this study, I characterized the activity of this downstream enhancer region in regulating gene expression at the cellular level during development. Human LHX3 enhancer-driven Cre reporter transgenic mice were generated to facilitate studies of enhancer actions. The downstream LHX3 enhancer primarily guides gene transcription in αGSU-expressing cells secreting the TSHβ, LHβ or FSHβ hormones and expressing the GATA2 and SF1 transcription factors. In the developing nervous system, the enhancer serves as a targeting module for expression specifically in V2a interneurons. These results demonstrate that the downstream LHX3 enhancer is important in specific endocrine and neural cell types but also indicate that additional regulatory elements are likely involved in LHX3 gene expression in other cell types. Further, these studies demonstrate significant gonadotrope cell heterogeneity during pituitary development, providing insights into the cellular physiology of this key reproductive regulatory cell. The human LHX3 enhancer-driven Cre reporter transgenic mice provide a valuable tool for further developmental studies of cell determination and differentiation in the pituitary and nervous system. Furthermore understanding the regulation of human LHX3 gene will help develop tools to better diagnose and treat pituitary CPHD disease.

Indiana University-Purdue University Indianapolis (IUPUI) / LIM homeodomain 3 (LHX3) is an important regulator of pituitary and nervous system development. To date, twelve LHX3 gene mutations have been identified in patients with combined pituitary hormone deficiency disease (CPHD). Understanding the molecular mechanisms governing LHX3/Lhx3 gene regulation will provide critical insights into organ development pathways and associated diseases. DNA methylation has been implicated in gene regulation in multiple physiological systems. This dissertation examines the role of DNA methylation in regulating the murine Lhx3 gene. To determine if demethylation of the Lhx3 gene promoter would induce its expression, murine pre-somatotrope pituitary cells that do not normally express Lhx3 (Pit-1/0 cells) were treated with the demethylating reagent, 5-Aza-2’-deoxycytidine. This treatment lead to activation of the Lhx3 gene and thus suggested that methylation contributes to Lhx3 gene regulation. Proteins that modify chromatin, such as histone deacetylases (HDACs) have also been shown to affect DNA methylation patterns and subsequent gene activation. Pit-1/0 pituitary cells treated with a combination of the demethylating reagent and the HDAC inhibitor, Trichostatin A led to activation of the Lhx3 gene, suggesting crosstalk between DNA methylation and histone modification processes. To assess DNA methylation levels, treated and untreated Pit-1/0 genomic DNA were subjected to bisulfite conversion and sequencing. Treated Pit-1/0 cells had decreased methylation compared to untreated cells. Chromatin immunoprecipitation assays demonstrated interactions between the methyl-binding protein, MeCP2 and the Lhx3 promoter regions in the Pit-1/0 cell line. Overall, the study demonstrates that DNA methylation patterns of the Lhx3 gene are associated with its expression status.