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Cognitive function in hypothyroidism: what is that deiodinase again?

Arturo Hernandez

    The Journal of Clinical Investigation
    |December 4, 2018
    PubMed
    Summary

    A common genetic variant reduces the activity of type 2 deiodinase (DIO2), impacting thyroid hormone conversion. This affects brain T3 levels, glial cell stress, and cognitive function, with implications for hypothyroidism treatment.

    Area of Science:

    • Endocrinology
    • Neuroscience
    • Genetics

    Background:

    • Thyroid hormone replacement therapy for hypothyroidism often relies on thyroxine (T4) monotherapy.
    • The conversion of T4 to the active form, 3,5,3'-triiodothyronine (T3), is crucial for effective thyroid hormone action.
    • Individual variations in this conversion process can lead to suboptimal treatment outcomes.

    Purpose of the Study:

    • To investigate the enzymatic activity of a common genetic variant of type 2 deiodinase (DIO2).
    • To elucidate the functional consequences of this DIO2 variant on brain T3 levels, glial cell endoplasmic reticulum stress, and cognitive function.
    • To understand the clinical implications for hypothyroidism treatment and susceptibility to neurological and metabolic diseases.

    Main Methods:

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  • Enzyme activity assays to assess the function of the DIO2 variant.
  • In vivo and in vitro models to evaluate brain T3 levels and glial cell responses.
  • Cognitive function assessments in relevant models.
  • Main Results:

    • The common genetic variant of DIO2 exhibits reduced enzymatic activity compared to the wild-type enzyme.
    • This reduced activity leads to decreased T3 availability in the brain.
    • The variant is associated with increased endoplasmic reticulum stress in glial cells and impaired cognitive function.

    Conclusions:

    • Reduced DIO2 enzymatic activity due to a common genetic variant contributes to suboptimal thyroid hormone conversion.
    • This variant has significant functional consequences on brain T3 levels, glial cell health, and cognitive performance.
    • Findings highlight the importance of considering genetic variations in DIO2 for personalized hypothyroidism treatment and understanding disease susceptibility.