Higher thyrotropin leads to unfavorable lipid profile and somewhat higher cardiovascular disease risk: evidence from multi-cohort Mendelian randomization and metabolomic profiling.

BACKGROUND: Observational studies suggest interconnections between thyroid status, metabolism, and risk of coronary artery disease (CAD), but causality remains to be proven. The present study aimed to investigate the potential causal relationship between thyroid status and cardiovascular disease and to characterize the metabolomic profile associated with thyroid status. METHODS: Multi-cohort two-sample Mendelian randomization (MR) was performed utilizing genome-wide significant variants as instruments for standardized thyrotropin (TSH) and free thyroxine (fT4) within the reference range. Associations between TSH and fT4 and metabolic profile were investigated in a two-stage manner: associations between TSH and fT4 and the full panel of 161 metabolomic markers were first assessed hypothesis-free, then directional consistency was assessed through Mendelian randomization, another metabolic profile platform, and in individuals with biochemically defined thyroid dysfunction. RESULTS: Circulating TSH was associated with 52/161 metabolomic markers, and fT4 levels were associated with 21/161 metabolomic markers among 9432 euthyroid individuals (median age varied from 23.0 to 75.4 years, 54.5% women). Positive associations between circulating TSH levels and concentrations of very low-density lipoprotein subclasses and components, triglycerides, and triglyceride content of lipoproteins were directionally consistent across the multivariable regression, MR, metabolomic platforms, and for individuals with hypo- and hyperthyroidism. Associations with fT4 levels inversely reflected those observed with TSH. Among 91,810 CAD cases and 656,091 controls of European ancestry, per 1-SD increase of genetically determined TSH concentration risk of CAD increased slightly, but not significantly, with an OR of 1.03 (95% CI 0.99-1.07; p value 0.16), whereas higher genetically determined fT4 levels were not associated with CAD risk (OR 1.00 per SD increase of fT4; 95% CI 0.96-1.04; p value 0.59). CONCLUSIONS: Lower thyroid status leads to an unfavorable lipid profile and a somewhat increased cardiovascular disease risk

Multi-trait analysis characterizes the genetics of thyroid function and identifies causal associations with clinical implications

To date only a fraction of the genetic footprint of thyroid function has been clarified. We report a genome-wide association study meta-analysis of thyroid function in up to 271,040 individuals of European ancestry, including reference range thyrotropin (TSH), free thyroxine (FT4), free and total triiodothyronine (T3), proxies for metabolism (T3/FT4 ratio) as well as dichotomized high and low TSH levels. We revealed 259 independent significant associations for TSH (61% novel), 85 for FT4 (67% novel), and 62 novel signals for the T3 related traits. The loci explained 14.1%, 6.0%, 9.5% and 1.1% of the total variation in TSH, FT4, total T3 and free T3 concentrations, respectively. Genetic correlations indicate that TSH associated loci reflect the thyroid function determined by free T3, whereas the FT4 associations represent the thyroid hormone metabolism. Polygenic risk score and Mendelian randomization analyses showed the effects of genetically determined variation in thyroid function on various clinical outcomes, including cardiovascular risk factors and diseases, autoimmune diseases, and cancer. In conclusion, our results improve the understanding of thyroid hormone physiology and highlight the pleiotropic effects of thyroid function on various diseases.</p

Multi-trait analysis characterizes the genetics of thyroid function and identifies causal associations with clinical implications

To date only a fraction of the genetic footprint of thyroid function has been clarified. We report a genome-wide association study meta-analysis of thyroid function in up to 271,040 individuals of European ancestry, including reference range thyrotropin (TSH), free thyroxine (FT4), free and total triiodothyronine (T3), proxies for metabolism (T3/FT4 ratio) as well as dichotomized high and low TSH levels. We revealed 259 independent significant associations for TSH (61% novel), 85 for FT4 (67% novel), and 62 novel signals for the T3 related traits. The loci explained 14.1%, 6.0%, 9.5% and 1.1% of the total variation in TSH, FT4, total T3 and free T3 concentrations, respectively. Genetic correlations indicate that TSH associated loci reflect the thyroid function determined by free T3, whereas the FT4 associations represent the thyroid hormone metabolism. Polygenic risk score and Mendelian randomization analyses showed the effects of genetically determined variation in thyroid function on various clinical outcomes, including cardiovascular risk factors and diseases, autoimmune diseases, and cancer. In conclusion, our results improve the understanding of thyroid hormone physiology and highlight the pleiotropic effects of thyroid function on various diseases

Multi-trait analysis characterizes the genetics of thyroid function and identifies causal associations with clinical implications

To date only a fraction of the genetic footprint of thyroid function has been clarified. We report a genome-wide association study meta-analysis of thyroid function in up to 271,040 individuals of European ancestry, including reference range thyrotropin (TSH), free thyroxine (FT4), free and total triiodothyronine (T3), proxies for metabolism (T3/FT4 ratio) as well as dichotomized high and low TSH levels. We revealed 259 independent significant associations for TSH (61% novel), 85 for FT4 (67% novel), and 62 novel signals for the T3 related traits. The loci explained 14.1%, 6.0%, 9.5% and 1.1% of the total variation in TSH, FT4, total T3 and free T3 concentrations, respectively. Genetic correlations indicate that TSH associated loci reflect the thyroid function determined by free T3, whereas the FT4 associations represent the thyroid hormone metabolism. Polygenic risk score and Mendelian randomization analyses showed the effects of genetically determined variation in thyroid function on various clinical outcomes, including cardiovascular risk factors and diseases, autoimmune diseases, and cancer. In conclusion, our results improve the understanding of thyroid hormone physiology and highlight the pleiotropic effects of thyroid function on various diseases.</p

Genome-wide analyses identify a role for SLC17A4 and AADAT in thyroid hormone regulation.

Thyroid dysfunction is an important public health problem, which affects 10% of the general population and increases the risk of cardiovascular morbidity and mortality. Many aspects of thyroid hormone regulation have only partly been elucidated, including its transport, metabolism, and genetic determinants. Here we report a large meta-analysis of genome-wide association studies for thyroid function and dysfunction, testing 8 million genetic variants in up to 72,167 individuals. One-hundred-and-nine independent genetic variants are associated with these traits. A genetic risk score, calculated to assess their combined effects on clinical end points, shows significant associations with increased risk of both overt (Graves' disease) and subclinical thyroid disease, as well as clinical complications. By functional follow-up on selected signals, we identify a novel thyroid hormone transporter (SLC17A4) and a metabolizing enzyme (AADAT). Together, these results provide new knowledge about thyroid hormone physiology and disease, opening new possibilities for therapeutic targets

Identification of Novel Genetic Loci Associated with Thyroid Peroxidase Antibodies and Clinical Thyroid Disease

Peer reviewe

LE POTENTIEL HEPATIQUE DES CELLULES SOUCHES MESENCHYMATEUSES RAJEUNNIES ET DES PROGENITEURS ENDODERMIQUES : CONTRIBUTION DES VOIES DE SIGNALISATION DE LA LGR5 et la CDC42

Hepatocytes cell-based transplantation is a promising strategy for treating liver diseases. However, there are still several limitations for their use in clinical applications among them the generation of highthrouput of functional hepatocytes, their life span in culture, the age of the donor age and the source of hepatic stem cells (SCs). At present, the challenge lies to develop approaches aiming the identification of the new molecular markers signaling pathways involved in the differentiation of SCs toward functional hepatocytes. In fact, Wnt(s) pathways governs multiple biological processes controlling the differentiation fate of SCs into hepatocytes, some of them result in the activation of small GTPase and the Lgr5 pathway regulators. Indeed, Lgr5 (a target gene of Wnt, the Leucine-rich-repeat-containing G protein-coupled Receptor 5) was shown to be crucial for maintaining long-term expansion of hepatic SC in vitro. In addition, Lgr5 primarily functions as an effector of the Cdc42 GTPases (a RhoGTPase protein, the cell division cycle 42). Higher activity of Cdc42 was reported to be correlated to hematopoietic SCs aging. However, this correlation has never been studied before in adipose tissue Mesenchymal Stem Cells (ADSCs) which were proposed recently as a promising tool for liver regeneration.In this study, we were interested (i) to propose a novel method of reprogramming mouse mature hepatocytes into murine endodermic progenitors (mEndoPCs) that express Lgr5, generate liver-specific organoids and can differentiate into hepatocytes and cholangiocytes in vitro and give arise to bile duct structures and into functional hepatocytes in vivo, and (ii) to study the activity of Cdc42 in human aged-derived hADSCs and the impact of its selective inhibition by ML141 on their hepatic differentiation potential in vitro.In our study we succeeded to generate mEndoPCs and to improve the functionality of the aged-hADSCs derived-hepatocytes. We showed that both Lgr5 and Cdc42 are regulated distinctly by Wnt signaling pathways. In addition, our results revealed that LIFR/STAT3 and LGR5/WNT pathways are important to maintain the unlimited expansion of mEndoPCs in vitro when STAT3 pathway is activated. MAPK/PKA, WNT/ β-catenin pathways and the exosome’s production were shown to be deregulated with hADSCs aging. We showed also that a mesenchymal to epithelial transition was crucial to transdifferentiate hADSCs into functional hepatocytes. On the other side, ML141 is proposed as a new pharmacological tool to rejuvenate aged-hADSCs toward functionally younger-like cells thus by promoting cell proliferation, doubling and cell adherence. Finally, the transfer of these methodologies to human could serve the regenerative medicine of the liver as a good tool for hepatocyte-based drug toxicity screening systems and for the liver engineering using a « bio printing » approach.La thérapie cellulaire utilisant une greffe d’hépatocytes est une stratégie prometteuse pour traiter les maladies du foie. Cependant, plusieurs limitations freinent leur transfert pour des applications cliniques, comprenant la production à haut débit d'hépatocytes fonctionnels, leur survie en culture, l’âge du donneur et la source des cellules souches hépatiques (CS). Les avancées scientifiques réalisées à ce jour ont permis d’identifier de nouveaux marqueurs moléculaires et les voies de signalisation impliquées dans la différenciation des CS en hépatocytes fonctionnels. En effet, la voie de signalisation Wnt a montré être importante pour réguler de nombreux processus biologiques des CS permettant de contrôler leur différenciation hépatique dont l’activation des GTPases et les gènes ciblant la voie de signalisation de Lgr5. Récemment, des études ont montré que le marqueur Lgr5 (récepteur 5 couplé à la protéine G contenant une répétition d’acides aminés riche en leucine) est décisif pour maintenir une expansion à long terme des CS hépatiques in vitro. En outre, Lgr5 fonctionne principalement comme un effecteur de la Cdc42 (cycle de division cellulaire 42) qui est un membre de la famille des Rho-GTPase. Une forte expression de la Cdc42 a montré être corrélée avec le vieillissement des SCs hématopoïétiques. Néanmoins, cette corrélation n'a jamais été étudiée à ce jour dans les cellules souches mésenchymateuses dérivées du tissu adipeux humain (hADSCs).Au cours de nos travaux de thèse, nous nous sommes intéressés (i) à proposer une nouvelle technologie de reprogrammation d’hépatocytes matures murins en progéniteurs endodermiques (mEndoPCs) exprimant Lgr5 capables de générer des organoïdes spécifiques du foie et de se différencier en hépatocytes et cholangiocytes in vitro et en des structures biliaires et hépatiques in vivo (ii) à étudier l’activité de Cdc42 dans les hADSCs âgées et l'impact de son inhibition sélective par le ML141 sur leur potentiel de différenciation hépatique in vitro.Nous montrons qu’il a été possible de générer des mEndoPCs et à améliorer la différenciation hépatique des hADSCs âgés. Nous montrons également que Lgr5 et Cdc42 sont régulés de façon distincte par la voie de signalisation Wnt. De plus, nos résultats ont révélé que les voies LIFR/STAT3 et Lgr5/WNT sont essentielles pour l’auto renouvellement des mEndoPCs permettant leur expansion illimitée in vitro en présence d’activateur de STAT3. Les voies MAPK/PKA, WNT/ β-caténine et la production d'exosomes ont montré avoir rôle majeur dans l’âge des hADSCs. Nous montrons qu’une transition mésenchymato-épithéliale était nécessaire pour différencier les hADSCs en hépatocytes fonctionnels. D’autre part, ML141 est proposé comme un nouvel outil pharmacologique permettant de reverser l’âge des hADSC âgés et d’amplifier le taux de prolifération, d’adhésion et de fonctionnalité hépatique à un niveau équivalent aux hADSCs jeunes. Enfin, le transfert de ces méthodologies à l’homme pourrait servir pour la médecine régénératrice du foie, comme outil pour évaluer la toxicité hépatique des médicaments et pour l'ingénierie et la reconstitution d’un foie entier par des approches de « bio printing »

Hepatic potential of Reversed-age Mesenchymal Stem Cells and Endodermal Progenitors : Contribution of LGR5 and Cdc42 cell signaling pathways

La thérapie cellulaire utilisant une greffe d’hépatocytes est une stratégie prometteuse pour traiter les maladies du foie. Cependant, plusieurs limitations freinent leur transfert pour des applications cliniques, comprenant la production à haut débit d'hépatocytes fonctionnels, leur survie en culture, l’âge du donneur et la source des cellules souches hépatiques (CS). Les avancées scientifiques réalisées à ce jour ont permis d’identifier de nouveaux marqueurs moléculaires et les voies de signalisation impliquées dans la différenciation des CS en hépatocytes fonctionnels. En effet, la voie de signalisation Wnt a montré être importante pour réguler de nombreux processus biologiques des CS permettant de contrôler leur différenciation hépatique dont l’activation des GTPases et les gènes ciblant la voie de signalisation de Lgr5. Récemment, des études ont montré que le marqueur Lgr5 (récepteur 5 couplé à la protéine G contenant une répétition d’acides aminés riche en leucine) est décisif pour maintenir une expansion à long terme des CS hépatiques in vitro. En outre, Lgr5 fonctionne principalement comme un effecteur de la Cdc42 (cycle de division cellulaire 42) qui est un membre de la famille des Rho-GTPase. Une forte expression de la Cdc42 a montré être corrélée avec le vieillissement des SCs hématopoïétiques. Néanmoins, cette corrélation n'a jamais été étudiée à ce jour dans les cellules souches mésenchymateuses dérivées du tissu adipeux humain (hADSCs).Au cours de nos travaux de thèse, nous nous sommes intéressés (i) à proposer une nouvelle technologie de reprogrammation d’hépatocytes matures murins en progéniteurs endodermiques (mEndoPCs) exprimant Lgr5 capables de générer des organoïdes spécifiques du foie et de se différencier en hépatocytes et cholangiocytes in vitro et en des structures biliaires et hépatiques in vivo (ii) à étudier l’activité de Cdc42 dans les hADSCs âgées et l'impact de son inhibition sélective par le ML141 sur leur potentiel de différenciation hépatique in vitro.Nous montrons qu’il a été possible de générer des mEndoPCs et à améliorer la différenciation hépatique des hADSCs âgés. Nous montrons également que Lgr5 et Cdc42 sont régulés de façon distincte par la voie de signalisation Wnt. De plus, nos résultats ont révélé que les voies LIFR/STAT3 et Lgr5/WNT sont essentielles pour l’auto renouvellement des mEndoPCs permettant leur expansion illimitée in vitro en présence d’activateur de STAT3. Les voies MAPK/PKA, WNT/ β-caténine et la production d'exosomes ont montré avoir rôle majeur dans l’âge des hADSCs. Nous montrons qu’une transition mésenchymato-épithéliale était nécessaire pour différencier les hADSCs en hépatocytes fonctionnels. D’autre part, ML141 est proposé comme un nouvel outil pharmacologique permettant de reverser l’âge des hADSC âgés et d’amplifier le taux de prolifération, d’adhésion et de fonctionnalité hépatique à un niveau équivalent aux hADSCs jeunes. Enfin, le transfert de ces méthodologies à l’homme pourrait servir pour la médecine régénératrice du foie, comme outil pour évaluer la toxicité hépatique des médicaments et pour l'ingénierie et la reconstitution d’un foie entier par des approches de « bio printing ».Hepatocytes cell-based transplantation is a promising strategy for treating liver diseases. However, there are still several limitations for their use in clinical applications among them the generation of highthrouput of functional hepatocytes, their life span in culture, the age of the donor age and the source of hepatic stem cells (SCs). At present, the challenge lies to develop approaches aiming the identification of the new molecular markers signaling pathways involved in the differentiation of SCs toward functional hepatocytes. In fact, Wnt(s) pathways governs multiple biological processes controlling the differentiation fate of SCs into hepatocytes, some of them result in the activation of small GTPase and the Lgr5 pathway regulators. Indeed, Lgr5 (a target gene of Wnt, the Leucine-rich-repeat-containing G protein-coupled Receptor 5) was shown to be crucial for maintaining long-term expansion of hepatic SC in vitro. In addition, Lgr5 primarily functions as an effector of the Cdc42 GTPases (a RhoGTPase protein, the cell division cycle 42). Higher activity of Cdc42 was reported to be correlated to hematopoietic SCs aging. However, this correlation has never been studied before in adipose tissue Mesenchymal Stem Cells (ADSCs) which were proposed recently as a promising tool for liver regeneration.In this study, we were interested (i) to propose a novel method of reprogramming mouse mature hepatocytes into murine endodermic progenitors (mEndoPCs) that express Lgr5, generate liver-specific organoids and can differentiate into hepatocytes and cholangiocytes in vitro and give arise to bile duct structures and into functional hepatocytes in vivo, and (ii) to study the activity of Cdc42 in human aged-derived hADSCs and the impact of its selective inhibition by ML141 on their hepatic differentiation potential in vitro.In our study we succeeded to generate mEndoPCs and to improve the functionality of the aged-hADSCs derived-hepatocytes. We showed that both Lgr5 and Cdc42 are regulated distinctly by Wnt signaling pathways. In addition, our results revealed that LIFR/STAT3 and LGR5/WNT pathways are important to maintain the unlimited expansion of mEndoPCs in vitro when STAT3 pathway is activated. MAPK/PKA, WNT/ β-catenin pathways and the exosome’s production were shown to be deregulated with hADSCs aging. We showed also that a mesenchymal to epithelial transition was crucial to transdifferentiate hADSCs into functional hepatocytes. On the other side, ML141 is proposed as a new pharmacological tool to rejuvenate aged-hADSCs toward functionally younger-like cells thus by promoting cell proliferation, doubling and cell adherence. Finally, the transfer of these methodologies to human could serve the regenerative medicine of the liver as a good tool for hepatocyte-based drug toxicity screening systems and for the liver engineering using a « bio printing » approach

Inhibition of the RhoGTPase Cdc42 by ML141 enhances hepatocyte differentiation from human adipose-derived mesenchymal stem cells via the Wnt5a/PI3K/miR-122 pathway: impact of the age of the donor

Abstract Background Human adipose-derived mesenchymal stem cells (hADSCs) are promising cells that may promote hepatocyte differentiation (Hep-Dif) and improve liver function, but the involvement of Cdc42, a key small RhoGTPase which plays a crucial role in aging, is still not well established. We hypothesized that the inhibition of Cdc42 may rescue the hepatogenic potential of hADSCs derived from aged donors. Methods hADSCs isolated from 61 women of different ages were cultured for evaluation of the proliferation of cells, adherence, apoptosis, immunomodulation, immunophenotyping, multipotency, gene expression, and cell function during Hep-Dif. Inhibition of Cdc42 by ML141 was realized during two phases: initiation (days –2 to 14 (D–2/14)) from undifferentiated to hepatoblast-like cells, or maturation (days 14 to 28 (D14/28)) from undifferentiated to hepatocyte-like cells. Mechanistic insights of the Wnt(s)/MAPK/PI3K/miR-122 pathways were studied. Results Cdc42 activity in undifferentiated hADSCs showed an age-dependent significant increase in Cdc42-GTP correlated to a decrease in Cdc42GAP; the low potentials of cell proliferation, doubling, adherence, and immunomodulatory ability (proinflammatory over anti-inflammatory) contrary to the apoptotic index of the aged group were significantly reversed by ML141. Aged donor cells showed a decreased potential for Hep-Dif which was rescued by ML141 treatment, giving rise to mature and functional hepatocyte-like cells as assessed by hepatic gene expression, cytochrome activity, urea and albumin production, low-density lipoprotein (LDL) uptake, and glycogen storage. ML141-induced Hep-Dif showed an improvement in mesenchymal-epithelial transition, a switch from Wtn-3a/β-catenin to Wnt5a signaling, involvement of PI3K/PKB but not the MAPK (ERK/JNK/p38) pathway, induction of miR-122 expression, reinforcing the exosomes release and the production of albumin, and epigenetic changes. Inhibition of PI3K and miR-122 abolished completely the effects of ML141 indicating that inhibition of Cdc42 promotes the Hep-Dif through a Wnt5a/PI3K/miR-122/HNF4α/albumin/E-cadherin-positive action. The ML141(D–2/14) protocol had more pronounced effects when compared with ML141(D14/28); inhibition of DNA methylation in combination with ML141(D–2/14) showed more efficacy in rescuing the Hep-Dif of aged hADSCs. In addition to Hep-Dif, the multipotency of aged hADSC-treated ML141 was observed by rescuing the adipocyte and neural differentiation by inducing PPARγ/FABP4 and NeuN/O4 but inhibiting Pref-1 and GFAP, respectively. Conclusion ML141 has the potential to reverse the age-related aberrations in aged stem cells and promotes their hepatogenic differentiation. Selective inhibition of Cdc42 could be a potential target of drug therapy for aging and may give new insights on the improvement of Hep-Dif

iPSC-Derived Hereditary Breast Cancer Model Reveals the BRCA1-Deleted Tumor Niche as a New Culprit in Disease Progression

International audienceTumor progression begins when cancer cells recruit tumor-associated stromal cells to produce a vascular niche, ultimately resulting in uncontrolled growth, invasion, and metastasis. It is poorly understood, though, how this process might be affected by deletions or mutations in the breast cancer type 1 susceptibility (BRCA1) gene in patients with a lifetime risk of developing breast and/or ovarian cancer. To model the BRCA1-deleted stroma, we first generated induced pluripotent stem cells (iPSCs) from patients carrying a germline deletion of exon 17 of the BRCA1 gene (BRCA1+/− who, based on their family histories, were at a high risk for cancer. Using peripheral blood mononuclear cells (PBMCs) of these two affected family members and two normal (BRCA1+/+) individuals, we established a number of iPSC clones via non-integrating Sendai virus-based delivery of the four OCT4, SOX2, KLF4, and c-MYC factors. Induced mesenchymal stem cells (iMSCs) were generated and used as normal and pathological stromal cells. In transcriptome analyses, BRCA1+/− iMSCs exhibited a unique pro-angiogenic signature: compared to non-mutated iMSCs, they expressed high levels of HIF-1α, angiogenic factors belonging to the VEGF, PDGF, and ANGPT subfamilies showing high angiogenic potential. This was confirmed in vitro through the increased capacity to generate tube-like structures compared to BRCA1+/+ iMSCs and in vivo by a matrigel plug angiogenesis assay where the BRCA1+/− iMSCs promoted the development of an extended and organized vessel network. We also reported a highly increased migration capacity of BRCA1+/− iMSCs through an in vitro wound healing assay that correlated with the upregulation of the periostin (POSTN). Finally, we assessed the ability of both iMSCs to facilitate the engraftment of murine breast cancer cells using a xenogenic 4T1 transplant model. The co-injection of BRCA1+/− iMSCs and 4T1 breast cancer cells into mouse mammary fat pads gave rise to highly aggressive tumor growth (2-fold increase in tumor volume compared to 4T1 alone, p = 0.01283) and a higher prevalence of spontaneous metastatic spread to the lungs. Here, we report for the first time a major effect of BRCA1 haploinsufficiency on tumor-associated stroma in the context of BRCA1-associated cancers. The unique iMSC model used here was generated using patient-specific iPSCs, which opens new therapeutic avenues for the prevention and personalized treatment of BRCA1-associated hereditary breast cancer