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Screening of nineteen unrelated families with generalized resistance to thyroid hormone for known point mutations in the thyroid hormone receptor beta gene and the detection of a new mutation



Screening of nineteen unrelated families with generalized resistance to thyroid hormone for known point mutations in the thyroid hormone receptor beta gene and the detection of a new mutation



Journal of Clinical Investigation 87(2): 496-502



Generalized resistance to thyroid hormone (GRTH) is a syndrome chracterized by impaired tissue responsivenss to thyroid hormone. Two distinct point mutations in the hormone binding domain of the thyroid hromone receptor (TR) .beta. have recently been identified in two unrelated families with GRTH. One, Mf, involves a preplacement of the normal glycine-345 for arginine in exon 7 and another, Mh, replaces the normal proline-453 for histidine in exon 8. To probe for the presence of the Mf and Mh defect in 19 unrelated families with GRTH, we applied separate polymerase chain reactions using allele-specific oligonucleotide primers containing the normal and each of the two mutant nucleotides at the 3'-position. A total of 24 affected subjects and 13 normal family members were studied. The mode of inheritance was dominant in 13 families, was unknown in 5 families, and was clearly recessive in 1 family in which only the consanguineous subjects were affected. Primers containing the substitutions specific for Mf and Mh amplified exons 7 and 8, respectively, only in affected members of each of the two index families. Primers containing the normal sequences amplified exons 7 and 8 of the TR.beta. gene in all subjects except affected members of one family. In this family with recessively inherited GRTH, neither exon could be amplified using any combination of primers and DNA blot revealed absence of all coding exons. These results indicate a major deletion of the TR.beta. gene, including both DNA and hormone binding domains. Since heterozygous members of this family are not affected, the presence of a single normal allele is sufficient for normal function of the TR.beta. These data also support the hypothesis that in the dominant mode of GRTH inheritance the presence of an abnormal TR.beta. interferences with the function of the normal TR.beta. Distinct mutations are probably responsible for GRTH in unrelated families.

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Accession: 007771475

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PMID: 1991834


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