title: [Tpit mutations reveal a new model of pituitary differentiation and account for isolated ACTH deficiency].
abstract: Pituitary hormone-producing cells differentiate sequentially from a common epithelial primordium, Rathke's pouch, under the combinatorial action of a subset of tissue- and cell-restricted transcription factors. Some factors have been implicated in early events of pituitary induction and morphogenesis while other factors like Pit-1 and SF-1 have been associated with differentiation of particular lineages. In POMC-expressing cells, Pitx1, NeuroD1 and Tpit were shown to be important for cell specific transcription of the POMC gene. Since Tpit is exclusively expressed in pituitary POMC-expressing lineages, the corticotrophs and melanotrophs, we investigated the TPIT gene coding sequences in 17 patients presenting with congenital isolated ACTH deficiency (IAD). We demonstrated that human TPIT gene mutations cause a neonatal onset form of IAD (8/11), but not juvenile forms of this deficiency (0/6). In the absence of glucocorticoid replacement, IAD can lead to neonatal death by acute adrenal insufficiency. To assess the importance of Tpit in pituitary differentiation and function, we produced Tpit-null mice. Concordant with the human phenotype, Tpit-null mice have IAD : plasma ACTH is greatly reduced in these mice, their plasma corticosterone is undetectable and the adrenals are hypoplastic. Analysis of the pituitary in Tpit-null mice revealed multiple roles of this factor in cell differentiation. First, Tpit is a positive regulator for POMC cell differentiation. Tpit is also a negative regulator of the pituitary gonadotroph fate. Thus, Tpit operates as a molecular switch to orient differentiation of a common precursor towards either POMC or gonadotroph fate. A binary choice model of pituitary cell differentiation is presented.
authors.affiliation: Laboratoire de Génétique moléculaire, Institut de Recherches cliniques de Montréal (IRCM), Montréal, Québec, H2W 1R7 Canada.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Pulichino
authors.forename: Sophie
authors.initials: S
authors.lastname: Vallette-Kasic
authors.forename: Catherine
authors.initials: C
authors.lastname: Couture
authors.forename: Thierry
authors.initials: T
authors.lastname: Brue
authors.forename: Jacques
authors.initials: J
authors.lastname: Drouin
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000172:deficiency*; D000818:Animals; D002454:Cell Differentiation; D004252:DNA Mutational Analysis; D004195:Disease Models, Animal; D018398:Homeodomain Proteins / Q000235:genetics*; D006801:Humans; D007231:Infant, Newborn; D051379:Mice; D010902:Pituitary Gland / Q000254:growth & development* / Q000473:pathology / Q000502:physiology*; D020825:T-Box Domain Proteins; D014157:Transcription Factors / Q000235:genetics*
chemical_list: D018398:Homeodomain Proteins; D020825:T-Box Domain Proteins; C486589:TBX19 protein, human; D014157:Transcription Factors; D000324:Adrenocorticotropic Hormone