Pituitary transcription factors in the aetiology of combined pituitary hormone deficiency
Abstract
The somatotropic axis is the central postnatal regulator of longitudinal growth. One of its major components--growth hormone--is produced by the anterior lobe of the pituitary, which also expresses and secretes five additional hormones (prolactin, thyroid stimulating hormone, follicle stimulating hormone, luteinizing hormone, adrenocorticotropic hormone). Proper development of the pituitary assures the regulation of critical processes such as metabolic control, puberty and reproduction, stress response and lactation. Ontogeny of the adenohypophysis is orchestrated by inputs from neighbouring tissues, cellular signalling molecules and transcription factors. Perturbation of expression or function of these factors has been implicated in the aetiology of combined pituitary hormone deficiency (CPHD). Mutations within the genes encoding for the transcription factors LHX3, LHX4, PROP1, and POU1F1 (PIT1) that act at different stages of pituitary development result in unique patterns of hormonal deficiencies reflecting their differential expression during organogenesis. In the case of LHX3 and LHX4 the phenotype may include extra-pituitary manifestations due to the function of these genes/proteins outside the pituitary gland. The remarkable variability in the clinical presentation of affected patients indicates the influence of the genetic background, environmental factors and possibly stochastic events. However, in the majority of CPHD cases the aetiology of this heterogeneous disease remains unexplained, which further suggests the involvement of additional genes. Identification of these factors might also help to close the gaps in our understanding of pituitary development, maintenance and function.
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The most frequently identified mutations associated with multiple pituitary hormone deficiency are in PROP1.
“The most frequently identified mutations associated with MPHD are in PROP1 [27, 34-37].”
From 2018 European Thyroid Association (ETA) Guidelines on the Diagnosis and Management of Central Hypothyroidism (2018) · cites this paper as [35]
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- Authors
- Pfäffle, R., & Klammt, J.
- Affiliations
- Leipzig University (DE)
- Corresponding author
- Pfäffle, R.
- Venue
- Best Practice & Research Clinical Endocrinology & Metabolism
- Publisher
- Elsevier BV
- Published
- 2011-02
- Volume
- 25
- Issue
- 1
- Pages
- 43-60
- ISSN
- 1521-690X (ISSN-L)
- OpenAlex
- W2004740577
- Cited by
- 115
- References
- 141
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 3 · 2021: 4 · 2020: 9 · 2019: 12 · 2018: 6 · 2017: 8 · 2016: 13 · 2015: 15 · 2014: 11 · 2013: 7 · 2012: 11
- FWCI
- 1.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Best Practice & Research Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Deutsche Forschungsgemeinschaft
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Keywords
- combined pituitary hormone deficiency, transcription factors, pituitary development, anterior pituitary, LHX3, LHX4, PROP1, Pit-1, growth hormone, somatotropic axis, genetic aetiology
- MeSH terms
- Amino Acid Sequence, Animals, Humans, Mutation, Pituitary Gland, Anterior, Pituitary Hormones, Transcription Factors, Homeodomain Proteins, Transcription Factor Pit-1, Mice, LIM-Homeodomain Proteins
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