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Graves’ disease and nodular toxic thyroid disease are the leading causes of hyperthyroidism. Iodine fortification (IF) among mild-to-moderate iodine deficiency populations is associated with transient increase in incident thyrotoxic nodular disease that may last up to 10 years. A rise in incident Graves’ disease and other autoimmune thyroid conditions has also been associated with IF. Epidemiological studies from different geographical settings around the globe suggest increased incidence even among reproductive age groups in affected populations. Recurrent iodine deficiency in iodine replete populations in developed countries may also predispose them to a similar phenomenon. The prevalence and consequences of hyperthyroidism in pregnancy may be higher than previously reported. We intend to describe the aetiopathology and epidemiology of hyperthyroidism, the mechanisms through which hyperthyroidism predisposes to infertility; the impact of hyperthyroidism on fertility treatment, pregnancy in general and among women with infertility; as well as the effects of hyperthyroidism or agents used in the treatment of hyperthyroidism on perinatal outcomes and adult life for those exposed in utero.

Summary During retroviral infection, viral capsids are subject to restriction by the cellular factor TRIM5α. Here, we show that dendritic cells (DCs) derived from human and non-human primate species lack efficient TRIM5α-mediated retroviral restriction. In DCs, endogenous TRIM5α accumulates in nuclear bodies (NB) that partly co-localize with Cajal bodies in a SUMOylation-dependent manner. Nuclear sequestration of TRIM5α allowed potent induction of type I interferon (IFN) responses during infection, mediated by sensing of reverse transcribed DNA by cGAS. Overexpression of TRIM5α or treatment with the SUMOylation inhibitor ginkgolic acid (GA) resulted in enforced cytoplasmic TRIM5α expression and restored efficient viral restriction but abrogated type I IFN production following infection. Our results suggest that there is an evolutionary trade-off specific to DCs in which restriction is minimized to maximize sensing. TRIM5α regulation via SUMOylation-dependent nuclear sequestration adds to our understanding of how restriction factors are regulated., Graphical Abstract, Highlights • Primate dendritic cells (DCs) lack efficient TRIM5α-mediated retroviral restriction • In DCs TRIM5α is sequestered in the nucleus in a SUMOylation-dependent manner • TRIM5α nuclear sequestration allows DC sensing of retroviral DNA by cGAS, Retroviruses can be efficiently blocked by a cellular restriction factor called TRIM5α. Intriguingly, TRIM5α is inactive in dendritic cells (DCs). Portilho et al. show that in DCs TRIM5α is sequestered in the nucleus in a SUMOylation-dependent manner, favoring innate sensing of retroviruses in the cytoplasm by cGAS and thus an antiviral response.

A cytogenetic survey of 475 patients in an institution for the mentally retarded is reported. The chromosomes of all patients were studied using both a non-banding and a G-banding technique in order to estimate the relative efficiency of the two techniques in detecting structural rearrangements of the chromosomes. A total of 57 patients was found to have a chromosome abnormality, including five with a balanced structural rearrangement. The contribution of chromosome aberrations to the etiology of mental retardation is discussed with special emphasis on the contribution of balanced structural rearrangements.

A cytogenetic survey of a population of 274 mentally retarded males on community placement is described. Thirty-five had an aneuploid chromosome constitution and five had the mar(X) syndrome. The range of clinical variation among the mar(X) probands and their affected relatives is described. Family studies were possible for four of the five mar(X) probands and in two families the mar(X) gene was apparently transmitted through a clinically normal male, suggesting that this type of male transmission may be a not uncommon phenomenon.

Cytogenetic abnormalities were discovered in more than half of 16 lymphoblastoid cell lines established from fragile X individuals and their relatives upon routine cytogenetic analysis of early passage cultures. Subsequently, a second series of lymphoblastoid lines was analyzed to determine if the aneuploidy was (1) a characteristic of lymphoblastoid cell lines derived from fragile X families or (2) a result of the use of cyclosporin A in the establishment of these lines. In the second series of 33 lymphoblastoid cultures, no aneuploid clones were found in the fragile X group, while two were detected in the control cultures, one in a line initiated with cyclosporin A and the other in a line established without cyclosporin A. We conclude that the abnormal clones in our preliminary series were not a characteristic of lines derived from fragile X families and probably not due to the use of cyclosporin A. However, the finding of chromosome abnormalities in a large proportion of lines during the first 3 mo of culture contrasts with previous reports of chromosome stability for the first 12–18 mo of cultivation and indicates that the chromosomes of lymphoblastoid lines should be monitored in any experiment in which a normal diploid complement is critical.

It has been known for some time that there is an association between chronological aging and X-chromosome aneuploidy in peripheral blood lymphocyte cultures from females. In an attempt to elucidate the mechanism of X-chromosome aneuploidy in aging females, we used a BrdU late-labeling technique to determine the X-inactivation pattern in 45, X and 47, XXX lymphocytes of older women. In 50 of 58 X-aneuploid cells the inactive X chromosome was missing or extra. This implies that either the inactive X has a special propensity for mitotic errors or mitotic errors occur at random but subsequent selection is less stringent against cells with a missing or additional inactive X chromosome than against aneuploid cells involving the active X chromosome. Evidence is presented in favor of the former hypothesis.

A cytogenetic survey of a population of 278 mentally retarded females on community placement is described. Thirty-five females had an aneuploid chromosome constitution and a single female was found to have the fra(X) syndrome. The frequency of the fra(X) syndrome among female retardates is discussed together with the apparent absence of de novo mutants among this class of fra(X) probands.

Eighty-one probands from an initial population of 223 school-aged retarded individuals were assessed by history, clinical examination and, where appropriate, cytogenetic analysis. In 51 individuals, the retardation occurred as an isolated event within the family, whereas 30 patients had a family history of retardation. In 39 of the isolated individuals, the retardation was either related to environmental factors or associated with a major neurological abnormality. The remaining 12 patients were phenotypically normal with no cytogenetic abnormality. Of the 30 probands from 15 families with a history of retardation, 3 families had X-linked syndromes. One, with 4 proband daughters, had the mar(X) syndrome and two families were considered to have the phenotypically similar syndrome but without demonstrating the mar(X). In an additional 5 families, the distribution and clinical features of the affected individuals were compatible with nonspecific X-linked mental retardation.

We performed chromosomal analysis of a primary testicular tumor from an individual who, on subsequent analysis of peripheral blood, was found to have a balanced (13q14q) translocation. Histologically, the tumor was a mixed germ cell neoplasm, predominantly embryonal carcinoma, with some teratomatous elements. The modal chromosome count of the tumor cells was 62, with most counts ranging from 54 to 66. In addition to a t(13q14q) chromosome (of constitutional origin), nine nonrandomly acquired chromosomal abnormalities were identified, including an abnormal chromosome #1 and a probable i(12p). These findings are further discussed and compared with cytogenetic data on human testicular neoplasms from the literature. This case is also discussed with regard to the possible association of a constitutional t(13q14q) and various malignancies and related disorders.

We report an oriental family with sex-linked mental retardation, macroorchidism, and a marker or fragile site on the X chromosome--mar(X)(q28). The three affected males resemble clinically most previously reported affected Caucasians. The marker was present in four female 40-70 years old, including one with normal intelligence. Transmission of the disorder appears to have taken place through a clinically normal male to his grandson.

Sixteen patients with unusual heteromorphisms involving alterations of the length and/or position of centromeric heterochromatin are described. Family studies showed that the heteromorphisms were present in other relatives and segregated in the expected 1:1 ratio. There was a significantly greater frequency of unusual heteromorphisms among Orientals than in other races studied.

Three populations of retarded individuals were surveyed and the frequency of the fra (X) was found to be 1.9% in males and 0.3% in females.

Heteromorphisms of chromosomes 3, 4, 13-15, 21-22, and Y were studied in a population of 374 mentally retarded patients from diverse ethnic groups. A significant variation in the size of the Y chromosome was found among different racial groups, those of the Orientals and Filipinos being larger than those of the Caucasians or Polynesians. No other significant variation was found among the different racial groups, although suggestive differences were seen in bands 3 cen, 13p3, and 14p3. Band 13 cen/pl was significantly larger in the category of socio-familial retardation than in the other two categories. However, as the significance was at the 0.05% level and as this was the only heteromorphism whose distribution was different among the three categories of mental retardation, we assign little importance to this observation.

Seven families with X-linked mental retardation (MR) have been studied clinically and cytogenetically. All affected males in six of the families were found to have a fragile site on Xq in a number of their peripheral lymphocytes. The fragile site was not seen in any of the affected males in the seventh family. The affected males in the six families with the fragile X had a syndrome characterized by a variable degree of MR, macro-orchidism, a characteristic repetitive, jocular speech, normal body proportions, and large jaws and ears. The fragile X chromosome could only be detected in a proportion of female carriers and its frequency in females was found to be correlated with their mental status to be inversely correlated with their age.

Caffeine has been reported to enhance the expression of the fragile X [fra(X)] and common fragile sites in peripheral blood lymphocyte cultures (PBLC) treated with 5-fluorodeoxyuridine (FUdR). One of the effects of caffeine on replicating cells is inhibition of DNA repair suggesting that fragile sites may be regions of DNA with a high rate of misreplication under the conditions of thymidylate stress induced by FUdR. We have studied the effect of caffeine on the expression of the fra(X) and common folate-dependent fragile sites in PBLC from two fra(X) expressing individuals and in five lymphoblastoid cell lines (LCL) established from individuals in families in which the fra(X) is segregating. Caffeine did not enhance the expression of the fra(X) in the PBLC or in the three LCL from fra(X) expressing individuals nor did it elicit fra(X) expression in LCL from a non-expressing obligate-carrier female and a transmitting male. However, in all cultures there was a marked increase of common fragile site expression due to caffeine treatment. These data suggest that the mechanism of expression of the common fragile sites and the fra(X) may be quite different.