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dicer 1, ribonuclease III OKDB#: 1449
 Symbols: DICER1 Species: human
 Synonyms: DCR1, GLOW, MNG1, Dicer, HERNA, RMSE2, Dicer1e, K12H4.8-LIKE  Locus: 14q32.13 in Homo sapiens


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General Comment Human DICER protein possesses an RNA helicase motif containing a DEXH box in its amino terminus and an RNA motif in the carboxy terminus. DICER, also known as helicase-MOI, is required by the RNA interference and small temporal RNA (stRNA) pathways to produce the active small RNA component that represses gene expression. Role of Dicer in female fertility. Luense LJ et al. Dicer is an RNAse III endonuclease that is essential for the biogenesis of microRNAs and small interfering RNAs. These small RNAs post-transcriptionally regulate mRNA gene expression through several mechanisms to affect key cellular events including proliferation, differentiation and apoptosis. Recently, the role of Dicer function in female reproductive tissues has begun to be elucidated through the use of knockout mouse models. Loss of Dicer within ovarian granulosa cells, luteal tissue, oocyte, oviduct and, potentially, the uterus renders females infertile. This review discusses these early studies and other data describing the current understanding of microRNAs and small interfering RNAs in female reproduction.

NCBI Summary: This gene encodes a protein possessing an RNA helicase motif containing a DEXH box in its amino terminus and an RNA motif in the carboxy terminus. The encoded protein functions as a ribonuclease and is required by the RNA interference and small temporal RNA (stRNA) pathways to produce the active small RNA component that represses gene expression. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Sep 2010]
General function RNA binding
Comment Molecular characterization, tissue distribution, and expression of two ovarian Dicer isoforms during follicle development in goose (Anser cygnoides). Hu S 2014 et al. Dicer plays a key role in the biogenesis of microRNAs and small interfering RNAs, which control the coordinated expression of multiple of genes during follicle development. In this study, the cDNAs encoding two Dicer isoforms (gDicer-a and gDicer-b, respectively) were isolated and cloned from goose ovary using RT-PCR. This is the first time a new Dicer splice variant has been characterized at the molecular level in vertebrates. Sequence analysis indicated that both of the two isoforms consist of seven conserved functional domains, where gDicer-b lacks a linker sequence between DEAD box and helicase C domain composed of 158 amino acids. Each domain of gDicer-a/gDicer-b showed higher than 89.5% identity to corresponding domain of Dicers from chicken, human, and mouse. The ubiquity of transcripts of gDicer-a/gDicer-b were found in all tested tissues by real time PCR with the pituitary, oviduct, and hypothalamus being the predominant site of expression of gDicer-a. A similar expression profile of the gDicer-a/gDicer-b mRNAs was found during follicle development. The abrupt changes in transcripts of gDicer in follicles of 2-4mm, 9-10mm, F5, and F1 follicles support its participation in the process of follicle recruitment, selection, dominance, and ovulation. However, high mRNA levels of gDicer-b and caspase-3 were detectable in atretic and post-ovulatory follicles, where expression of gDicer-a was considerably low. These findings suggest that gDicer is required for follicle development, and structural differences in the helicase domain of two gDicer isoforms might contribute to their different roles in controlling granulosa cell apoptosis. ///////////////////////// mRNA-Seq whole-transcriptome analysis of a single cell. Tang F et al. Next-generation sequencing technology is a powerful tool for transcriptome analysis. However, under certain conditions, only a small amount of material is available, which requires more sensitive techniques that can preferably be used at the single-cell level. Here we describe a single-cell digital gene expression profiling assay. Using our mRNA-Seq assay with only a single mouse blastomere, we detected the expression of 75% (5,270) more genes than microarray techniques and identified 1,753 previously unknown splice junctions called by at least 5 reads. Moreover, 8-19% of the genes with multiple known transcript isoforms expressed at least two isoforms in the same blastomere or oocyte, which unambiguously demonstrated the complexity of the transcript variants at whole-genome scale in individual cells. Finally, for Dicer1(-/-) and Ago2(-/-) (Eif2c2(-/-)) oocytes, we found that 1,696 and 1,553 genes, respectively, were abnormally upregulated compared to wild-type controls, with 619 genes in common.
Cellular localization Nuclear
Comment
Ovarian function Oocyte maturation, Early embryo development
Comment A Requirement for ERK-Dependent Dicer Phosphorylation in Coordinating Oocyte-to-Embryo Transition in C. elegans. Drake M et al. (2014) Signaling pathways and small RNAs direct diverse cellular events, but few examples are known of defined signaling pathways directly regulating small RNA biogenesis. We show that ERK phosphorylates Dicer on two conserved residues in its RNase IIIb and double-stranded RNA (dsRNA)-binding domains and that phosphorylation of these residues is necessary and sufficient to trigger Dicer's nuclear translocation in worms, mice, and human cells. Phosphorylation of Dicer on either site inhibits Dicer function in the female germline and dampens small RNA repertoire. Our data demonstrate that ERK phosphorylates and inhibits Dicer during meiosis I for oogenesis to proceed normally in Caenorhabditis elegans and that this inhibition is released before fertilization for embryogenesis to proceed normally. The conserved Dicer residues, their phosphorylation by ERK, and the consequences of the resulting modifications implicate an ERK-Dicer nexus as a fundamental component of the oocyte-to-embryo transition and an underlying mechanism coupling extracellular cues to small RNA production.////////////////// Maternal microRNAs are essential for mouse zygotic development. Tang F et al. MicroRNAs (miRNAs) have important roles in diverse cellular processes, but little is known about their identity and functions during early mammalian development. Here, we show the effects of the loss of maternal inheritance of miRNAs following specific deletion of Dicer from growing oocytes. The mutant mature oocytes were almost entirely depleted of all miRNAs, and they failed to progress through the first cell division, probably because of disorganized spindle formation. By comparing single-cell cDNA microarray profiles of control and mutant oocytes, our data are compatible with the notion that a large proportion of the maternal genes are directly or indirectly under the control of miRNAs, which demonstrates that the maternal miRNAs are essential for the earliest stages of mouse embryonic development. Dicer is a key player in oocyte maturation. Liu HC et al. OBJECTIVE: Apply Dicer siRNA to study functions of Dicer and miRNA during oogenesis. MATERIALS AND METHODS: Mouse oocytes were injected with Dicer siRNA and negative control siRNA and then matured in vitro. After IVM, oocytes were examined for maturation rates, spindle and chromosomal organization, and various gene expressions. RESULTS: Dicer siRNA significantly reduced maturation rates, increased abnormal spindle and chromosomal organization, and reduced the transcripts of Dicer miRNAs, spindle formation proteins (plk1 and AURKA) and spindle check points (Bub1, Bublb). Depletion of bulb16 markedly prohibited the first polar body extrusion and increased the incidence of misaligned chromosomes and abnormal meiotic spindle assembly. CONCLUSION: Dicer siRNA triggered a cascade reduction for gene expressions starting from Dicer to miRNAs than to spindle assembly proteins and checkpoints which led to abnormal spindle and chromosomal organization. Thus, Dicer and miRNA appeared to play an important role during oogenesis and were essential for meiotic completion.
Expression regulated by
Comment
Ovarian localization Oocyte, Granulosa
Comment A retrotransposon-driven dicer isoform directs endogenous small interfering RNA production in mouse oocytes. Flemr M 2013 et al. In mammals, a single Dicer participates in biogenesis of small RNAs in microRNA (miRNA) and RNAi pathways. In mice, endogenous RNAi is highly active in oocytes, but not in somatic cells, which we ascribe here to an oocyte-specific Dicer isoform (Dicer(O)). Dicer(O) lacks the N-terminal DExD helicase domain and has higher cleavage activity than the full-length Dicer in somatic cells (Dicer(S)). Unlike Dicer(S), Dicer(O) efficiently produces small RNAs from long double-stranded (dsRNA) substrates. Expression of the Dicer(O) isoform is driven by an intronic MT-C retrotransposon promoter, deletion of which causes loss of Dicer(O) and female sterility. Oocytes from females lacking the MT-C element show meiotic spindle defects and increased levels of endogenous small interfering RNA (endo-siRNA) targets, phenocopying the maternal Dicer null phenotype. The alternative Dicer isoform, whose phylogenetic origin demonstrates evolutionary plasticity of RNA-silencing pathways, is the main determinant of endogenous RNAi activity in the mouse female germline. ///////////////////////// Nicholson RH, Nicholson AW 2002 reported the molecular characterization of a mouse cDNA encoding Dicer, a ribonuclease III ortholog involved in RNA interference. Members of the ribonuclease III superfamily of double-stranded(ds)-RNA-specific endoribonucleases participate in diverse cellular RNA maturation and degradation pathways. A recently identified eukaryotic RNase III family member, named "Dicer", functions in the RNA interference (RNAi) pathway by producing 21-23 by dsRNAs which target the selective destruction of homologous RNAs. RNAi is operative in animals, plants, and fungi, where it is proposed to inhibit viral reproduction and retroposon movement, as well as to participate in developmental pathways. RNAi functions in mammalian cells, including mouse oocytes and embryos. This article reports the cDNA sequence characterization and expression analysis of the mouse Dicer ortholog. On the basis of the cDNA sequence, the Dicer polypeptide is 1906 amino acids and has a predicted molecular mass of 215 kDa. Mouse Dicer contains a DExH/DEAH helicase motif; a PAZ domain; a tandem repeat of RNase III catalytic domain sequences; and a dsRNA-binding motif. The Dicer gene maps to a single locus on the distal portion of mouse Chromosome (Chr) 12. The Dicer transcript is expressed from the embryonic through adult stages of development. The Dicer transcript is also present in a wide variety of adult mouse organs. The highly conserved set of functional domains and the occurrence of a single-copy gene strongly indicate that the encoded protein is the RNase III ortholog responsible for dsRNA processing in the RNAi pathway. MicroRNA Activity Is Suppressed in Mouse Oocytes. Ma J et al. MicroRNAs (miRNAs) are small endogenous RNAs that typically imperfectly base pair with 3' untranslated regions (3'UTRs) and mediate translational repression and mRNA degradation. Dicer, which generates small RNAs in the miRNA and RNA interference (RNAi) pathways, is essential for meiotic maturation of mouse oocytes. We found that 3'UTRs of transcripts upregulated in Dicer1(-/-) oocytes are not enriched in miRNA binding sites, implicating a weak impact of miRNAs on the maternal transcriptome. Therefore, we tested the ability of endogenous miRNAs to mediate RNA-like cleavage or translational repression of reporter mRNAs. In contrast to somatic cells, endogenous miRNAs in oocytes poorly repressed translation of mRNA reporters, whereas their RNAi-like activity was much less affected. Reporter mRNA carrying let-7-binding sites failed to localize to P body-like structures in oocytes. Our data suggest that miRNA function is downregulated during oocyte development, an idea supported by normal meiotic maturation of oocytes lacking Dgcr8, which is required for the miRNA but not the RNAi pathway (Suh et al. [1], this issue of Current Biology). Suppressing miRNA function during oocyte growth is likely an early event in reprogramming gene expression during the transition of a differentiated oocyte into pluripotent blastomeres of the embryo.
Follicle stages Primordial, Primary, Secondary, Antral
Comment Meiotic maturation failure induced by DICER1 deficiency is derived from primary oocyte ooplasm. Mattiske D et al. RNA interference (RNAi) has diverse functions across cellular processes, including a role in the development of the mammalian oocyte. Mouse primary oocytes deficient in the key RNAi enzyme DICER1 exhibit pronounced defects in chromosome congression and spindle formation during meiotic maturation. The cause of this meiotic maturation failure is unknown. In this study, observations of chromosomes and spindle microtubules during prometaphase in DICER1 deficient oocytes indicate that chromosome congression and spindle formation are overtly normal. Spindle breakdown and chromosome displacement occurs after the metaphase plate has formed, during the metaphase to anaphase transition. We hypothesised that this defect could be attributed to either RNAi mediated regulation of nuclear factors, such as regulation of centromere chromatin assembly, or regulation of mRNA expression within the cytoplasm. By transplanting germinal vesicles between DICER1 deficient and wild-type primary oocytes, we show that, unexpectedly, the meiotic failure is not caused by a deficiency derived from the germinal vesicle component. Instead, we reveal that the ooplasm of primary oocytes contains DICER1 dependent factors that are crucial for chromosome segregation and meiotic maturation.
Phenotypes
Mutations 10 mutations

Species: C. elegans
Mutation name: None
type: null mutation
fertility: infertile - ovarian defect
Comment: Knight SW, et al reported a role for the RNase III enzyme DCR-1 in RNA interference and germ line development in Caenorhabditis elegans. An early event in RNA interference (RNAi) is the cleavage of the initiating double-stranded RNA (dsRNA) to short pieces, 21 to 23 nucleotides in length. The authors we describe a null mutation in dicer-1 (dcr-1), a gene proposed to encode the enzyme that generates these short RNAs and found find that dcr-1(-/-) animals have defects in RNAi under some, but not all, conditions. Mutant animals have germ line defects that lead to sterility, suggesting that cleavage of dsRNA to short pieces is a requisite event in normal development.

Species: mouse
Mutation name: None
type: null mutation
fertility: infertile - ovarian defect
Comment: Impaired microRNA processing causes corpus luteum insufficiency and infertility in mice. Otsuka M et al. The microRNA (miRNA) processing enzyme Dicer1 is required for zygotic and embryonic development, but the early embryonic lethality of Dicer1 null alleles in mice has limited our ability to address the role of Dicer1 in normal mouse growth and development. To address this question, we used a mouse mutant with a hypomorphic Dicer1 allele (Dicer(d/d)) and found that Dicer1 deficiency resulted in female infertility. This defect in female Dicer(d/d) mice was caused by corpus luteum (CL) insufficiency and resulted, at least in part, from the impaired growth of new capillary vessels in the ovary. We found that the impaired CL angiogenesis in Dicer(d/d) mice was associated with a lack of miR17-5p and let7b, 2 miRNAs that participate in angiogenesis by regulating the expression of the antiangiogenic factor tissue inhibitor of metalloproteinase 1. Furthermore, injection of miR17-5p and let7b into the ovaries of Dicer(d/d) mice partially normalized tissue inhibitor of metalloproteinase 1 expression and CL angiogenesis. Our data indicate that the development and function of the ovarian CL is a physiological process that appears to be regulated by miRNAs and requires Dicer1 function.

Species: mouse
Mutation name: None
type: null mutation
fertility: subfertile
Comment: Deletion of Dicer in somatic cells of the female reproductive tract causes sterility. Nagaraja AK et al. Dicer is an evolutionarily conserved RNase III that is necessary for microRNA (miRNA) processing and the synthesis of small interfering RNAs from long double-stranded RNA. While it has been shown that Dicer plays important roles in the mammalian germline and early embryogenesis, the functions of Dicer-dependent pathways in the somatic cells of the female reproductive tract are unknown. Using a transgenic line in which Cre is driven by the anti-M?an hormone receptor type 2 promoter, we conditionally inactivated Dicer1 in the mesenchyme of the developing M?an ducts and postnatally in ovarian granulosa cells and mesenchyme-derived cells of the oviducts and uterus. Deletion of Dicer in these cell types results in female sterility and multiple reproductive defects including decreased ovulation rates, compromised oocyte and embryo integrity, prominent bilateral paratubal (oviductal) cysts, and shorter uterine horns. The paratubal cysts act as a reservoir for spermatozoa and oocytes, and prevent embryos from transiting the oviductal isthmus and passing the uterotubal junction to enter the uterus for implantation. Deep sequencing of small RNAs in oviduct revealed downregulation of specific miRNAs in Dicer conditional knockout females compared to wild type. The majority of these differentially expressed miRNAs are predicted to regulate genes important for M?an duct differentiation and mesenchyme-derived structures, and several of these putative target genes were significantly upregulated upon conditional deletion of Dicer1. Thus, our findings reveal diverse and critical roles for Dicer and its miRNA products in the development and function of the female reproductive tract.

Species: mouse
Mutation name: None
type: null mutation
fertility: infertile - ovarian defect
Comment: Dicer1 is essential for female fertility and normal development of the female reproductive system. Hong X et al. The RNAse III endonuclease, Dicer1, is essential for the synthesis of the 19-25 nucleotide non-coding RNAs known as microRNAs (miRNA). These miRNAs associate with the RNA-induced silencing complex to regulate gene expression post-transcriptionally by base pairing with 3'untranslated-regions of complementary messenger RNA targets. While it is established that miRNAs are expressed in the reproductive tract their functional role and effect on reproductive disease remains unknown. The studies herein establish for the first time the reproductive phenotype of mice with loxP insertions in the Dicer1 gene (Dicer1(fl/fl)) when crossed with mice expressing Cre-recombinase driven by the anti-Mullerian hormone receptor 2 promoter (Amhr2(Cre/+)). Adult female Dicer1(fl/fl);Amhr2(Cre/+) mice displayed normal mating behavior, but failed to produce offspring when exposed to fertile males during a 5-month breeding trial. Morphological and histological assessments of the reproductive tracts of immature and adult mice indicated that the uterus and oviduct were hypotrophic and the oviduct was highly disorganized. Natural mating of Dicer1(fl/fl);Amhr2(Cre/+) females resulted in successful fertilization as evidenced by the recovery of fertilized oocytes on day 1 of pregnancy which developed normally to blastocysts in culture. Developmentally delayed embryos were collected from Dicer1(fl/fl);Amhr2(Cre/+) mice on day 3 of pregnancy when compared to controls. Oviductal transport was disrupted in the Dicer1(fl/fl);Amhr2(Cre/+) mouse as evidenced by the failure of embryos to enter the uterus on day 4 of pregnancy. These studies implicate Dicer1/miRNA mediated post-transcriptional gene regulation in reproductive somatic tissues as critical for the normal development and function of these tissues and for female fertility.

Species: mouse
Mutation name: None
type: null mutation
fertility: infertile - ovarian defect
Comment: Critical roles for Dicer in the female germline. Murchison EP et al. Dicer is an essential component of RNA interference (RNAi) pathways, which have broad functions in gene regulation and genome organization. Probing the consequences of tissue-restricted Dicer loss in mice indicates a critical role for Dicer during meiosis in the female germline. Mouse oocytes lacking Dicer arrest in meiosis I with multiple disorganized spindles and severe chromosome congression defects. Oogenesis and early development are times of significant post-transcriptional regulation, with controlled mRNA storage, translation, and degradation. Our results suggest that Dicer is essential for turnover of a substantial subset of maternal transcripts that are normally lost during oocyte maturation. Furthermore, we find evidence that transposon-derived sequence elements may contribute to the metabolism of maternal transcripts through a Dicer-dependent pathway. Our studies identify Dicer as central to a regulatory network that controls oocyte gene expression programs and that promotes genomic integrity in a cell type notoriously susceptible to aneuploidy.

Species: mouse
Mutation name: None
type: null mutation
fertility: infertile - ovarian defect
Comment: MicroRNA function is globally suppressed in mouse oocytes and early embryos. Suh N et al. Dicer, which is required for the processing of both microRNAs (miRNAs) and small interfering RNAs (siRNAs), is essential for oocyte maturation [1, 2]. Oocytes express both miRNAs and endogenous siRNAs (endo-siRNAs) [3, 4]. To determine whether the abnormalities in Dicer knockout oocytes during meiotic maturation are secondary to the loss of endo-siRNAs and/or miRNAs, we deleted Dgcr8, which encodes an RNA-binding protein specifically required for miRNA processing. In striking contrast to Dicer, Dgcr8-deficient oocytes matured normally and, when fertilized with wild-type sperm, produced healthy-appearing offspring, even though miRNA levels were reduced to similar levels as Dicer-deficient oocytes. Furthermore, the deletion of both maternal and zygotic Dgcr8 alleles did not impair preimplantation development, including the determination of the inner cell mass and trophectoderm. Most surprisingly, the mRNA profiles of wild-type and Dgcr8 null oocytes were essentially identical, whereas Dicer null oocytes showed hundreds of misregulated transcripts. These findings show that miRNA function is globally suppressed during oocyte maturation and preimplantation development and that endo-siRNAs, rather than miRNAs, underlie the Dicer knockout phenotype in oocytes.

Species: mouse
Mutation name: None
type: null mutation
fertility: None
Comment: Murine Follicular Development Requires Oocyte DICER, but Not DROSHA. Yuan S 2014 et al. Both DICER and DROSHA are RNase III enzymes involved in the biogenesis of small noncoding RNAs. DROSHA cleaves the stem-loop portion of the primary miRNAs and produces precursor miRNAs in the nucleus, whereas DICER processes double-stranded RNA precursors into mature miRNAs and endo-siRNAs in the cytoplasm. Selective inactivation of Dicer in growing oocytes of primary follicles leads to female infertility due to oocyte spindle defects. However, it remains unknown if oocyte Dicer expression in the fetal ovary is required for proper follicular development in the postnatal ovary. Moreover, the role of Drosha in folliculogenesis has never been investigated. Here, we report that conditional knockout of Dicer in prophase I oocytes of the fetal ovary led to compromised folliculogenesis, premature ovarian failure and female infertility in the adult ovary, whereas selective inactivation of Drosha in oocytes of either the fetal or the developing ovary had no effects on normal folliculogenesis and female fertility in adulthood. Our data indicate that oocyte DICER expression in the fetal ovary is required, and oocyte DROSHA is dispensable, for postnatal follicular development and female fertility in adulthood. /////////////////////////

Species: human
Mutation name:
type: naturally occurring
fertility: fertile
Comment: Functional characterization of multiple DICER1 mutations in an adolescent. Wu MK et al. (2015) DICER1 is an endoribonuclease which catalyzes the generation of mature 5p and 3p miRNAs. We present the detailed molecular characterization of three DICER1 mutations occurring in a child with multinodular goitre (MNG) and an ovarian sex cord-stromal tumor (OSCST), conditions associated with the DICER1 syndrome (OMIM 601200). We identified three DICER1 mutations affecting the RNase IIIb domain in the child: a novel germ-line DICER1 mutation (c.5441C>T) which does not affect the metal ion binding residues of RNase IIIb, and two different somatic mutations (5425G>T in the MNG and c.5125G>A in the OSCST), both situated at these metal ion binding residues. In vitro functional studies of the germ-line DICER1 (c.5441C>T) mutation showed that both 5p and 3p miRNAs were decreased, whereas the somatic mutation occurring in the MNG, c. 5425G>T, is predicted to function either as a missense (p.D1810Y) or a cryptic splice site (p.K1844fsX17). When the latter, no miRNAs are made. We also identified the previously studied c.5125G>A (p.D1709N) mutation in the OSCST. Following identification of the c.5125G>A, review of the original diagnosis of the OSCST (adult granulosa cell tumour) was revised to Sertoli-Leydig cell tumour, illustrating how molecular analysis can assist in the diagnosis of uncommon ovarian neoplasms. We also report the first instance of biallelic DICER1 mutations in a MNG. The three single base pair substitutions in DICER1 all affect the RNase IIIb domain, but have different effects on miRNA generation. This study demonstrates that detailed functional characterisation of DICER1 missense mutations may be required to determine pathogenicity.//////////////////

Species: mouse
Mutation name:
type: targeted overexpression
fertility: None
Comment: Constitutive Dicer1 phosphorylation accelerates metabolism and aging in vivo. Aryal NK et al. PNAS (2018)//////////////////

Species: human
Mutation name:
type: naturally occurring
fertility: fertile
Comment: Gynecologic and reproductive health in patients with pathogenic germline variants in DICER1. Merideth MA et al. (2020) Germline pathogenic variation in DICER1 underlies a tumor-predisposition disorder with increased risk for cervical embryonal rhabdomyosarcoma and ovarian sex-cord stromal tumors, particularly Sertoli-Leydig cell tumors. The gynecologic and reproductive health of these females has not yet been described. All female subjects recruited from November 2011 to July 2018 participating in an epidemiologic study of families with pathogenic DICER1 germline variation were included in this cross-sectional analysis. Participant evaluation included obstetric-gynecologic history, physical examination, hormone testing, pelvic ultrasound and record review. Of 64 females aged 2-72 years, fifteen underwent treatment for pleuropulmonary blastoma as children and three were treated for cervical embryonal rhabdomyosarcoma. Of nine patients reporting a history of ovarian tumors, all presented with virilization or amenorrhea; eight occurred in adolescence. Post-pubertal females with no history of ovarian tumors experienced normal pubertal development, reported regular menstrual cycles, were fertile and underwent natural menopause at median age of 52 years. Thirty-two of 33 women who tried to conceive successfully delivered liveborn children. Of these 32, 10 experienced pregnancy-related thyroid enlargement resulting in thyroidectomy within one year of pregnancy; nine others had undergone pre-pregnancy thyroidectomy. In these DICER1-carrier females, DICER1-related gynecological tumors occurred during childhood or adolescence in some after which women generally experienced healthy reproductive lives. Individual education and screening for these tumors is warranted. The high rate of DICER1-related multinodular goiter resulting in pre- and post-pregnancy thyroidectomy underscores the importance of thyroid monitoring during pregnancy to ensure maternal and fetal wellbeing.//////////////////

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created: March 5, 2002, 2:26 p.m. by: hsueh   email:
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last update: Jan. 23, 2020, 10:47 a.m. by: hsueh    email:



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