Thalidomide causes the degradation of a surprisingly wide range of transcription factors, which are cell proteins that help switch genes on or off. But SALL4 is of special interest because it is also implicated in Duane Ray Syndrome. Specifically, SALL4 is mutated in Duane Ray Syndrome, which is evident in newborns and is characterized by missing thumbs, underdeveloped limbs, eye and ear defects, and congenital heart disease—problems that mirror those in children exposed to thalidomide in the womb.
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