Unraveling the mystery of thalidomide

Developmental Biology Off-label use of thalidomide became a worldwide trend in the 1950s and early 1960s to alleviate morning sickness. It resulted in a historical tragedy, as thousands of babies were born with severe birth defects. Donovan et al. may have found a missing link to explain how the drug affects fetal development. The researchers show that thalidomide and closely related drugs rapidly degrade the transcription factor Sal-like protein 4 (SALL4), which is necessary for fetal limb and organ formation. Adding further weight to their findings, certain individuals with mutations in the SALL4 gene develop abnormalities that resemble thalidomide-induced birth defects. eLife 7 , e38430 (2018).