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PubMed1981

Dynamics of inhibition of iodothyronine deiodination during propylthiouracil treatment of thyrotoxicosis.

Serum 3,3',5'-triiodothyronine (rT3), 3,5,3'-triiodothyronine (T3), thyroxine (T4) and propylthiouracil (PTU) were measured before and at short intervals for 8 hours after oral administration of 200 mg PTU to six patients with untreated thyrotoxicosis. The study was repeated on the 4th day of treatment with 200 mg PTU every 8 hours. Six other patients with untreated thyrotoxicosis were studied after a single administration of 800 mg PTU. The results indicated that PTU inhibition of T4 deiodination to T3, evaluated by the fall in serum T3, was of the same duration as the PTU inhibition of rT3 deiodination, evaluated by the increase in serum rT3. After 200 mg PTU inhibition was maximal for only a few hours, and there was no cumulative effect of PTU during the first four days of treatment, when 200 mg PTU was given every 8 hours. After 800 mg PTU the full effect was maintained for the 9 hour period studied, after which serum T3 had fallen to 65 +/- 2% of the pretreatment level (mean +/- SE). Thus, to obtain a permanent full effect of PTU on iodothyronine deiodination during the treatment of thyrotoxicosis it is necessary to use large doses or frequent administration.

Adult↗

PubMed1975

Experimental alcohol-induced hepatic necrosis: suppression by propylthiouracil.

We have previously reported that a hypermetabolic state, resembling that produced by thryoid hormones, exists in the livers of animals treated chronically with ethanol. We propose that this alteration produces a relative hypoxia in the centrilobular zone of the liver which, if severe enough, leads to cellular death and to the production of hepatitis. Rats consuming ethanol for 30 days, given with a nutritionally adequate diet, and exposed to reduced oxygen tensions for only 6 hr, developed histological and biochemical evidence of hepatocellular necrosis and inflammatory lesions confined to the centrilobular zone. The severity was proportional to the degree of hypoxia. Pair-fed (nonalcohol) controls showed no such lesions. Treatment of the animals with propylthiouracil for 3-10 days abolished the hypermetabolic state of the liver in ethanol-consuming animals, and drastically reduced the histological and biochemical effects of hypoxia in them. These findings may have implications for pathogenesis and treatment of alcoholic hepatitis in man.

Animals↗

PubMed1996

Identification and characterization of novel genes modulated in the thyroid of dogs treated with methimazole and propylthiouracil.

Induction of cell proliferation by mitogen or growth factor stimulation leads to the specific stimulation or repression of a large number of genes. To better understand differentiated epithelial cell growth regulation, we have initiated a study to identify genes which are regulated by the thyrotropin-dependent mitogenic pathway in dog thyroid cells. A thyroid cDNA library was prepared from a methimazole and propylthiouracil-treated dog and differentially screened with probes derived from control or stimulated thyroids. Among 19 clones isolated, 6 encode known proteins (inwardly rectifying potassium channel, nucleosome assembly protein, ribosomal protein L7, elongation factor 1alpha, non-muscle myosin light chain, and heat shock protein 90beta). The 13 others correspond to proteins whose function is unknown. Among them, 5 correspond to mRNAs whose expression was modulated by mitogenic stimulation of thyrocytes in primary culture. A preliminary characterization of two of these cDNAs is reported: clone 5, which might represent a novel, atypical protein kinase, and clone 3, which contains ankyrin-like repeats, suggesting that it might interact with other proteins.

Animals↗

PubMed1991

Effects of supplemental ascorbic acid on performance, organ weight and plasma cholesterol concentration in broilers treated with propylthiouracil.

1. Four experiments were conducted to determine if dietary ascorbic acid (AA) affects body weight gain, food intake, organ weights, plasma cholesterol concentration, and ascorbic acid concentration in the plasma and liver of growing male broilers treated with an antithyroidal agent, propylthiouracil (PTU). 2. In the first experiment, 15 mg AA was administered daily into the crop of chicks fed on a diet supplemented with or without PTU (500 mg/kg). Administration of AA reduced plasma cholesterol concentrations in the PTU-treated chicks. 3. In the other three experiments, chicks were given the basal diet or an AA-containing (3 g/kg) diet supplemented with or without PTU (250 mg or 500 mg/kg). Feeding AA partly prevented the decreases in body weight gain, gain:food ratio and weights of the bursa of Fabricius and thymus in chicks fed on the 250 mg/kg PTU diet, and also prevented the increase in plasma cholesterol concentrations in chicks fed on the PTU diet. 4. These results suggest that AA improves the performance of chicks with experimentally induced hypothyroidism.

Adrenal Glands↗

PubMed1997

Sensory acceptance of Japanese green tea and soy products is linked to genetic sensitivity to 6-n-propylthiouracil.

Genetic sensitivity to 6-n-propylthiouracil (PROP), a heritable trait, has been linked to increased sensitivity to and increased dislike of other bitter compounds. Many phytochemicals with reputed chemopreventive activity have a bitter taste. This study tested the hypothesis that PROP-sensitive women would be more likely to reject Japanese green tea and selected soy products. Both foods contain bitter flavonoids that are thought to be useful in cancer prevention and control. Study subjects, 53 normal-weight, healthy young women, were divided into PROP nontasters (n = 14), regular tasters (n = 28), and supertasters (n = 11) on the basis of their PROP detection thresholds and mean response ratios to PROP compared with NaCl solutions. The subjects tasted a range of soy products, including tofu, miso, plain soymilk, vanilla-flavored soymilk, and five different concentrations of Japanese green tea. Taste intensity and hedonic preference ratings were measured using nine-point category scales. PROP sensitivity was linked to greater perceived bitterness and increased dislike of Japanese green tea. PROP tasters and supertasters preferred vanilla-flavored soymilk over other soy products. Genetic taste markers may alter dietary exposure to substances thought to affect cancer risk.

Adult↗

PubMed2002

Anti-neutrophil cytoplasmic autoantibody (ANCA) profiles in propylthiouracil-induced lupus-like manifestations in monozygotic triplets with hyperthyroidism.

We describe the ANCA profile of two monozygotic triplets (A and B) treated with propylthiouracil (PTU) for hyperthyroidism who developed LE-like manifestations. Triplet C also developed hyperthyroidism but was not treated with PTU and never experienced LE-like symptoms. Triplet A and B showed a marked rise in P-ANCA titer to 1:1280 after PTU was introduced whereas triplet C never had a titer higher than 1:80. Consecutive sera were investigated for ANCA to six different neutrophil granule proteins. Triplet A and B, but not C, both developed a strongly positive elastase-ANCA. Our results confirm the importance of a genetic factor influencing the susceptibility to drug-induced LE.

Antibodies, Antineutrophil Cytoplasmic↗

PubMed2006

Preparation and characterization of propylthiouracil niosomes.

Propylthiouracil, a lyophobic drug with an antiproliferative activity, was formulated into niosomes using various classes of nonionic surfactants. Feasibility of vesicle formation by the sonication method was evaluated. Size and size distribution was measured by laser diffraction. Entrapment and drug release over 24 h were monitored by UV spectrophotometric method at 275 nm. The results revealed that niosomes readily formed from various compositions of nonionic surfactant and cholesterol, with or without a stabilizer. Entrapment of PTU in niosomes depended on bilayer composition. The release of PTU from all niosomal formulations studied was retarded and followed the first-order kinetics. Degree of slow release had a negative correlation with drug entrapment. The release rate also depended on the physical state of the bilayer. The results of this study indicate that PTU niosomes were able to control the release of PTU and might be of value to develop further into topical formulations.

Buffers↗

PubMed2001

Oral propylthiouracil for the treatment of resistant plaque psoriasis.

BACKGROUND: Propylthiouracil (PTU) has been used in the treatment of hyperthyroidism for many years and inhibits the enzyme 5'-deiodinase, which converts thyroxine to triiodothyronine. Several studies have reported PTU as an effective treatment for plaque psoriasis. PTU exhibits immunomodulatory effects; however, its exact mechanism of action in psoriasis is unknown. Few patients were studied in these reports and treatment with PTU was continued for no longer than 8 weeks. METHODS: In this study we report on four patients with resistant plaque psoriasis who had treatment with oral PTU for 4-32 weeks (mean 18.4). RESULTS: Three of the four patients exhibited moderate clinical improvement with reductions in psoriasis severity observed within 4-6 weeks of commencing PTU therapy. The side effects noted were subclinical hypothyroidism in two patients and worsening of muscle aches in one patient. Monitoring included regular thyroid function, full blood count, and liver and renal function tests. CONCLUSION: This study illustrates that oral PTU can be a useful addition to the therapy of resistant cases of plaque psoriasis and shows that this treatment can be continued for longer than 8 weeks with few side effects occurring secondary to PTU.

Adjuvants, Immunologic↗

PubMed2004

Impact of thyroid hormone deficiency on the developing CNS: cerebellar glial and neuronal protein expression in rat neonates exposed to antithyroid drug propylthiouracil.

The developing rat cerebellum is vulnerable to thyroid hormone (TH) deficiency. The present study addresses the molecular mechanisms involved in this response. Specifically, the study focuses on the expression of selected cerebellar proteins that are known to be directly [protein expressing 3-fucosyl-N-acetyl-lactosamine antigen (CD15), neuronal cell adhesion molecule (L1)] or indirectly [glial fibrillary acidic protein (GFAP)], involved in glial-neuronal interactions and thus regulation of cell proliferation and granule cell migration. Cerebellar mass, structure, and protein expression in rat neonates exposed to antithyroid drug propylthiouracil (PTU) from the embryonic day (E) 16 to postnatal day (P) 21 were compared against rat neonates that received replacement of thyroxin (T4) starting on day P1 or untreated controls. Cerebellar proteins were analyzed by quantitative Western blots. PTU-treated rats lagged in growth and showed reduction in cerebellar mass and alterations in cerebellar structure on P15. Daily treatment of neonates with T4 restored normal cerebellum-to-body-mass ratio, cerebellar structure, and cerebellar protein expression. Densitometric analysis of Western blots revealed altered expression of selected proteins in the cerebella of hypothyroid neonates. A decrease of CD15 (46%, p = 0.031) was observed on P10 and was accompanied by a decrease in GFAP expression (64%, p = 0.039). Furthermore, a shift in the developmental GFAP profile was observed in the PTU-treated cerebellum. L1 expression was not significantly affected in the hypothyroid cerebellum. Altered expression of cerebellar proteins is likely to affect cell-cell interactions and consequently cell proliferation and migration and contribute to structural and functional alterations seen in the hypothyroid rat neonates.

Age Factors↗

PubMed2001

Influence of propylthiouracil treatment on oxidative stress and nitric oxide in Basedow disease patients.

Oxidative stress parameters and nitric oxide (NO) values were determined in 27 newly diagnosed Basedow patients before and after 1 mo of propylthiouracil (PTU) therapy and in 15 healthy controls. Basedow patients exhibited increased triiodothyronine (T3) and thyroxine (T4) and decreased thyroid-stimulating hormone (TSH) values compared to controls. Significantly higher thiobarbituric acid-reactive substances (TBARS), NO and glutathione (GSH) levels, and CuZn superoxide dismutase (CuZn SOD) activity were found in Basedow patients in comparison to controls, regardless of sex. Treatment with PTU (3 x 100 mg/d for 30 d) was effective in decreasing T1 and T4 and increasing TSH levels. Significantly decreased NO and TBARS and increased GSH and CuZn SOD levels were observed in PTU-treated Basedow patients compared to pre-PTU administration. PTU-treated patients compared to controls still exhibited significantly higher T3 and lower TSH values and higher NO, TBARS, GSH, and CuZn SOD levels. The induced antioxidant defense and decrease in NO) values in response to PTU therapy emphasizes the role of PTU as an antithyroid drug, where the ability to diminish hyperthyroidism results in decreased catabolism and lower oxidant generation.

Adult↗

PubMed2001

Development and validation of a high-performance liquid chromatographic method for the analysis of propylthiouracil in pharmaceuticals.

A simple, rapid, and stability-indicating high-performance liquid chromatographic (HPLC) method was developed and validated for the assay of propylthiouracil (PTU). The method was used to quantify PTU in topical formulations and in tablets. Excellent linearity was observed between PTU concentration and the peak area (R2= 0.999). The limit of detection was 1 ng, and the limit of quantitation was 1.2 ng. The method proved to be selective. Selectivity was validated by subjecting a stock solution of PTU to acidic, basic, and oxidative degradations. The peaks of the degradation products did not interfere with the peak of PTU. Excipients present in the dosage forms did not interfere with the analysis, and the recovery of PTU from each dosage form was quantitative.

Antithyroid Agents↗

PubMed2000

Acute interstitial nephritis and fatal Stevens-Johnson syndrome after propylthiouracil therapy.

We report a case of acute interstitial nephritis and fatal Stevens-Johnson syndrome in a 90-year-old woman with amiodarone-induced hyperthyroidism, who had been treated for 5 weeks with propylthiouracil (PTU). On admission, the patient exhibited acute renal failure and generalized macular purpuric eruption. Acute interstitial nephritis and Stevens-Johnson syndrome were diagnosed and PTU withdrawn. Although renal function recovered after PTU withdrawal and corticosteroid therapy, the patient's condition worsened, and she died after developing multiple organ failure. Acute interstitial nephritis seems to be rarely associated with PTU therapy. Moreover, a literature review suggested that this could represent the first published report of a Stevens-Johnson syndrome developing during PTU therapy.

Acute Disease↗

PubMed2002

Rectal administration of propylthiouracil in hyperthyroid patients: comparison of suspension enema and suppository form.

Previous studies have described the therapeutic effects of propylthiouracil (PTU) and methimazole in normal subjects after rectal suppositories. The goal of our study was to compare the pharmacokinetic and pharmacologic effects of a suppository and suspension form of PTU given per rectum. Fifteen newly diagnosed hyperthyroid patients of both genders (ages 21 to 55 years) were randomly given the drug as follows: group 1 (n = 7), a single enema (400 mg of PTU in 90 mL of sterile water) and group 2 (n = 8), two suppositories of polyethylene glycol base (200 mg of PTU in each). The pharmacokinetic study revealed earlier time to peak levels (T(max)) and significantly greater maximal peak levels (C(max)) in group 1 than in group 2, (85.71 +/- 12.12 minutes vs. 172.5 +/- 26.24 minutes for T(max) and 3.89 +/- 0.34 vs. 2.01 +/- 0.38 microg/mL, p < 0.05 for C(max), respectively). However, the area under the curve (635.16 +/- 105.71 vs. 377.87 +/- 68.09 microg x min/mL) was not statistically different between both groups. Both forms induced a significant decrease in serum free triiodothyronine (FT(3)) levels and an increase in serum rT(3) levels shortly after administration. Four subjects reported a bitter taste 5-10 minutes after receiving the drug. PTU can be effectively absorbed via the rectal route. The enema form appeared to provide better bioavailability than the suppository form. However, both preparations exhibited comparable therapeutic effect.

Administration, Rectal↗

PubMed2004

Propylthiouracil reduces the effectiveness of radioiodine treatment in hyperthyroid patients with Graves' disease.

In order to assess the effect of propylthiouracil (PTU) or methimazole (MMI) pretreatment on patient outcome after radioiodine therapy, we examined 100 patients with Graves' disease 3, 6, 9, and 12 months after administration of a 10-mCi standard single dose of 131I. They were assigned to one of three groups: no drug (ND) treatment (30 cases); MMI (45 cases); and PTU (25 cases). Antithyroid drugs (ATD) were withdrawn 15 days before radioiodine administration. The groups were similar concerning age, gender, ATD pretreatment duration, goiter size, and initial serum triiodothyronine (T3), thyroxine (T4), free thyroxine (FT4), antithyroid autoantibody levels, 24-hour radioiodine uptake and 131I dose administered per gram of thyroid tissue. ND and MMI groups presented a similar rate of cure of 73.3% and 77.8% respectively (p = NS). In contrast, the PTU group showed a rate of cure of only 32% (p < 0.05). Logistic regression analysis indicated that PTU administration (p = 0.003) and thyroid size (p = 0.02) were the variables related to radioiodine therapy failure. Our data demonstrate that the chance of 131I treatment failure is higher in individuals using PTU than in patients using MMI or not using any ATD before radioiodine (odds ratio [OR] 5.84; 95% confidence interval [CI] 1.82-18.76) suggesting that PTU should be avoided in the treatment of patients with Graves' disease.

Adolescent↗

PubMed1991

Effects of amiodarone on serum T3 and T4 concentrations in hyperthyroid patients treated with propylthiouracil.

Amiodarone (Cordarone) has been proven to be useful in the management of atrial fibrillation. However, because of a large iodine content, this drug is not used in this complication of thyrotoxicosis. We previously have observed a greater fall in serum T3 and T4 concentrations in hyperthyroid patients treated with amiodarone and methimazole than with methimazole alone. In the present study, we determined whether the addition of amiodarone to propylthiouracil (PTU) could improve the levels of circulating thyroid hormones in hyperthyroid patients, and we assessed the release of iodide from amiodarone by measuring the 24 h urinary iodine excretion. Twelve hyperthyroid patients were treated either with PTU, 600 mg daily for 10 days (group PTU), or with amiodarone (A), 1200 mg daily for 3 days in addition to PTU (group A-PTU). Basal serum T4, T3, and rT3 concentrations (mean +/- SEM) were respectively 206 +/- 13 nmol/L, 5.13 +/- 0.8 nmol/L, and 81 +/- 7 ng/dL for group PTU and 238 +/- 39 nmol/L, 4.73 +/- 1.06 nmol/L, and 84 +/- 12 ng/dL for group A-PTU (NS). In group A-PTU, plasma amiodarone peaked on day 3 (mean +/- SEM: 0.48 +/- 0.11 mg/L), and urinary iodine reached 5.27 +/- 1.28 mg/day on day 5. The fall in serum T3 and the increase in serum rT3 concentrations were significantly greater in group A-PTU than in group PTU (ANOVA, p less than 0.05). In group A-PTU, the minimal serum T3 concentration was observed on day 5 of treatment (28 +/- 6% of the pretreatment values).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1993

Adjunctive treatment with propylthiouracil or iodine following radioiodine therapy for Graves' disease.

The effect of radioiodine therapy in Graves' disease is gradual in onset and the subjects continue to be hyperthyroid for several weeks after such therapy. In a prospective study of 112 patients, we compared the usefulness of two commonly employed antithyroid drug regimens in controlling hyperthyroidism in the period immediately following radioiodine therapy. They received propylthiouracil (PTU, 100 mg orally three times a day), saturated solution of potassium iodide (10 drops once a day) or no drugs starting 5 days after radioiodine therapy. Thyroid status was monitored clinically and by serum thyroxine index and TSH measured at 4-6 week intervals over a 6-month period. The control or drug-treated groups did not differ in thyroid status 6 weeks after radioiodine. The PTU-treated group had greater incidence of hyperthyroidism and a lower incidence of hypothyroidism at 6 months. However, the differences were explained on the basis of a greater incidence of large goiters that appeared to confer relative radioresistance in the PTU group. We conclude that patients with mild to moderate hyperthyroidism do not benefit from adjunctive treatment with PTU or potassium iodide immediately after radioiodine therapy.

Adult↗

PubMed1993

Propylthiouracil (PTU)-induced agranulocytosis treated with recombinant human granulocyte colony-stimulating factor (G-CSF).

Two premenopausal female patients with Graves' hyperthyroidism and propylthiouracil (PTU)-induced agranulocytosis are presented. The first patient, age 47, received 300 mg of PTU per day and developed agranulocytosis within 6 weeks of the commencement of therapy. There were no granulocytes in the peripheral smear and a bone marrow biopsy demonstrated an absence of the entire myeloid cell line as well as the presence of many granulomas. The second patient, age 39, received PTU 1600 mg per day for two and half weeks and then 2 days of methimazole, 200 mg per day. She developed complete agranulocytosis on peripheral smear within 3 weeks of the initiation of therapy. Her bone marrow biopsy demonstrated maturation arrest of the granulocytic cell line at the myelocyte stage. In addition to discontinuing their antithyroid drugs, both patients were treated with G-CSF subcutaneously. The first patient received 300 micrograms of G-CSF on days 2 and 4 after discontinuing PTU with the appearance of 4.7 x 10(9)/L granulocytes and granulocyte precursors on day 4. The second patient received 575 micrograms of G-CSF for 2 days and 300 micrograms for 1 additional day beginning on the third day after discontinuing antithyroid drugs. On the second treatment day there were 5.8 x 10(9)/L granulocytes and granulocyte precursors on the peripheral smear. A comparison to previously published cases on antithyroid drug induced agranulocytosis suggests that the use of G-CSF decreased the amount of time required for marrow recovery after the cessation of the offending drug.

Adult↗

PubMed1995

Treatment with propylthiouracil before radioactive iodine therapy is associated with a higher treatment failure rate than therapy with radioactive iodine alone in Graves' disease.

Older reports have suggested that the use of antithyroid drugs with radioactive iodine-131 (RAI) results in higher rates of persistent hyperthyroidism than treatment with RAI alone. Our objective was to determine if propylthiouracil (PTU) given prior to RAI would be associated with a higher single dose RAI failure rate than treatment with RAI alone. Patients were considered treatment failures if a second dose of RAI was required to produce euthyroidism or hypothyroidism. All study patients stopped PTU at least 4 days before RAI therapy and did not receive PTU after RAI. The overall failure rate of one course of treatment in the 86 study patients was 17% (15/86). Persistent hyperthyroidism was seen in 4% of patients (2/48) treated with only RAI and in 34% of patients (13/38) receiving RAI after pretreatment with PTU (p = 0.003). Patients were treated with PTU for a mean of 151 +/- 32 days. There were no significant differences in race, gender, thyroid size, RAI dose, or days of follow-up between patients receiving RAI alone and those receiving PTU before RAI therapy. These data suggest that pretreatment with PTU leads to a higher failure rate even if PTU is discontinued at least 4 days before RAI therapy and not restarted after RAI dosing. Consideration should be given to increasing the dose of RAI in patients pretreated with PTU to ensure adequate treatment of Graves' disease.

Adult↗