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Thyroid hormones in differentiated thyroid cancer.

In a study of 136 differentiated thyroid cancer patients referred for radioiodine therapy since January 1991, it was observed that 80 patients had metastatic disease. Of them, 51 had elevated levels of thyroglobulin (Tg), and of these 51 there were 15 patients who had functioning metastases with evidence of thyroid hormone synthesis by these metastases. All but 1 of these 15 cases with normal hormone levels in the circulation were follicular carcinomas with skeletal metastases. The response of these patients to radioiodine was poor. The group of patients with high Tg levels but low hormone synthesis and low circulating hormones responded better to radioiodine. Patients with low Tg levels and low hormone synthesis showed good response to radioiodine--especially patients with residual thyroid tissue after surgery and those with nodal disease.

Adenocarcinoma, Follicular↗

Thyroid hormone receptor-beta mutants associated with generalized resistance to thyroid hormone show defects in their ligand-sensitive repression function.

Thyroid hormone (T3) responses are mediated by two receptors, TR alpha and TR beta, that have been shown to require heterodimer formation with the retinoid-X receptors for effective interaction with most T3-responsive elements (TRE). In addition, it has been shown recently that one type of TRE, an inverted palindrome (IP) with a 4-, 5-, or 6-base pair spacer, can also bind TR homodimers with high affinity. This binding, however, is sensitive to T3, which suggests that TR homodimers could have important biological roles as T3-sensitive repressors. Here we have analyzed eight natural TR beta mutants associated with the syndrome of generalized resistance to thyroid hormone (GRTH). These receptor mutants are characterized by a variably decreased affinity for T3. We show here that their homodimer binding characteristics are altered. For example, kindred GH binds as a homodimer more weakly to DNA than wild-type (WT), whereas mutant PV forms clearly stronger homodimer complexes than WT even in the presence of TREs that bind WT receptor homodimers poorly. Although other mutants were able to bind IP-6 elements efficiently as homodimers, these homodimers showed a decreased sensitivity to T3 in accordance with their reduced affinities for the ligand. In vivo, six of the eight mutants were able to function as strong repressors on IP sites located 3' of the TATA box. Although T3 released repression by WT TR beta, the hormone did not release repression by some of the mutant receptors, and elevated concentrations of T3 were required to release repression by other mutants. Importantly, most of the GRTH-associated mutants were able to function as potent dominant negative repressors of WT in the homodimer pathway, whereas they showed little dominant negative activity in the heterodimer-dependent transcriptional activation pathway. Only one of the eight GRTH mutants, a deletion of the carboxy-terminus, was found to have a strong dominant negative activity on both T3 response pathways. Our data suggest a dominant negative mechanism of action for GRTH mutants that is consistent with their homodimer binding characteristics to IP-TREs and correlates well with T3 resistance in patients.

Animals↗

A de novo L330S point mutation in thyroid hormone receptor beta gene in a Thai female with resistance to thyroid hormone.

In the present study, we report a Thai female with a de novo mutation in thyroid hormone receptor-beta (TRbeta) gene causing resistance to thyroid hormone (RTH). The patient was a 19 year-old woman who presented with goiter for 1 year. Except for tachycardia she had no signs of thyrotoxicosis. Previously she was treated with propylthiouracil based on the diagnosis of thyrotoxicosis for 9 months and her goiter became more enlarged. The patient was the only child of the family. Her parents were alive and healthy, and did not have goiter or any other thyroid diseases. Physical examination revealed no sign of thyrotoxicosis. Her thyroid gland was diffusely enlarged with an estimated weight of 100 gm. Laboratory determinations revealed elevated free T4, T3 and nonsuppressed TSH levels. Exon 9 of the TRbeta gene was amplified by PCR and the DNA sequence was determined by dye terminator cycle sequencing. Heterozygous point mutation in which T was replaced by C was detected at position 1274 (TTG to TCG) corresponding to a leucine to serine substitution at codon 330. No mutation was found in the parents indicating that the mutation was de novo. The nucleotide change created a restriction site for Taq 1 restriction endonuclease and the mutation was confirmed by restriction fragments length polymorphism. The same nucleotide change has been reported in a family with RTH.

Adult↗

Defective thyroid hormone action in fibroblasts cultured from subjects with the syndrome of resistance to thyroid hormones.

Two preadolescent girls and their mother with the syndrome of central and peripheral resistance to thyroid hormones are reported. The sisters had goiters, high radioiodine uptakes, high plasma levels of thyroid hormones, normal TSH levels, and brisk increases in TSH after TRH administration, but had no clinical evidence of thyrotoxicosis. The mother, who had undergone partial thyroidectomy and radioiodine therapy, presented with mild hypothyroid symptoms, normal thyroid hormone levels, and a high TSH level. On T4 treatment, her TSH fell toward normal, and thyroid levels became elevated without thyrotoxic symptoms. Special studies were performed with cultured skin fibroblasts. T3 stimulated low density lipoprotein receptor activity in cells from normal subjects, but failed to do so in fibroblasts form the three patients, indicating that their fibroblasts had a defective response to T3. However, after incubation of fibroblasts with labeled T3, no abnormalities in the binding capacity or affinity of nuclei were observed. These findings suggest that in this family, the thyroid hormone resistance demonstrable in vivo and in vitro results from a cellular defect at a site other than at the nuclear binding site.

Adult↗

Resistance to thyroid hormone in subjects from two unrelated families is associated with a point mutation in the thyroid hormone receptor beta gene resulting in the replacement of the normal proline 453 with serine.

Resistance to thyroid hormone (RTH) is a condition of impaired tissue responsiveness to thyroid hormone characterized by elevated free thyroid hormone levels in serum accompanied by nonsuppressed TSH. RTH has been associated with mutations in the thyroid hormone receptor (TR) beta gene. We report studies carried out in 9 members of a family (F94) of Jewish ethnic origin and a single subject of Mexican origin. All subjects fulfilling the criteria of RTH (6 of family F94 and one of family F27) had the same point mutation in the T3-binding domain on one of the two alleles of the TR beta gene. This mutation resulted in the replacement of the normal proline-453 with serine (P453S). Nevertheless, the clinical characteristics of affected members of each of the two families differed as did the severity of hormonal resistance in terms of responses to the administration of L-T3. Genetic studies indicate that the same mutation occurred independently in each of the two families.

Adult↗

Cross-talk between thyroid hormone receptor and liver X receptor regulatory pathways is revealed in a thyroid hormone resistance mouse model.

Hypercholesterolemia is found in patients with hypothyroidism and resistance to thyroid hormone. In this study, we examined cholesterol metabolism in a thyroid hormone receptor beta (TR-beta) mutant mouse model of resistance to thyroid hormone. Whereas studies of cholesterol metabolism have been reported in TR-beta knock-out mice, generalized expression of a non-ligand binding TR-beta protein in this knock-in model more fully recapitulates the hypothyroid state, because the hypothyroid effect of TRs is mediated by the unliganded receptor. In the hypothyroid state, a high cholesterol diet increased serum cholesterol levels in wild-type animals (WT) but either did not change or reduced levels in mutant (MUT) mice relative to hypothyroidism alone. 7alpha-Hydroxylase (CYP7A1) is the rate-limiting enzyme in cholesterol metabolism and mRNA levels were undetectable in the hypothyroid state in all animals. triiodothyronine replacement restored CYP7A1 mRNA levels in WT mice but had minimal effect in MUT mice. In contrast, a high cholesterol diet markedly induced CYP7A1 levels in MUT but not WT mice in the hypothyroid state. Elevation of CYP7A1 mRNA levels and reduced hepatic cholesterol content in MUT animals are likely because of cross-talk between TR-beta and liver X receptor alpha (LXR-alpha), which both bind to a direct repeat + 4 (DR+4) element in the CYP7A1 promoter. In transfection studies, WT but not MUT TR-beta antagonized induction of this promoter by LXR-alpha. Electromobility shift analysis revealed that LXR/RXR heterodimers bound to the DR+4 element in the presence of MUT but not WT TR-beta. A mechanism for cross-talk, and potential antagonism, between TR-beta and LXR-alpha is proposed.

Animals↗

Kindred S thyroid hormone receptor is an active and constitutive silencer and a repressor for thyroid hormone and retinoic acid responses.

Mutations in the gene encoding the human thyroid hormone receptor beta (hTR beta) have been associated with generalized thyroid hormone resistance (GTHR). However, the molecular basis by which the receptor mutants cause the clinical symptoms is largely unknown. We show here that the beta form of the human receptor possesses, in addition to hormone-dependent activation, the ability to repress basal-level activity of a target promoter. This silencing function is localized in the carboxyl-terminal part of the receptor and can be transferred to a heterologous DNA binding domain. This mode of silencing is therefore distinct from inhibition by competition with activator proteins on DNA. We show that two receptor mutants isolated from patients with GTHR are impaired in transcriptional activation but fully retain the silencing function, which enforces dominant negative regulation by the receptor. Interestingly, the kindred S receptor (hTR delta 332) acts as a constitutive repressor with a strong silencing ability similar to that of the v-erbA oncogene product. We also provide evidence for distinct transcriptional regulatory properties of both proteins. Finally, we show that both thyroid hormone- and retinoic acid-responsive genes are potentially repressed to generate the clinical manifestations of the GTHR syndrome. Our findings suggest that silencing plays an important role in the phenotypic expression of the symptoms in patients with GTHR.

Binding Sites↗

Thyroid hormone receptor monomer, homodimer, and heterodimer (with retinoid-X receptor) contact different nucleotide sequences in thyroid hormone response elements.

Thyroid hormone receptors (TRs) bind as monomers, homodimers, and heterodimers with nuclear proteins such as retinoid-X receptors (RXRs) to thyroid hormone response elements (TREs). However, it is not known which nucleotides each TR complex contacts in a particular TRE. To identify the precise contact sites on a synthetic DR4 (TRE half-sites arranged as a direct repeat with a four-nucleotide spacer) and a chick lysoenzyme TRE, F2 (half-sites arranged as an inverted palindrome with a six-nucleotide spacer), for various TR complexes, mobility shift assays, and dimethylsulfate and KMnO4 DNA modification interference assays were employed. First, TR alpha monomer bound to the downstream half-site of these TREs, whereas TR alpha homodimer bound to both half-sites. TR alpha/RXR alpha heterodimer also bound to both half-sites, but "preferred" to contact the down-stream half-site. Second, the specific flanking and spacing sequences of DR4 influenced the contact sites and the binding of TR alpha monomer and homodimer, but not TR alpha/RXR alpha heterodimer. Finally, cotransfection studies, using reporter plasmids containing DR4 or F2 in both orientations with respect to the basal promoter, provide evidence that preferential contact with the down-stream half-site by TR/RXR heterodimer may be important for maximal transcriptional activation.

Animals↗

Identification of a thyroid hormone response element in the mouse myogenin gene: characterization of the thyroid hormone and retinoid X receptor heterodimeric binding site.

Thyroid hormones are positive regulators of muscle development in vivo. Triiodo-L-thyronine (T3) treatment of myogenic cell lines results in the precocious expression of myogenin, a muscle specific, helix-loop-helix factor that can trans-activate muscle specific gene expression (G. Carnac et al., Mol. Endocrinol., 6: 1185-1194, 1992). We have identified a T3 response element (TRE) in the mouse myogenin (MM) promoter between nucleotide positions -526 and -494 (5' GTGGTAGGTCTTTAGGGGTCTCATGGGACTGACA 3'). This sequence conferred appropriate hormonal regulation to an enhancerless SV40 promoter. Electrophoretic mobility shift analysis experiments showed that thyroid hormone receptor alpha (TR alpha) and retinoid X receptor alpha (RXR alpha) formed a heterodimeric complex on the MM TRE that was specifically competed by classical TREs and not by other response elements. Analyses of this heterodimer with a battery of steroid hormone response elements indicated that the complex was efficiently competed by a direct repeat of the AGGTCA motif separated by 4 nucleotides, as predicted by the 3-4-5 rule. Electrophoretic mobility shift analysis experiments showed that the myogenin, growth hormone, and myosin heavy chain TREs interacted with an identical nuclear factor(s) in muscle cells that was constitutively expressed during myogenesis. Mutagenesis of the MM TRE indicated that the sequence of the direct repeats (AGGTCA) and the 4-nucleotide gap were necessary for efficient binding to the TR alpha/RXR alpha heterodimeric complex. In conclusion, our data suggest that the MM TRE is a target for direct cross-talk between two different hormonal signals (T3 and 9-cis-retinoic acid) at the receptor level.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

A comparison of the effects of propylthiouracil and methimazol on circulating thyroid hormones and various measures of peripheral thyroid hormone effects in thyrotoxic patients.

Two groups of patients with newly diagnosed thyrotoxicosis were treated with propylthiouracil (PTU) 400 mg every 6 h for 4 days followed by methimazol (MMI) 40 mg every 6 h for 4 days or by MMI for 4 days followed by PTU for 4 days. The shift from MMI to PTU induced a considerable decrease in serum T3 while shift from PTU to MMI led to an increase in serum T3. Serum T4 decreased gradually during the whole treatment period. The opposite variations in serum T3 were accompanied by similar opposite variations in basal metabolic rate (BMR) (P less than 0.001). Hence the rapid variations in serum T3 which can be induced by PTU in thyrotoxic patients, are followed by rapid alterations in the thyrotoxic state as evaluated by BMR.

Achilles Tendon↗

[Studies on cytosol thyroid hormone binding proteins in the rat liver: Part II. Alterations of thyroid hormone binding proteins in various thyroid function states].

Alterations of binding characteristics of cytosolic thyroid hormone binding proteins (CTHBPs) were examined in livers of rats with different thyroid function. Seven days after thyroidectomy, rats were divided into three groups. Group I received no treatment. Group II was treated with 230 ng triiodothyronine (T3)/100 g body weight per day for three days, and Group III with 40 micrograms T3/100 g body weight per day for three days. On the fourth day, each rat was given 0.7 microCi of 125I-T3/100 g body weight intraperitoneally and exsanguinated two hours later. During three days' treatment, body weight in Group II increased significantly compared with that in Group I (P less than 0.05), and body weight in Group III actually decreased. The ratio of liver weight to body weight in Group II was significantly higher than that in Group I or Group III (P less than 0.01). Percent distributions of 125I-T3 in cytosol fraction per liver or concentrations of cytosolic protein did not differ significantly among these three groups. Serum T3 concentrations (mean +/- SD ng/ml: Group I; not detectable, Group II; 0.50 +/- 0.27, Group III; 7.10 +/- 2.31), cytosolic T3 concentrations (mean +/- SD ng/ml: Group I; not detectable, Group II; 0.59 +/- 0.26, Group III; 10.38 +/- 3.08) and mitochondrial alpha-glycerophosphate dehydrogenase activities (mean +/- SD delta OD500 millimicrons/min/mg: Group I; 28.0 +/- 1.5, Group II; 46.7 +/- 7.3, Group III; 267.7 +/- 9.1) suggested that Group I was in hypothyroid state, Group II in euthyroid state and Group III in thyrotoxic state. Binding characteristics of cytosolic T3 binding protein (CT3BP) were different among the three groups.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

[Determination of the concentration of thyroid hormones in dialysate and assessment of the loss of thyroid hormone during hemodialysis (author's transl)].

In order to determine the hormone concentration in a dialysate, the commercially available radioimmunoassay test of Dow-Lepetit for determination of free thyroid hormones in serum had to be modified. The results raised the suspicion that additional protein-bound hormone had passed the membrane. This could be demonstrated by the addition of Thiomersal. In 64 patients examined 1 and 5 hrs after the beginning of hemodialysis the mean total hormone concentration in the dialysate was 12.05 pg/ml for thyroxine and 5.47 pg/ml for triiodothyronine. The resulting loss of total hormone in hemodialysis patients, calculated for 1 week, amounted to 2.25 microgram triiodothyronine and 4.87 microgram thyroxine. The comparison with the physiologic renal elimination of thyroid hormone shows that the hormone elimination in hemodialysis patients is negligibly small. The quantitative determination of the protein concentration in the dialysate gave 384 ng/ml and was close to the limit of sensitivity of the method and consequently uncertain. It can be said, however, that the loss of protein is without clinical relevance.

Humans↗

Anti-thyroid hormonal activity of tetrabromobisphenol A, a flame retardant, and related compounds: Affinity to the mammalian thyroid hormone receptor, and effect on tadpole metamorphosis.

The thyroid hormone-disrupting activity of tetrabromobisphenol A (TBBPA), a flame retardant, and related compounds was examined. TBBPA, tetrachlorobisphenol A (TCBPA), tetramethylbisphenol A (TMBPA) and 3,3'-dimethylbisphenol A (DMBPA) markedly inhibited the binding of triiodothyronine (T3; 1 x 10(-10) M) to thyroid hormone receptor in the concentration range of 1 x 10(-7)-1 x 10(-4) M, while bisphenol A and 2,2-diphenylpropane were inactive. TBBPA, TCBPA, TMBPA and DMBPA did not exhibit thyroid hormonal activity in a thyroid hormone-responsive reporter assay using a Chinese hamster ovary cell line (CHO-K1) transfected with thyroid hormone receptor alpha1 or beta1, but TBBPA and TCBPA showed significant anti-thyroid hormone effects on the activity of T3 (1 x 10(-8) M) in the concentration range of 3 x 10(-6) - 5 x 10(-5) M. The thyroid hormone-disrupting activity of TBBPA was also examined in terms of the effect on amphibian metamorphosis stimulated by thyroid hormone. TBBPA in the concentration range of 1 x 10(-8) to 1 x 10(-6) M showed suppressive action on T3 (5 x 10(-8) M)-enhancement of Rana rugosa tadpole tail shortening. These facts suggest that TBBPA, TCBPA, TMBPA and DMBPA can act as thyroid hormone-disrupting agents.

Animals↗

Ligand-dependent, Pit-1/growth hormone factor-1 (GHF-1)-independent transcriptional stimulation of rat growth hormone gene expression by thyroid hormone receptors in vitro.

The expression of the rat growth hormone (rGH) gene in the anterior pituitary gland is modulated by Pit-1/GHF-1, a pituitary-specific transcription factor, and by other more widely distributed factors, such as the thyroid hormone receptors (TRs), Sp1, and the glucocorticoid receptor. Thyroid hormone (T3)-mediated transcriptional stimulation of rGH gene expression has been extensively studied in vivo and in vitro including the measurements of (i) rGH mRNA by blot hybridization, (ii) transcriptional rate of rGH gene by nuclear run-on, and (iii) reporter gene expression in which a chimeric plasmid containing 5'-flanking sequences of the rGH gene linked to a reporter gene has been transfected either stably or transiently into pituitary and/or nonpituitary cells. From these studies, it has been suggested that the Pit-1/GHF-1 binding site is necessary for full T3 action. We developed a cell-free in vitro transcription system to examine further the roles of the TRs and Pit-1/GHF-1 in rGH gene activation. Using GH3 nuclear extract as a source of TRs and Pit-1/GHF-1, this in vitro transcription assay showed that T3 stimulation of rGH promoter activity is dependent on the addition of T3 to the GH3 nuclear extract. This transcriptional stimulation was augmented with increasing concentrations of ligand and was T3, but not T4 or reverse T3, specific. T3-mediated stimulation of rGH promoter activity was completely abolished by preincubation of the nuclear extract with rGH-thyroid hormone response element (-200 to -160) but not with Pit-1/GHF-1 (-137 to -65) oligonucleotides. Further, neither deletion of both Pit-1/GHF-1 binding sites nor mutation of the proximal Pit-1/GHF-1 binding site from the rGH promoter abrogated the T3 effect. These results provide evidence that T3-stimulated rGH promoter activity is independent of Pit-1/GHF-1 and raise the possibility that the stimulation of rGH gene expression by T3 might involve direct interaction of TRs with the general transcriptional apparatus.

Animals↗

Thyroid hormone and DNA binding properties of a mutant c-erbA beta receptor associated with generalized thyroid hormone resistance.

We have previously reported a family, Kindred A, with autosomal dominant generalized thyroid hormone resistance in which affected members were found to have a mutation in the carboxy-terminal domain of the c-erbA beta thyroid hormone receptor. In the current study, the thyroid hormone and DNA-binding properties of this mutant receptor were determined using c-erbA beta protein synthesized in vitro. Both the wild-type human placental c-erbA beta and Kindred A receptors bound [125I]-triiodothyronine, although the Kindred A receptor had decreased affinity for the hormone. The affinity for triiodothyronine was 4.5 x 10(9) M-1 and 2.3 x 10(10) M-1 for the mutant and wild-type receptors, respectively. No abnormality of DNA-binding was detected with the Kindred A receptor using a sensitive avidin-biotin DNA-binding assay with DNA fragments containing thyroid hormone response elements. The Kindred A mutant receptor which displays abnormal triiodothyronine-binding but normal DNA-binding activities in vitro acts as a dominant negative inhibitor of thyroid hormone action in man.

Cloning, Molecular↗

Enhancement of thyroid hormone receptor isoform specificity by insertion of a distant half-site into a thyroid hormone response element.

The two isoforms of thyroid hormone receptor (TR), alpha and beta, are highly homologous, except in the amino-terminal domain. Specific physiological roles for the receptor isoforms have not yet been defined. In transient transfection assays, TRalpha is twice as potent a thyroid hormone (T3)-dependent transactivator as TRbeta on a number of thyroid hormone response elements (TREs). Using chimeras of TRalpha and -beta, we have determined that the higher transactivation by TRalpha requires the entire ligand-binding domain. The amino-terminal and DNA-binding domains of the two isoforms are interchangeable. These studies were facilitated by the use of a synthetic TRE composed of a direct repeat separated by 4 bp which also included a third half-site 19 bp 3' to this on the opposite strand. In the presence of T3, this TRE confers a 5-fold higher response to TRalpha than to TRbeta, but there is no difference in expression without T3. Functional studies indicate that all three half-sites are needed for the increased responsiveness to TRalpha, but gel shift analyses show no striking differences in the ratios of TRalpha to TRbeta binding compared to other wild-type TREs. These results suggest that important functional differences are present in the ligand-binding domain of TRalpha and -beta despite their high homology.

Animals↗