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Effects of TSH on cAMP levels and thyroid hormone release in human thyroid 'autonomous' nodules: relationship with iodothyronine and iodine content in thyroglobulin.

The effect of TSH on the adenylate cyclase-cAMP system and in vitro iodothyronine release, together with the iodothyronine and iodine content of 19s thyroglobulin, were studied in seven clinically euthyroid patients with autonomous thyroid nodules. Basal cAMP and cGMP content together with phosphodiesterase and protein-kinase activities were normal in nodular, and suppressed in extranodular tissue. TSH-dependent cAMP accumulation was reduced in nodular tissue, but normal in the suppressed extranodular tissue. In vitro TSH-dependent iodothyronine release from nodular and extranodular tissue was absent. Thyroxine and iodine content of thyroglobulin extracted from nodular tissue was reduced, while triiodothyronine content was normal but with a low T4/T3 ratio. In extranodular tissue T3, T4 and iodine contents were reduced. In conclusion, autonomous thyroid nodules produced a poorly iodinated thyroglobulin leading to preferential T3 secretion with increased circulating free thyroid hormones even in clinically euthyroid patients.

Adult↗

Thyroid hormone resistance.

Resistance to thyroid hormone (RTH) is a rare autosomal dominant inherited syndrome of reduced end-organ responsiveness to thyroid hormone. Patients with RTH have elevated serum free thyroxine (FT4) and free triiodothyronine (FT3) concentrations and normal or slightly elevated serum thyroid stimulating hormone (TSH) level. Despite a variable clinical presentation, the common characteristic clinical features are goitre but an absence of the usual symptoms and metabolic consequences of thyroid hormone excess. Patients with RTH can be classified on clinical grounds alone into either generalized resistance (GRTH), pituitary resistance (PRTH) or combined. Mutations in the thyroid hormone receptor (TR) beta gene are responsible for RTH and 122 different mutations have now been identified belonging to 300 families. With the exception of one family found to have complete deletion of the TRbeta gene, all others have been demonstrated to have minor alterations at the DNA level. The differential diagnosis includes a TSH-secreting pituitary adenoma and the presence of endogenous antibodies directed against thyroxine (T4) and triiodothyronine (T3). Failure to differentiate RTH from primary thyrotoxicosis has resulted in the inappropriate treatment of nearly one-third of patients. Although occasionally desirable, no specific treatment is available for RTH; however, the diagnosis allows appropriate genetic counselling.

Humans↗

The effect of thyroid hormone on skeletal integrity.

BACKGROUND: Thyroid disease and osteoporosis are common problems often managed by primary care physicians. Despite many studies, confusion still exists about the effect of thyroid hormone on skeletal health. PURPOSE: To review evidence on the effect of thyroid hormone (from hyperthyroidism, exogenous or endogenous suppression of thyroid-stimulating hormone [TSH], and thyroid hormone replacement therapy) on skeletal integrity. DATA SOURCES: A MEDLINE search of papers published between 1966 and 1997. DATA SELECTION: Cross-sectional studies, longitudinal studies, and meta-analyses that had appropriate control groups (patients matched for age, sex, and menopausal status), made comparisons with established databases, or defined thyroid state by TSH level or thyroid hormone dose were reviewed. DATA EXTRACTION AND SYNTHESIS: Data synthesis was not straightforward because of changes in doses and types of thyroid hormone preparations; changes in definitions of thyroid hormone replacement therapy and suppressive therapies; problems with study design; differences in skeletal sites assessed (hip, spine, forearm, or heel) and techniques used to measure bone mineral density; and inclusion of heterogenous and changing thyroid disease states. Overall, hyperthyroidism and use of thyroid hormone to suppress TSH because of thyroid cancer, goiters, or nodules seem to have an adverse effect on bone, especially in postmenopausal women; the largest effect is on cortical bone. Thyroid hormone replacement seems to have a minimal clinical effect on bone. CONCLUSION: Women with a history of hyperthyroidism or TSH suppression by thyroid hormone should have skeletal status assessed by bone mineral densitometry, preferably at a site containing cortical bone, such as the hip or forearm.

Bone Density↗

The adenovirus E1A protein is a potent coactivator for thyroid hormone receptors.

The thyroid hormone receptors interact with several different cofactors when activating transciption. In this study, we show that the adenovirus E1A oncoprotein functions as a strong coactivator for the thyroid hormone receptor (TR), and that TR and E1A synergistically activate transcription via direct (DR4) or palindromic (IRO) hormone-responsive sites. Cotransfection experiments using different isoforms of the chicken TR and E1A show synergistic, ligand-enhanced transactivation. This transactivation is accomplished through a direct, ligand-independent interaction between TR and E1A. The interaction domains in TR are localized to the DNA-binding domain and to the carboxy-terminal part of the ligand-binding domain. In E1A, the regions of interactions are localized to the conserved regions 1 and 3. Both of these domains in E1A are required for a 40-fold enhancement of TR-mediated activation in transfection experiments. Taken together, we show that E1A strongly enhances transcriptional activation, which suggests that it serves as a bridging factor between the receptor and other components of the transcription machinery.

Adenovirus E1A Proteins↗

Cross-kingdom hormonal signaling: an insight from thyroid hormone functions in marine larvae.

Thyroid hormones (THs) are small, lipophilic signaling molecules built from tyrosine and iodine. TH action is well characterized in vertebrates, where these molecules play a fundamental role as regulators of development, metabolism, growth and differentiation. Increasing evidence suggests that THs also function in a variety of invertebrate species. Two alternative sources of hormone for animals are exogenous (from food items) and endogenous synthesis. We propose that exogenous THs can convey environmental information as well as regulate metabolism, revealing new communication avenues between organisms from different kingdoms. While such modes of cross-kingdom communication have been previously considered for fatty acid-based signaling and steroid hormones in plant-animal interactions, this is the first attempt to explore such a mode of action for TH signaling. We suggest that exogenous sources of TH (from food) may have been ancestral, while the ability to synthesize TH endogenously may have evolved independently in a variety of metazoans, resulting in a diversity of signaling pathways and, possibly, morphological structures involved in TH-signaling.

Animals↗

A zinc finger homeodomain transcription factor binds specific thyroid hormone response elements.

Thyroid hormone receptors can act through response elements (TREs) having a wide variation of sequence. We screened for transcription factors that bind the rat (r) glycoprotein hormone alpha-subunit TRE (alpha-sub), and isolated a cDNA, termed zinc finger homeodomain enhancer-binding protein (Zfhep), which encodes two separate zinc finger domains (ZD1 and ZD2), and a region similar to homeodomains. DNA-binding assays show that ZD1 or ZD2 can bind the alpha-subunit, rat growth hormone, or thyrotropin beta (TSHbeta) gene TREs, but do not bind DR4 or palindromic (pal) TREs. Methylation interference footprinting demonstrates that Zfhep binds the alpha-sub overlapping the TR-binding site. Similarly, the ZD1 protein footprints over TR-binding halfsites of the rat growth hormone (rGH) and TSHbeta TREs. Hence, Zfhep binding is dependent on sequences within and outside the AGGTCA TR-binding halfsite. Interactions of non-receptor transcription factors (such as Zfhep) with certain TREs are important to modify gene-specific regulation by thyroid hormones.

Amino Acid Sequence↗

Thyroid iodine content and serum thyroid hormone levels in autoimmune thyroiditis: effect of iodide supplementation.

The relationship between thyroid iodine content (TIC) measured by x-ray fluorescence and serum TSH, T4, and T3 levels was investigated under iodide supplementation (0.5 mg/day for 1 to 9 mo). In five euthyroid control patients, whose TIC ranged from 2.5 to 14 mg, the TIC increased from 1.5 to 4 mg after 4 wk of treatment and had a tendency to plateau when the treatment was pursued. No significant changes in serum T4, T3, and TSH levels have been observed in these control subjects. Fourteen patients with autoimmune thyroiditis with low TIC (0-5 mg) were also studied. In six patients, the TIC increased significantly (3-10 mg over initial value after 3-7 mo of treatment). In parallel, there was a significant increase in serum T4 levels (35-150% over initial value) while T3 levels were modified in only two patients. In five patients serum TSH level decreased and was two- to seven-fold lower than before treatment whatever was its initial value; however, the spectrum of changes varied among patients from slight increase to a complete normalization of hormonosynthesis. In the eight other patients, iodide supplementation aggravated the thyroid disorders during the first months of treatment. The thyroid hormone blood levels dropped significantly in six patients (percent decrease below initial value: 20-100%) and was unchanged in the two others. An increase in the TSH blood level (X2-6) was observed in all patients except one. Concomitantly, the iodine stores were progressively depleted in three patients, unchanged in three and increased in two. When iodide treatment was pursued, an escape from this organification block was observed in two patients.

Adult↗

Behavioral effects of liothyronine (L-T3) in children with attention deficit hyperactivity disorder in the presence and absence of resistance to thyroid hormone.

Evidence that the thyroid may play a role in the pathogenesis of attention deficit hyperactivity disorder (ADHD) comes from observations that 48% to 73% of children with the syndrome of resistance to thyroid hormone (RTH) have ADHD. Casual observations in subjects with RTH have suggested that treatment with thyroid hormone may improve the symptoms of ADHD. The aim of this study was to determine whether thyroid hormone has a beneficial effect on the behavior of children with RTH. A prospective, randomized, double-blinded, placebo-controlled, cross-over study was conducted to evaluate the effect of the rapid acting thyroid hormone, liothyronine (L-T3), on the behavior of 8 children with ADHD + RTH, and 9 children with ADHD and normal thyroid function (ADHD Only). Parent and teacher ratings of hyperactivity (Conners scale) and a computerized continuous performance test (CPT) were used as objective measures of hyperactivity, attention and impulsivity. L-T3 had no effect on Conners Hyperactivity Index in 7 of 9 children with ADHD Only; it caused improvement and deterioration in 1 subject each. In contrast, the rating in 5 of 8 subjects with ADHD + RTH showed improvement, whereas 3 of 8 subjects remained unchanged. L-T3 was associated with increased commission errors in 5 of 8 children with ADHD Only and decreased commission errors in 4 of 7 with ADHD + RTH. In children with RTH and ADHD, particularly those that exhibit hyperactivity, L-T3 in supraphysiological doses may be beneficial in reducing hyperactivity and impulsivity. In the majority of children with ADHD who do not have RTH, L-T3 treatment has no effect or may be detrimental.

Attention Deficit Disorder with Hyperactivity↗

Bioenergetic remodeling of heart mitochondria by thyroid hormone.

Changes in thyroid status are associated with profound alterations in biochemical and physiological functioning of cardiac muscle impacting metabolic rate, contractility and structural hypertrophy. Using an in vivo model of chronic treatment with thyroid hormone (T4, 0.3 mg/kg/day), we evaluated how mitochondria are regulated in response to T4, and assessed the relationship of T4-induced mitochondrial biogenesis and bioenergetics to overall cardiac hypertrophy. The role of thyroid hormone in cardiac bioenergetic remodeling was addressed in rats treated with T4 for 5, 10 and 15 days. Over that time, myocardial oxygen consumption substantially increased as did cardiac hypertrophy. Myocardial levels of mitochondrial enzyme activities, mitochondrial DNA (mtDNA), specific proteins and transcript were assessed. Activity levels of respiratory complexes I-V and citrate synthase significantly increased with 15 but not with 5 or 10-day T4 treatment. Myocardial levels of mtDNA, mitochondrial proteins (e.g. cytochrome c, cytochrome b, ATPase subunits, MnSOD) and the global transcription factor PPARalpha were significantly elevated with 15-day T4. Transcript analysis revealed increased expression of transcription factors and cofactors involved in mitochondrial biogenesis including PPARalpha, mtTFA, ErbAalpha and PGC-1alpha. Our findings indicate parallel increases in myocardial mitochondrial bioenergetic capacity, oxygen consumption and markers of mitochondrial biogenesis with 15-day T4; these changes were not present with 10-day T4 even with significant cardiac hypertrophy. The marked, parallel increases in PPARalpha levels suggest its potential involvement in mediating myocardial-specific remodeling of mitochondria in response to T4.

Animals↗

An endogenous signal triggering erythroid differentiation: identification as thyroid hormone.

The identification of thyroid hormone as an endogenous signal for erythroid differentiation began with our studies on the spontaneously differentiating murine erythroleukemia clone 3-1. We observed that the spontaneous differentiation frequency was dependent on a heat stable factor present in fetal calf serum or calf bone marrow. We also noted that the bone marrow extract stimulated erythroid colony-forming units in mouse bone marrow cells, suggesting the relevance of this factor in normal erythroid differentiation. The bone marrow extract did not supplant the requirement of erythropoietin but was synergistic. Purification of the bone marrow extract indicated that the differentiation-inducing activity for clone 3-1 cells cochromatographed with a low-molecular-weight, UV (280 nm)-absorbing component(s). These observations and previous reports identifying the avian erythroblastosis virus oncogene v-erbA as a mutated thyroid hormone receptor which blocked erythroid differentiation led us to test thyroid hormone in our assay. Both triiodothyronine and thyroxine were highly active, and the active constituents in the chromatographically purified fraction were identified as triiodothyronine and thyroxine. Although thyroid hormone action has been associated with both in vivo and in vitro erythroid differentiation, its role has been often relegated to a secondary status. We suggest that thyroid hormone is required for the commitment of erythroid cells to terminal differentiation.

Animals↗

Contrasting developmental and tissue-specific expression of alpha and beta thyroid hormone receptor genes.

Thyroid hormones and their receptors (TRs) have critical functions in development. Here we show that a chicken TR beta cDNA clone encodes a receptor with a novel, short N-terminal domain. In vitro-expressed TR beta protein bound thyroid hormone with similar affinity as the chicken TR alpha. Comparison of expression of TR alpha and TR beta mRNAs throughout chicken development until 3 weeks post-hatching revealed ubiquitous expression of TR alpha mRNAs (in 14 different tissues) with some variations in levels, from early embryonic stages. In contast, expression of TR beta mRNA was restricted, occurring notably in brain, eye, lung, yolk sac and kidney, and was subject to striking developmental control, especially in brain where levels increased 30-fold upon hatching. Levels also sharply increased in late embryonic lung, but were relatively high earlier in embryonic eye and yolk sac. RNase protection analyses detected no obvious mRNAs for alpha and beta TRs with variant C-termini as demonstrated previously for the rat TR alpha gene. The data suggest a general role for TR alpha and specific developmental functions for TR beta, and that thyroid-dependent development involves temporal and tissue-specific expression of the TR beta gene.

Amino Acid Sequence↗

[Discrepancy between the basal level of TSH and the thyrotropic response to TRH during thyroid hormone treatment of differentiated thyroid cancers].

Serum TSH (Thyroid Stimulating Hormone) was measured before and 30 minutes after a 200 microgram intravenous TRH (Protiréline*) injection in 270 patients. These patients have been treated for one year at least, by a suppressive thyroid therapy after thyroidectomy for a differentiated thyroid carcinoma. 314 tests were performed. We used an ultrasensitive TSH method (Ciba-Corning-Diagnostics). The normal range (mean :1.68 mUI/l; range: 0.45 to 3.80 mUI/l) was determined in 116 euthyroid patients. Minimal response to TRH was studied in 35 untreated patients with hyperthyroidism (TSH TO: less than 0.30 mUI/l and delta TSH: less than 0.09 mUI/l). There was a relationship (r = 0.916) between TSH response 30 minutes after TRH stimulation (T30) and basal TSH value: in a logarithmic scale (fitting of the data by a bi-gaussian model). TRH tests were classified too, by basal TSH values (TO) and delta TSH (TSH at T30-TSH at TO). In 201 tests in which TO TSH was less than 0.30 mUI/l (maximal value in hyperthyroidism), 50 showed a delta TSH higher than 0.15 mUI/l (25% of the cases) and in 6 cases (3%), delta TSH was even higher than 2.0 mul/l; in 67 of the 75 tests (89.3%) where TSH TO is less than 0.15 mUI/l, delta TSH is no (less than 0.15 mUI/l). In 93 tests where TO TSH was upper than 0.45 mUI/l (minimal value in euthyroidism), delta TSH was higher than 2.0 mUI/l in 87 cases (93.6%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Different dimerization activities of alpha and beta thyroid hormone receptor isoforms.

Thyroid hormone receptors (TR) are ligand-dependent transcription factors that are encoded as multiple isoforms on two genes. To date, no functional differences have been shown between the TR isoforms; however, the maintenance of alpha and beta genes during vertebrate evolution argues that functional differences do exist. We have localized a TR-binding site in the rabbit beta-myosin heavy chain gene. This site and TR-binding sites in the chicken lysozyme and rat alpha-glycoprotein hormone genes were used to compare the DNA-binding activities of TR alpha and TR beta and the influence of auxiliary proteins (TRAP). TR alpha formed alpha/alpha homodimers poorly, whereas TR beta formed beta/beta homodimers preferentially. This difference was not due to either a lower amount of TR alpha synthesized in the reticulocyte lysate or to an inability of the expressed TR alpha to form dimers, since both TR alpha and TR beta readily formed heterodimers with TRAP on these TR-binding sites. Additionally, a TR alpha fragment containing the dimerization domains (TR alpha C291) blocks TR beta/TRAP complexes but not TR alpha/TRAP complexes. This indicates that TR beta/TR alpha dimers form more readily than TR alpha/TR alpha dimers. We conclude that on the binding sites examined, TR beta has a greater tendency to form homodimers than TR alpha, whereas both isoforms form heterodimers similarly. The different homodimerization potentials of TR alpha and TR beta may underlie functional differences that affect thyroid hormone responses.

Animals↗

Thyroid hormone and phenotypes of cardioprotection.

Thyroid hormone has multiple effects on the cardiovascular system with important physiological consequences. Several genes that encode important regulatory and structural proteins in the heart have been shown to be thyroid hormone responsive. More notably, certain effects of thyroid hormone have been exploited therapeutically. Thyroid hormone is currently being evaluated as an inotrope and vasodilator in various clinical settings. Furthermore, new information has been recently accumulated on the role of thyroid hormone in the response of the heart to ischaemic stress. In fact, hyperthyroid and hypothyroid hearts display a phenotype of cardioprotection against ischaemia-reperfusion. Based on this evidence, the various actions of thyroid hormone on the cardiovascular system are highlighted in this review. Thyroid hormone, although limited by its adverse effects, might prove a suitable treatment for cardiovascular illnesses. Various thyroid hormone analogues are currently under development.

Animals↗