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2017 ; 102
(3
): 776-785
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English Wikipedia
Elevated Serum Tetrac in Graves Disease: Potential Pathogenic Role in
Thyroid-Associated Ophthalmopathy
#MMPMID27768856
Fernando R
; Placzek E
; Reese EA
; Placzek AT
; Schwartz S
; Trierweiler A
; Niziol LM
; Raychaudhuri N
; Atkins S
; Scanlan TS
; Smith TJ
J Clin Endocrinol Metab
2017[Mar]; 102
(3
): 776-785
PMID27768856
show ga
CONTEXT: The sources and biological impact of 3,3',5,5' tetraiodothyroacetic acid
(TA4) are uncertain. CD34+ fibrocytes express several proteins involved in the
production of thyroid hormones. They infiltrate the orbit in Graves disease (GD),
an autoimmune process known as thyroid-associated ophthalmopathy. It appears that
the thyrotropin receptor plays an important role in the pathogenesis of
thyroid-associated ophthalmopathy. OBJECTIVE: To quantify levels of TA4 in
healthy participants and those with GD, determine whether fibrocytes generate
this thyroid hormone analogue, and determine whether TA4 influences the actions
of thyroid-stimulating hormone and thyroid-stimulating immunoglobulins in orbital
fibroblasts. DESIGN/SETTING/PARTICIPANTS: Patients with GD and healthy donors in
an academic medical center clinical practice were recruited. MAIN OUTCOME
MEASURES: Liquid chromatography-tandem mass spectrometry, autoradiography,
real-time polymerase chain reaction, hyaluronan immunoassay. RESULTS: Serum
levels of TA4 are elevated in GD. TA4 levels are positively correlated with those
of thyroxine and negatively correlated with serum levels of triiodothyronine.
Several cell types in culture generate TA4 from ambient thyroxine, including
fibrocytes, HELA cells, human Müller stem cells, and retinal pigmented epithelial
cells. Propylthiouracil inhibits TA4 generation. TA4 enhances the induction by
thyrotropin and thyroid-stimulating immunoglobulins of several participants in
the pathogenesis of thyroid-associated ophthalmopathy, including interleukin 6,
hyaluronan synthase 1, prostaglandin endoperoxide H synthase 2, and haluronan
production. CONCLUSION: TA4 may be ubiquitously generated in many tissues and
enhances the biological impact of thyrotropin and thyroid-stimulating
immunoglobulins in orbital connective tissue. These findings may identify a
physiologically important determinant of extrathyroidal thyroid-stimulating
hormone action.