THYROID HORMONE RECEPTOR EXPRESSION IN THE "SICK EUTHYROID" SYNDROME
Abstract
To explore the hypothesis that alteration of T3 receptor expression may be an important mechanism controlling the tissue effects of thyroid hormones in the "sick euthyroid" syndrome, specific triiodothyronine (T3) receptor mRNAs were measured in tissues from normal subjects and from patients with liver disease, chronic renal failure, or with multiple organ failure on an intensive care unit (ICU). In all patient groups circulating free thyroxine and free T3 were reduced, while thyroid stimulating hormone remained normal. In patients with liver or renal disease, there were significant increases in levels of both alpha and beta T3 receptor mRNAs in peripheral mononuclear cells (PMNCs); in ICU patients there was a significant increase in beta mRNA. In patients with liver disease increases in T3 receptor mRNAs were not confined to PMNCs but were also found in liver biopsy specimens when levels were compared with those in normal donor liver. After liver transplantation, receptor mRNAs in PMNCs were similar to those in controls; likewise beta mRNA was similar in liver tissue to normal liver. There was, however, persistent elevation in alpha receptor mRNA. Increases in T3 receptor expression in non-thyroidal illness may be responsible for the maintenance of euthyroidism in the face of reduced levels of circulating thyroid hormones.
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TRα and TRβ mRNA expression are increased in liver biopsies of patients with chronic liver disease prior to liver transplantation, in association with low serum T3 and T4 levels.
“In contrast, TRα and TRβ mRNA expression are increased in liver biopsies of patients with chronic liver disease prior to liver transplantation, in association with low serum T3 and T4 levels [40].”
From An update on non-thyroidal illness syndrome (2021) · cites this paper as [40]
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- Authors
- WILLIAMS, G.
- Affiliations
- Queen Elizabeth Hospital Birmingham (GB)
- Corresponding author
- WILLIAMS, G
- ORCID
- WILLIAMS, G
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 1989-12
- Volume
- 334
- Issue
- 8678-8679
- Pages
- 1477-1481
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2158108644
- Cited by
- 71
- References
- 30
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 2 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 1 · 2017: 1 · 2016: 2 · 2015: 2 · 2013: 1 · 2012: 1
- FWCI
- 3.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- low T3 syndrome, triiodothyronine receptor, liver disease, chronic kidney disease, multiple organ failure, peripheral blood mononuclear cells, liver biopsy, liver transplantation, thyroid hormone resistance, thyroid-stimulating hormone
- MeSH terms
- Adolescent, Adult, Aged, Euthyroid Sick Syndromes, Female, Gene Expression Regulation, Humans, Kidney Failure, Chronic, Liver, Liver Diseases, Male, Middle Aged, Multiple Organ Failure, Neutrophils, Nucleic Acid Hybridization, Proto-Oncogene Proteins, Receptors, Thyroid Hormone, RNA, Messenger, Thyroid Function Tests, Thyroid Hormones, DNA Probes, ErbB Receptors
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