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IL-6 promotes nonthyroidal illness syndrome by blocking thyroxine activation while promoting thyroid hormone inactivation in human cells
Open accessAbstract
Nonthyroidal illness syndrome (NTIS) is a state of low serum 3,5,3' triiodothyronine (T₃) that occurs in chronically ill patients; the degree of reduction in T₃ is associated with overall prognosis and survival. Iodthyronine deiodinases are enzymes that catalyze iodine removal from thyroid hormones; type I and II deiodinase (D1 and D2, respectively) convert the prohormone thyroxine T₄ to active T₃, whereas the type III enzyme (D3) inactivates T₄ and T₃. Increased production of cytokines, including IL-6, is a hallmark of the acute phase of NTIS, but the role of cytokines in altered thyroid hormone metabolism is poorly understood. Here, we measured the effect of IL-6 on both endogenous cofactor-mediated and dithiothreitol-stimulated (DTT-stimulated) cell sonicate deiodinase activities in human cell lines. Active T₃ generation by D1 and D2 in intact cells was suppressed by IL-6, despite an increase in sonicate deiodinases (and mRNAs). N-acetyl-cysteine (NAC), an antioxidant that restores intracellular glutathione (GSH) concentrations, prevented the IL-6-induced inhibitory effect on D1- and D2-mediated T₃ production, which suggests that IL-6 might function by depleting an intracellular thiol cofactor, perhaps GSH. In contrast, IL-6 stimulated endogenous D3-mediated inactivation of T₃. Taken together, these results identify a single pathway by which IL-6-induced oxidative stress can reduce D1- and D2-mediated T₄-to-T₃ conversion as well as increasing D3-mediated T₃ (and T₄) inactivation, thus mimicking events during illness.
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“In addition, decreased availability of glutathione (GSH), a co-factor required for DIO1 catalytic activity, may also play a role [80].”
From An update on non-thyroidal illness syndrome (2021) · cites this paper as [80]
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InfluentialArticle Review: Immunological Markers Related with Thyroidisum
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“Also, the activation of thyroxine can be blocked by specific inflammatory factors such as IL-6, which in turn promotes the development of nonthyroidal illness syndrome (Wajner et al., 2011).”
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“It may also influence peripheral thyroid hormone metabolism and participate in low T3 syndrome during systemic illness (14, 15).”
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Metadata
- Authors
- Wajner, S. M., Goemann, I. M., Bueno, A. L., Larsen, P. R., & Maia, A. L.
- Affiliations
- Universidade Federal do Rio Grande do Sul (BR)
- Brigham and Women's Hospital (US)
- Corresponding author
- Maia, Ana Luiza
- Venue
- Journal of Clinical Investigation
- Published
- 2011-05-02
- Volume
- 121
- Issue
- 5
- Pages
- 1834-1845
- ISSN
- 0021-9738 (ISSN-L)
- PMC
- PMC3083773
- OpenAlex
- W2114397821
- Cited by
- 168
- References
- 74
- Citations by year
- 2026: 14 · 2025: 11 · 2024: 13 · 2023: 13 · 2022: 13 · 2021: 10 · 2020: 11 · 2019: 6 · 2018: 15 · 2017: 13 · 2016: 18 · 2015: 9 · 2014: 6 · 2013: 6 · 2012: 8
- FWCI
- 5.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Investigation (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Dartmouth College
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul
- Universidade Federal do Rio Grande do Sul
- Fundação Instituto de Pesquisas Econômicas
- National Institutes of Health
- Fogarty International Center (R03TW007559, TW007559)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK36256, R01DK036256)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- low T3 syndrome, interleukin-6, thyroid hormone metabolism, deiodinases, type I deiodinase, type 2 deiodinase, type III deiodinase, triiodothyronine, thyroxine, oxidative stress, glutathione, N-acetylcysteine, cytokines, thyroid hormone inactivation
- MeSH terms
- Acetylcysteine, Cell Line, Dithiothreitol, Glutathione, Humans, RNA, Messenger, Thyroid Diseases, Thyroid Hormones, Thyroxine, Interleukin-6, Cytokines, Reactive Oxygen Species, Oxidative Stress, Cell Line, Tumor
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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