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Cited by 432

The DOI matches its Crossref record; 27 of the 27 references it cites were found in a registry or an index.

Mechanisms behind the non-thyroidal illness syndrome: an update

Open access
Warner, Maria H, Beckett, Geoffrey J·2010·Journal of Endocrinology
DOI 10.1677/joe-09-0412
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Abstract

The mechanisms behind the changes in serum triiodothyronine (T 3), thyroxine (T 4) and TSH that occur in the non-thyroidal illness syndrome (NTIS) are becoming clearer. Induction of a central hypothyroidism occurs due to a diminution in hypothalamic thyrotropin-releasing hormone. This can be signalled by a decrease in leptin caused by malnutrition and possibly a localised increase in hypothalamic T 3 catalyzed by altered expression of hypothalamic iodothyronine deiodinases D2 and D3. Data from D1 and D2 knockout mice suggest that these enzymes may have little contribution to the low serum T 3 found in acute illness. The decline in serum T 3 and T 4 in models of acute illness precedes the fall in hepatic D1, suggesting that much of the initial fall in these hormones may be attributable to an acute phase response giving rise to a reduction in the thyroid hormone binding capacity of plasma. When measured by reliable methods, changes in serum free T 4 and free T 3 are modest in comparison to the fall seen in total thyroid hormone. Thyroid hormone transporter expression is up-regulated in many models of the NTIS, thus if diminished tissue uptake of hormone occurs in vivo, it is likely to be the result of impaired transporter function caused by diminished intracellular ATP or plasma inhibitors of transporter action. In man, chronic illness leads to an upregulation of thyroid hormone receptor (THR) expression at least in liver and renal failure. In contrast, human and animal models of sepsis and trauma indicate that expression of THRs and their coactivators are decreased in acute illness.

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Metadata

Authors
Warner, M. H., & Beckett, G. J.
Venue
Journal of Endocrinology
Publisher
Bioscientifica
Published
2009-12-16
Volume
205
Issue
1
Pages
1-13
ISSN
  • 0022-0795 (ISSN-L)
  • 1479-6805
DOI
10.1677/joe-09-0412
OpenAlex
W2168760648
Cited by
432
References
27
FWCI
14.14
Type
journal article
Language
en
Open access
bronze

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