Cited by 55Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryThyroid Cancer Diagnosis and Treatment

Mathematical modeling of the pituitary–thyroid feedback loop: role of a TSH-T3-shunt and sensitivity analysis

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Berberich, Julian, Dietrich, Johannes W., Hoermann, Rudolf, Müller, Matthias A.·2018·Frontiers in Endocrinology

Abstract

Despite significant progress in assay technology, diagnosis of functional thyroid disorders may still be a challenge, as illustrated by the vague upper limit of the reference range for serum thyrotropin (TSH). Diagnostical problems also apply to subjects affected by syndrome T, i.e. those 10% of hypothyroid patients who continue to suffer from poor quality of life despite normal $TSH$ concentrations under substitution therapy with levothyroxine (L-T_4). In this paper, we extend a mathematical model of the pituitary-thyroid feedback loop in order to improve the understanding of thyroid hormone homeostasis. In particular, we incorporate a TSH-T_3-shunt inside the thyroid, whose existence has recently been demonstrated in several clinical studies. The resulting extended model shows good accordance with various clinical observations, such as a circadian rhythm in free peripheral triiodothyronine (FT_3). Furthermore, we perform a sensitivity analysis of the derived model, revealing the dependence of TSH and hormone concentrations on different system parameters. The results have implications for clinical interpretation of thyroid tests, e.g. in the differential diagnosis of subclinical hypothyroidism.

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Crossref · 10.3389/fendo.2018.00091

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  • Upregulation of DIO1 and DIO2 by TSH is important in establishing the intrathyroidal TSH-T3 shunt pathway to preferentially stimulate T3 production.

    “The upregulation of DIO1 and DIO2 by TSH is important in establishing the intrathyroidal TSH-T3 shunt pathway (180) to preferentially stimulate T3 production (181).”

    From Intrathyroidal feedforward and feedback network regulating thyroid hormone synthesis and secretion (2022) · cites this paper as [180]

    The Introduction and Presentation of the Extended Model describe a TSH-stimulated intrathyroidal TSH–T3 pathway that includes conversion by type 1 and type 2 deiodinases. They do not establish that TSH upregulates both enzymes to create the pathway. The Dynamic Simulation also finds that type 2 deiodinase contributes negligibly to thyroidal T3 production in the modeled parameter set, so the claimed importance of both enzymes is overstated. (LLM, conf=0.87)

    Experimental — accuracy not yet measured
  • The intrathyroidal T4-to-T3 conversion driven by TSH-stimulated DIO2 induction was explored for its role in circadian secretion of T3.

    “The intrathyroidal T4-to-T3 conversion driven by TSH-stimulated DIO2 induction was explored for its role in circadian secretion of T3 (180).”

    From Intrathyroidal feedforward and feedback network regulating thyroid hormone synthesis and secretion (2022) · cites this paper as [180]

    The model description says it explores TSH-stimulated intrathyroidal T4-to-T3 conversion, and the Conclusion and Outlook links intrathyroidal T3 secretion to a circadian FT3 pattern. But the Dynamic Simulation section does not identify TSH-induced DIO2 as the driver: type 2 deiodination contributes only 0.002% of modeled thyroidal T3 secretion and is described as negligible. Page numbers are not available in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured
  • A comprehensive mathematical model of the HPT axis involving both T3-TSH interaction and deiodinase activities has been established, though the submodel is composed of five differential equations.

    “A comprehensive mathematical model of the HPT axis involving both T3-TSH interaction and deiodinase activities has been established, though the submodel per se is composed of five differential equations (79).”
  • Many models focus on various aspects of the HPT axis, but models that specifically simulate the molecular regulations in thyroid follicles are still uncommon.

    “While there are many models focusing on various aspects of the HPT axis (180, 273–275), models that specifically simulate the molecular regulations in thyroid follicles are still uncommon.”

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Authors
Berberich, J., Dietrich, J. W., Hoermann, R., & Müller, M. A.
Affiliations
  • University of Stuttgart (DE)
  • Witten/Herdecke University (DE)
Corresponding author
Müller, Matthias A.
Venue
Frontiers in Endocrinology
Published
2018-03-21
Volume
9
Pages
91-91
ISSN
1664-2392 (ISSN-L)
OpenAlex
W2790723135
Cited by
55
References
30
Citations by year
2026: 2 · 2025: 9 · 2024: 7 · 2023: 7 · 2022: 9 · 2021: 9 · 2020: 4 · 2019: 4 · 2018: 4
FWCI
4.18
Type
journal article
Language
en
Open access
Locations
  • Frontiers in Endocrinology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • OPUS Publication Server of the University of Stuttgart (University of Stuttgart) (submittedVersion, other-oa)
  • Universitätsbibliothek Stuttgart
Funders
Baden-Württemberg Stiftung
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
Keywords
triiodothyronine, thyroid hormone homeostasis, subclinical hypothyroidism, sensitivity analysis, TSH reference range

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