Síndrome nefrótico asociado a hipotiroidismo severo / Nephrotic syndrome associated to severe hypothyroidism

Las hormonas tiroideas tienen acciones renales directas en conjunto con efectos dinámicos y cardiovasculares que influyen en la función renal. Cuadros de hipotiroidismo con enfermedad renal son una combinación peculiar y poco descrita, es por ello que el propósito de este trabajo es exponer el caso de dos pacientes con síndrome nefrótico asociado a hipotiroidismo severo, los cuales presentaron disminución de la proteinuria y casi normalización de función renal luego de iniciar tratamiento de reemplazo con levotiroxina.

Thyroid hormones have direct renal actions in conjunction with dynamic and cardiovascular effects that influence renal function. Cases of primary hypothyroidism with renal disease are a peculiar and poorly described combination, is for it that the objective of this work is to expose the cases of two patients with nephrotic syndrome associated with severe hypothyroidism, whom presented decreased proteinuria and almost normalized renal function after starting replacement therapy with levothyroxine.

Evaluation of redox profiles in exogenous subclinical hyperthyroidism at two different levels of TSH suppression

ABSTRACT Objective: Evaluate the relationship between exogenous subclinical hyperthyroidism and oxidative stress through the analysis of the redox profile of patients with subclinical hyperthyroidism exogenous (SCH) grade I (TSH = 0.1 to 0.4 IU/mL) and grade II (TSH < 0.1 IU/mL). Subjects and methods: We analyzed 46 patients with SCH due to the use of TSH suppressive therapy with LT4 after total thyroidectomy along with 6 control euthyroid individuals (3M and 3W). Patients were divided into two groups, G1 with TSH ≥ 0.1-0.4 IU/mL (n = 25; and 7M 14W) and G2 with TSH < 0.1 IU/mL (n = 25; and 4M 21W). Venous blood samples were collected to measure the levels of markers for oxidative damage (TBARS, FOX and protein carbonylation), muscle and liver damage (CK, AST, ALT, GGT) and antioxidants (GSH, GSSG and catalase). Results: Individuals in G2 showed a GSH/GSSG ratio ~ 30% greater than those in G1 (p = 0.004) and a catalase activity that was 4 times higher (p = 0.005). For lipid peroxidation, the levels measured in G2 were higher than both control and G1 (p = 0.05). No differences were observed for both protein carbonyl markers. G1 and G2 presented with greater indications of cell injury markers than the control group. Conclusion: TSH suppression therapy with LT4 that results in subclinical hyperthyroidism can cause a redox imbalance. The greater antioxidant capacity observed in the more suppressed group was not sufficient to avoid lipid peroxidation and cellular damage.

The effect of levothyroxine treatment on left ventricular function in subclinical hypothyroidism

ABSTRACT Objective: Treatment of subclinical hypothyroidism (ScH), especially the mild form of ScH, is controversial because thyroid hormones influence cardiac function. We investigate left ventricular systolic and diastolic function in ScH and evaluate the effect of 5-month levothyroxine treatment. Subjects and methods: Fifty-four patients with newly diagnosed mild ScH (4.2 <TSH < 10.0 mU/L) and 30 euthyroid subjects matched by age were analysed. Laboratory analyses and an echocardiography study were done at the first visit and after 5 months in euthyroid stage in patients with ScH. Results: Compared to healthy controls, patients with ScH had a lower E/A ratio (1.03 ± 0.29 vs. 1.26 ± 0.36, p < 0.01), higher E/e' sep. ratio (762 ± 2.29 vs. 6.04 ± 1.64, p < 0.01), higher myocardial performance index (MPI) (0.47 ± 0.08 vs. 0.43 ± 0.07, p < 0.05), lower global longitudinal strain (GLS) (-19.5 ± 2.3 vs. −20.9 ± 1.7%, p < 0.05), and lower S wave derived by tissue Doppler imaging (0.077 ± 0.013 vs. 0.092 ± 0.011 m/s, p < 0.01). Levothyroxine treatment in patients with ScH contributed to higher EF (62.9 ± 3.9 vs. 61.6 ± 4.4%, p < 0.05), lower E/e' sep. ratio (6.60 ± 2.06 vs. 762 ± 2.29, p < 0.01), lower MPI (0.43 ± 0.07 vs. 0.47 ± 0.08%, p < 0.01), and improved GLS (-20.07 ± 2.7 vs. −19.55 ± 2.3%, p < 0.05) compared to values in ScH patients at baseline. Furthermore, in all study populations (ScH patients before and after levothyroxine therapy and controls), TSH levels significantly negatively correlated with EF (r = −0.15, p < 0.05), E/A (r = −0.14, p < 0.05), GLS (r = −0.26, p < 0.001), and S/TDI (r = −0.22, p < 0.01) and positively correlated with E/e' sep. (r = 0.14, p < 0.05). Conclusion: Patients with subclinical hypothyroidism versus healthy individuals had subtle changes in certain parameters that indicate involvement of systolic and diastolic function of the left ventricle. Although the values of the parameters were in normal range, they were significantly different compared to ScH and the control group at baseline, as well as to the ScH groups before and after treatment.The results of our study suggest that patients with ScH must be followed up during treatment to assess improvement of the disease. Some of the echocardiography obtained parameters were reversible after levothyroxine therapy.

Treatment of hypothyroidism with levothyroxine plus liothyronine: a randomized, double-blind, crossover study

ABSTRACT Objective To compare the effects of a unique fixed combination levothyroxine/liothyronine (LT4/LT3) therapy in patients with primary hypothyroidism. Subjects and methods This is a randomized, double-blind, crossover study. Adults with primary hypothyroidism (n = 32, age 42.6 ± 13.3, 30 females) on stable doses of LT4 for ≥ 6 months (125 or 150 μg/day) were randomized to continue LT4 treatment (G1) or to start LT4/LT3 therapy (75/15 μg/day; G2). After 8 weeks, participants switched treatments for 8 more weeks. Thyroid function, lipid profile, plasma glucose, body weight, electrocardiogram, vital signs, and quality of life (QoL) were evaluated at weeks 0, 8 and 16. Results Free T4 levels were significantly lower while on LT4/LT3 (G1: 1.07 ± 0.29 vs. 1.65 ± 0.46; G2: 0.97 ± 0.26 vs. 1.63 ± 0.43 ng/dL; P < 0.001). TSH and T3 levels were not affected by type of therapy. More patients on LT4/LT3 had T3 levels above the upper limit (15% vs. 3%). The combination therapy led to an increase in heart rate, with no significant changes in electrocardiogram or arterial blood pressure. Lipid profile, body weight and QoL remained unchanged. Conclusions The combination therapy yielded significantly lower free T4 levels, with no changes in TSH or T3 levels. More patients on LT4/T3 had elevated T3 levels, with no significant alterations in the evaluated outcomes. No clear clinical benefit of the studied formulation could be observed. Future trials need to evaluate different formulations and the impact of the combined therapy in select populations with genetic polymorphisms.

Effects of excess maternal thyroxin on the bones of rat offspring from birth to the post-weaning period

ABSTRACT Objective To evaluate, in rat offspring, bone changes induced by excess maternal thyroxin during pregnancy and lactation, and to assess the reversibility of these changes after weaning. Material and methods Twenty Wistar rats were distributed in two groups, hyperthyroid and control, that were treated daily with L-thyroxin (50 mcg/animal) and placebo, respectively. The treatment was initiated seven days before mating and continued throughout pregnancy and lactation. From every female of each of the two groups, two offspring were euthanized after birth, two at 21 days of age (weaning), and two at 42 days of age (21 days after weaning). In newborns, the length of pelvic and thoracic limbs were measured, and in the other animals, the length and width of the femur and humerus were measured. Bones were dissected, decalcified, embedded in paraffin, and analyzed histomorphometrically. Results Excess maternal thyroxin significantly reduced the length of the pelvic limb in neonates. In 21-day-old individuals, excess maternal thyroxine reduced the length and the width of the femur and the humerus. It also increased thickness of the epiphyseal plate and the percentage of trabecular bone tissue. In 42-day-old individuals, there were no significant differences between groups in relation to the parameters evaluated in the previous periods. Conclusion Excess maternal thyroxine reduced growth in suckling rats both at birth and at weaning, and it also increased the percentage of trabecular bone tissue in 21-day-old animals. These changes, however, were reversible at 42 days, i.e., 21 days after weaning. Arch Endocrinol Metab. 2016;60(2):130-7.

Effects of thyroid hormone replacement on glycated hemoglobin levels in non diabetic subjects with overt hypothyroidism

Objective Glycated hemoglobin (HbA1c) may not accurately reflect the level of glycemia in conditions of altered erythrocyte turnover. Hypothyroidism is one condition associated with sluggish erythropoesis. To assess changes in HbA1c, independent of changes in plasma glucose after initiation of thyroxine replacement in patients with overt hypothyroidism. Materials and methods In this prospective longitudinal study carried out in a tertiary care centre, adult non-diabetic patients with overt hypothyroidism recruited between March 2012 to August 2013 were rendered euthyroid on thyroxine. They underwent testing for hemoglobin, HbA1c, reticulocyte count, thyroxine, thyrotropin and a standard oral glucose tolerance test, both before and at 3 months after restoration to the euthyroid state. Main outcome assessed was the change in HbA1c independent of the change in glucose parameters. Results Thirty eight patients (35 female and 3 male) aged 37.8 ± 10.2 years with overt hypothyroidism (thyroxine 12.6 ± 13.4 ng/mL and thyrotropin -98.1 ± 63.7 µIU/mL respectively) were recruited. While HbA1c fell from 5.8 ± 0.7% to 5.6 ± 0.5% (p = 0.009) at 3 months following the correction of hypothyroidism, there were no changes in the fasting and the 2 hr post oral glucose tolerance test glucose (p = 0.67 and 0.56 respectively). The number of patients with dysglycemia diagnosed by HbA1c (i.e HbA1c≥ 5.7%) fell from 25 (65.78%) to 17 (44.7%) after treatment (p = 0.008). There were 7 (18.4%) patients with HbA1c ≥ 6.5% at baseline, but this fell to just 4 (10.5%) (p < 0.001) after 3 months of euthyroidism. Conclusion HbA1c is not a reliable diagnostic test for diabetes in the presence of hypothyroidism.

A case of thyroid hormone resistance: a rare mutation / Caso de resistência aos hormônios tireóideos: mutação rara

Reduced sensitivity to thyroid hormones (RSTH) is a rare disease that affects about 3,000 individuals, belonging to about 1,000 families. It results from reduced intracellular action of thyroid hormones (TH) genetically determined and manifests as persistent hyperthyroxinemia with non-suppressed thyroid-stimulating hormone (TSH). We describe a 67-years old, Caucasian woman, with past history of subtotal thyroidectomy due to diffuse goiter, who presents with a recurrence of goiter. Although she is clinically euthyroid, laboratory evaluation shows persistent hyperthyroxinemia with non-suppressed TSH. Response to thyrotropin releasing hormone (TRH) test was normal and TSH concentrations were not suppressed during oral administration of suprafisiologic doses of levothyroxine (L-T4). Peripheral blood DNA was extracted from the patient and a mutation was found localized in cluster one, at codon 346 of the ligand binding domain of the THRB gene. The patient’s son underwent thyroid function testing (TFT) and genetic study, both negative, suggesting a sporadic mutation. RSTH should be considered in all hyperthyroxinemic patients who are clinically euthyroid. Mutations interfering with three major steps required for TH action on target tissues have been, so far, identified (TR-β, TR-α, MCT8, SPB2). Each mutation is associated with a distinctive syndrome. Goal of management is to maintain a normal serum TSH level and a eumetabolic state and offer appropriate genetic counselling and prenatal diagnosis. Inappropriate treatment of eumetabolic patients results in hypothyroidism and need for TH replacement.

A sensibilidade reduzida aos hormônios tiroidianos (RSTH) é uma doença rara que afeta cerca de 3.000 indivíduos em 1.000 famílias. Ela resulta de uma ação intracelular reduzida de hormônios tiroidianos (TH), é geneticamente determinada e se manifesta como hipertiroxinemia persistente com hormônio tireoestimulante (TSH) não suprimido. Descrevemos o caso de uma mulher caucasiana de 67 anos de idade com histórico de tiroidectomia subtotal por bócio difuso e que apresentou recorrência do bócio. Embora ela fosse clinicamente eutiroide, a avaliação laboratorial mostrou hipertiroxinemia persistente com TSH não suprimido. A resposta ao hormônio liberador da tireotrofina (TRH) foi normal e as concentrações de TSH não foram suprimidas durante a administração oral de doses suprafisiológicas de levotiroxina (L-T4). Foi extraído DNA de sangue periférico da paciente e encontrada uma mutação no cluster um do códon 346 do domínio de ligação do ligante do gene THRB. O filho da paciente foi submetido a um teste de função da tiroide e a um estudo genético, ambos negativos, o que sugeriu uma mutação esporádica. O RSTH deve ser considerado em todos os pacientes hipertiroxinêmicos que sejam clinicamente eutiroides. Foram identificadas, até hoje, mutações que interferem com os três passos principais necessários para a ação do TH sobre os tecidos-alvo (TR-b, TR-α, MCT8, SPB2). Cada mutação está associada com uma síndrome distinta. O objetivo do manejo é manter o nível sérico normal de TSH e um estado eumetabólico, além de se oferecer aconselhamento genético adequado e diagnóstico pré-natal. O tratamento inadequado de pacientes eumetabólicos leva ao hipotireoidismo e requer reposição de TH.

The effect of thyroid hormones on the white adipose tissue gene expression of PAI-1 and its serum concentration

Metabolic syndrome is associated with an increased risk of developing cardiovascular diseases and Plasminogen activator inhibitor 1 (PAI-1) overexpression may play a significant role in this process. A positive correlation between adipose tissue gene expression of PAI-1 and its serum concentration has been reported. Furthermore, high serum levels of thyroid hormones (T3 and T4) and PAI-1 have been observed in obese children. The present study evaluates the impact of thyroid hormone treatment on white adipose tissue PAI-1 gene expression and its serum concentration. Male Wistar rats (60 days old) were treated for three weeks with T4 (50 µg/day, Hyper) or with saline (control). Additionally, 3T3-L1 adipocytes were treated for 24 h with T4 (100 nM) or T3 (100 nM). PAI-1 gene expression was determined by real-time PCR, while the serum concentration of PAI-1 was measured by ELISA using a commercial kit (Innovative Research, USA). Both the serum concentration of PAI-1 and mRNA levels were similar between groups in retroperitoneal and epididymal white adipose tissue. Using 3T3-L1 adipocytes, in vitro treatment with T4 and T3 increased the gene expression of PAI-1, suggesting non-genomic and genomic effects, respectively. These results demonstrate that thyroid hormones have different effects in vitro and in vivo on PAI-1 gene expression in adipocytes.

Effect of thyroxine on plasminogen activator and inhibitor activity in rat.

Thyroid hormones influence mineral metabolism, distribution of water and electrolytes and are therefore of great importance in the maintenance of homeostasis under normal and diseased conditions such as renal failure. The present study was carried out to determine the effect of thyroxine on fibrinolytic parameters such as plasminogen activators (PA) in rat kidney, levels of PA and plasminogen activator inhibitor (PAI), glucose in plasma and serum lipid profile injected with thyroxine (75 microg eltroxine/ 100 g(-1) body weight, ip for 7 days). Treatment increased PA activity significantly in rat kidneys. No changes were seen in PA, PAI and glucose in plasma of rats. There was significant decrease in total cholesterol and LDL-cholesterol levels in serum of treated group resulting in the decrease of HDL/LDL and total cholesterol/cholesterol ratios. However, triglycerides and VLDL showed significant higher activity in the serum of treated group as compared to controls. The results suggest beneficial effects of thyroxine treatment by increasing PA activity in kidney and reducing the cholesterol content in blood. It may be helpful to prevent hypercoagulable state by maintaining the normal homeostatic balance and restoring renal function.

Proliferação, apoptose e histomorfometria da glândula mamária de ratas tratadas com tiroxina na lactação e ao desmame e desenvolvimento dos filhotes / Proliferation, apoptosis and mammary gland histomorphometry of thyroxine-treated rats on lactation and after weaning and development of offspring

O objetivo deste estudo foi avaliar a histomorfometria e a taxa de proliferação e apoptose da glândula mamária de ratas tratadas com tiroxina pela imuno-expressão de CDC-47 e caspase-3, respectivamente. Também foi avaliado o desenvolvimento dos filhotes de ratas tratadas com tiroxina. Foram utilizadas 36 ratas distribuídas em dois grupos, tratado com tiroxina e controle. Após 60 dias de tratamento com tiroxina, as ratas foram acasaladas. Seis animais/grupo foram sacrificados no 2° e 21° dias de lactação e no 5° dia após o desmame. Houve diferença significativa entre grupos apenas no quinto dia após o desmame. O tratamento com tiroxina aumentou a taxa de apoptose caracterizada pela maior expressão de caspase-3 nas células do epitélio mamário. As mães tratadas com tiroxina apresentaram comportamento alterado, mas não houve diferença significativa no que se refere aos cuidados com o filhote quanto a higienização e aquecimento. Levando-se em consideração o sexo e o tamanho da ninhada, os filhotes das ratas tratadas com tiroxina e controle não apresentaram diferença significativa de peso ao desmame. Conclui-se que a administração de baixas doses de tiroxina aumenta a taxa de apoptose, caracterizada pelo aumento da expressão de caspase-3 no epitélio mamário cinco dias após o desmame, mas não altera a taxa de proliferação celular e o comportamento materno.

The purpose of this study was to evaluate mammary gland histomorphometry and proliferation rate and apoptosis of thyroxine-treated rats by CDC-47 and caspase-3 immunoexpression. The development of thyroxine-treated rats offspring was also evaluated. Thirty-six female rats were used, distributed in two groups, treated and non-treated with thyroxine. After 60 days of treatment, with thyroxine, rats were mated. Six animals/group were sacrificed on the 2nd and 21st days of lactation and on the 5th day after weaning. A significant difference was observed between groups only on the 5th day after weaning. Thyroxine treatment increased apoptosis rate, which was characterized by a higher caspase-3 expression in mammary epithelial cells. Thyroxine-treated mothers presented changed behavior, but there was no significant difference regarding taking care of offspring, as for cleaning offspring and keeping them warm. Taking into account sex and size of offspring, those from control and thyroxine-treated mothers presented no significant difference of weight and weaning. In conclusion, administering low doses of thyroxine increases apoptosis rate, which is characterized by the increased caspase-3 immunoexpression in mammary epithelial cells 5 days after weaning. But does not affect proliferation rate and development of thyroxine-treated rats offspring.

Effect of Thyroxine and Propylthiouracil in Ehrlich Ascitic Tumor Cells / Efecto de la Tiroxina y Propiltiouracilo en las Células del Tumor Ascítico de Ehrlich

The main purpose of this study was to investigate the effect of thyroxine and PTU in ascitic Ehrlich tumor cells. Tumor was implanted in 30 female mice distributed in three groups: treated with PTU, treated with thyroxine and control. Each group received an intraperitoneal injection of neoplastic cells, pre-incubated with sterile solutions of PTU, thyroxine and distilled water, respectively. On the fifth and seventh days after inoculation, animals received an intraperitoneal injection of the respective solutions. On the tenth day after inoculation, animals were sacrificed. Volume of ascitic liquid, number of neoplastic cells/ml and percentage of viable cells were determined. Ascitic liquid smears were carried out for tumor cytological evaluation. There was no difference among groups regarding ascitic liquid and as for the number and viability of tumor cells. However, cells under the effect of thyroxine presented significantly larger mean of nuclear diameter, size and number of nucleolus organizer regions. In this group, there was a predominance of clear, round cells with abundant eosinophilic and very vacuolated cytoplasm with little defined edges. Under the PTU effect, tumor cells were small with hyperchromatic nucleus and the same number of NORs as the control group. It was concluded that PTU and thyroxine have not changed the number and viability of cells after 10 days of tumor inoculation but they changed significantly cell characteristics. Whilst thyroxine increases cell size and the number of NORs of ascitic Ehrlich tumor cells, PTU causes an opposite effect.

El propósito principal de este estudio ha sido investigar el efecto de la tiroxina y del propiltiouracilo (PTU) en las células del tumor de Ehrlich. El tumor fue implantado en 30 ratones hembras distribuidas en tres grupos: tratado con PTU, tratado con tiroxina y control. Cada grupo recibió una inyección intraperitoneal de células neoplásicas, pre-incubadas con las soluciones estériles de PTU, tiroxina y agua, respectivamente. En el quinto y séptimo días después de la inoculación, los animales recibieron una inyección intraperitoneal de las soluciones respectivas. En el décimo día después de la inoculación, se sacrificaron los animales. Fueron determinados el volumen de líquido ascítico, el número de células/ml y el porcentaje de células viables. Además se realizaron frotis del líquido ascítico para la evaluación de la citología del tumor. No hubo ninguna diferencia entre los grupos con respecto al volumen del líquido ascítico y el número y viabilidad de las células del tumor. Sin embargo, las células bajo el efecto de la tiroxina presentaron una media significativamente superior del diámetro nuclear, tamaño y número de regiones organizadoras de nucleélos. En este grupo, había un predominio de células claras, redondas con citoplasma abundante, eosinofílico y vacuolado con poca definición de los bordes. Bajo el efecto del PTU, las células del tumor eran pequeñas con el núcleo hipercromático y el mismo número de NORs como el grupo control. Se concluye que el PTU y tiroxina no afectaron el número y viabilidad de las células después de 10 días de inoculación del tumor, pero sí cambiaron las características celulares. Aunque la tiroxina aumenta el tamaño celular y el número de NORs de las celulas del tumor de Ehrlich, PTU causa efectos opuestos.

Effect of hypothyroidism and thyroxin replacement on growth of long bones in prenatally treated albino rats

To study the effect of induced hypothyroidism and thyroxin replacement on bone growth. Design: An animal study carried out on experimental Albino rats. Place and duration of study: The study was carried out in the Department of Anatomy, Basic Medical Sciences Institute [BMSI], Jinnah Postgraduate Medical Centre [JPMC], Karachi, from June 1999 to May 2002. Pregnant female Albino rats obtained from the animal house of Basic Medical Sciences Institute, JPMC, Karachi were treated with carbimazole and carbimazole plus thyroxin from 10th day of gestation till parturition. Another group of pregnant rats did not receive any treatment and acted as controls. Pups born to the treated as well as control animals were sacrificed on 10th postnatal day and fixed in formal saline. They were then processed through 95% ethanol and acetone, bulk stained with alizarin red and cleared in 4% KOH to reveal their bony and cartilaginous elements. The ulna and tibia of both sides were disarticulated from the treated and control animals and measured for intact bone length and diameter. The measurements of the three groups were then compared statistically. The retardation in length observed at the end of experimental period in ulna was by 13.67% and in tibia by 27.84% in carbimazole treated group while in carbimazole plus thyroxin treated group the reduction in length of ulna was 5.08% and of tibia 3.91% when compared with their age matched controls. Prenatal hypothyroidism has an adverse effect on bone growth and results in reduction of long bone length

Effects of levothyroxine administration on ovulation rate and sex hormone levels in prepubertal and adult rats

Thyroid gland dysfunction is associated with disorders of female reproductive functions. The aim of this study was to examine the effects of hyperthyroidism on ovulation rate and peripheral sex steroid levels in prepubertal and adult rats. Two groups of female rats aging 30 days [prepubertal rats] and 60 days [adult rats] were made hyperthyroid by oral administration of levothyroxine daily. In the two control groups [n=10] rats with the same ages received the same volume of normal saline. After 10 days the serum levels of T[3], T[4], LH, FSH, estradiol and progesterone were measured by RIA technique and also sections of ovaries were prepared for histological studies. All ovarian follicles and corpora lutea were counted to estimate ovulation rate. The results indicated that serum estradiol and progesterone levels of adult hyperthyroid rats were significantly lower than those of the control group [p<0.05]. However, there was no significant difference between estradiol levels in the prepubertal hyperthyroid group and its control group. In the hyperthyroid groups the mean number of primary, secondary and antral follicles and corpora lutea was significantly less than those of control groups. It was concluded that high levels of plasma thyroid hormones resulted in lowered body weight and disturbed ovarian follicle development and differentiation leading to reduction in ovarian steroidogenesis and ovulation

Effects of Thyroxine on Hyperkalemia and Renal Cortical Na(+), K(+) - ATPase Activity Induced by Cyclosporin A

Cyclosporin A (CsA)-induced hyperkalemia is caused by alterations in transepithelial K(+) secretion resulting from the inhibition of renal tubular Na(+), K(+) -ATPase activity. Thyroxine enhances renal cortical Na(+), K(+) -ATPase activity. This study investigated the effect of thyroxine on CsA-induced hyperkalemia. Sprague-Dawley rats were treated with either CsA, thyroxine, CsA and thyroxine, or olive-oil vehicle. CsA resulted in an increase in BUN and serum K(+), along with a decrease in creatinine clearance, fractional excretion of potassium, and renal cortical Na(+), K(+) -ATPase activity, as compared with oil vehicle administration. Histochemical study showed reduced Na(+), K(+) -ATPase activity in the proximal tubular epithelial cells of the CsA-treated compared with the oil-treated rats. Histologically, isometric intracytoplasmic vacuolation, disruption of the arrangement and swelling of the mitochondria, and a large number of lysosomes in the tubular epithelium were characteristic of the CsA-treated rats. Co-administration of thyroxine prevented CsA-induced hyperkalemia and reduced creatinine clearance, Na(+), K(+) -ATPase activity, and severity of the histologic changes in the renal tubular cells when compared with the CsA-treated rats. Thyroxine increased the fractional excretion of potassium via the preservation of Na(+), K(+) -ATPase activity in the renal tubular cells. Thus, the beneficial effects of thyroxine may be suited to treatment modalities for CsA-induced hyperkalemia.

Effect of combined treatment with calcitonin on bone densitometry of patients with treated hypothyroidism

INTRODUCTION: Thyroid hormones (TH) may affect bone metabolism and turnover, inducing a loss of bone mass among hyperthyroid and in hypothyroid patients under hormone replacement treatment. Thyroid dysfunction leads to changes in the dynamics of parathyroid hormone (PTH) and calcitonin (CT) secretion. OBJECTIVE: The objective of the study was to determine the usefulness of CT as adjuvant therapy in the prevention of bone loss during the treatment of hypothyroidism. MATERIAL AND METHODS: We studied 16 female patients with recently diagnosed primary hypothyroidism, divided into two groups: group G1 (n=8) submitted to treatment with thyroxine (L-T4), and Group 2 (n=8) that, in addition to being treated with L-T4, received a nasal CT spray. All patients were submitted to determination of TSH, free T4, bone mineral densitometry (BMD) and total bone calcium (TBC) at the time of diagnosis, after 6 to 9 months of treatment, and after 12 months of treatment. RESULTS: No statistical significant differences were detected in either group between the total BMD values obtained for the femur and lumbar spine before and after treatment. However, group G1 presented a statistical significant TBC loss after 12 months of treatment compared to initial values. In contrast, no TBC loss was observed in the group treated with LT-4 in combination with CT, a fact that may suggest that CT was responsible for the lower bone reabsorption during treatment of hypothyroidism.

Effect of the dopamine antagonist, domperidone alone and in combination with thyroxine, clomiphene, hcg or gnRH on serum sex steroid profile, gonadal maturation and spawning of nile catfish, clarias lazera

The present investigation was carried out on one hundred and twenty mature Clarias lazera fish during the prespawning season [March - April]. Fish were allocated into two main groups [sixty fish of each sex] Fish weight ranged between 200-220 g. b. wt. Each main group was subdivided into six equal groups [Ten fish each], Fish of each group; both males and females were subjected to the same regimen of intraperitoneal exogenous treatment, as follows. 1[st] Group: Saline 0.65% NaCL solution. [Control] 2[nd] Group: Domperidone 5 microg/g. b. wt. in saline. 3[rd] Group: Domperidone 5 microg/g. b. wt, plus thyroxine 1 nancg / g. b. wt. in saline. 4[th] Group; Domperidone 5 microg/g, b. wt. plus clomiphene citrate l gamma g/g. b wt. in saline. 5[th] Group: Domperidone 5 micro g/g. b. wt. plus hCG 2 lU/g, b. wt. in saline. 6[th] Group: Domperidone 5 microg/g. b. wt. plus GnRH 10 microg/kg. b. wt. in saline. The present study revealed that [Domperidone] administration alone, in each sex of Clarias fish; increased serum sex steroid hormones [testosterone and 17 beta estradiol], gonadal weights [testes and ovaries], final gonadal maturation and gonadosomatic indices of both sexes as compared to respective controls. Exogenous administration of domperidone plus gonadotropin releasing hormone [GnRH] was the most effective treatment for production of sex hormones, final gonadal maturation and spawning in both sexes of Clarias lazera fish, followed by domperidone plus thyroxine; domperidone plus clomiphene citrate and domperidone plus hCG, respectively. In conclusion, the exogenous administration of dopamine antagonist plus GnRH is the most efficient regimen for enhancement of gonads maturation [gonadal recrudescence], spawning and spermiation of Clarias lazera fish throughout the prespawning season

Acción de las hormonas tiroideas sobre la modulación de la expresión genética de la enzima málica citosólica hepática, en ratas intoxicadas con hexaclorobenceno / Action of the thyroid hormone on modulation of the gene expression of the liver cytosolic malic enzyme, in intoxicated rats with hexachlorobenzene

El hexaclorobenceno (HCB) es un tóxico ampliamente distribuído en la biosfera. La exposición crónica de animales de laboratorio al HCB provoca disfunciones tiroideas. Previamente hemos demostrado que el HCB incrementa la actividad de enzimas hepáticas reguladas por hormonas tiroideas (HT) tales como: enzima málica (EM) y glucosa-6fosfato de dehidrogenasa (G6PD) sin alterar la actividad de la alpha-glicerol fosfato deshidrogenasa mitocondrial (alpha-GPD). En éste estudio hemos investigado si el HCB afectaba: a) la concentración del receptor de hormonas tiroideas (RT3) y su afinidad por el ligando, b) la expresión del gen de EM y de otras enzimas HT-dependientes, c) los complejos proteína/DNA formados sobre el elemento de respuesta a hormonas tiroideas (TRE). Se utilizaron hígados de ratas hembras Wistar intoxicadas con HCB (100 mg/100 g P.C.), por 9 y 15 días. El análisis de Scatchard mostró que ni la afinidad ni el número de sitios RT3 estaban alterados luego de 9 y 15 días de tratamiento con HCB (Control, Ka: 1,9 nM, Bmáx:3.9 fmol/100mug DNA; HCB9díasKa2.1nM, Bmáx4.5 fmol/100mug DNA; HCB15 días Ka 1.9nM, Bmáx5.1 fmol/100mug DNA). Tampoco los niveles de RNAm de TRbeta1 medidos por ensayos de protección a RNasa fueron afectados por HCB. Ensayos de Northern Blot han demostrado que los niveles de RNAm de EM se incrementaban 4 veces y 2 veces con respecto al control después de 9 y 15 días de intoxicación respectivamente, sin observarse alteraciones en los niveles de RNAm de otras enzimas cuya expresión es regulada por HT como gliceraldehído - 3 - fosfato deshidrogenasa (GAPDH) y fosfoenolpiruvatocarboxiquinasa (PEPCK) ni tampoco en la alpha-GPD mitocondrial. Ensayos de retardo en gel mostraron que el HCB no modificó la afinidad de las proteínas presentes en extractos nucleares por el TRE presente en el promotor de EM. Nuestros resultados sugieren que el RT3 no está involucrado en forma directa en la inducción de la expresión del gen de EM por HCB, sin embargo podría interaccionar con otros factores de transcripción en la sobreexpresión del gen de EM.

El olpadronato previene la perdida de hueso cortical y trabecular inducida por dosis suprafisiologicas de tiroxina en ratas ovariectomizadas / Olpadronate prevents cortical and trabecular bone loss induced by supraphysiological dosis of thyroxine in ovariectomized rats

En el presente estudio experimental en ratas se evaluaron los efectos de la ovariectomia (OVX) y la administración de tiroxina (T4) sobre la densidad mineral ósea (DMO) del hueso cortical y trabecular. Además se estudió la eficacia del olpadronato (Olpa) para prevenir la pérdida ósea axial y periférica inducida por el exceso e hormonas tiroideas. Ratas hembras Sprague-Dawley (220 + 2 gr)se dividieron en los siguientes grupos: SHAM, OVX+Vh (Vh: vehículo); OVX+T4 (T4 250 mug/Kg peso/día); OVX+Olpa (0.3 mg de Olpa/Kg de peso/semana) y OVX+T4+Olpa (ambos: T4+Olpa). La DMO de las OVX+Vh fue significativamente menor que la de las SHAM en tibia total (p<0.01) pero no en el fémur ni en la columna lumbar. En el segmento medio de la tibia los resultados fueron similares en ambos grupos; un valor menor se observó en la parte distal (pns) y en la proximal (p <0.003) en el grupo OVX+Vh. La DMO de las OVX+T4 fue significativamente menor que la de las OVX+Vh en la tibia total (p<0.02), el fémur (p<0.006), la columna lumbar (p<0.006); además, la DMO de las OVX+T4 fue menor en todos los sectores analizados de la tibia, pero alcanzó un nivel estadísticamente significativo sólo en la parte media (p<0.004). La DMO de las OVX+Olpa fue mayor que la de las OVX+Vh en fémur (p<0.002), columna lumbar (p<0.03), tibia total (p<0.001) y tibia proximal (p<0.001). Sorprendentemente, la DMO de las OVX+Olpa fue mayor que la de las SHAM, en tibia total y proximal (p<0.05 y p<0.001, respectivamente). La DMO del grupo OVX+T4+Olpa fue significativamente mayor que el de OVX+T4 en fémur (p<0.001), columna lumbar (p<0.001), tibia total (p<0.001), tibia proximal (p<0.0001); asimismo, alcanzó niveles significativamente mayores que la de las SHAM en columna lumbar, tibia total y proximal (p<0.01 para todas ellas). El presente estudio sugiere que el hueso cortical, en condiciones de deficiencia estrogénica, sería más sensible que el trabecular al efecto de la T4. El Olpa prevendría la pérdida ósea axial y periférica del hueso inducida por un exceso de hormonas tiroideas.

Sever hypothyroidism Effect of L- thyroxine therapy on the lipid contents of serum lipoproteins

Thyroidal status has s well known effect on lipid metabolism. Thyroid insufficiency may cause secondary hyperlipidemia, but effect of short course [pound l2 weeks] L-thyroxine therapy on elevated high density lipoprotein cholesterol [HDL-c] is controversial. Particularly the effect of short course of L-thyroxine therapy on elevated levels of various serum lipoproteins in severely hypothyroid patients.[serum T[4] levels <15 mmol/L and hTSH >150 mU/L] has not been established. To assess the efficacy of L-thyroxine therapy in normalizing the elevated lipid contents of various serum lipoprotein fractions in severe primary hypothyroidism in the local population. DESIGN: Controlled clinical trial. PATIENTS AND METHODS: 17 male patients referred to Punjab Institute of Nuclear Medicine, Faisalabad, mean age [mean age 32 +/- 18 years, ranging 23-67 years], having serum levels of T[4] <15 mmol/L and hTSH >150 mU/L were selected. pre-therapy fasting blood samples was taken at the time of diagnosis. All subjects became euthyroid after 9 weeks of L-thyroxine therapy with gradual increase of dosing from 50 to 150 [micro] g/d. Post-therapy fasting blood was taken after 12 weeks of L-thyroxine therapy. With L-thyroxine therapy euthyroid state was achieved within 9 weeks and all patients became free from signs and symptoms of hypothyroidism. Serum triacylglycerols, total cholesterol and LDL-c levels were reduced significantly [P <0.01] but there was a slight reduction in the serum HDL-c levels. CONCLUSIONS: L-thyroxine therapy in severe hypothyroidism does have a cardioprotective effect by normalizing the elevated levels of TAGs, total cholesterol and LDL-c