Proposing a causal link between thyroid hormone resistance and primary autoimmune hypothyroidism.
Resistance to thyroid hormone (RTH) is a rare, inherited condition. It is characterised by raised circulating fT4 and TSH levels. The literature contains a number of descriptions of the finding of thyroid autoantibodies in patients with RTH. Until now, this has been attributed to the coincidental development of primary autoimmune thyroiditis as a second unrelated pathology. Our hypothesis is that the chronic TSH elevation in RTH stimulates lymphocytes to produce the pro-inflammatory cytokine TNF-alpha. TNF-alpha, in turn mediates thyroid cell destruction by binding to its receptors on thyrocytes, or indirectly by potentiating antibody formation or cytotoxic T lymphocyte production.
Gavin
Claire
C
Division of Endocrinology and Metabolism, Department of Medicine, University of Ottawa, The Ottawa Hospital, Riverside Campus, 1967 Riverside Drive, Ottawa, Ontario, Canada K1H 7W9. cgavin@ottawahospital.on.ca
Meggison
Hilary
H
Ooi
Teik Chye
TC
D000328:Adult; D001327:Autoimmune Diseases / Q000150:complications* / Q000378:metabolism*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000378:metabolism*; D007249:Inflammation; D008954:Models, Biological; D008962:Models, Theoretical; D011988:Receptors, Thyroid Hormone / Q000378:metabolism; D013602:T-Lymphocytes, Cytotoxic / Q000378:metabolism; D013961:Thyroid Gland / Q000378:metabolism; D018382:Thyroid Hormone Resistance Syndrome / Q000150:complications* / Q000378:metabolism*; D013972:Thyrotropin / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D011988:Receptors, Thyroid Hormone; D014409:Tumor Necrosis Factor-alpha; D013972:Thyrotropin