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围产期垂体-甲状腺轴对甲状腺功能亢进和减退的反应性:调节的个体发生及反应的长期编程。

Pituitary-thyroid axis reactivity to hyper- and hypothyroidism in the perinatal period: ontogeny of regulation of regulation and long-term programming of responses.

作者信息

Pracyk J B, Seidler F J, McCook E C, Slotkin T A

机构信息

Department of Pharmacology, Duke University Medical Center, Durham, North Carolina 27710.

出版信息

J Dev Physiol. 1992 Sep;18(3):105-9.

PMID:1301414
Abstract

To evaluate the role of perinatal thyroid status in the development of pituitary-thyroid axis regulation, we administered triiodothyronine to newborn rats for the first five days postpartum to achieve hyperthyroidism, or propylthiouracil perinatally to rat dams and pups from gestational day 17 through postnatal day 5 to achieve hypothyroidism. Plasma T4, T3, and TSH levels were determined from birth through 50 days postpartum. Administration of exogenous T3 produced the expected immediate suppression of plasma T4 and TSH, with recovery toward normal values beginning within days of discontinuing the T3 regimen. Plasma T3 values were markedly elevated during the period in which T3 was being given, but subsequently became subnormal, with deficits persisting into young adulthood. With the PTU regimen, plasma T4 and T3 levels were markedly suppressed through postnatal day 10, rose over the ensuing two weeks, but nevertheless showed significant deficits into adulthood. TSH levels in the immediate neonatal period were subnormal in the PTU group, despite the marked lowering of circulating thyroid hormones; TSH then rose dramatically to levels four times normal, subsiding to control values by the end of the first month. These results suggest that a critical period exists in which regulation of pituitary-thyroid axis function is programmed. During this phase, TSH secretion can be suppressed by excess thyroid hormones, but cannot be increased by hormone deficiencies. Perhaps more importantly, perinatal thyroid status "programs" its own future reactivity, so that early hypothyroidism results in reduced T4 and T3 levels in adulthood, despite normal levels of TSH.

摘要

为评估围产期甲状腺状态在垂体 - 甲状腺轴调节发育中的作用,我们在产后头五天给新生大鼠注射三碘甲状腺原氨酸以造成甲状腺功能亢进,或者在妊娠第17天至出生后第5天对大鼠母鼠和幼鼠进行围产期丙硫氧嘧啶处理以造成甲状腺功能减退。从出生到产后50天测定血浆T4、T3和TSH水平。给予外源性T3导致血浆T4和TSH立即受到预期的抑制,在停止T3给药方案后的数天内开始恢复至正常水平。在给予T3期间血浆T3值显著升高,但随后变得低于正常水平,这种不足持续到成年早期。采用丙硫氧嘧啶方案时,血浆T4和T3水平在出生后第10天一直受到显著抑制,在随后的两周内上升,但成年后仍显示出明显不足。尽管循环甲状腺激素显著降低,但丙硫氧嘧啶组新生儿期即刻的TSH水平低于正常;TSH随后急剧上升至正常水平的四倍,在第一个月末降至对照值。这些结果表明存在一个关键时期,在此期间垂体 - 甲状腺轴功能的调节被编程。在此阶段,过量的甲状腺激素可抑制TSH分泌,但激素缺乏时TSH分泌不能增加。也许更重要的是,围产期甲状腺状态“编程”了其自身未来的反应性,因此早期甲状腺功能减退导致成年期T4和T3水平降低,尽管TSH水平正常。

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