Sasaki Shigekazu, Kawai Kotaro, Honjo Yumiko, Nakamura Hirotoshi
Second Division of Internal Medicine, Hamamatsu University School of Medicine.
Nihon Rinsho. 2006 Dec;64(12):2323-9.
Thyroid hormone (T3) and its receptor (TR) have the diverse effects on the lipid metabolism and hypothyroidism causes hypercholesterolaemia characterized by increased levels of low-density ripoproteins (LDL). There are multiple TR isoforms such as TRalpha1, TRbeta1 and TRbeta2, of which expressions are known to be tissue-specific. For example, TRbeta1 is the major TR in the liver while T3 action is mediated via TRalpha1 in the heart. The X-ray crystallography of the ligand-binding domain of TRs enabled the development of TRbeta isoform specific T3 analogues including GC1. Without tachycardia, GC1 selectively targets the TRbeta1 in the liver and decreases cholesterol levels with more potent efficacy than that of atorvastatin, a potent HMG-CoA reductase. However, the reduction of serum TSH by GC1 should be overcome in future. Current reports also describe the existence of the complex cross-talks in the lipid metabolism between TR and other nuclear hormone receptors including peroxisome proliferator -activated receptors (PPARs), liver X receptor alpha (LXRalpha) and farnesoid X receptors (FXRs). Understanding for the function of TRs and other nuclear factors may provide the new approach to the control of hypercholesterolaemia.
甲状腺激素(T3)及其受体(TR)对脂质代谢具有多种影响,甲状腺功能减退会导致高胆固醇血症,其特征是低密度脂蛋白(LDL)水平升高。存在多种TR亚型,如TRα1、TRβ1和TRβ2,已知它们的表达具有组织特异性。例如,TRβ1是肝脏中的主要TR,而T3在心脏中的作用是通过TRα1介导的。TR配体结合域的X射线晶体学使得能够开发包括GC1在内的TRβ亚型特异性T3类似物。在不引起心动过速的情况下,GC1选择性地靶向肝脏中的TRβ1,并以比强效HMG-CoA还原酶阿托伐他汀更强的效力降低胆固醇水平。然而,未来应克服GC1降低血清促甲状腺激素(TSH)的问题。目前的报道还描述了TR与其他核激素受体(包括过氧化物酶体增殖物激活受体(PPARs)、肝脏X受体α(LXRα)和法尼醇X受体(FXRs))之间在脂质代谢中存在复杂的相互作用。了解TR和其他核因子的功能可能为控制高胆固醇血症提供新的方法。