van der Poll T, Romijn J A, Wiersinga W M, Sauerwein H P
Department of Internal Medicine, University of Amsterdam, The Netherlands.
J Clin Endocrinol Metab. 1990 Dec;71(6):1567-72. doi: 10.1210/jcem-71-6-1567.
Tumor necrosis factor-alpha (TNF) is believed to be an important mediator in many diseases that are associated with the sick euthyroid syndrome. To investigate the effect of TNF on thyroid hormone metabolism, we performed a controlled study in six healthy postabsorptive males, in whom plasma thyroid hormones and TSH were sequentially measured after iv bolus injections of recombinant human TNF (50 micrograms/m2) and isotonic saline. During the 10.5-h study TNF produced the characteristic changes in circulating thyroid hormones and TSH observed in the sick euthyroid syndrome. Compared with the control experiment, TNF induced significant decreases in T3 (-36 +/- 2%; saline, -20 +/- 3%; P less than 0.05) and TSH levels (-68 +/- 3%; saline, -44 +/- 8%; P less than 0.05) and a significant increase in rT3 values (+48 +/- 11%; saline, -12 +/- 7%; P less than 0.05). T4 and free T4 index were not affected by TNF. Free T4 showed a mean transient increase of 18% in five subjects (nonsignificant), which occurred synchronically with a transient 3.5-fold rise in circulating FFA levels. Our results suggest that TNF is involved, either directly or indirectly, in the pathogenesis of the sick euthyroid syndrome.
肿瘤坏死因子-α（TNF）被认为是许多与病态甲状腺综合征相关疾病中的重要介质。为了研究TNF对甲状腺激素代谢的影响，我们对6名健康的空腹男性进行了一项对照研究，在静脉推注重组人TNF（50微克/平方米）和等渗盐水后，依次测量他们的血浆甲状腺激素和促甲状腺激素（TSH）。在为期10.5小时的研究中，TNF引起了病态甲状腺综合征中所观察到的循环甲状腺激素和TSH的特征性变化。与对照实验相比，TNF导致T3水平显著降低（-36±2%；盐水组为-20±3%；P<0.05）以及TSH水平显著降低（-68±3%；盐水组为-44±8%；P<0.05），同时反T3（rT3）值显著升高（+48±11%；盐水组为-12±7%；P<0.05）。T4和游离T4指数不受TNF影响。5名受试者的游离T4平均出现了18%的短暂升高（无统计学意义），这与循环游离脂肪酸（FFA）水平短暂升高3.5倍同时发生。我们的结果表明，TNF直接或间接参与了病态甲状腺综合征的发病机制。
