Ferrara Alfonso Massimiliano, Liao Xiao-Hui, Ye Honggang, Weiss Roy E, Dumitrescu Alexandra M, Refetoff Samuel
Departments of Medicine (A.M.F., X.-H.L., H.Y., R.E.W., A.M.D., S.R.) and Pediatrics (R.E.W., S.R.) and the Committee on Genetics (S.R.), The University of Chicago, Chicago, Illinois 60637.
Endocrinology. 2015 Nov;156(11):3889-94. doi: 10.1210/en.2015-1234. Epub 2015 Aug 31.
Mutations in the gene encoding the thyroid hormone (TH) transporter, monocarboxylate transporter 8 (MCT8), cause mental retardation in humans associated with a specific thyroid hormone phenotype manifesting high serum T3 and low T4 and rT3 levels. Moreover, these patients have failure to thrive, and physiological changes compatible with thyrotoxicosis. Recent studies in Mct8-deficient (Mct8KO) mice revealed that the high serum T3 causes increased energy expenditure. The TH analog, diiodothyropropionic acid (DITPA), enters cells independently of Mct8 transport and shows thyromimetic action but with a lower metabolic activity than TH. In this study DITPA was given daily ip to adult Mct8KO mice to determine its effect on thyroid tests in serum and metabolism (total energy expenditure, respiratory exchange rate, and food and water intake). In addition, we measured the expression of TH-responsive genes in the brain, liver, and muscles to assess the thyromimetic effects of DITPA. Administration of 0.3 mg DITPA per 100 g body weight to Mct8KO mice brought serum T3 levels and the metabolic parameters studied to levels observed in untreated Wt animals. Analysis of TH target genes revealed amelioration of the thyrotoxic state in liver, somewhat in the soleus, but there was no amelioration of the brain hypothyroidism. In conclusion, at the dose used, DITPA mainly ameliorated the hypermetabolism of Mct8KO mice. This thyroid hormone analog is suitable for the treatment of the hypermetabolism in patients with MCT8 deficiency, as suggested in limited preliminary human trials.
编码甲状腺激素(TH)转运体单羧酸转运体8(MCT8)的基因突变会导致人类智力发育迟缓,并伴有特定的甲状腺激素表型,表现为血清T3水平升高、T4和反式T3水平降低。此外,这些患者生长发育不良,且有与甲状腺毒症相符的生理变化。最近对Mct8基因敲除(Mct8KO)小鼠的研究表明,血清T3水平升高会导致能量消耗增加。甲状腺激素类似物二碘甲状腺丙酸(DITPA)可独立于Mct8转运进入细胞,并表现出甲状腺模拟作用,但代谢活性低于甲状腺激素。在本研究中,每天给成年Mct8KO小鼠腹腔注射DITPA,以确定其对血清甲状腺检测和代谢(总能量消耗、呼吸交换率以及食物和水摄入量)的影响。此外,我们测量了大脑、肝脏和肌肉中甲状腺激素反应性基因的表达,以评估DITPA的甲状腺模拟作用。给Mct8KO小鼠每100克体重注射0.3毫克DITPA,可使血清T3水平和所研究的代谢参数达到未处理野生型动物的水平。对甲状腺激素靶基因的分析显示,肝脏中的甲状腺毒症状态有所改善,比目鱼肌中也有一定改善,但大脑中的甲状腺功能减退没有改善。总之,在所使用的剂量下,DITPA主要改善了Mct8KO小鼠的代谢亢进。正如有限的初步人体试验所表明的,这种甲状腺激素类似物适用于治疗MCT8缺乏患者的代谢亢进。