Safran M, Fang S L, Bambini G, Pinchera A, Martino E, Braverman L E
Am J Med Sci. 1986 Sep;292(3):136-41. doi: 10.1097/00000441-198609000-00003.
The effect of acute administration of amiodarone, its major metabolite desethylamiodarone and iodine in an amount equal to that contained in amiodarone on serum thyroid hormone and thyrotropin (TSH) concentrations and hepatic and pituitary 5' deiodination of thyroxine (T4) in the euthyroid and hypothyroid rat was evaluated. Amiodarone, desethylamiodarone and iodine all caused a decrease in serum T4 and triiodothyronine (T3) concentrations in euthyroid rats, while serum TSH concentrations and pituitary and hepatic 5' deiodinase activities were decreased only in the amiodarone and desethylamiodarone-treated animals. Serum TSH was increased in the iodine treated rats. Amiodarone, but not iodine, decreased serum T3 and TSH concentrations and pituitary and hepatic 5' deiodinase activities in hypothyroid rats. Inhibition of hepatic 5' deiodinase activity was also observed by the addition of amiodarone in vitro in the absence of dithiothreitol (DTT) but not in the presence of DTT. The decrease in the serum T4 concentration observed with amiodarone and desethylamiodarone administration is probably secondary to the inhibitory effect of iodine released from the drugs on thyroidal T4 synthesis and secretion. Iodine inhibition of thyroidal T3 synthesis and secretion, decreased T4 substrate for a peripheral generation of T3 and inhibition of T4 to T3 conversion all contribute to the decrease in serum T3 observed. The decrease in the serum TSH concentration, despite low serum T4 and T3 concentrations and inhibition of pituitary 5' deiodinase, suggest that amiodarone may function as a thyroid hormone agonist in the pituitary.(ABSTRACT TRUNCATED AT 250 WORDS)
评估了急性给予胺碘酮、其主要代谢产物去乙基胺碘酮以及与胺碘酮所含碘量相等的碘,对正常甲状腺功能和甲状腺功能减退大鼠血清甲状腺激素和促甲状腺激素(TSH)浓度以及肝脏和垂体中甲状腺素(T4)的5'脱碘作用的影响。胺碘酮、去乙基胺碘酮和碘均可导致正常甲状腺功能大鼠血清T4和三碘甲状腺原氨酸(T3)浓度降低,而仅在接受胺碘酮和去乙基胺碘酮治疗的动物中,血清TSH浓度以及垂体和肝脏的5'脱碘酶活性降低。接受碘治疗的大鼠血清TSH升高。胺碘酮而非碘可降低甲状腺功能减退大鼠的血清T3和TSH浓度以及垂体和肝脏的5'脱碘酶活性。在无二硫苏糖醇(DTT)存在的情况下,体外添加胺碘酮也可观察到肝脏5'脱碘酶活性受到抑制,但在有DTT存在时则未观察到。给予胺碘酮和去乙基胺碘酮后血清T4浓度降低,可能是由于药物释放的碘对甲状腺T4合成和分泌的抑制作用所致。碘对甲状腺T3合成和分泌的抑制、外周T3生成的T4底物减少以及T4向T3转化的抑制,均导致了观察到的血清T3降低。尽管血清T4和T3浓度较低且垂体5'脱碘酶受到抑制,但血清TSH浓度降低,这表明胺碘酮可能在垂体中作为甲状腺激素激动剂发挥作用。(摘要截取自250字)