Levey G S, Epstein S E
J Clin Invest. 1969 Sep;48(9):1663-9. doi: 10.1172/JCI106131.
The mechanism responsible for the hyperdynamic circulatory state in hyperthyroidism has not been defined. Although certain cardiac manifestations resemble those caused by excessive adrenergic stimulation, recent evidence suggests that thyroid hormone exerts an effect on the heart that is independent of the adrenergic system. Since the inotropic and chronotropic effects of norepinephrine appear to be mediated by activation of adenyl cyclase, the possibility that thyroxine and triiodothyronine are also capable of activating adenyl cyclase was examined in the particulate fraction of cat heart homogenates.L-thyroxine and L-triiodothyronine increased the conversion of adenosine triphosphate-(32)P (ATP-(32)P) to cyclic 3',5'-adenosine monophosphate-(32)P (3',5'-AMP-(32)P) by 60 and 45% respectively (P < 0.01). A variety of compounds structurally related to the thyroid hormones, but devoid of thyromimetic activity did not activate adenyl cyclase: these included 3,5-diiodo-L-thyronine, L-thyronine, 3,5-diiodotyrosine, monoiodotyrosine, and tyrosine. D-thyroxine activated adenyl cyclase and half maximal activity was identical to that of the L-isomer. Although the beta adrenergic blocking agent propranolol abolished norepinephrine-induced activation of adenyl cyclase, it failed to alter activation caused by thyroxine. When maximal concentrations of L-thyroxine (5 x 10(-6) moles/liter) and norepinephrine (5 x 10(-5) moles/liter) were incubated together, an additive effect on cyclic 3',5'-AMP production resulted. THIS INVESTIGATION DEMONSTRATES: (a) thyroid hormone is capable of activating myocardial adenyl cyclase in vitro and (b) this effect is not mediated by the beta adrenergic receptor. Moreover, the additive effects of norepinephrine and thyroxine suggest that at least two separate adenyl cyclase systems are present in the heart, one responsive to norepinephrine, the other to thyroid hormone. These findings are compatible with the hypothesis that the cardiac manifestations of the hyperthyroid state may, in part, be caused by the direct activation of myocardial adenyl cyclase by thyroid hormone.
甲状腺功能亢进时高动力循环状态的机制尚未明确。尽管某些心脏表现类似于肾上腺素能过度刺激所引起的表现,但最近的证据表明甲状腺激素对心脏产生的作用独立于肾上腺素能系统。由于去甲肾上腺素的变力性和变时性作用似乎是由腺苷酸环化酶的激活介导的,因此在猫心脏匀浆的微粒部分研究了甲状腺素和三碘甲状腺原氨酸是否也能够激活腺苷酸环化酶。L-甲状腺素和L-三碘甲状腺原氨酸分别使三磷酸腺苷 -(32)P(ATP -(32)P)向环3',5'-腺苷单磷酸 -(32)P(环3',5'-AMP -(32)P)的转化增加了60%和45%(P < 0.01)。多种与甲状腺激素结构相关但缺乏拟甲状腺活性的化合物不能激活腺苷酸环化酶:这些化合物包括3,5-二碘-L-甲状腺原氨酸、L-甲状腺原氨酸、3,5-二碘酪氨酸、单碘酪氨酸和酪氨酸。D-甲状腺素激活腺苷酸环化酶,其半数最大活性与L-异构体相同。尽管β肾上腺素能阻滞剂普萘洛尔消除了去甲肾上腺素诱导的腺苷酸环化酶激活,但它未能改变甲状腺素引起的激活。当将最大浓度的L-甲状腺素(5×10^(-6)摩尔/升)和去甲肾上腺素(5×10^(-5)摩尔/升)一起孵育时,对环3',5'-AMP的产生产生了相加作用。本研究表明:(a)甲状腺激素在体外能够激活心肌腺苷酸环化酶,(b)这种作用不是由β肾上腺素能受体介导的。此外,去甲肾上腺素和甲状腺素的相加作用表明心脏中至少存在两个独立的腺苷酸环化酶系统,一个对去甲肾上腺素有反应,另一个对甲状腺激素有反应。这些发现与以下假设相符,即甲状腺功能亢进状态的心脏表现可能部分是由甲状腺激素直接激活心肌腺苷酸环化酶所致。