Bisbocci D, Gallo V, Damiano P, Sidoli L, Cantoni R, Aimo G, Priolo G, Pagni R, Chiandussi L
Dipartimento di Medicina ed Oncologia Sperimentale, University of Torino, Italy.
J Endocrinol Invest. 1996 Sep;19(8):511-5. doi: 10.1007/BF03349009.
Hyperthyroidism is a well documented cause of impaired bone turnover characterized by increased osteoblastic and osteoclastic activity, resulting in predominance of bone resorption and in decreased bone mass. Thyroid hormones can carry out a direct effect on osteoblasts which express specific receptors on their surface membrane; differently effect on osteoclast seems to be mediated by local factors, cytokynes released by activated osteoblasts or by bone monocytes cells. Interleukin 1 beta is the first purified cytokyne shown to have bone resorbing activity. In ten thyrotoxic female patients IL 1 beta in the cellular medium of the monocytes blood cells culture has been measured, compared to PYD/cr urinary excretion, and FT3, BGP serum levels, before and after thyrostatic treatment. Ten normal females were studied as control group. The results before treatment showed osteopenia in 20% (DEXA densitometry), increased values of FT3, BGP, IL 1 beta and PYD/cr in patients versus controls (p < 0.001). The thyrostatic therapy obtained normalization of IL 1 beta, PYD/cr, BGP, and FT3 levels. Our data demonstrate that increased thyroid hormone levels in vivo are associated to increased secretion of monocytes cytokynes in vitro and suggest that alterations in local production of bone acting cytokyne may underlie to thyrotoxic osteodistrophy.
甲状腺功能亢进是一种有充分文献记载的导致骨转换受损的病因，其特征是成骨细胞和破骨细胞活性增加，导致骨吸收占优势且骨量减少。甲状腺激素可对其表面膜上表达特定受体的成骨细胞产生直接作用；对破骨细胞的不同作用似乎是由局部因素介导的，即活化的成骨细胞或骨单核细胞释放的细胞因子。白细胞介素1β是第一种被纯化的显示具有骨吸收活性的细胞因子。在10名甲状腺毒症女性患者中，在进行甲状腺抑制治疗前后，测量了单核血细胞培养细胞培养基中的白细胞介素1β，并与吡啶啉/肌酐尿排泄量以及游离三碘甲状腺原氨酸（FT3）、骨钙素（BGP）血清水平进行了比较。选取10名正常女性作为对照组。治疗前的结果显示，20%的患者存在骨质减少（双能X线吸收法骨密度测定），患者的FT3、BGP、白细胞介素1β和吡啶啉/肌酐值高于对照组（p<0.001）。甲状腺抑制治疗使白细胞介素1β、吡啶啉/肌酐、BGP和FT3水平恢复正常。我们的数据表明，体内甲状腺激素水平升高与体外单核细胞细胞因子分泌增加有关，并提示骨活性细胞因子局部产生的改变可能是甲状腺毒症性骨营养不良的基础。
