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Synthesis and Regulation of Thyroid Hormones01:20

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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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Functions of Thyroid Hormones01:18

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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
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Hormones, the biochemical messengers produced by endocrine glands, are pivotal in regulating bodily functions and maintaining homeostasis. Each hormone's balance is crucial; imbalances can lead to significant physiological disruptions. Major hormones include oxytocin, cortisol, epinephrine, estrogen, testosterone, thyroxine, growth hormone, insulin, and glucagon.
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In addition to multiple alleles at the same locus influencing traits, numerous genes or alleles at different locations may interact and influence phenotypes in a phenomenon called epistasis. For example, rabbit fur can be black or brown depending on whether the animal is homozygous dominant or heterozygous at a TYRP1 locus. However, if the rabbit is also homozygous recessive at a locus on the tyrosinase gene (TYR), it will have an unshaded coat that appears white, regardless of its TYRP1...
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Tachyphylaxis is described as a rapid decrease in response to a drug after repeated or continuous administration of the same drug dose. It is a phenomenon where the body becomes less responsive to a particular substance or intervention over time, requiring higher doses or stronger interventions to achieve the same effect. It results from adaptive changes in the body's receptors, signaling pathways, or physiological processes that occur in response to prolonged exposure to a stimulus.
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Thyroid Hormone Hyposensitivity: From Genotype to Phenotype and Back.

Giuditta Rurale1, Emery Di Cicco2, Monica Dentice2

  • 1Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy.

Frontiers in Endocrinology
|February 11, 2020
PubMed
Summary

Thyroid hormone action defects (THADs) are now broadly defined as thyroid hormone hyposensitivity (THH), encompassing genetic defects in hormone transport, metabolism, and receptor action. Understanding these genetic causes aids in early diagnosis and targeted therapies for patients.

Keywords:
thyroid hormone cell membrane transport defectsthyroid hormone hyposensitivitythyroid hormone metabolism defectsthyroid hormonesthyroid hormones action defects

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Area of Science:

  • Endocrinology
  • Genetics
  • Molecular Biology

Background:

  • Thyroid hormone action defects (THADs) were initially linked to thyroid hormone receptor gene alterations.
  • Recent discoveries expanded the definition to thyroid hormone hyposensitivity (THH), including defects in TH transport (e.g., MCT8) and metabolism (e.g., SECISBP2, DIO2).
  • These genetic defects lead to diverse patient phenotypes, ranging from tissue-specific hypothyroidism to mixed hypo- and hyperthyroid states.

Purpose of the Study:

  • To review the molecular mechanisms and genetic basis of thyroid hormone action defects.
  • To correlate specific gene alterations with distinct thyroid function test (TFT) profiles.
  • To aid clinicians in early recognition, diagnosis, and genetic screening of THH.

Main Methods:

  • Review of existing literature on genetic mutations affecting thyroid hormone action.
  • Analysis of genotype-phenotype correlations, including TFTs (TSH, T4, T3 levels).
  • Discussion of the impact of genetic defects on target tissue morphology and function.

Main Results:

  • Identification of various genes (THRA, THRB, MCT8, SECISBP2, DIO2) involved in THADs/THH.
  • Demonstration of a wide spectrum of clinical presentations and TFT abnormalities associated with specific genetic defects.
  • Elucidation of molecular mechanisms underlying impaired thyroid hormone activity.

Conclusions:

  • Understanding the genetic basis of THH is crucial for accurate diagnosis and management.
  • Specific gene defects correlate with distinct TFT patterns, guiding clinical suspicion and genetic testing.
  • Further research into genetic variants will advance thyroid physiology understanding and therapeutic strategies.