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Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model
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An update on non-thyroidal illness syndrome.

E Fliers1, A Boelen2

  • 1Department of Endocrinology and Metabolism, Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. e.fliers@amsterdamumc.nl.

Journal of Endocrinological Investigation
|December 15, 2020
PubMed
Summary
This summary is machine-generated.

Non-thyroidal illness syndrome (NTIS) involves altered thyroid hormone (TH) levels in severe illness, impacting patient outcomes. Research shows tissue TH levels vary by organ, and more trials are needed to guide treatment.

Keywords:
DeiodinaseLow T3 syndromeSick euthyroid syndromeT3T4THTRHTSHrT3

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Area of Science:

  • Endocrinology
  • Critical Care Medicine
  • Molecular Biology

Background:

  • Non-thyroidal illness syndrome (NTIS) is characterized by significant changes in serum thyroid hormone (TH) concentrations during severe illness.
  • NTIS is linked to increased morbidity and mortality, making it a critical area of study in critical care.
  • Recent findings highlight the role of parenteral nutrition in influencing NTIS and patient outcomes.

Purpose of the Study:

  • To explore the complex mechanisms underlying NTIS, including organ-specific changes in TH concentrations.
  • To investigate the role of molecular factors like TH transporters, receptors, and deiodinases in NTIS.
  • To clarify the involvement of inflammatory pathways and TH metabolism in innate immune cells.

Main Methods:

  • Review of experimental animal and clinical studies on TH concentrations in critical illness.
  • Analysis of molecular studies focusing on organ-specific TH transport and metabolism.
  • Examination of research on the role of inflammatory pathways in NTIS.

Main Results:

  • Serum TH levels, particularly triiodothyronine (T3), decrease robustly in NTIS.
  • Tissue TH concentrations can vary significantly across different organs and illnesses, not always mirroring serum levels.
  • Inflammatory pathways and TH metabolism in immune cells are increasingly understood, though their clinical impact is still under investigation.

Conclusions:

  • NTIS is a complex endocrine response to critical illness with significant implications for patient prognosis.
  • Understanding organ-specific TH regulation and the role of molecular factors is crucial for comprehending NTIS.
  • Further high-quality randomized clinical trials are essential to determine the efficacy of TH supplementation in managing NTIS.