Reversible and irreversible inhibition of thyroid peroxidase-catalyzed iodination by thioureylene drugs

The mechanism of reversible and irreversible inhibition of thyroid peroxidase (TPO)-catalyzed iodination by thioureylene drugs was investigated using a model incubation system. The major observations may be summarized as follows. 1) TPO is inactivated by 1-methyl-2-mercaptoimidazole and propylthiouracil even in the presence of a relatively high concentration of iodide. The extent of this inactivation depends on the ratio of iodide to drug. 2) Spectral changes observed on oxidation of the drugs with the peroxidase-iodide system were very similar to those observed when the drugs were oxidized nonenzymatically with I3-. These findings support the view that oxidized iodine is an intermediate in TPO-catalyzed oxidation of the drugs. 3) Under conditions where TPO is largely inactivated, inhibition of iodination is complete and irreversible. Drug metabolism, on the other hand, occurs to a limited extent. 4) Under conditions where TPO is only partially inactivated, inhibition of iodination is transient (reversible). In this case, drug metabolism is extensive, and higher oxidation products (sulfate and sulfinic acid) are observed. Inhibition of iodination occurs only during the interval required to reduce the drug concentration to a low level. Thereafter, iodination may occur at a rate close to that observed in the absence of drug. Based on these and other observations, a scheme is presented to explain the mechanism of reversible and irreversible inhibition of iodination. In essence, the type of inhibition depends on the relative rates and extent of TPO inactivation and drug oxidation. These rates, in turn, depend primarily on the iodide to drug concentration ratio. A high ratio favors extensive drug oxidation and reversible inhibition. A low ratio favors TPO inactivation and irreversible inhibition.

Kinetic evidence suggesting two mechanisms for iodothyronine 5'-deiodination in rat cerebral cortex

Enzymatic 5'-deiodination of 3,3',5'-triiodothyronine (rT3) and 3,3',5,5'-tetraiodothyronine (thyroxine, T4) was studied in microsomal preparations of rat cerebral cortex. Evidence was obtained for the existence of two thiol-dependent 5'-deiodinase entities. One of these predominates in tissue from euthyroid and long-term hypothyroid rats, is specific for rT3, follows "ping-pong" kinetics with dithiothreitol as the cosubstrate, and is inhibited by propylthiouracil (PrSUra) and iodoacetate. Inhibition by PrSUra is uncompetitive with rT3 and competitive with dithiothreitol. These properties are shared with the 5'-deiodinase activity of liver and kidney. The activity of a second type of 5'-deiodinase is highest in cerebral cortex from short-term hypothyroid rats, prefers T4 to rT3 as the substrate, is insensitive to PrSUra and iodoacetate, and follows "sequential" reaction kinetics. A similar PrSUra-insensitive 5'-deiodinase activity is also found in pituitary but is not detectable in liver and kidney; it seems, therefore, characteristic of tissues in which local T4 to 3,3',5-triiodothyronine (T3) conversion supplies a major portion of the total intracellular T3.

Preferential inhibition of thyroxine and 3,5,3'-triiodothyronine formation by propylthiouracil and methylmercaptoimidazole in thyroid peroxidase-catalyzed iodination of thyroglobulin

The present study was undertaken to determine whether the thioureylene antithyroid drugs propylthiouracil [6-propyl-2-thiouracil (PTU)] and methylmercaptoimidazole [1-methyl-2-mercaptoimidazole (MMI)] have a specific inhibitory effect on the thyroid peroxidase (TPO)-catalyzed conversion of diiodotyrosine to T4 (coupling reaction) independent of their well known inhibitory effect on peroxidase-catalyzed iodination. We have employed model incubation systems containing highly purified TPO to examine this question. Most experiments were performed with a model iodination system containing TPO, low iodine thyroglobulin, [131]iodide, and glucose-glucose oxidase. Both PTU and MMI are effective inhibitors of iodination of this system at physiological concentrations, and the system is well suited for studying the simultaneous action of these drugs on iodination and coupling. The addition of graded doses of the drugs to the iodination system demonstrated a relatively greater inhibitory effect on iodothyronine than on iodotyrosine formation. However, this observation in itself does not establish a specific inhibitory effect on coupling, since the formation of T4 involves a reaction between two molecules of 3,5-diiodotyrosine (DIT). The rate of this reaction, therefore, is second order with respect to DIT concentration, and the inhibition of DIT formation by thioureylene drugs would be expected to result in a disproportionately greater reduction in T4 formation even id there were no selective inhibitory effect of the drugs on the coupling reaction. Under certain conditions of incubation, however, it was possible to demonstrate a significant inhibitory effect on T4 and T3 formation without any decrease (in fact, a slight increase) in diiodotyrosine formation. These observations indicate that, at least under some conditions, PTU and MMI can exert a specific inhibitory effect on the coupling reaction. In the case of PTU, a specific inhibitory effect on coupling was also demonstrated with an incubation system in which TPO-catalyzed coupling was measured in the absence of iodination.

Inhibition of rat hepatic thyroxine 5'-monodeiodinase by propylthiouracil: relation to site of interaction of thyroxine and glutathione

When rat liver cytosol, dialyzed free of glutathione, was chromatographed on Sephadex G-100 after incubation with 35S-propylthiouracil, 2 peaks of bound radioactivity were observed, 1 of which contained nearly all the thyroxine 5'-monodeiodinase activity in rat liver cytosol. Binding of propylthiouracil to this peak was inhibited by glutathione but not by thyroxine. Approximately 25% of 35S-propylthiouracil initially bound to the thyroxine 5'-monodeiodinating activity peak remained bound after dialysis, precipitation with trichloroacetic acid, and multipe extractions with ethanol, methanol, and chloroform, suggesting that binding was at least in part covalent. Dialysis studies showed that the presumed covalent binding of 35S-propylthiouracil to the thyroxine 5'-monodeiodinase peak could be inhibited by glutathione, dithioerythritol, and unlabelled propylthiouracil but not by oxidized glutathione or thyroxine. Conversely, thyroxine binding was unaffected by thiol compounds. We studied the kinetics of thyroxine 5'-monodeiodination by radioimmunoassay techniques using rat liver homogenates as source of enzyme and observed the dependence of enzymic reaction upon glutathione (Km = 2.4 mM). Propylthiouracil inhibited the reaction and this inhibition could be overcome with increasing glutathione concentrations. We conclude that the thiol-dependent thyroxine 5'-monodeiodinase is inhibited by propylthiouracil through its covalent binding, probably as mixed disulfide, to s site on the enzyme at which glutathione interacts either as a cosubstrate or reducing agent. This binding site is separate from the site at which thyroxine binds.

Substrate requirement for inactivation of iodothyronine-5'-deiodinase activity by thiouracil

Preincubation of rat liver microsomal fraction with 1 microM 2-thiouracil and 0.01-1 microM 3,3',5'-triiodothyronine or 3',5'-diiodothyronine, 0.1-10 microM thyroxine or 3,5-diiodothyronine led to a progressive, irreversible and concomitant decrease in subsequently assayed 3,3',5'-triiodothyronine- and 3',5'-diiodothyronine-5'-deiodinase activity. Preincubation with thiouracil alone, with iodothyronines alone or with thiouracil and 10 microM thyronine or 3,5-diiodotyrosine had no or virtually no effect. The results indicate that (1) a previously proposed ping-pong mechanism for thyroid hormone deiodination, involving the formation of an enzyme-sulphenyl iodide intermediate, is correct; (2) thyroxine, 3,3',5'-triiodothyronine and 3',5'-diiodothyronine are substrates for a common 5'-deiodinase; (3) this 5'-deiodinase is not fully specific as regards the position of the iodine substituents in the substrate, since it also appears to catalyse the 5-deiodination of 3,5-diiodothyronine.

Opposite effects of thiocyanate on tyrosine iodination and thyroid hormone synthesis

The effect of a pseudohalide, SCN-, an anion with the same molecular size as iodide, was studied on two reactions: thyroglobulin iodination and thyroid hormone synthesis (coupling reaction) catalyzed by peroxidases. The coupling reaction was studied separately from the iodination reaction by using labelled thyroglobulin samples previously iodinated but containing little or no hormones. 1. SCN- inhibits iodide oxidation (I- leads to I2) whatever the enzyme, thyroid, lactoperoxidase or horseradish peroxidase. The amount of SCN- required to completely inhibit this reaction varies depending on the enzyme. Similarly tyrosine iodination is inhibited by SCN- with large variations, depending on the peroxidase, in the concentration of this anion required for inhibition. 2. In contrast SCN- stimulates the coupling reaction: (a) this affect is seen with the thyroid and lactoperoxidases but not with horseradish peroxidase; (b) the concentration of SCN- required for half-maximal stimulation of the coupling reaction is much lower (0.5-1 microM) than that required for the inhibition of iodide oxidation (60-80 microM); (c) ClO4(-), an anion with the same molecular size as SCN- and I-, has no effect on the coupling reaction; (d) this stimulatory effect of SCN- does not depend on a modification of the thyroglobulin molecule since it is not seen with horseradish peroxidase or in purely chemical coupling conditions. 3. The stimulatory effect of SCN- is therefore seen as resulting from the binding of this anion to a limited number of high-affinity sites present at the surface of both thyroid and lactoperoxidases. The inhibitory effect depends, in contrast, on the binding of SCN- to the substrate site with lower affinities. Since iodide also behaves both as a substrate for the iodination reaction and as a stimulatory ligand for the coupling reaction, these data provide further support in favour of the existence of an enzyme-iodide (or SCN-) complex with catalytic properties different from those of the native peroxidase.

Effects of phenylbutazone on thyroid iodine metabolism in vitro

Several alterations of thyroid function parameters have been reported in patients treated with phenylbutazone and we have studied the effect of this drug on the intrathyroidal iodine metabolism. An inhibition of the iodide transport expressed in terms of T/M ratios was observed in bovine thyroid slices incubated with high phenylbutazone concentrations. 10−3m produced 72% inhibition whereas lower concentrations showed no significant difference as compared with controls.

Iodotyrosine synthesis was affected by 10−4m and 10−5m phenylbutazone. Formation of iodothyronine synthesis was markedly affected between 10−4m and 10−7m phenylbutazone concentrations. Thyroid peroxidase activity was measured by tyrosine-iodinase, triiodide and guaiacol assays. Soluble, pseudosolubilized and crude peroxidase preparations from bovine glands, as well as the soluble enzyme from human thyroids, have shown inhibition of tyrosine-iodinase activity when incubated with phenylbutazone in concentrations ranging from 10−3m to 10−8m, with a Ki of 4 × 10−6m for bovine thyroid peroxidase and of 6 × 10−6m for human soluble peroxidase. Formation of triiodide was affected between 10−3m and 10−8m phenylbutazone concentrations. Guaiacol peroxidation was scarcely affected by the action of the drug.

We have concluded that phenylbutazone affects the intrathyroidal iodine metabolism through the inhibition of thyroid peroxidase in concentrations which are usually present in the sera of patients treated with this drug.

Effects of organic and inorganic mercurials on thyroidal functions

Acute effects of methylmercuric chloride and mercuric chloride on thyroidal functions were examined. The organic mercurial concentration of 4 x 10(-5) M inhibited by 50% of Na+K+ATPase in the membraneous preparation from the hog thyroid, and 6 x 10(-7) M of the inorganic mercurial showed the same extent of the inhibition. The Mg2+ ATPase activity in the preparation was neither affected by CH3HgCl up to a concentration of 2 x 10(-3) M, nor by HgCl2 up to 1 x 10(-4) M. After an intraperitoneal injection to mice of 5 micrograms of mercurial per gram body weight daily for 2 consecutive days, the 4-hour and the 24-hour uptakes of 131I by the thyroids were partially reduced by both organic and inorganic mercurials. A significant reduction in percentages of labeled iodothyronines was demonstrated to suggest that mercurial may cause a coupling defect in the synthesis of iodothyronines. Incubation of hog thyroglobulin with 8 x 10(-3) M of methylmercuric chloride caused no observable aberration in slab disc electrophoreogram, but the protein was apparently denatured by the same concentration of mercuric chloride suggesting that thyroglobulin may carry a large binding capacity against either mercurial, but the inorganic mercurial can be more potent denaturant of the protein. The in vitro lysosomal hydrolysis of the mercurial-pretreated rat thyroglobulin which was labeled with 125I in vivo and fortified with the carrier hog thyroglobulin was not affected, but the direct addition of either mercurial in the medium resulted in a significant inhibition of the proteolytic action. Iodotyrosine deiodinase in the thyroid was inhibited by both mercurials in in vitro and in vivo systems. A partial reduction in the serum bound 131I-iodide in both mercurial treated groups was observed at 4 hours and 24 hours after the radioiodide administration. The blood thyroxine levels estimated by radioimmunoassay were quite reduced in the inorganic mercurial treated group and also moderately reduced in the methylmercurial treated group, indicating that the hormone secretion was affected by mercurials.

Mechanism of inhibition of iodothyronine-5'-deiodinase by thioureylenes and sulfite

Previous studies have demonstrated that thiouracil inhibits the 5'-deiodination of 3,3',5'-triiodothyronine uncompetitively with respect to substrate and competitively with respect to cofactor (thiol compounds). This paper shows that sulfite is also a strong inhibitor of this reaction showing a dose-dependent effect between 1 microM and 1 mM. The mode of inhibition is similar to that described for thiouracil. Dose-dependent inhibition was also observed with thiosulfate (0.01-1 mM), iodide and thiocyanate (both greater than 1 mM). No effect was exerted by up to 10 mM cyanide and up to 100 mM azide. Methimazole and thiourea were weak inhibitors above 0.1 mM but inhibition did not reach completion. These experiments were carried out in the presence of 1 mM dithiothreitol. The effect of thiouracil was found to be competitively obviated by methimazole and thiourea. However, the effect of sulfite and that of methimazole or thiourea were additive. It is proposed that an enzyme-sulfenyl iodide is formed during deiodination (ping-pong mechanism). This sulfenyl iodide may be reduced by cofactor to yield native enzyme. It may also react with thioureylenes, yielding mixed disulfides, or with sulfite, yielding a thiosulfate. The enzyme-methimazole disulfide is apparently less stable than the enzyme-thiouracil complex. It is suggested that sulfite also reacts with the enzyme-thioureylene disulfide.

Mechanism of action of iodothyronine-5'-deiodinase

Production of 3,3'-di-iodothyronine (3,3'-T2) from 3,3',5'-tri-iodothyronine (reverse T3, rT3) as catalysed by rat liver microsomal fraction was measured with a specific radioimmunoassay. The effect of the addition of 2-thiouracil and of varying concentrations of cofactor (dithiothreito) on the kinetic parameters of this reaction were studied. It was found that thiouracil is an uncompetitive inhibitor with respect to substrate and a competitive inhibitor with respect to cofactor. The effect of a decrease in the concentration of cofactor was similar to the effect of addition of thiouracil, i.e. a proportional decrease in Km and V. The results strongly suggest that enzymatic 5'-deiodination of iodothyronines follows a ping-pong mechanisms, which may be envisaged as a transiodination and the subsequent reduction of the iodo-enzyme complex by cofactor. The intermediate is probably a sulfenyl iodide form of the enzyme, which reacts with thiouracil to yield a mixed disulfide.

Rapid conversion of carbimazole to methimazole in serum; evidence for an enzymatic mechanism

Carbimazole (CBZ) is one of the major drugs currently used for the treatment of Graves' disease. It is a carbethoxy derivative of methimazole (MMI), originally developed in the hope of obtaining a longer acting drug than methimazole. In the present study we have demonstrated that carbimazole is rapidly converted to methimazole in vitro by serum from rats and humans, and we have obtained evidence that this conversion is enzymatic. Experiments with [35S] CBZ in rats showed that the drug is so rapidly transformed to MMI after i.v. injection (within 3 min) that very little of the unchanged drug would be expected to reach the thyroid gland. The antithyroid action of CBZ in rats, therefore, can be ascribed entirely to the MMI to which it is rapidly converted. Although no experiments were performed with human subjects in vivo, the very rapid conversion of CBZ to MMI by human serum in vitro suggests that the antithyroid action of CBZ in humans can also be attributed to MMI. The original expectation of a longer acting drug has, therefore, not been met by CBZ. On the basis of the studies reported here there appears to be no advantage in using CBZ in preference to MMI for the treatment of Graves' disease. Although the in vivo action of CBZ must be attributed to its rapid conversion to MMI, the drug does possess inherent antithyroid activity. This was shown in the present study by the finding that CBZ is as potent as MMI in blocking thyroid peroxidase-catalysed iodination of thyroglobulin.

Thiourea and cyanamide as inhibitors of thyroid peroxidase: the role of iodide

Thiourea, methylmercaptoimidazole, propylthiouracil, and thiouracil are all potent inhibitors of thyroid peroxidase (TPO)-catalyzed iodination. Unlike the cyclic thioureylenes, thiourea at 5 mM has no effect on guaiacol oxidation. If iodide is added to guaiacol assays containing thiourea, enzyme activity is lost. The latter observation may be explained as follows. In the presence of iodide, the iodinating species [TPO.Ioxid], oxidizes thiourea to formamidine disulfide. This product decomposes to cyanamide at neutral pH. We have shown cyanamide to be an inhibitor of the peroxidative and iodinating functions of TPO. Studies in rats demonstrate that doses of thiourea which completely inhibit in vivo protein-bound iodine formation have no irreversible effect on TPO, as measured by guaiacol peroxidation after removal of the thyroids. The major in vivo action of cyanamide is similar to that of thiourea. The data suggest that the primary in vivo and in vitro mode of action of thiourea is the reversible Ioxid-trapping mechanism. The anomalous inhibition of guaiacol peroxidation seen in the presence of thiourea plus iodide derives from the formation of formamide disulfide, followed by its nonenzymic decomposition to cyanamide.

The irreversible inactivation of thyroid peroxidase by methylmercaptoimidazole, thiouracil, and propylthiouracil in vitro and its relationship to in vivo findings

A reinvestigation of the mechanism of action of methylmercaptoimidazole, propylthiouracil, and thiouracil on thyroid peroxidase (TPO) was undertaken. A preliminary incubation of TPO and H2O2 with methylmercaptoimidazole, propylthiouracil, or thiouracil was carried out in the absence of oxidizable substrates (i.e. I- or guaiacol). This incubation resulted in irreversible inactivation of TPO. The extent of inactivation could be determined after removal of the drug by gel filtration or by dilution into the assay mixture. Preincubation, as above, in the presence of iodide or thiocyanate prevented the irreversible inactivation of TPO. Rats receiving doses of these drugs which completely inhibited protein-bound iodine formation showed normal levels of TPO in their thyroid glands 30 min after drug administration. These findings suggest that the initial in vivo action of these drugs is to block iodination by trapping oxidized iodide, not by acting as "general inhibitors" of the TPO.

Effect of antithyroid agents 6-propyl-2-thiouracil and 1-mehtyl-2-mercaptoimidazole on human thyroid iodine peroxidase

The mechanism of inhibition of human thyroid iodide peroxidase (TPO) by 6-propyl-2-thiouracil (PTU) and 1-methyl-2-mercaptoimidazole (MMI) used in the therapy of hyperthyroid patients was studied in vitro. The inhibition of TPO by MMI was not restored either by dialysis or by dilution, but the inhibition by PTU was restored by both treatments. PTU interacted directly with the product of TPO action (oxidized iodide) in the reaction mixture without significantly affecting TPO activity. MMI interacted directly with TPO and inhibited enzyme activity, rather than interacting with the product (oxidized iodide). The inhibition was irreversible with MMI, but reversible with PTU. The concentrations of PTU and MMI producing 50% inhibition of TPO were 2 x 10-6m and 8 x 10-7m, respectively, 2-Mercaptoimidazole inhibited TPO reversibly but 1-methylimidazole and imidazole did not. Both the methyl and mercaptoresidues in MMI moiety are thought to be essential to its irreversible inhibition of TPO. The in vivo effect of MMI and PTU on TPO activity was also studied. TPO activities in the thyroid homogenate of rats to which MMI (2 mg per rat) or PTU (10 mg per rat) had been administered intraperitoneally were determined before and after dialysis against buffer. TPO activity in the PTU treated thyroid homogenate was significantly lower than that in the control before dialysis, but the activity was restored to the control value after dialysis. On the contrary, TPO activity in the MMI treated thyroid homogenate was significantly lower than that in the control and was not affected by dialysis. These data may explain why MMI is a more potent inhibitor of iodination than PTU and may fit the clinical results observed when hyperthyroid patients are treated with these agents.