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Sheng MY, Peng DW, Peng HM, Zhang YL, Xiao L, Zhang MR, Wang SY, Zhao CP, Zhu SY, Lu JK, Lin L, Huang R, Nie J, Fang JB. Effective substances and molecular mechanisms guided by network pharmacology: An example study of Scrophulariae Radix treatment of hyperthyroidism and thyroid hormone-induced liver and kidney injuries. JOURNAL OF ETHNOPHARMACOLOGY 2024; 326:117965. [PMID: 38423410 DOI: 10.1016/j.jep.2024.117965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/02/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Scrophulariae Radix (Xuanshen [XS]) has been used for several years to treat hyperthyroidism. However, its effective substances and pharmacological mechanisms in the treatment of hyperthyroidism and thyroid hormone-induced liver and kidney injuries have not yet been elucidated. AIM OF THE STUDY This study aimed to explore the pharmacological material basis and potential mechanism of XS therapy for hyperthyroidism and thyroid hormone-induced liver and kidney injuries based on network pharmacology prediction and experimental validation. MATERIALS AND METHODS Based on 31 in vivo XS compounds identified using ultra-performance liquid chromatography tandem quadruple exactive orbitrap high-resolution accurate-mass spectrometry (UPLC-QE-HRMS), a network pharmacology approach was used for mechanism prediction. Systematic networks were constructed to identify the potential molecular targets, biological processes (BP), and signaling pathways. A component-target-pathway network was established. Mice were administered levothyroxine sodium through gavage for 30 d and then treated with different doses of XS extract with or without propylthiouracil (PTU) for 30 d. Blood, liver, and kidney samples were analyzed using an enzyme-linked immunosorbent assay (ELISA) and western blotting. RESULTS A total of 31 prototypes, 60 Phase I metabolites, and 23 Phase II metabolites were tentatively identified in the plasma of rats following the oral administration of XS extract. Ninety-six potential common targets between the 31 in vivo compounds and the diseases were identified. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis revealed that Bcl-2, BAD, JNK, p38, and ERK1/2 were the top targets. XS extract with or without PTU had the following effects: inhibition of T3/T4/fT3/fT4 caused by levothyroxine; increase of TSH levels in serum; restoration of thyroid structure; improvement of liver and kidney structure and function by elevating the activities of anti-oxidant enzymes catalase (CAT),superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px); activation anti-apoptotic proteins Bcl-2; inhibition the apoptotic protein p-BAD; downregulation inflammation-related proteins p-ERK1/2, p-JNK, and p-p38; and inhibition of the aggregation of pro-inflammatory cytokines TNF-α, IL-1β, and IL-6, as well as immune cells in the liver. CONCLUSION XS can be used to treat hyperthyroidism and liver and kidney injuries caused by thyroid hormones through its anti-oxidant, anti-inflammatory, and anti-apoptotic properties. In addition, serum pharmacochemical analysis revealed that five active compounds, namely 4-methylcatechol, sugiol, eugenol, acetovanillone, and oleic acid, have diverse metabolic pathways in vivo and exhibit potential as effective therapeutic agents.
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Affiliation(s)
- Meng-Yuan Sheng
- School of Pharmacy, Hubei University of Traditional Chinese Medicine, Wuhan, 430065, China; School of Pharmacy, Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China; Hubei Institute for Drug Control, Wuhan, 430064, China; Department of Anatomy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - De-Wei Peng
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Hui-Ming Peng
- Department of Anatomy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Ya-Li Zhang
- School of Pharmacy, Hubei University of Traditional Chinese Medicine, Wuhan, 430065, China.
| | - Ling Xiao
- Hubei Institute for Drug Control, Wuhan, 430064, China.
| | - Meng-Ru Zhang
- School of Pharmacy, Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Si-Yu Wang
- School of Pharmacy, Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Chuan-Peng Zhao
- School of Pharmacy, Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Si-Ying Zhu
- School of Pharmacy, Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Jian-Kang Lu
- School of Pharmacy, Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Li Lin
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Rong Huang
- Department of Ophthalmology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430061, Hubei, China; Hubei Key Laboratory of Theory and Application Research of Liver and Kidney in Traditional Chinese Medicine, China.
| | - Jing Nie
- School of Pharmacy, Hubei University of Traditional Chinese Medicine, Wuhan, 430065, China; Hubei Institute for Drug Control, Wuhan, 430064, China.
| | - Jin-Bo Fang
- School of Pharmacy, Hubei Key Laboratory of Natural Medicinal Chemistry and Resource Evaluation, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Sabra MK, Joudeh A, Al Niserat M, Hammamy R. A young patient with Graves' disease presenting with a triad of heart failure, pancytopenia, and jaundice: A case report. Clin Case Rep 2024; 12:e8698. [PMID: 38681046 PMCID: PMC11043085 DOI: 10.1002/ccr3.8698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 05/01/2024] Open
Abstract
Key Clinical Message Graves's disease must be treated promptly to avoid serious sequelae such as cardiomyopathy, liver injury, and pancytopenia. Early initiation of antithyroid medications and beta blockers could not be overrated even in the presence of these complications. Abstract Graves' disease causes a large spectrum of clinical manifestations. Delayed diagnosis and management of Graves' disease could lead to serious systemic sequelae. We describe a case of a young man who presented with progressive cough, increased abdominal girth and ankle swelling for a few months. On examination, he had jaundice, bilateral exophthalmos, diffuse goiter, ascites, and significant lower limb edema. Laboratory investigations showed increased Thyroxin level with a suppressed thyroid stimulating hormone and positive anti-thyrotropin receptor antibodies. Also, the patient had pancytopenia, coagulopathy and cholestatic pattern of elevated liver enzymes. Echocardiography demonstrated mildly reduced left ventricular function with diastolic dysfunction, but electrocardiogram did not show atrial fibrillation. Despite the concerns about using antithyroid medications in patients with impaired liver function tests and pancytopenia, the patient improved dramatically without worsening of his hematological or biochemical parameters. Early initiation of antithyroid medications and beta blockers is essential for patients who are newly diagnosed with hyperthyroidism.
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Affiliation(s)
- Mohamed Kamal Sabra
- Department of Internal MedicineAl‐Khor Hospital, Hamad Medical CorporationDohaQatar
| | - Anwar Joudeh
- Department of Internal MedicineAl‐Khor Hospital, Hamad Medical CorporationDohaQatar
- Internal Medicine, Collage of MedicineUniversity of QatarDohaQatar
| | | | - Riyadh Hammamy
- Department of Internal MedicineAl‐Khor Hospital, Hamad Medical CorporationDohaQatar
- Internal Medicine, Collage of MedicineUniversity of QatarDohaQatar
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Quiroz-Aldave JE, Gamarra-Osorio ER, Durand-Vásquez MDC, Rafael-Robles LDP, Gonzáles-Yovera JG, Quispe-Flores MA, Concepción-Urteaga LA, Román-González A, Paz-Ibarra J, Concepción-Zavaleta MJ. From liver to hormones: The endocrine consequences of cirrhosis. World J Gastroenterol 2024; 30:1073-1095. [PMID: 38577191 PMCID: PMC10989500 DOI: 10.3748/wjg.v30.i9.1073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/02/2024] [Accepted: 02/06/2024] [Indexed: 03/06/2024] Open
Abstract
Hepatocrinology explores the intricate relationship between liver function and the endocrine system. Chronic liver diseases such as liver cirrhosis can cause endocrine disorders due to toxin accumulation and protein synthesis disruption. Despite its importance, assessing endocrine issues in cirrhotic patients is frequently neglected. This article provides a comprehensive review of the epidemiology, pathophysiology, diagnosis, and treatment of endocrine disturbances in liver cirrhosis. The review was conducted using the PubMed/Medline, EMBASE, and Scielo databases, encompassing 172 articles. Liver cirrhosis is associated with endocrine disturbances, including diabetes, hypoglycemia, sarcopenia, thyroid dysfunction, hypogonadotropic hypogonadism, bone disease, adrenal insufficiency, growth hormone dysfunction, and secondary hyperaldosteronism. The optimal tools for diagnosing diabetes and detecting hypoglycemia are the oral glucose tolerance test and continuous glucose monitoring system, respectively. Sarcopenia can be assessed through imaging and functional tests, while other endocrine disorders are evaluated using hormonal assays and imaging studies. Treatment options include metformin, glucagon-like peptide-1 analogs, sodium-glucose co-transporter-2 inhibitors, and insulin, which are effective and safe for diabetes control. Established standards are followed for managing hypoglycemia, and hormone replacement therapy is often necessary for other endocrine dysfunctions. Liver transplantation can address some of these problems.
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Affiliation(s)
| | | | | | | | | | | | | | - Alejandro Román-González
- Department of Endocrinology, Hospital Universitario de San Vicente Fundación, Medellin 050010, Colombia
- Internal Medicine, Universidad de Antioquia, Medellín 050010, Colombia
| | - José Paz-Ibarra
- School of Medicine, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru
- Department of Endocrinology, Hospital Nacional Edgardo Rebagliati Martins, Lima 15072, Peru
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Yorke E. Co-Morbid Hypothyroidism and Liver Dysfunction: A Review. Clin Med Insights Endocrinol Diabetes 2024; 17:11795514241231533. [PMID: 38348020 PMCID: PMC10860496 DOI: 10.1177/11795514241231533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/11/2024] [Indexed: 02/15/2024] Open
Abstract
The liver and thyroid hormones interact at multiple levels to maintain homoeostasis. The liver requires large adequate amounts of thyroid hormones to execute its metabolic functions optimally, and deficiency of thyroid hormones may lead to liver dysfunction. Hypothyroidism has been associated with abnormal lipid metabolism, non-alcoholic fatty liver disease (NAFLD), hypothyroidism-induced myopathy, hypothyroidism-associated gallstones and occasionally, interferon-induced thyroid dysfunction. NAFLD remain an important association with hypothyroidism and further studies are needed that specifically compare the natural course of NAFLD secondary to hypothyroidism and primary NAFLD. Hepatic dysfunction associated with hypothyroidism is usually reverted by normalizing thyroid status. Large scale studies geared towards finding new and effective therapies, especially for NAFLD are needed. The clinician must be aware that there exists overlapping symptomatology between liver dysfunction and severe hypothyroidism which may make delay the diagnosis and treatment of hypothyroidism; this requires a high index of suspicion.
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Affiliation(s)
- Ernest Yorke
- Department of Medicine & Therapeutics, University of Ghana Medical School, Accra, Ghana
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Kawara RS, Moawed FS, Elsenosi Y, Elmaksoud HA, Ahmed ESA, Abo-Zaid OA. Melissa officinalis extract palliates redox imbalance and inflammation associated with hyperthyroidism-induced liver damage by regulating Nrf-2/ Keap-1 gene expression in γ-irradiated rats. BMC Complement Med Ther 2024; 24:71. [PMID: 38303002 PMCID: PMC10832092 DOI: 10.1186/s12906-024-04370-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 01/22/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Melissa officinalis (MO) is a well-known medicinal plant species used in the treatment of several diseases; it is widely used as a vegetable, adding flavour to dishes. This study was designed to evaluate the therapeutic effect of MO Extract against hyperthyroidism induced by Eltroxin and γ-radiation. METHODS Hyperthyroidism was induced by injecting rats with Eltroxin (100 µg/kg/ day) for 14 days and exposure to γ-radiation (IR) (5 Gy single dose). The hyperthyroid rats were orally treated with MO extract (75 mg/kg/day) at the beginning of the second week of the Eltroxin injection and continued for another week. The levels of thyroid hormones, liver enzymes and proteins besides the impaired hepatic redox status and antioxidant parameters were measured using commercial kits. The hepatic gene expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and its inhibitor Kelch-like ECH-associated protein-1(Keap-1) in addition to hepatic inflammatory mediators including tumor necrosis factor-α (TNF- α), Monocyte chemoattractant protein-1 (MCP-1) and fibrogenic markers such as transforming growth factor-beta1 (TGF-β1) were determined. RESULTS MO Extract reversed the effect of Eltroxin + IR on rats and attenuated the thyroid hormones. Moreover, it alleviated hyperthyroidism-induced hepatic damage by inhibiting the hepatic enzymes' activities as well as enhancing the production of proteins concomitant with improving cellular redox homeostasis by attenuating the deranged redox balance and modulating the Nrf2/Keap-1 pathway. Additionally, MO Extract alleviated the inflammatory response by suppressing the TNF- α and MCP-1 and prevented hepatic fibrosis via Nrf2-mediated inhibition of the TGF-β1/Smad pathway. CONCLUSION Accordingly, these results might strengthen the hepatoprotective effect of MO Extract in a rat model of hyperthyroidism by regulating the Nrf-2/ Keap-1 pathway.
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Affiliation(s)
- Ragaa Sm Kawara
- Biochemistry and Molecular Biology Department, Faculty of Vet. Med, Benha University, Banha, Egypt
| | - Fatma Sm Moawed
- Health radiation research, National Center for Radiation Research and Technology, Egyptian Atomic Energy Authority, Nasr City, 11787, Cairo, Egypt
| | - Yakout Elsenosi
- Biochemistry and Molecular Biology Department, Faculty of Vet. Med, Benha University, Banha, Egypt
| | - Hussein Abd Elmaksoud
- Biochemistry and Molecular Biology Department, Faculty of Vet. Med, Benha University, Banha, Egypt
| | - Esraa S A Ahmed
- Radiation Biology Research, National Center for Radiation Research and Technology, Egyptian Atomic Energy Authority, Nasr City, 11787, Cairo, Egypt.
| | - Omayma Ar Abo-Zaid
- Biochemistry and Molecular Biology Department, Faculty of Vet. Med, Benha University, Banha, Egypt
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Ibraheem A, Abdullah A. Thyrotoxic Cardiomyopathy Unveiled: Insights From a Compelling Case Report. Cureus 2023; 15:e51172. [PMID: 38283537 PMCID: PMC10817802 DOI: 10.7759/cureus.51172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Thyrotoxicosis is a clinical condition characterized by inappropriately elevated thyroid hormone levels in the bloodstream, leading to systemic effects on the body. In fact, the thyrotoxic state has tight regulatory control over the cardiovascular system through genomic and non-genomic mechanisms. This study highlights a rare presentation of thyrotoxic cardiomyopathy (TCM), which, to the best of our knowledge, is one of the very few case reports involving heart failure with preserved ejection fraction (HFpEF) and only atrial involvement, compared to the previous literature. A 37-year-old female presented to the outpatient clinic with abdominal distention and neglected signs and symptoms consistent with thyrotoxicosis for a year. Investigations revealed high N-terminal pro-b-type natriuretic peptide (NT-proBNP) levels of 1788 pg/mL. Cardiac MRI and trans-thoracic echocardiogram (TTE) revealed bilateral atrial dilatation, a left ventricular ejection fraction (LVEF) of 60%, and diastolic dysfunction. Additionally, severe free-flowing tricuspid and mitral valve regurgitation were observed, with no evidence of pericardial effusion or ventricular abnormalities. Therefore, a diagnosis of TCM was suspected and eventually confirmed by excluding other differential diagnoses. Besides a diffuse goiter on ultrasonography, the thyroid panel test revealed low thyroid-stimulating hormone (TSH) levels of <0.01 mIU/L, a free thyroxine T4 of >100 pmol/L, and positive anti-thyroid peroxidase (TPO) and TSH receptor antibodies. Accordingly, a team of endocrinologists, cardiologists, and internists managed the patient with anti-thyroid medications alongside symptomatic treatment. A few days later, she was discharged in good condition, and a follow-up visit was arranged with the endocrinology and cardiology clinics. It is crucial to maintain a high level of suspicion to detect and treat TCM promptly, and a multidisciplinary approach should ideally be employed. This is not only important for the prevention of but also reversing potentially life-threatening cardiovascular complications.
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Affiliation(s)
- Anas Ibraheem
- Internal Medicine/Clinical Hematology, Al Karama Teaching Hospital, Baghdad, IRQ
| | - Abdullah Abdullah
- General Medicine, Frimley Health NHS Foundation Trust/Wexham Park Hospital, Slough, GBR
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Hutchison AL, Tavaglione F, Romeo S, Charlton M. Endocrine aspects of metabolic dysfunction-associated steatotic liver disease (MASLD): Beyond insulin resistance. J Hepatol 2023; 79:1524-1541. [PMID: 37730124 DOI: 10.1016/j.jhep.2023.08.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 09/22/2023]
Abstract
While the association of metabolic dysfunction-associated steatotic liver disease (MASLD) with obesity and insulin resistance is widely appreciated, there are a host of complex interactions between the liver and other endocrine axes. While it can be difficult to definitively distinguish direct causal relationships and those attributable to increased adipocyte mass, there is substantial evidence of the direct and indirect effects of endocrine dysregulation on the severity of MASLD, with strong evidence that low levels of growth hormone, sex hormones, and thyroid hormone promote the development and progression of disease. The impact of steroid hormones, e.g. cortisol and dehydroepiandrosterone, and adipokines is much more divergent. Thoughtful assessment, based on individual risk factors and findings, and management of non-insulin endocrine axes is essential in the evaluation and management of MASLD. Multiple therapeutic options have emerged that leverage various endocrine axes to reduce the fibroinflammatory cascade in MASH.
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Affiliation(s)
| | - Federica Tavaglione
- Clinical Medicine and Hepatology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy; Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy; Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Stefano Romeo
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Cardiology Department, Sahlgrenska University Hospital, Gothenburg, Sweden; Clinical Nutrition Unit, Department of Medical and Surgical Sciences, University Magna Graecia, Catanzaro, Italy
| | - Michael Charlton
- Center for Liver Diseases, University of Chicago, United States.
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Cheng CW, Fang WF, Lin JD. Associations of serum keratin 1 with thyroid function and immunity in Graves' disease. PLoS One 2023; 18:e0289345. [PMID: 38019813 PMCID: PMC10686460 DOI: 10.1371/journal.pone.0289345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 07/08/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Autoimmune thyroid disease (AITD) can cause enormous health burdens; however, trustworthy biomarkers in identifying the onset and progression of AITD are limited. In this study, we attempted to discover new potential serum biomarkers to discriminate AITD using mass spectrometry (MS). METHODS In the biomarker study cohort, 20 patients with Graves' disease (GD), 20 patients with Hashimoto's thyroiditis (HT), and 20 healthy controls were enrolled for a liquid chromatographic-tandem MS assessment. A novel biomarker, keratin 1 (KRT1), was selected for further evaluation in the validation cohort, including 125 patients with GD, 34 patients with HT, and 77 controls. Relationships of serum KRT1 with AITD-related immunomodulatory cytokines were also analyzed using enzyme-linked immunosorbent assays (ELISAs). RESULTS In the MS analysis, KRT1 was the single marker overexpressed in GD, while it was underexpressed in HT. In the ELISA analysis of the validation cohort, KRT1 was consistently upregulated in GD, while it was not downregulated in HT. There were significant associations of KRT1 levels with thyroid function in GD, AITD, and overall subjects. Additionally, a significant association of KRT1 levels with thyroid-stimulating hormone receptor antibody (TSHRAb) levels was observed. Moreover, there were significant associations of KRT1 with osteopontin (OPN) and B-cell activating factor (BAFF) levels in GD. CONCLUSIONS Serum KRT1 levels were upregulated in GD and were associated with thyroid function and TSHRAb levels. Moreover, KRT1 was correlated with the BAFF and OPN levels in GD patients. Further molecular-based research to elucidate the role of KRT1 in the pathogenesis of AITD is needed.
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Affiliation(s)
- Chao-Wen Cheng
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Traditional Herb Medicine Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
- Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | | | - Jiunn-Diann Lin
- Department of Internal Medicine, Division of Endocrinology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Wang CC, Lin CH, Chou HW, Wang CT, Liang YC, Wu HT, Ou HY. Compensatory Increase of Serum Hepassocin Protects Hyperthyroidism-Induced Hepatic Dysfunction. Biomedicines 2023; 11:1936. [PMID: 37509575 PMCID: PMC10377103 DOI: 10.3390/biomedicines11071936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/02/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
Hepatic dysfunction is commonly observed in subjects with hyperthyroidism. Hepassocin is a hepatokine playing an important role in metabolic diseases and exhibiting a hepatic protective effect. Nevertheless, the relationship between hepassocin and hyperthyroidism was still unknown. In the present study, a total of 36 subjects with Graves' disease were enrolled, and we found that the alanine aminotransferase (ALT) levels were significantly decreased in parallel with the decrement in serum hepassocin concentrations at 6 months after standard treatment for hyperthyroidism. In addition, HepG2 cell line was used to investigate the role of hepassocin in hyperthyroidism-induced hepatic dysfunction. Treatment of hepassocin recombinant protein in HepG2 cells dose-dependently decreased triiodothyronine (T3)-induced ALT and aspartate aminotransferase (AST) elevation. Moreover, hepassocin significantly increased the expression of phosphoenolpyruvate carboxykinase (PEPCK) in a dose-dependent manner. Deletion of hepassocin in HepG2 cells reversed the effects of T3 on PEPCK expressions. Furthermore, we found that T3 increased the expression of hepassocin through a hepatocyte nuclear factor 1α-dependent pathway. Taken together, these results indicated a compensatory increase in serum hepassocin might have a protective role in hyperthyroidism-induced hepatic dysfunction.
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Affiliation(s)
- Chih-Chen Wang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Ching-Han Lin
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Hsuan-Wen Chou
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Chung-Teng Wang
- Department of Internal Medicine, School of Medicine, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan
| | - Yu-Cheng Liang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Hung-Tsung Wu
- Department of Internal Medicine, School of Medicine, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan
| | - Horng-Yih Ou
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Internal Medicine, School of Medicine, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan
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10
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Li C, Wang KL, Hu JH, Su HB. Clinical manifestations and early effectiveness of methimazole in patients with graves' hyperthyroidism-related severe hepatic dysfunction. Scand J Gastroenterol 2023; 58:1514-1522. [PMID: 37545358 DOI: 10.1080/00365521.2023.2244107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/29/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Graves' hyperthyroidism (GH) is often accompanied by mild to moderate liver injury, but severe hepatic dysfunction (SHD) is relatively rare. Whether patients with GH-related SHD can be treated with methimazole (MMI) remains controversial. This study aimed to determine the clinical characteristics and to evaluate the role of low-dose MMI for such patients. METHODS 33 patients with GH-related SHD were selected for this retrospective study in the Fifth Medical Center of Chinese PLA General Hospital from January 2017 to July 2022. The clinical manifestations, therapeutic responses, and effectiveness of MMI were evaluated. RESULTS Systemic jaundice (100.0%), yellow urine (100.0%), fatigue (87.9%), and goiter (66.7%) were the main symptoms. Total bilirubin (TBIL) had no linear correlation with free triiodothyronine (FT3) (r = -0.023, p = .899), free thyroxine (FT4) (r = 0.111, p = .540), T3 (r = -0.144, p = .425), and T4 (r = 0.037, p = .837). On the 14th day after admission, FT3, FT4, T3, T4, TBIL, direct bilirubin (DBIL), alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), γ-glutamyltransferase (GGT), and international normalized ratio (INR) decreased compared with the baseline (p < .05). The decrease rates of FT3, FT4, T3, T4, TBIL, and DBIL in the MMI group were higher than those in the non-MMI group (p < .05). The improvement rate of the MMI group (77.8%) was higher than that of the non-MMI group (9.5%, p = .001). MMI treatment is an independent predictor affecting the early improvement of patients (OR = 0.022, p = .010). CONCLUSIONS The main clinical manifestations of patients with GH-related SHD were symptoms related to liver disease. Low-dose MMI was safe and effective for them.
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Affiliation(s)
- Chen Li
- Department of Hepatology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
- Clinical Medical School, Peking University, Beijing, China
| | - Kai-Li Wang
- Department of Hepatology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
- Clinical Medical School, Peking University, Beijing, China
| | - Jin-Hua Hu
- Department of Hepatology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
- Clinical Medical School, Peking University, Beijing, China
| | - Hai-Bin Su
- Department of Hepatology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
- Clinical Medical School, Peking University, Beijing, China
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11
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Christidis G, Krawczyk M, Haberkorn B. Hepatopathy in Graves Thyrotoxicosis. Am J Med 2023:S0002-9343(23)00211-5. [PMID: 37001719 DOI: 10.1016/j.amjmed.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 04/24/2023]
Affiliation(s)
- Grigorios Christidis
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany; Endokrinologikum Ulm, Ulm, Germany.
| | - Marcin Krawczyk
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany; Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Centre for Preclinical Research, Medical University of Warsaw, Poland
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12
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Makris K, Mousa C, Cavalier E. Alkaline Phosphatases: Biochemistry, Functions, and Measurement. Calcif Tissue Int 2023; 112:233-242. [PMID: 36571614 DOI: 10.1007/s00223-022-01048-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/01/2022] [Indexed: 12/27/2022]
Abstract
Alkaline phosphatases (ALPs) are a group of isoenzymes, situated on the external layer of the cell membrane; they catalyze the hydrolysis of organic phosphate esters present in the extracellular space. Zinc and magnesium are significant co-factors for the biological activity of these enzymes. Although ALPs are available in various body tissues and have distinct physiochemical properties, they are true isoenzymes since they catalyze a similar reaction. In the liver, ALP is cytosolic and present in the canalicular membrane of the hepatocytes. ALPs are available in placenta, ileal mucosa, kidney, bone, and liver. However, most of the ALPs in serum (over 80%) are delivered from liver and bone and in more modest quantities from the intestines. Despite the fact that alkaline phosphatases are found in numerous tissues all through the body, their exact physiological function remains largely unknown.
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Affiliation(s)
- Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, Kifissia, Athens, Greece
- Laboratory for the Research of Musculoskeletal System "Th. Garofalidis", School of Medicine, National and Kapodistrian, University of Athens, Athens, Greece
| | - Chagigia Mousa
- 6th Orthopedic Department, KAT General Hospital, Kifissia, Athens, Greece
| | - Etienne Cavalier
- Department of Clinical Chemistry, CIRM, University of Liege, CHU de Liège, CHU Sart-Tilman, B-4000, Liège, Belgium.
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13
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Song Y, Wang X, Ma W, Yang Y, Yan S, Sun J, Zhu X, Tang Y. Graves' disease as a driver of depression: a mechanistic insight. Front Endocrinol (Lausanne) 2023; 14:1162445. [PMID: 37152963 PMCID: PMC10157224 DOI: 10.3389/fendo.2023.1162445] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/05/2023] [Indexed: 05/09/2023] Open
Abstract
Graves' disease (GD) is characterized by diffuse enlargement and overactivity of the thyroid gland, which may be accompanied by other physical symptoms. Among them, depression can dramatically damage patients' quality of life, yet its prevalence in GD has not received adequate attention. Some studies have established a strong correlation between GD and increased risk of depression, though the data from current study remains limited. The summary of mechanistic insights regarding GD and depression has underpinned possible pathways by which GD contributes to depression. In this review, we first summarized the clinical evidence that supported the increased prevalence of depression by GD. We then concentrated on the mechanistic findings related to the acceleration of depression in the context of GD, as mounting evidence has indicated that GD promotes the development of depression through various mechanisms, including triggering autoimmune responses, inducing hormonal disorders, and influencing the thyroid-gut-microbiome-brain axis. Finally, we briefly presented potential therapeutic approaches to decreasing the risk of depression among patients with GD.
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Affiliation(s)
- Yifei Song
- Beijing University of Chinese Medicine, Beijing, China
| | - Xinying Wang
- Beijing University of Chinese Medicine, Beijing, China
| | - Wenxin Ma
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yan Yang
- Tongling Municipal hospital, Anhui, China
| | - Shuxin Yan
- Beijing University of Chinese Medicine, Beijing, China
| | - Jiapan Sun
- Department of Geriatrics, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, Guangdong, China
- *Correspondence: Jiapan Sun, ; Xiaoyun Zhu, ; Yang Tang,
| | - Xiaoyun Zhu
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Jiapan Sun, ; Xiaoyun Zhu, ; Yang Tang,
| | - Yang Tang
- Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Jiapan Sun, ; Xiaoyun Zhu, ; Yang Tang,
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14
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Mazzilli R, Medenica S, Di Tommaso AM, Fabozzi G, Zamponi V, Cimadomo D, Rienzi L, Ubaldi FM, Watanabe M, Faggiano A, La Vignera S, Defeudis G. The role of thyroid function in female and male infertility: a narrative review. J Endocrinol Invest 2023; 46:15-26. [PMID: 35945393 PMCID: PMC9829629 DOI: 10.1007/s40618-022-01883-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/25/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE We herein aimed to review the new insights into the impact of impaired thyroid function on male and female fertility, spacing from spontaneous pregnancy to ART, with the objective of providing an updated narrative revision of the literature. METHODS This narrative review was performed for all available prospective, retrospective and review articles, published up to 2021 in PubMed. Data were extracted from the text and from the tables of the manuscript. RESULTS Thyroid dysfunction is frequently associated with female infertility, whereas its link with male infertility is debated. Female wise, impaired function is detrimental to obstetric and fetal outcomes both in spontaneous pregnancies and in those achieved thanks to assisted reproduction technologies (ART). Furthermore, the reference range of TSH in natural pregnancy and ART procedures has recently become a matter of debate following recent reports in this field. On the other hand, the impact of thyroid function on the male reproductive system is less clear, although a possible role is suggested via modulation of Sertoli and Leydig cells function and spermatogenesis. CONCLUSION Thyroid function should be carefully monitored in both male and female, in couples seeking spontaneous pregnancy as well as ART, as treatment is generally immediate and likely to improve chances of success.
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Affiliation(s)
- R Mazzilli
- Endocrinology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant' Andrea Hospital, Rome, Italy
| | - S Medenica
- Department of Endocrinology, Internal Medicine Clinic, Clinical Center of Montenegro, School of Medicine, University of Montenegro, Podgorica, Montenegro
| | - A M Di Tommaso
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy
| | - G Fabozzi
- Clinica Valle Giulia, GeneraLife IVF, Rome, Italy
| | - V Zamponi
- Endocrinology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant' Andrea Hospital, Rome, Italy
| | - D Cimadomo
- Clinica Valle Giulia, GeneraLife IVF, Rome, Italy
| | - L Rienzi
- Clinica Valle Giulia, GeneraLife IVF, Rome, Italy
| | - F M Ubaldi
- Clinica Valle Giulia, GeneraLife IVF, Rome, Italy
| | - M Watanabe
- Department of Experimental Medicine, Sapienza University of Rome, Viale Regina Elena, 328, 00161, Rome, Italy.
| | - A Faggiano
- Endocrinology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant' Andrea Hospital, Rome, Italy
| | - S La Vignera
- Department of Clinical and Experimental Medicine, Policlinico "G. Rodolico, " University of Catania, Catania, Italy
| | - G Defeudis
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy
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15
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Bouare N. Current management of liver diseases and the role of multidisciplinary approach. World J Hepatol 2022; 14:1920-1930. [PMID: 36483606 PMCID: PMC9724103 DOI: 10.4254/wjh.v14.i11.1920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/10/2022] [Accepted: 11/16/2022] [Indexed: 11/24/2022] Open
Abstract
Liver is an organ having extremely diversified functions, ranging from metabolic and synthetic to detoxification of harmful chemicals. The multifunctionality of the liver in principle requires the multidisciplinary and pluralistic interventions for its management. Several studies have investigated liver function, dysfunction and clinic. This editorial work discusses new ideas, challenges and perspectives of current research regarding multidisciplinary and pluralistic management of liver diseases. In one hand the discussions have carried out on the involvement of extracellular vesicles, Na+/H+ exchangers, severe acute respiratory syndrome coronavirus 2 and Epstein–Barr virus infections, Drug-induced liver injury, sepsis, pregnancy, and food supplements in hepatic disorders. In the other hand this study has discussed hepatocellular carcinoma algorithms and new biochemical and imaging experiments pertaining to liver diseases. Relevant articles with an impact index value "> 0" from reference citation analysis, which is an open multidisciplinary citation analysis database based on artificial intelligence technology, have served for the study’s argumentation. This work may be a useful tool for the clinical practice and research in managing and investigating liver disorders.
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Affiliation(s)
- Nouhoum Bouare
- Department of Assurance Quality and Biosafety/Biosecurity, National Institute of Public Health, Bamako 1771, Mali
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