Schilddrüsenhormonwirkung – jenseits klassischer Konzepte

Zusammenfassung

Schilddrüsenhormone spielen eine entscheidende Rolle in fast allen Organsystemen. Liegt eine Schilddrüsenfunktionsstörung vor, kann das pathophysiologische Konsequenzen in vielen Organsystemen haben. Die Einschätzung einer normalen oder pathologischen Schilddrüsenfunktion erfolgt biochemisch über die Bestimmung von TSH und der Schilddrüsenhormone T3 und T4, wobei es internationale Debatten darüber gibt, welcher Normbereich für TSH zu verwenden ist. Dies hat jedoch Auswirkungen auf die Behandlung der Patienten. Es klagen leider häufig Patienten, deren Schilddrüsenfunktion laborchemisch richtig eingestellt ist, über diverse Beschwerden. Mit den kürzlich identifizierten Schilddrüsenhormontransportern sowie der Identifizierung von neuen Schilddrüsenhormonmetaboliten, könnte eine bessere Einschätzung des individuellen Schilddrüsenhormonstatus möglich sein. Um die Zusammenhänge und Auswirkungen dieser neuen Parameter besser verstehen und für den Patienten nutzen zu können, wurde das durch die Deutsche Forschungsgemeinschaft initiierte Schwerpunktprogramm Thyroid Trans Act ins Leben gerufen. Der Fokus dieses interdisziplinären Forschungsverbundes ist die Bearbeitung der Frage nach dem gesunden Schilddrüsen-Status und der besseren Einschätzung eines pathologischen Schilddrüsenstatus mit dem übergeordneten Ziel einer besseren und adäquaten Behandlung der Patienten sowie der Prävention von Schilddrüsenhomon-abhängigen Erkrankungen.

Abstract

Thyroid hormones are of crucial importance for the function of nearly all organ systems. In case of dysfunction of thyroid hormone production and function many organ systems may be affected. The estimation of normal thyroid function is based on determination of TSH and the thyroid hormones T3 and T4. However, international conventions about the normal TSH range are still lacking which bears consequences for patient`s treatment. Hence not unexpected, many patients complain although their thyroid hormone status is in the normal range by clinical estimation. Here, more precise parameters are needed for a better definition of the healthy thyroid status of an individual. Recently, new key players in the system of thyroid hormone action were detected, like specific transporters for uptake of thyroid hormones and thyroid hormone derivatives. DFG, the German Research Foundation supports the priority program Thyroid Trans Act to find answers to the main question: what defines the healthy thyroid status of an individual. The overall aim of this interdisciplinary research consortium is to specify physiological and pathophysiological functions of thyroid hormone transporters and thyroid hormone derivative as new players in thyroid regulation in order to better evaluate, treat, and prevent thyroid-related disease.

Schlüsselwörter

Schilddrüsenhormonwirkung - Schilddrüsenhormontransporter - Thyronamine

Keywords

thyroid hormone action - thyroid hormone transporters - thyronamines

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