甲状腺刺戟ホルモン (TSH) に関する臨床的並びに実験的研究
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概要
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A new technique for the quantitative determination of TSH, based on the measurement of the hormone in stimulating thyroidal uptake and release of inorganic radioiodine, was further investigated using surviving bovine thyroid slices in vitro. The results were as follows : <BR>1) TSH, added in vitro, stimulated the uptake and decreased the release of inorganic iodine by the slices.<BR>2) According to the results of the chromatographic separation, the radioactivity discharged into the medium after the release experiment was not of hormonal radioiodine but of inorganic.<BR>3) In the uptake experiment, when TSH and radioiodine were added simultaneously, no usefull TSH dose-response proportionality was obtained. There were statistically significant differences in the radioiodine uptake among 10<SUP>-4</SUP>, 10<SUP>-3</SUP>, 10<SUP>-1</SUP> and 10-1 JSu/ml of TSH when the thyroid slices were incubated with TSH for 4 hours prior to the addition of radioiodine. However the reproductivity of these relationships was very poor.<BR>4) In the release experiment, statistically significant linearity and differences were observed over the range from 10<SUP>-5</SUP> to 10<SUP>-2</SUP> JSu/ml of TSH, but there was a great variation in the TSH dose-response curve and the mean λ value was 0.68, being higher than that obtained by any other recent techniques.<BR>5) For the purpose to increase the slope of the dose-response curve and augment the precision in the release experiment developed by Bakke et al., the author has made some improvements on their method, and obtained satisfactory outcomes for the most part. This procedure seems to offer a fairly convenient and sensitive technique for the assay of TSH ; with a mean λ of 0.34, as precise as that obtained by current methods.<BR>6) 1 USP unit was estimated to be equivallent approximately to 10 JS units by the improved release experiment applied to the 4 or 6 point method.<BR>A modified assay technique for thyrothrophin (TSH) based on the release of inorganic radioiodine by bovine thyroid tissue slices in vitro was designed for its clinical application and was used in titrations of serum TSH levels in various disorders.<BR>In normal adults, the mean serum TSH level was 1.82±1.38 (standard deviation) milli JSU/ml in 15 males in the 2nd-4th decades, 0.89±0.54 milli JSU/ml in 5 males above the 5th decade, and 1.91±1.49 milli JSU/ml in 21 femeles in the 2nd and 3rd decades. The confidence limit (P=0.05) of serum TSH level in 41 normal adults was 2.2-1.3 milli JSU/ml, and its seasonal changes was estimated.<BR>In simple goiters, the serum TSH level in PAS induced-and endemic diffuse goiter was rather high, but in cystic or nodular type it was normal or partially low. In these euthyroid patients, a negative correlation between the TSH level and the PBI value in serum was observed.<BR>In primary hypothyroidism, the serum TSH level was markedly elevated. On the contrary, in secondary hypothyroidism it was extraordinarily decreased or beyond measure.<BR>In hyperthyroid patients, the serum TSH level varied from less than 0.1 to more than10 milli JSU/ml, its mean value was in upper part of the normal range, and abnormally high or low levels of TSH in serum were observed not only in the group with exophthalmos but also in the group without exophthalmos, whereas the former showed somewhat high level of TSH in serum on the average. Two euthyroid patients without goiter but with marked exophthalmos did not differ from normals in their serum TSH levels. In the group of hyperthyroidism, in which the thyroidal radioiodine uptake curve showed the "descending type", exophthalmos was more frequenthy observed and the serum TSH level tended to be higher than that of the group showing the "ascending type" of the thyroidal radioiodine uptake curve.
- 一般社団法人 日本内分泌学会の論文