ヒト血中TSH subunitsに関する臨床的研究

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In order to investigate the physiological and pathophysiological roles of TSH subunits, changes of serum TSH, its subunits, and T3 and T4 levels before and after the intravenous administration of 500μg synthetic TRH were examined in 13 normal subjects and 125 patients with endocrinopathy. Serum levels of TSH, its subunits, and T3 and T4 were determined directly by each specific radioimmunoassay. The responsiveness of serum TSH to TRH administration was the same as that in our previous report and was observed to be regulated by serum T3 and T4. In 13 normal subjects, serum levels of TSH subunits increased differently from one another after the TRH administration. Basal and peak levels of TSH-a varied from an undetectable level (U.D. : <0.2 ng/ml) to 0.3 ng/ml, and from 0.2 ng/ml to 1.8 ng/ml respectively. Basal and peak levels of TSH-β varied from an undetectable level (U.D. : <0.2 ng/ml) to 0.8 ng/ml, and from 1.4 ng/ml to 17.5 ng/ml respectively. In 12 patients with primary hypothyroidism, basal and peak levels of TSH-α varied from U.D. to 4.9 ng/ml, and from 2.6 ng/ml to 5.0 ng/ml respectively. Basal and peak levels of TSH-β varied from U.D. to 13.6 ng/ml, and from 3.3 ng/ml to 48.7 ng/ml respectively. In 3 patients with secondary hypothyroidism, basal and peak levels of TSH-α varied from U.D. to 0.4 ng/ml, and from 0.4 ng/ml to 0.9 ng/ml respectively. Levels of TSH-β remained at U.D. before and after the TRH administration. In one patient with tertiary hypothyroidism, basal and peak levels of TSH-α ranged at U.D. and 0.7 ng/ml. Basal and peak levels of TSH-β were ranged at U.D. and 0.8 ng/ml. In 7 patients with hyperthyroidism, basal and peak levels of TSH-α varied from U.D. to 4.3 ng/ml, and from 0.6 ng/ml to 6.9 ng/ml respectively. Levels of TSH-β remained at U.D. before and after the TRH administration. In 6 patients with euthyroid Graves' disease, basal and peak levels of TSH-α varied from U.D. to 1.5 ng/ml, and from 0.2 ng/ml to 2.0 ng/ml respectively. Basal and peak levels of TSH-β varied from U.D. to 2.0 ng/ml, and from 0.9 ng/ml to 5.5 ng/ml respectively. In 7 euthyroid hypothalamo-pituitary disorder, 7 anorexia nervosa, 3 Cushing's disease, one diabetes insipidus, 7 acromegaly and 2 Turner syndrome, levels of TSH subunits remained at around U.D. before and after the TRH administration. A positive correlation was observed between basal or peak levels of TSH-β and those of TSH, and a negative correlation was observed between basal or peak levels of TSH-β and those of T3 or T4, while the correlation was not observed between basal or peak levels of TSH-α and those of TSH, T3 or T4. From the above data, it is suggested that : 1. TSH subunits exist in human serum and are released from pituitary to peripheral blood after a TRH administration. 2. TSH-α does not respond significantly after a TRH administration. 3. TSH-β responds significantly after a TRH administration, and its response is regulated by T3 and T4. 4. In patients with secondary hypothyroidism and hyperthyroidism, the decrease of TSH reserve is accompanied by the decrease of TSH-β synthesis. 5. TSH-β has some pathophysiological roles in some cases of euthyroid Graves' disease.
日本内分泌学会の論文

著者

鰐部春松
名古屋大学医学部第一内科学教室

ヒト血中TSH subunitsに関する臨床的研究

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