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The thyroid as the largest endocrine gland mainly produces and secretes the thyroid hormones (TH): 3,3’,5-triiodo-L-thyronine (T3) and its pro-hormone L-thyroxine (T4). Besides the impact on growth, normal development, bone marrow structure, the cardiovascular system, body weight and thermogenesis, TH play a vivid role in many metabolic regulatory mechanisms in almost all tissues. Thyroid diseases are relatively prevalent and cause, due to the resulting TH imbalances, a broad spectrum of effects. Many of them manifest in pathologically increased or decreased TH levels defined as hyperthyroidism or hypothyroidism, respectively. Routinely, determination of the thyroid state is based on the assessment of the classical markers TSH and free T4. However, this practice has several drawbacks. Moreover, elucidation of the pleiotropic effects of TH on multiple molecular pathways is mostly based on cell culture, tissue and rodent models. Analysis of animal biofluids like serum and urine using metabolomics approaches demonstrated the extensive impact of TH on other body compartments. In contrast, proteome profiling has not been exploited for the comprehensive characterization of the general metabolic effects of TH. Plasma as a large and diverse compartment of the human proteome provides a great opportunity to identify novel protein markers of thyroid function as well as to characterize metabolic effects of TH in humans.
Therefore, a study of experimental thyrotoxicosis was performed with 16 male volunteers treated with 0.25 mg/d levothyroxine (L-T4) for 8 weeks to induce a hyperthyroid state. Plasma samples were collected before the L-T4 application started, two times during the treatment and additionally two times after withdrawal. Proteome analysis revealed remarkable alterations including increased levels of two known proteins known to correlate with TH levels (sex hormone-binding globulin and cystatin C). The correlation with free T4 levels revealed 76 out of 437 detected proteins with a Pearson correlation coefficient of r ≥ |0.9|. One prominent signature included 10 coagulation cascade proteins exhibiting significantly increased plasma levels during thyrotoxicosis, thereby revealing a trend towards a hypercoagulative state in hyperthyroidism. To overcome the statistical drawbacks of the Pearson correlation analysis, additionally a mixed-effect linear regression model using serum free T4 concentrations as exposure and protein abundances as outcome while controlling for age, BMI, and batch was implemented. Application of this model resulted in the detection of 63 proteins with significant associations to free T4 levels. Besides the already mentioned augmented coagulation, a significant drop in the amounts of three apolipoproteins (ApoD, ApoB-100 and ApoC3) was observed. Furthermore, an increased abundance of proteins assigned to the complement system was detected.
Experimental studies in humans were complemented by corresponding analyses in murine models. In the current work, plasma samples of two murine studies including male C57BL/6 wildtype mice were analyzed to elucidate the impact of thyroid dysfunction on the plasma proteome. The first study was similarly designed as the human model of experimentally induced thyrotoxicosis and assigned the animals to three groups: a control group, a T4 treatment group, and a T4 recovery group, whereupon the latter first received T4 followed by a subsequent TH normalization period. A high proportion of plasma proteins exhibited significantly different protein levels during T4 application (n = 120), where 90 of these also showed a corresponding reverse trend after T4 withdrawal (T4 recovery vs. T4), thereby displaying transient alterations. The molecular pattern of hyperthyroidism in the murine model indicated, as in the human study, a pronounced decrease in apolipoproteins. However, in clear contrast to the human data, the levels of proteins related to the coagulation cascade and complement system were also transiently decreased in mice, while being increased in humans.
The second murine analysis focused on the impact of hyper- and hypothyroidism caused by T3 or T4 treatment and MMI/KClO4 application, respectively. In general, compared to the first murine study less clear alterations of protein levels were detected. Proteins related to the complement system revealed fewer changes in the T3 group and only marginal changes after T4 induction. Unexpectedly, the MMI/KClO4-induced hypothyroidism caused a reduction of the levels of several proteins assigned to the complement system, although different components and factors were affected.
Generally, rodent studies partially provided a divergent picture of TH action as compared to human studies. However, in spite of inconsistent results in studies regarding the effects of TH that are possibly due to species-specific differences, an important role of TH on several metabolic and other pathways, e.g. in the process of blood coagulation and apolipoprotein regulation, is evident. The results from both murine and human studies presented here provide novel insights into changes in the plasma proteome in the context of thyroid diseases which might contribute to a better understanding of TH action on metabolism and other pathways.