Endocrinology and Metabolism

Review Article

Obesity and Metabolism
Food Preferences and Obesity: Sara Spinelli, Erminio Monteleone; Endocrinol Metab. 2021;36(2):209-219. Published online April 19, 2021; DOI: https://doi.org/10.3803/EnM.2021.105

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Obesity is a multifactorial disease with several potential causes that remain incompletely understood. Recent changes in the environment, which has become increasingly obesogenic, have been found to interact with individual factors. Evidence of the role of taste responsiveness and food preference in obesity has been reported, pointing to a lower taste sensitivity and a higher preference and intake of fat and, to a lesser extent, sweet foods in obese people. Studies in the last decades have also suggested that individual differences in the neurophysiology of food reward may lead to overeating, contributing to obesity. However, further studies are needed to confirm these findings. In fact, only a limited number of studies has been conducted on large samples, and several studies were conducted only on women. Larger balanced studies in terms of sex/gender and age are required in order to control the confounding effect of these variables. As many factors are intertwined in obesity, a multidisciplinary approach is needed. This will allow a better understanding of taste alteration and food behaviours in obese people in order to design more effective strategies to promote healthier eating and to prevent obesity and the related chronic disease risks.

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Case Report

A Case of Propylthiouracil - Induced Hepatitis; Showed Chronic Active Hepatitis by Pathologic Finding.: Yoon Sok Chung, Hyeon Man Kim, Deok Bae Park, Kwang Hwa Park, Chull Sim, Min Kyung Song, Heui Chul Chung; J Korean Endocr Soc. 1994;10(3):289-294. Published online November 6, 2019

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Abstract PDF: A 15-year old girl developed propylthiouracil-induced hepatitis documented as chronic active hepatitis by liver biopsy, who had suffered from Graves' disease for 1 year and treated with propylthiouracil. The result of lymphocyte transformation test was negative which was performed after 3 months of onset of hepatitis.

Original Article

Endocrine Research
Propylthiouracil, Perchlorate, and Thyroid-Stimulating Hormone Modulate High Concentrations of Iodide Instigated Mitochondrial Superoxide Production in the Thyroids of Metallothionein I/II Knockout Mice: Qi Duan, Tingting Wang, Na Zhang, Vern Perera, Xue Liang, Iruni Roshanie Abeysekera, Xiaomei Yao; Endocrinol Metab. 2016;31(1):174-184. Published online March 16, 2016; DOI: https://doi.org/10.3803/EnM.2016.31.1.174

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Abstract PDF PubReader

Background

Increased oxidative stress has been suggested as one of the underlying mechanisms in iodide excess-induced thyroid disease. Metallothioneins (MTs) are regarded as scavengers of reactive oxygen species (ROS) in oxidative stress. Our aim is to investigate the effects of propylthiouracil (PTU), a thyroid peroxidase inhibitor, perchlorate (KClO₄), a competitive inhibitor of iodide transport, and thyroid stimulating hormone (TSH) on mitochondrial superoxide production instigated by high concentrations of iodide in the thyroids of MT-I/II knockout (MT-I/II KO) mice.

Methods

Eight-week-old 129S7/SvEvBrd-Mt1^tm1Bri Mt2^tm1Bri/J (MT-I/II KO) mice and background-matched wild type (WT) mice were used.

Results

By using a mitochondrial superoxide indicator (MitoSOX Red), lactate dehydrogenase (LDH) release, and methyl thiazolyl tetrazolium (MTT) assay, we demonstrated that the decreased relative viability and increased LDH release and mitochondrial superoxide production induced by potassium iodide (100 µM) can be relieved by 300 µM PTU, 30 µM KClO₄, or 10 U/L TSH in the thyroid cell suspensions of both MT-I/II KO and WT mice (P<0.05). Compared to the WT mice, a significant decrease in the relative viability along with a significant increase in LDH release and mitochondrial superoxide production were detected in MT-I/II KO mice(P<0.05).

Conclusion

We concluded that PTU, KClO₄, or TSH relieved the mitochondrial oxidative stress induced by high concentrations of iodide in the thyroids of both MT-I/II KO and WT mice. MT-I/II showed antioxidant effects against high concentrations of iodide-induced mitochondrial superoxide production in the thyroid.

Citations

Citations to this article as recorded by

Exposure to Polybrominated Diphenyl Ethers and Thyroid Disease: a Systematic Review and Meta-analysis of Epidemiological Studies
Yuxin Lin, Lili Yang, Manling Xie, Haibo Li, Qian Zhang
Current Epidemiology Reports.2024; 11(1): 20. CrossRef
The reversal of drug resistance by two‐dimensional titanium carbide Ti2C (2D Ti2C) in non‐small‐cell lung cancer via the depletion of intracellular antioxidant reserves
Yue Zhu, Baiyan Sui, Xin Liu, Jiao Sun
Thoracic Cancer.2021; 12(24): 3340. CrossRef
Thyroid function alterations attributed to high iodide supplementation in maternal rats and their offspring
Xue Liang, Yanni Feng, Laixiang Lin, Iruni Roshanie Abeysekera, Umar Iqbal, Tingting Wang, Ying Wang, Xiaomei Yao
Journal of Trace Elements in Medicine and Biology.2018; 47: 89. CrossRef
Ecotoxicological assessment of perchlorate using in vitro and in vivo assays
Rosa Acevedo-Barrios, Consuelo Sabater-Marco, Jesus Olivero-Verbel
Environmental Science and Pollution Research.2018; 25(14): 13697. CrossRef
Isolated domains of recombinant human apo-metallothionein 1A are folded at neutral pH: a denaturant and heat-induced unfolding study using ESI-MS
Gordon W. Irvine, Natalie Korkola, Martin J. Stillman
Bioscience Reports.2018;[Epub] CrossRef
Reappraisal of metallothionein: Clinical implications for patients with diabetes mellitus
Yongsoo Park, Jian Zhang, Lu Cai
Journal of Diabetes.2018; 10(3): 213. CrossRef
Mammalian Metallothionein-2A and Oxidative Stress
Xue-Bin Ling, Hong-Wei Wei, Jun Wang, Yue-Qiong Kong, Yu-You Wu, Jun-Li Guo, Tian-Fa Li, Ji-Ke Li
International Journal of Molecular Sciences.2016; 17(9): 1483. CrossRef

Case Report

A Case of Antineutrophil Cytoplasmic Antibody (ANCA) Positive, Propylthiouracil-Induced Diffuse Alveolar Hemorrhage in Graves' Disease.: Der Sheng Sun, Dong Kyu Kim, Hyo Jin Lee, Hee Yun Lee, Dae Jun Kim, Eun Sook Kim, Jae Hyoung Cho, Seung Hyun Ko, Wan Ook Kim, Chi Hong Kim, Ki Ho Song, Yu Bae Ahn; J Korean Endocr Soc. 2007;22(3):215-219. Published online June 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.3.215

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Abstract PDF

Graves' disease is one of the common autoimmune diseases, and it has been controlled by such antithyroid drugs as propylthiouracil (PTU) or methimazole. There are a number of side effects, including agranulocytosis, skin rash, hepatotoxicity, fever, arthralgia and a lupus-like syndrome during treatment. PTU has been recently observed to be associated with the development of antineutrophil cytoplasmic antibody (ANCA) positive vasculitis, and this can cause diffuse alveolar hemorrhage. A 32-year-old woman with Graves' disease had been treated with PTU for 4 years, and she had experienced intermittent hemoptysis for 2 weeks before she visited the hospital. Both myeloperoxidase and proteinase 3 ANCA were positive without other organ systems being involved. She was diagnosed with PTU-induced vasculitis. Cessation of PTU and administration of corticosteroids improved the clinical manifestations.

Citations

Citations to this article as recorded by

A Case of Diffuse Alveolar Hemorrhage with Glomerulonephritis after Propylthiouracil Treatment
Ji Hyun Lee, Min Su Kim, Jae Gon Lee, Dae Sik Kim, Hae Jin Yang, Kyung Woo Kang
Tuberculosis and Respiratory Diseases.2012; 72(1): 93. CrossRef

Original Article

Hepatic Injury during Treatment with Antithyroid Drugs in Patients with Hyperthyroidism.: Ki Young Lee, Yun Jeong Lee, Soon Hong Hong, Sung Kwoen Jung, Hwa Eun Lee, Chan Jong Seo, Yon Sil Jung, Sung Kwang Lee, Hong Kyu Kim, Hye Young Park, Moon Ho Kang; J Korean Endocr Soc. 2000;15(4-5):554-560. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Propylthiouracil (PIV) and methimazole (MMI) were widely used for the treatment of hyperthyroidism. Hepatic injury caused by these agents is a rare but serious complication. This study is to investigate the clinical features of hepatotoxicity from antithyroid drugs. METHODS: We reviewed 17 cases of hepatic injury during treatment with antithyroid drugs in patients with hyperthyroidism. Included were 6 cases we experienced and 11 cases reported in Korean literature from 1986 to 1999. We analyzed the clinical features of hepatic injury. RESULTS: Of 17 cases of hepatic injury, 12 were PTU cases and 5 MMI cases. The mean age of PTU cases was 40 years with 6/12 patients over 40 years old and 2/5 MMI cases were over 40 years old. The dose of PTU was 300 mg/d or more in 10/12 cases (83%) and the dose of MMI was 30 mg/d in 3/5 cases (60%). The hepatic injury occurred within 3 months in 8/12 PTU cases (67%) and within 2 months in 4/5 MMI cases (80%). The duration of hepatic injury tended to be longer in MMI cases than in PTV cases (median; 80 vs 41 days, p=0.102). In PTU cases, the duration of hepatic injury was correlated with the duration of drug use before hepatic injury (p<0.05). All of 8 biopsied cases who took PTU had predominantly hepatocellular necrosis. Two biopsied cases who took MMI had cholestatic jaundice and nonspecific abnormality, respectively. Biochemical findings of all MMI cases were compatible with cholestatic jaundice. As to the treatment of hyperthyroidism after hepatic injury, 4/12 PTU cases were treated with RAI therapy, 5 with MMI and one with surgery, and treatment was unknown in two. On the other hand 3/5 MMI cases interestingly entered into spontaneous remission after hepatic injury and 2/5 had RAI therapy. Hepatic dysfunction recurred in each one whom treatment by changing to MMI or PTU was tried on. CONCLUSION: Most of hepatic injury during treatment with antithyroid drugs developed within two to three months of drug use. The hepatic injury related to PTU was mainly cytotoxic whereas that related to MMI was cholestatic. Since there is a cross-reaction between PTU and MMI in hepatotoxicity, RAI therapy or operation shoud be considered as an alternative treatment of hyperthyroidism after hepatic injury.

Case Reports

A Case of Propylthiouracil Induced Anti: Neutrophil Cytoplasmic Antibody (ANCA) Positive Vasculitis.: Yumie Rhee, Sang Su Chung, Su Youn Nam, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1999;14(4):757-763. Published online January 1, 2001

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Abstract PDF: A 40-year-old woman just had started to take propylthiouracil for Graves disease, However, the treatment had to be interrupted because she developed skin rash, arthritis, chest pain, fever and proteinuria after 2 months. The serologic study revealed antineutrophil cytoplasmic antibody(ANCA) positivity, especially showing perinuclear pattern. The anti-myeloperoxidase titer was high. The hematoxylin & eosin stain of the specimen obtained from kidney was compatible with pauci-immune glomerulonephritis with crescent formation. There were no immune complex deposits under electron microscope. Such findings suggested propylthiouracil-induced vasculitis. Vasculitis is a rare side effect of propylthiouracil. Recently more cases of vasculitis associated with anti-thyroid drug with ANCA positivity are being reported up to about 36 cases worldwide. There are possibilities of underdiagnosis of this side effect, meaning more cautions on the patients under anti-thyroid drug treatment. We present a case with review of related literature.

Two Cases of Aplastic Anemia Following Propylthiouracil.: Hong Seung Kim, Choon Hee Chung, Hee Sun Kim, Mi Duk Lee, Young Hak Shim, Soon Won Hong; J Korean Endocr Soc. 1998;13(2):258-263. Published online January 1, 2001

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Abstract PDF: Aplastic anemia is characterized by a failure of blood cell production resulting in varying degrees of pancytopenia with a markedly hypocellular bone marrow. Most cases of aplastic anemia are acquired, but the disease may also occur as the result of inherited abnormalities. In 50-65% of cases, however, the etiology is unknown. For acquired forms of aplastic anemia, a variety of causative factors, including radiation, viruses, chemicals and drugs, have been implicated. Antithyroid drugs(Carbimazole, Methimazole, Propylthiouracil) are usually listed among agents associated with the development of agranulocytosis, but aplastic anemia rarely follows their use. The first case of aplastic anemia followmg propylthiouracil was reported by Marte~lo et al. in 1967 and the second case was by Aksoy and Erdem in 1968. Recently, we experienced two cases of aplastic anemia following propylthiouracil therapy due to Graves disease, so we report here these cases with literature review.

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