Search PubMed⌕ Search

Biomedical subjects

A H Klein

Publications and source records attributed to A H Klein.

At least 37 records · Page 2Linked to original sources

Thyroid hormones and plasma corticosteroid binding globulin capacity in fetal and newborn lambs.

Although the increase in plasma corticosteroid binding globulin (CBG) capacity during late gestation in the fetal sheep is dependent on an intact fetal pituitary, the possible role of thyroid hormones is unknown. In rats, thyroid hormones control the postnatal increase in CBG. In the present study we investigated the effect of thyroidectomy and T3 treatment on CBG capacity in both the fetal and newborn lamb. Fifteen fetal lambs were thyroidectomized in utero at 119-121 days gestation and then infused with either vehicle or T3 (8-50 micrograms/h) for 8 days. Thyroidectomy alone did not prevent the expected increase in CBG capacity. T3 treatment of thyroidectomized fetuses caused a dose-dependent reduction in CBG capacity (maximum decrease = 31% of control). By contrast, plasma concentrations of total protein, albumin, and beta-globulins were unaltered. T3 treatment reduced plasma total corticoid concentrations, but the unbound level was unchanged. Administration of T3 (maximum dose 8 micrograms/h) to one intact fetus did not affect CBG capacity. Eleven newborn lambs were thyroidectomized between 2 and 8 days of age and infused with either vehicle or T3 (25 micrograms/h) for 8 days. Thyroidectomy alone did not prevent the normal decrease in CBG capacity after birth. T3 administration to the thyroidectomized lambs resulted in even lower plasma CBG capacity. We conclude that the prenatal increase in CBG capacity of the fetal sheep is not regulated by thyroid hormones, and that pharmacological concentrations of T3 decrease plasma CBG capacity and secondarily plasma corticoids. These findings indicate that CBG in the fetal sheep is apparently controlled by a different hormone(s) than in other species which have been studied.

Adrenal Cortex Hormones↗

Developmental changes in pituitary-thyroid function in the human fetus and newborn.

Maturation of the hypothalamic pituitary thyroid axis as reflected in cord serum thyroid hormone concentrations was assessed in premature and full term infants born between 26 and 43 weeks gestation. Measurements of thyroxine (T4), free T4 (FT4), thyrotropin (TSH) and thyroxine binding globulin (TBG) in cord sera were correlated with gestational age, sex and birthweight and compared to similar measurements in well two month old infants and adults. There were significant increases in T4, FT4, and TBG with increasing gestational age (GA) between 26 and 33-35 weeks (P less than 0.001). After 34 weeks, none of these parameters varied with GA. When the infants were separated on the basis of sex the linear regression curves describing the relationships between hormone and TBG concentrations and GA were not different from the curves in the total population. The mean FT4/TSH ratio increased significantly with age throughout gestation (P less than 0.01) and was significantly lower in cord blood samples than in blood samples from the 2-month-old infants or the adults. The results suggest that the set point for negative feedback control of TSH secretion at the pituitary level is changing between 26 weeks GA and 2 months of life. Thyroid gland sensitivity to TSH stimulation also appears to be increasing between 26 and 33 weeks GA.

Female↗

Ontogenesis of brown adipose tissue thermogenesis in the rabbit.

Basal and norepinephrine (NE) stimulated oxygen consumption was measured in BAT cells isolated from fetal and newborn rabbits at 24, 28, and 31 days gestation, and 3 and 10 days postnatal age. Maximum catecholamine stimulated respiration was measured at a final NE concentration of 10(-6) M. Cell diameter, calculated cell volume and mitochondrial alpha glycerophosphate dehydrogenase (alpha GPD) were also determined at each age. Basal respiration increased continuously during fetal and neonatal life from a mean (+/- SEM) of 12.2 +/- 0.4 mul O2/10(6) cells . hr at 24 days gestation to a mean of 70.5 +/- 4.2 mul O2/10(6) cells . hr at 24 days gestation to 670.5 +/- 60.4 mul O2/10(6) cells . hr at 31 days. A further increase of 30% measured at 10 days of age was also observed. BAT mitochondrial alpha GPD activity was several fold greater than that measured in liver. Both cell size and enzyme activity increased in parallel to increasing respiratory response to NE. We conclude from this data that the maturation of catecholamine stimulated BAT thermogenesis occurs primarily in the fetus prior to delivery. This increase is associated with both an increase in mitochondrial enzyme activity and an increase in cell size.

Adipose Tissue, Brown↗

Thyroid hormone-sensitive brown adipose tissue respiration in the newborn rabbit.

The effects of thyroid hormone treatment on brown adipose tissue (BAT) and liver metabolism were assessed by measuring oxygen consumption, sodium-potassium adenosine triphosphatase (Na-K-ATPase), and mitochondrial alpha-glycerophosphate dehydrogenase (alpha-GPD) activities in tissues from triiodothyronine- (T3) and vehicle-injected (for 3 days) newborn and adult rabbits. In the newborns, basal BAT cellular respiration was increased [mean (%/- SE) = 119 +/- 18 vs. 65 +/- 4 microliter O2/10(6) cells-1 . h in controls (P less than 0.005)], whereas hepatic respiration was unchanged. Ouabain had no effect on basal BAT cellular respiration, but suppressed hepatic respiration by 30% in both newborn groups. T3 treatment had no effect on NE- (10(-6) M) stimulated BAT respiration, whereas adult hepatic respiration was increased almost twofold. alpha-GPD activities were increased in both newborn BAT and adult liver but not in newborn liver. Na-K-ATPase activity was significantly increased only in newborn liver. In conclusion, 1) both BAT and liver are thyroid-hormone sensitive in the newborn rabbit, but the responses to T3 treatment are different in the two tissues; 2) the failure to stimulate both hepatic alpha-GPD and respiration in the newborn appears to be a developmental phenomenon characteristic of the rabbit; 3) thyroid hormones have little effect on sodium transport-dependent respiration in either BAT of liver in the newborn rabbit.

Adipose Tissue, Brown↗

Ovine maternal and fetal plasma oxytocin concentrations before and during parturition.

To study the relationships between fetal and maternal oxytocin (OT) levels and the initiation of labor in sheep, paired maternal and fetal plasma OT concentrations (microunits per ml) were measured by RIA. Samples were obtained daily from pregnant ewes and their fetuses for 5 days before spontaneous delivery and frequently during the first and second stages of labor and during the 3 h after delivery. The mean maternal plasma OT concentration during the first stage of labor was not different from that preceding labor. In contrast, the mean maternal plasma OT level during stage 2 of labor was significantly higher than the earlier baseline maternal values or the mean paired fetal concentration. There was no significant increase in the mean fetal plasma OT concentration before delivery. The newborn plasma OT concentration was elevated 15 min after delivery. From these data, we conclude that in the sheep, 1) the onset of labor is not associated with increased maternal plasma OT levels, 2) cervical or vaginal distension may be the stimulus for maternal OT release during stage 2 of labor, 3) an increase in the fetal plasma OT concentration does not occur before the initiation of labor or during the course of labor, and 4) stress in the final moments of labor or in early neonatal life may be responsible for elevated cord and early neonatal plasma OT levels.

Animals↗

Plasma norepinephrine, epinephrine, and dopamine concentrations in maternal and fetal sheep during spontaneous parturition and in premature sheep during cortisol-induced parturition.

The plasma catecholamine response to parturition was studied in two groups of chronically catheterized fetal sheep. Group I consisted of full term pregnancies with a mean gestation of 147 days at delivery. Group II was comprised of fetal sheep infused with cortisol to induce premature delivery at a mean gestational age of 135 days. Plasma catecholamine concentrations were measured in group I mothers and fetuses and group II fetuses by radioenzymatic assay using 50 microliter samples. Uterine contractions began 4--14 h before delivery in both groups. Significant increases in fetal plasma norepinephrine (NE) concentrations occurred within 3 h of delivery in both groups. Group I plasma epinephrine (E) and group I and II plasma dopamine levels were significantly increased within 1 h of delivery. Only plasma E levels differed in group I and II fetuses; there was no significant rise in plasma E concentrations in cortisol-infused (group II) fetuses. Maternal plasma NE and E concentrations were increased 2--3 h before delivery in group I animals. Maternal plasma dopamine concentrations were only elevated 30 min before delivery when plasma NE and E levels were highest.

Animals↗

Significance of transient postnatal hypothyroxinemia in premature infants with and without respiratory distress syndrome.

The significance of relatively low thyroxine (T4) levels in preterm infants with and without respiratory distress syndrome (RDS) was assessed by evaluating the free T4 level, the thyrotropin (TSH) response to thyrotropin releasing hormone (TRH), and intellectual development in infants less than or equal to 35 weeks with cord blood T4 concentrations less than 6.5 microgram/100 ml. Fifty-four (19 well, 28 with RDS, and seven without RDS and sick) of 215 premature infants (25%) and 27 of 8,831 term infants (0.3%) had cord T4 levels less than 6.5 microgram/100 ml. Serum T4 levels were measured in 39 surviving preterm infants (20 RDS and 19 well) during the first 5 days of life and at 2, 4, 24, and 52 weeks postnatally. Serum total T4 level during the first week was 4.5 +/- 0.3 microgram/100 ml (mean +/- SEM). Free T4 levels ranged from 1.1 to 2.2 ng/100 ml (normal adult range 0.8 to 2.3 ng/100 ml). Administration of TRH resulted in a clear increase in both TSH and T4 levels in all infants. T4 levels increased significantly (r = .70, P less than .01) with increasing postnatal age, reaching stable levels by 6 to 7 weeks. Developmental quotients obtained in the infants with low T4 levels were no different from those found in a matched control population at 12 months of age. The low T4, free T4, and TSH concentrations and normal TSH responses to TRH found in these infants are characteristic of hypothalamic (tertiary) hypothyroidism, but differ from classic tertiary hypothyroidism in that the disorder was transient. The normal intellectual development at 12 months of age and the spontaneous increase in T4 levels that occurs over the first six weeks of life suggest that the low T4 levels in these infants reflect a benign relative delay in maturation of hypothalamic-pituitary-thyroid control.

Child Development↗

Amniotic fluid thyroid hormone concentrations during human gestation.

AFT4, AFT3, and AFrT3 concentrations were measured in samples from pregnant women between 10 and 43 weeks' gestation. During the first half of pregnancy, AFT4 and AFrT3 concentrations increased progressively, reaching peak levels at 25 to 30 and 17 to 20 weeks, respectively. AFT3 concentrations were low and increased slowly during this stage of pregnancy. During the last half of pregnancy, AFT4 and AFrT3 levels decreased while AFT3 continued to increase. This pattern of change is most likely explained by an increase in 5'-iodothyronine monodeiodinase activity in the fetal compartment. Normal values of amniotic fluid thyroid hormone concentrations as standards of reference for possible prenatal diagnosis of fetal thyroid abnormalities are provided.

Amniotic Fluid↗

Time-trend analysis of plasma cortisol concentrations in the fetal sheep in relation to parturition.

Using a cortisol RIA carefully validated for specificity in fetal ovine plasma, we studied plasma cortisol time-trend changes in eight chronically catheterized sheep fetuses in the last 22 days of gestation before the spontaneous onset of labor. Best fit exponential type curves were drawn for each individual fetus to define the time before the onset of labor at which fetal plasma cortisol was rising at different rates. Fetal plasma cortisol increased at a rate of 0.5 ng ml-1 day-1 as early as 17.1 days before labor in one fetus, whereas the mean value for all eight fetuses occurred 11.8 +/- 1.0 (SEM) days before labor. The rate of increase doubled to 1.0 ng cortisol ml-1 day-1 as early as 14.4 days before labor in one fetus, whereas the mean value for all eight fetuses occurred 9.3 +/- 0.9 days before labor. These findings suggest that the regulatory mechanisms responsible for the prelabor increase in fetal cortisol production are activated earlier in gestation than we previously thought.

Animals↗

[TSH-screening program for congenital hypothyroidism. Experiences with early thyrotropin (TSH) screening].

14,919 newborn infants were screened for congenital hypothyroidism within the last 5 years using a sensitive TSH method. 10 infants with congenital hypothyroidism were discovered thus presenting a frequency of 1:4500. Four of these infants showed abnormally high TSH levels and normal thyroxine levels. The determination of TSH in cord blood--or combined with the screening program for phenylketonuria--in eluate of dried filter paper specimens is the most sensitive test for primary hypothyroidism without false negative results and a low false positive recall rate of 0.16%. After initiation of therapy with thyroxine the TSH level falls unless therapy is delayed for longer. In the latter case TSH levels may remain elevated for several months despite therapy with thyroxine. We would suggest to start therapy with triiodothyronine for up to 14 days prior to initiation of the usual thyroxine therapy.

Congenital Hypothyroidism↗

Comparison of T4, T3, rT3 and TSH concentrations in cord blood and serum of infants up to 3 months of age.

T4, T3, TSH and rT3 concentrations were measured by radioimmunoassay in cord and postnatal (8--94 days of age) serum samples from randomly selected normal newborn infants (Group I). T4 and TSH levels also were determined in cord and postnatal sera from an additional group of apparently healthy infants 8--260 days of age, whose cord serum T4 levels were in the upper or lower 10% of the normal range of values (Group II). Postnatal T4, T3 and TSH concentrations were stable over this age range; there were no significant differences between male and female infant samples. However, there was a significant decrease in serum rT3 concentrations from 8 to 50 days of age. For the Group I infants, there were significant positive correlations between cord serum T4 and postnatal serum T4 levels, cord serum TSH and postnatal serum TSH levels, and cord serum rT3 and postnatal serum rT3 concentrations. For Group II infants, a significant positive correlation was found for cord T4--postnatal T4 serum concentrations.

Age Factors↗

Screening for congenital hypothyroidism: results of screening one million North American infants.

Pilot programs for screening of newborn infants for congenital hypothyroidism began in North America in 1972. To date, the five oldest programs (Quebec, Pittsburgh, Toronto, Oregon Regional, and New England Regional) have screened 1,046,362 infants. A total of 277 infants with congenital hypothyroidism have been detected and seven have been missed, resulting in a total of 284 affected infants in the screened population and an overall incidence of one in 3,684 live births. Of the affected infants, 246 were determined to have primary hypothyroidism, an incidence of one in 4,254 births. Ten infants with secondary-tertiary hypothyroidism were detected in Quebec, Oregon, and Toronto, an incidence of one in 68,200 births. Of all the infants with primary hypothyroidism who were adequately studied, 63% were determined to have aplastic or hypoplastic glands, 14% normal or enlarged glands, and 23% ectopic thyroid tissue. The estimated minimum incidence of infants with TBG deficiency is one in 8,913 births. Only 8 of the 277 detected infants were suspected clinically to have congenital hypothyroidism prior to the time of confirmation of the diagnosis at 4 to 8 weeks of age. The cost of screening varied from $0.70 to $1.60 per infant, depending on which costs were included in the estimate. Preliminary evidence from Quebec suggests that infants treated in the program have normal developmental testing scores at 18 months of age.

Alpha-Globulins↗

Oscillations in reverse triiodothyronine levels in serum of healthy infants aged 0 to 130 hours.

rT3 was measured by RIA in sera from 273 normal healthy infants between 0--130 h of age. The curve for the mean rT3 level plotted against age was polyexponential in shape and showed superimposed oscillations with a period of about 16 h, similar to the curves for T4, T3, and TSH previously found for the same group of subjects (J Clin Endocrinol Metab 47: 61, 1978). The ratio of concentrations of rT3 to T4 remained approximately constant, with a mean value of 0.016 over the age range of 3--130 h. These observations suggest that the variations in rT3 levels in newborn serum during the first few days of life are largely accountable by variations in T4 substrate concentrations.

Humans↗

Variation in values for iodothyronine hormones, thyrotropin, and thyroxine-binding globulin in normal umbilical-cord serum with season and duration of storage.

We measured concentrations of thyroxine, triiodothyronine, reverse triiodothyronine, thyroxine-binding globulin, and thyrotropin in pooled samples of cord sera from normal newborns. Sera collected in winter contain significantly (p less than 0.05) higher concentrations of the first tour--14.9, 13.4, 9k9, and 7.5%, respectively--than do sera collected in summer; thyrotropin concentrations are similar in samples collected during winter and summer (p greater than 0.05). With storage, the values for the thyronines and thyrotropin decreased progressively at rates between 0.9 and 5.3% per year; those for thyroxine-binding globulin did not change significantly.

Blood Specimen Collection↗