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Role of the thyroid-stimulating hormone receptor signaling in development and differentiation of the thyroid gland.

The thyroid-stimulating hormone/thyrotropin (TSH) is the most relevant hormone in the control of thyroid gland physiology in adulthood. TSH effects on the thyroid gland are mediated by the interaction with a specific TSH receptor (TSHR). We studied the role of TSHTSHR signaling on gland morphogenesis and differentiation in the mouse embryo using mouse lines deprived either of TSH (pit(dw)pit(dw)) or of a functional TSHR (tshr(hyt)tshr(hyt) and TSHR-knockout lines). The results reported here show that in the absence of either TSH or a functional TSHR, the thyroid gland develops to a normal size, whereas the expression of thyroperoxidase and the sodium/iodide symporter are reduced greatly. Conversely, no relevant changes are detected in the amounts of thyroglobulin and the thyroid-enriched transcription factors TTF-1, TTF-2, and Pax8. These data suggest that the major role of the TSH/TSHR pathway is in controlling genes involved in iodide metabolism such as sodium/iodide symporter and thyroperoxidase. Furthermore, our data indicate that in embryonic life TSH does not play an equivalent role in controlling gland growth as in the adult thyroid.

Animals↗

[Surgical therapy of carcinoma of the thyroid gland].

BACKGROUND: Thyroid carcinoma comprises tumours with a wide spectrum of aggressiveness. The method of first choice is surgery, however, views on its extent and technique are frequently controversial. The objective of the present work was to demonstrate and justify the procedure used at the author's department in treatment of this tumour. METHODS AND RESULTS: During 1988-1992 a total of 919 patients with thyroid disease were operated. The female:male ratio was 4.13:1; a benign finding was confirmed in 76.4% and a malignant one in 23.6%. The female:male ratio in patients with a malignant findings was 3.24:1. Most frequently a papillary carcinoma was confirmed--in 59.9%, followed by follicular carcinoma in 23.11%, medullary carcinoma in 7.0%, Hürtle's carcinoma in 4.25%, anaplastic carcinoma in 1.42% and epidermoid carcinoma in 0.47%. Metastases in the thyroid were present in 0.94% and a myeloma or sarcoma both in 0.47%. In retrosternal goitres papillary carcinoma was most frequent (19 patients) followed by follicular (7 patients). As to surgical operations, total thyroidectomy was performed in 47.6%, total lobectomy in 20.3%, subtotal thyroidectomy in 15.1% and subtotal lobectomy in 2.4% of the operated patients. A palliative resection was made in 11.8% and lymphadenectomy in 2.8% patients with a malignant finding on the thyroid gland. Permanent complications (paresis of the recurrent nerve, hypoparathyroidism) occurred in 0.95% of the patients, temporary complications (abscess in the scar, transient hypoparathyroidism, oedema of the vocal cords) in 8.66% of the operations. None of the patients died. CONCLUSIONS: Surgical results and experience of the clinic for nuclear medicine support a radical approach to all types of thyroid carcinoma in adults as well as in adolescents.

Female↗

Immunoreactive atrial natriuretic peptide in the thyroid gland.

Human thyroid follicles and primary cell cultures derived from them demonstrated atrial natriuretic peptide (ANP)-like immunoreactivity when stained with a monoclonal antibody raised against rat alpha-ANP (ANP 1-28). In thyroid sections the staining was most intense in the tall cuboidal epithelium of small follicles. The intracellular distribution of immunoreactive (ir)-ANP in primary cultures of thyroid follicular cells consisted of discrete granules with a largely perinuclear distribution. The granule density increased with time in culture but was unaffected by exogenous ANP, suggesting an intrinsic synthesis of the immunoreactivity. Thyroid stimulating hormone (TSH; thyrotropin) failed to alter the distribution of ir-ANP after either short-term (6 h) or long-term (1-12 day) exposure. Epinephrine or norepinephrine treatment, however, caused a reduction in the ir-ANP granularity compared with controls in what might represent a stimulated release of the immunoreactivity. The present results suggest that the peptide ANP coexists with thyroid hormones in follicular cells and that the two endocrine activities might be under separate control mechanisms.

Antibodies, Monoclonal↗

Surgery of the thyroid gland.

Total thyroid lobectomy is feasible with minimal morbidity utilizing a surgical procedure that commences at the inferior pole of the thyroid gland to identify the recurrent laryngeal nerve as the initial step. The superior pole vessels are carefully ligated as the last step, care being taken to avoid the external branch of the superior laryngeal nerve. The parathyroid glands can be easily identified and preserved, and if necessary they can be reimplanted in thin sections in either a strap muscle, sternocleidomastoid muscle, skin incision, or skin of the forearm. Muscle implantation is not performed when the diagnosis is carcinoma, since subsequent operations may require resection of the muscle.

Humans↗

[Ultrastructural localization of peroxidase activity in experimental thyroid gland tumors].

Thyroid adenomas and carcinomas were induced after continuous (12--15 months) treatment of Wistar rats with methylthiouracyl. Ultrastructural cytochemical technique was used in studying the localization of thyroid peroxydase in different follicular cell structures. In control animals, the enzyme was localized on the ER membranes, the internal lamellae of Golgi's apparatus, the perinuclear membrane, the microvilli and in isolated apically arranged lisosomes and microvesicles. No peroxidase activity was detected in animals, having received one-month methylthiouracyl treatment. This was confirmed also by the chromatographic study, showing the presence of inorganic iodine only. Peroxidase activity was demonstrable in only part of the thyroid adenomas and carcinomas; the enzymes was localized in the same subcellular structures as in control animals. In these tumors a variety of iodine-containing components were also identified, largely of the MIT and DIT group.

Animals↗