We recently reported that the novel thyroid hormone receptor β (TRβ) selective agonists SKL-12846 and SKL-13784 reduce blood cholesterol levels without affecting thyroid-stimulating hormone (TSH) in cholesterol-fed rats. Our aim in this study was to elucidate what sets apart these SKL-compounds as TRβ agonists with no effect on TSH. To this end, we determined SKL-compounds pharmacokinetics and tissue distribution in normal rats and compared them to those of GC-1, a liver-selective TRβ agonist with concomitant effect on TSH. The present study explains why SKL-12846 and SKL-13784 have beneficial effects on lowering lipids without affecting heart rate and TSH production at the therapeutic dose in cholesterol-fed rats. In addition, we found that SKL-13784 shows no sign of escape phenomenon in fructose-fed rats. These results demonstrate the advantages of extremely high liver specificity to TRβ agonists. However, SKL-13784 has been found significantly to reduce endogenous T 4 levels at doses lower than its lipid-lowering dose, which may raise concerns over this compound's ability to alter thyroid hormone metabolism in the liver. While the mechanism by which SKL-13784 reduces endogenous T 4 levels is still unclear, our results would help design better liver-selective TRβ modulators.Key words thyroid hormone receptor β; thyroid stimulating hormone; lipid-lowering effect; GC-1 Thyroid hormones (THs) are known to influence all major metabolic pathways including growth, development, and lipids metabolism. The involvement of THs in lipids metabolism was first reported in 1930, 1) and since then, accumulating evidence has shown that THs lower cholesterol levels in patients with hypercholesterolemia.2-4) TH synthesis and secretion are strictly regulated by the hypothalamic/pituitary/thyroid (HPT) axis, and their physiological action is modulated via two homologous TH receptors, TRα and TRβ, which belong to the nuclear receptor superfamily of ligand-dependent transcription factors.5) Because TH receptors are ubiquitously expressed in humans, plasma levels of circulating TH affect various physiological pathways and are associated with a number of pathological states such as hyperthyroidism, which is characterized by decreased serum cholesterol and triacylglycerides (TG) levels, body weight loss, tachycardia, palpitation, muscle wasting, and osteoporosis in postmenopausal women.
6)Both academia and industry are making numerous efforts to separate TH beneficial effects such as cholesterol lowering and body weight loss from their other hormonal functions.3,7-10) Studies in TR-mutant mice suggest that TRβ is responsible for the cholesterol-lowering effect of TH.11-13) In addition, TRβ is predominantly expressed in the liver, where it accounts for approximately 80% of T 3 -binding TRs.
14)Therefore a number of liver-selective TRβ agonists have been developed. Among them, GC-1 (Fig. 1) and KB2115 showed promising clinical trial results, but never reached the market probably due to undesirable side effects.10) Considering their drawb...