Synthetic Thyrotropin Releasing Factor as a Test of Pituitary Thyrotropin Reserve

Fleischer, Norman; Lorente, M.; Kirkland, John L.; Kirkland, Rebecca T.; Clayton, George W.; Calderon, Marcos

doi:10.1210/jcem-34-4-617

Cited by 62 publications

(10 citation statements)

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“…TRH deficiency appears, therefore, to have been confirmed by producing chemical euthyroidism by replacement of the presumedly missing hormone. Several other patients, however, have been described who, like L. C., and K. C., had low serum thyroid hormone and low-normal basal TSH levels and normal TSH responses to a single dose of TRH (18)(19)(20)(21)(22). The marked fall in the initially subnormal TSH response to TRH in M. J., the patient with presumed pituitary insensitivity to TRH, was accompanied by rises in serum T3 and T4, but rises so small that the final levels were still subnormal.…”

Section: Discussionmentioning

confidence: 99%

Repetitive Administration of Thyrotropin-Releasing Hormone Results in Small Elevations of Serum Thyroid Hormones and in Marked Inhibition of Thyrotropin Response

Snyder¹,

Utiger²

1973

J. Clin. Invest.

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A B S T R A C T Repetitive administration of thyrotropinreleasing hormone (TRH) to human subjects was used to produce small elevations of endogenous serum triiodothyronine (T3) and thyroxine (T4) levels and thereby to determine the effect of these small elevations on the serum thyrotropin (TSH) response to subsequent doses of TRH. Each subject received 13 consecutive doses of 25 ,Ag TRH at 4-h intervals. Serum Ta, T4, and TSH levels were measured before the 1st, 7th, and 13th doses ("basal levels") and for the 4 h after each of these doses.In 10 normal subjects, the mean TSH response fell from 14.6 AU/ml after the 1st TRH dose to 6.9 and 3.0 AU/ml after the 7th, and 13th doses. These falls in TSH response were accompanied by rises in the mean basal serum Ts levels from 81 to 115 to 114 ng/100 ml (normal range, 70-150 ng/100 ml) and rises in the mean basal serum T4 from 6.7 to 8.6 to 9.5 ,Ag/lOO ml (normal range, 5-11 Ag/lOO ml).

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Section: Discussionmentioning

confidence: 99%

Repetitive Administration of Thyrotropin-Releasing Hormone Results in Small Elevations of Serum Thyroid Hormones and in Marked Inhibition of Thyrotropin Response

Snyder¹,

Utiger²

1973

J. Clin. Invest.

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“…For diagnosis of thyroid function, the TSH response to TRH is well documented (Fleischer et al, 1972 other, non-parenteral routes of TRH administra-2.5.2 TERLIPRESSIN tion are necessary. Schurr et al (1985) demon-Intranasal terlipressin (Glypressin, Ferring) has strated that the nasal route gave significant and been used to treat nosebleeds, a common problem reproducible TSH and prolactin responses to among acute ENT patients.…”

Section: Thyroxine Releasing Hormonementioning

confidence: 99%

Review: Clinical Opportunities Provided by the Nasal Administration of Peptides

1993

Journal of Drug Targeting

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Peptides are rapidly being developed as potential new therapeutic agents and the nasal route is being evaluated as a means of achieving systemic absorption. Current research in man is being directed at a number of polypeptides, including calcitonin, growth hormone releasing hormones (GHRH), insulin, gonadotropin hormone releasing hormones (GnRH) and vasopressin analogues. The underlying protective functions of the nose provide anatomical, temporal and enzymatic barriers to absorption of peptides. The nasal route is relatively unsuccessful when used for high molecular weight polypeptides. Penetration enhancers improve bioavailability but are poorly tolerated. Reproducibility of effect is highly variable, major contributing factors including the site of deposition and type of delivery system as well as changes in the mucous secretion and mucociliary clearance, compounded by the presence of allergy, hay fever and the common cold in treated subjects. The future potential for this route lies in development of effective and well tolerated formulations in highly accurate delivery systems for the chronic administration of peptides, enabling the replacement of impractical and invasive intravenous injections in patients on lifelong substitution treatment for various deficiency states.

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“…TRH responsiveness was defined as being positive when the peak value was > 7.0 uU/ml, or when the difference between the basal and the peak values was > 5.0 u-U/ml. Values less than these were considered to be a hyporesponse; hyperresponsiveness to TRH was defined when the peak value of TSH was > 40 uU/ml (Fleischer et al 1972;Tamai et al 1975). …”

Section: Determination Ofantithyroid Antibodiesmentioning

confidence: 99%

Responses to TRH, T3 suppression tests and histological findings by needle biopsy in patients with simple goitre in Japan

Fukino¹,

Tamai²,

Kumai³

et al. 1982

Acta Endocrinologica

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Studies were performed in 120 patients with simple goitre, defined as relatively soft diffuse goitre. All were clinically and biochemically euthyroid and their antithyroid antibodies were negative. The TRH test was performed in 115, and a T3 suppression test was performed in 99 after the TRH test, while satisfactory biopsies of the thyroid were obtained in 37. The results showed that 28 of the 115 cases (24%) had an abnormal response to TRH; 8 (7%) were hyporesponders and 20 (17%) were hyperresponders. The T3 suppression test showed that 3 of 99 cases (3%) were non-suppressible. As determined by histological examination of the needle biopsy specimen, 17 of the 37 cases (46%) had normal follicles without lymphocytic infiltration, 10 (27%) had diffuse chronic thyroiditis, 5 (14%) had focal thyroiditis and 4 (11%) had diffuse epithelial hyperplastic change, and 1 (3%) had an adenomatous goitre. It is suggested that simple goitre defined as above includes various thyroid diseases and that the results of TRH tests, antithyroid antibody estimations and histological findings do not correlate in many patients.

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Synthetic Thyrotropin Releasing Factor as a Test of Pituitary Thyrotropin Reserve

Cited by 62 publications

References 0 publications

Repetitive Administration of Thyrotropin-Releasing Hormone Results in Small Elevations of Serum Thyroid Hormones and in Marked Inhibition of Thyrotropin Response

Repetitive Administration of Thyrotropin-Releasing Hormone Results in Small Elevations of Serum Thyroid Hormones and in Marked Inhibition of Thyrotropin Response

Review: Clinical Opportunities Provided by the Nasal Administration of Peptides

Responses to TRH, T3 suppression tests and histological findings by needle biopsy in patients with simple goitre in Japan

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