A comprehensive review of thyroid hormone metabolism in the gut and its clinical implications.

doi:10.1089/thy.2022.0491

Paper

A comprehensive review of thyroid hormone metabolism in the gut and its clinical implications.

Published Nov 2, 2022 · Aline C. Fenneman, E. Bruinstroop, M. Nieuwdorp

Thyroid : official journal of the American Thyroid Association

Q1 SJR score

30

Citations

2

Influential Citations

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Abstract

BACKGROUND The gut is a target organ of thyroid hormone that exerts its action via the nuclear thyroid hormone receptor 1 (TR1) expressed in intestinal epithelial cells. Thyroid hormones are partially metabolized via hepatic sulfation and glucuronidation resulting in the production of conjugated iodothyronines. Gut microbiota play an important role in peripheral thyroid hormone metabolism as they produce and secrete enzymes with deconjugation activity (β-glucuronidase and sulfatase), via which TH can re-enter the enterohepatic circulation. SUMMARY Intestinal epithelium homeostasis (the finely tuned balance between cell proliferation and differentiation) is controlled by the crosstalk between T3 and TRα1 and the presence of specific TH transporters and TH-activating and inactivating enzymes. Patients and experimental murine models with a dominant-negative mutation in the TR exhibit gross abnormalities in the morphology of the intestinal epithelium and suffer from severe symptoms of a dysfunctional gastrointestinal tract. Over the past decade, gut microbiota has been identified as an essential factor in health and disease, depending on its compositional and functional profile. This has led to a renewed interest in the so-called gut-thyroid axis. Disruption of gut microbial homeostasis (dysbiosis) is associated with autoimmune thyroid disease (AITD), including Hashimoto's thyroiditis (HT), Graves' disease (GD), and Graves' orbitopathy (GO). These studies reviewed here provide new insights into the gut microbiota roles in thyroid disease pathogenesis and may be an initial step toward microbiota-based therapies in AITD. However, it should be noted that cause-effect mechanisms remain to be proven, for which prospective cohort studies, randomized clinical trials, and experimental studies are needed. CONCLUSION This review aims to provide a comprehensive insight into the interplay between thyroid hormone metabolism and gut homeostasis.

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Study Snapshot

Gut microbiota play a crucial role in thyroid hormone metabolism and gut homeostasis, potentially contributing to autoimmune thyroid diseases.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

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Paper

A comprehensive review of thyroid hormone metabolism in the gut and its clinical implications.

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References

Citations

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