Priority Programme: THYROID TRANS ACT
Translation of Thyroid Hormone Actions beyond Classical Concepts

Prof. Dr. Georg Brabant, Prof. Dr. Jens Mittag

Unraveling the molecular basis for successful thyroid hormone replacement therapy

Clinical symptoms and signs are frequently misleading to diagnose thyroid dysfunction or to monitor thyroid hormone replacement therapy. Currently, the measurement of serum TSH concentrations  is regarded the best single, robust, sensitive, and reproducible test for determining systemic thyroid status whereas free or total thyroid hormone concentrations appear to be too insensitive to draw firm conclusions from small alterations. However, TSH fails as a marker in an increasing number of clinically difficult situations such as in central hypothyroidism where immunoactive TSH may be measurable despite a loss of its bioactivity or in the differential diagnosis of inadequately elevated TSH due to a mutation of the T3 receptor beta. Particularly under these conditions, other biochemical markers, generally representing organ-specific markers for thyroid hormone action, have been tested, but only the determination of sex-hormone binding globulin is of some clinical impact. The recent characterization of mutations of the thyroid hormone receptor alpha highlight that classical diagnostic approaches based on TSH and free thyroxine determination fail to diagnose the condition and new markers are urgently required.

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Project Coordinator(s):

Prof. Dr. Georg Brabant
Universität zu Lübeck
Medizinische Klinik I
Experimental and Clinical Endocrinology
Ratzeburger Allee 160
23538 Lübeck
Phone: +49 451 500 6131
Fax: +49 451 500 4807
georg.brabant@uksh.de

Prof. Dr. Jens Mittag
Universität zu Lübeck
Center of Brain Behavior and Metabolism (CBBM)
Ratzeburger Allee 160
23562 Lübeck
Phone: +49 451 290 3417
jens.mittag@uni-luebeck.de