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首页> 外文期刊>Frontiers in Endocrinology >A Review of the Phenomenon of Hysteresis in the Hypothalamus–Pituitary–Thyroid Axis
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A Review of the Phenomenon of Hysteresis in the Hypothalamus–Pituitary–Thyroid Axis

机译：下丘脑-垂体-甲状腺轴上的滞后现象的回顾。

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The existence of a phase of prolonged suppression of TSH despite normalization of serum thyroid hormones over a variable period of time during the recovery of thyrotoxicosis has been documented in literature. Conversely, a temporary elevation of TSH despite attainment of euthyroid levels of serum thyroid hormones following extreme hypothyroidism has also been observed. This rate-independent lag time in TSH recovery is an evidence of a “persistent memory” of the history of dysthyroid states the hypothalamus–pituitary–thyroid (HPT) axis has encountered after the thyroid hormone perturbations have faded out, a phenomenon termed “hysteresis.” Notwithstanding its perplexing nature, hysteresis impacts upon the interpretation of thyroid function tests with sufficient regularity that clinicians risk misdiagnosing and implementing erroneous treatment out of ignorance of this aspect of thyrotropic biology. Mathematical modeling of this phenomenon is complicated but may allow the euthyroid set point to be predicted from thyroid function data exhibiting strong hysteresis effects. Such model predictions are potentially useful for clinical management. Although the molecular mechanisms mediating hysteresis remain elusive, epigenetics, such as histone modifications, are probably involved. However, attempts to reverse the process to hasten the resolution of the hysteretic process may not necessarily translate into improved physiology or optimal health benefits. This is not unexpected from teleological considerations, since hysteresis probably represents an adaptive endocrinological response with survival advantages evolutionarily conserved among vertebrates with a HPT system.
机译：尽管在甲状腺毒症的恢复过程中，在可变的时间内血清甲状腺激素正常化，但仍存在TSH长期抑制期的存在。相反，还观察到尽管极端甲状腺功能减退后血清甲状腺激素的甲状腺功能正常，但TSH暂时升高。 TSH恢复中这种与速率无关的滞后时间是甲状腺功能异常病史的“永久记忆”证据，甲状腺激素扰动消失后下丘脑-垂体-甲状腺（HPT）轴遇到，这种现象称为“滞后”。 。”尽管具有滞后性，但滞后会以足够的规律性影响甲状腺功能检查的解释，以至于临床医生由于对促甲状腺生物学的这一方面的不了解而有可能误诊和实施错误的治疗方法。这种现象的数学建模很复杂，但可以允许从显示强烈滞后作用的甲状腺功能数据预测甲状腺功能正常值。这样的模型预测可能对临床管理有用。尽管介导磁滞的分子机制仍然难以捉摸，但可能涉及表观遗传学，例如组蛋白修饰。但是，尝试逆转过程以加快滞后过程的解决方法，未必会转化为改善的生理机能或最佳的健康益处。从目的论出发，这并不是意外的，因为滞后可能代表具有HPT系统的脊椎动物在进化上具有生存优势的适应性内分泌反应。

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