New Interfaces of Thyroid Hormone Actions With Blood Coagulation and Thrombosis

被引:28
作者
Davis, Paul J. [1 ,2 ]
Mousa, Shaker A. [1 ]
Schechter, Geraldine P. [3 ,4 ]
机构
[1] Albany Coll Pharm & Hlth Sci, Pharmaceut Res Inst, 1 Discovery Dr, Rensselaer, NY 12144 USA
[2] Albany Med Coll, Dept Med, Albany, NY 12208 USA
[3] Washington Vet Affairs Med Ctr, Med Serv, Hematol Sect, Washington, DC USA
[4] George Washington Univ, Dept Med, Washington, DC USA
关键词
platelet aggregation; hyperthyroidism; L-thyroxine (T-4); cancer; integrin v3; ACTIVATABLE FIBRINOLYSIS INHIBITOR; VENOUS THROMBOSIS; FREE-THYROXINE; CANCER; HYPERTHYROIDISM; RISK; THROMBOEMBOLISM; HYPOTHYROIDISM; ASSOCIATION; BRAIN;
D O I
10.1177/1076029618774150
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Substantial clinical evidence indicates hyperthyroidism enhances coagulation and increases the risk of thrombosis. In vitro and clinical evidence implicate multiple mechanisms for this risk. Genomic actions of thyroid hormone as 3,5,3-triiodo-L-thyronine (T-3) via a nuclear thyroid hormone receptor have been implicated, but recent evidence shows that nongenomic mechanisms initiated at the receptor for L-thyroxine (T-4) on platelet integrin v3 are prothrombotic. The T-4-initiated mechanisms involve platelet activation and, in addition, cellular production of cytokines and chemokines such as CX3CL1 with procoagulatory activities. These procoagulant actions of T-4 are particulary of note because within cells T4 is not seen to be functional, but to be only a prohormone for T-3. Finally, it is also possible that thyroid hormone stimulates platelet-endothelial cell interaction involved in local thrombus generation. In this brief review, we survey mechanisms by which thyroid hormone is involved in coagulation and platelet functions. It is suggested that the threshold should be lowered for considering the possibility that clinically significant clotting may complicate hyperthyroidism. The value of routine measurement of partial thromboplastin time or circulating D-dimer in patients with hyperthyroid or in patients treated with thyrotropin-suppressing dosage of T-4 requires clinical testing.
引用
收藏
页码:1014 / 1019
页数:6
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