Journal
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
Volume 24, Issue 14, Pages -Publisher
MDPI
DOI: 10.3390/ijms241411699
Keywords
macro-hormones; thyroid-stimulating hormone; pars tuberalis TSH; pars distalis TSH; immunoassay; circadian changes; ultradian changes; seasonal changes
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Thyroid-stimulating hormone (TSH) and thyroid hormone levels are important parameters in blood analysis, but immunoassays used may produce inaccurate results due to interference from certain materials in the sample. Macro-TSH, a complex of TSH with immunoglobulin or albumin, can lead to falsely elevated TSH concentrations. While less well-known, PT-TSH plays a significant role in central regulation of thyroid metabolism.
Thyroid-stimulating hormone (TSH) and thyroid hormone levels are standard parameters in blood analysis. However, the immunoassays employed may lead to false-positive or false-negative results when the sample contains certain materials that interfere with the assay. Macro-TSH, a complex of TSH with immunoglobulin or albumin, may cause apparently increased TSH concentrations. TSH is produced in the pars tuberalis (PT) of the pituitary gland and by thyrotrophs of the pars distalis (PD). It was found that variable glycosylation can render the molecule more strongly bound to antibodies or albumin in the blood, leading to the hypothesis that macro-TSH consists mainly of PT-TSH. Although less known than PD-TSH, PT-TSH plays an important role in the central regulation of thyroid metabolism. The present review summarizes the physiological function of human PT-TSH and its role in macro-TSH formation. The prevalence of macro-hyperthyrotropinemia, the structure of PT-TSH and macro-TSH, problems in the measurement of TSH, and the action of PT-TSH in animals with seasonal breeding are discussed. Despite the absence of a specific function of macro-TSH in the organism, the identification of macro-TSH is important for avoiding unnecessary treatment based on a falsified readout of increased TSH concentrations as numerous individual case reports describe.
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