A unified mathematical model of thyroid hormone regulation and implication for personalized treatment of thyroid disorders
A unified mathematical model of thyroid hormone regulation and implication for personalized treatment of thyroid disorders
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DOI：
10.1016/j.jtbi.2021.110853
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发表时间：
2021-08-13
影响因子：
2
通讯作者：
Rong, Libin
中科院分区：
文献类型：
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作者：
Yang, Boya;Tang, Xi;Rong, Libin
目前临床医生对患者甲状腺激素调节的实践是基于猜测和经验，而不是量化分析，这使患者面临更长的风险和不适。为了定量分析不同甲状腺状态患者的甲状腺调节功能，我们建立了一个二维数学模型，可以用来分析药物干预和非药物干预下甲状腺激素的动态行为。该统一模型可用于研究甲状腺功能正常者、桥本甲状腺炎患者和Graves病患者的TSH（促甲状腺激素）和FT 4（游离甲状腺素）的调节。结果提示，甲状腺过氧化物酶抗体（TPOAb）水平可能是决定Graves病是否由正常甲状腺状态发展为亚临床或临床甲减的一个因素，而TSH受体抗体（TRAb）升高可能导致Graves病由早期发展为显性甲亢。鉴于早期的血液检测数据，我们证明了医疗保健专业人员应用我们的模型为患者选择适当的剂量方案以在指定的时间范围内达到所需的TSH和FT4水平的可行性。该模型具有优化个性化治疗和缩短桥本甲状腺炎和Graves病患者治疗时间的潜力。(C)2021爱思唯尔有限公司版权所有。
Current clinician practice for thyroid hormone regulation of patients is based upon guesswork and experience rather than quantified analysis, which exposes patients under longer risk and discomfort. To quantitatively analyze the thyroid regulation for patients of different thyroid states, we develop a two-dimensional mathematical model that can be applied to analyze the dynamic behaviors of thyroid hormones with or without drug intervention. The unified model can be employed to study the regulation of TSH (thyroid-stimulating hormone) and FT4 (free thyroxine) for euthyroid (normal thyroid) subjects, Hashimoto's thyroiditis, and Graves' disease patients, respectively. The results suggest that the level of TPOAb (thyroid peroxidase antibody) may be a factor determining whether the patient would progress from euthyroid state to subclinical or clinical hypothyroidism, and that increased TRAb (TSH receptor antibody) may lead Graves' disease to deteriorate from the early stage to overt hyperthyroidism. Given the early blood-test data, we demonstrate the feasibility for healthcare professionals to apply our model in choosing an appropriate dosage regimen for patients to achieve the desired TSH and FT4 levels within a specified time frame. This proposed model has the potential to optimize personalized treatment and shorten the therapeutic time for patients suffering from Hashimoto's thyroiditis and Graves' disease. (C) 2021 Elsevier Ltd. All rights reserved.