Table 1.
ALF patients: Clinical parameters.
Table 2.
Grouped outcome and thyroid status.
Table 3.
Thyroid function and parameters in our patient collective and in the general population in Germany (28).
Fig 1.
Distribution of thyroid function parameters in ALF.
Individual parameters are plotted for the spontaneous remission (SR) and for the non-spontaneous remission (death or liver transplantation) patients with ALF. TSH (A), total T3 (TT3, C), and total T4 (TT4, E) were significantly lower in the NSR group. Free T3 (fT3, B) and free T4 (fT4, D) did not differ between the groups.
Fig 2.
Outcome according to TT3 status.
Incidence of low serum triiodothyronine for the spontaneous remission (SR) and for the non-spontaneous remission (death or liver transplantation) patients with ALF is shown. Low serum total T3 (TT3, A) alone occurred significantly more often in the NSR group compared to SR. Similarly low TT3 in combination with low total T4 (TT4, B) was present in a higher proportion of NSR patients than in SR.
Fig 3.
Correlation of serum thyroid parameters to the international normalized ratio (INR).
INR served as surrogate marker for liver function. TSH (A), TT3 (B), and TT4 (C) were weakly, inversely correlated to INR.
Fig 4.
Gene expression in primary human hepatocytes after toxic injury and T3 stimulation.
mRNA expressions of cell death related genes CD95 (A) and NOXA (B), as well as the thyroid hormone receptor β1 (THR B, C) and hepatocyte growth facor (HGF, D) were assessed. APAP significantly reduced mRNA expressions of CD95 (Fas receptor), THR B, and HGF. * p < 0.05 compared to vehicle (ethanol); # p < 0.05 compared to T3. Statistical significance experiments was determined by one-way ANOVA with Tukey’s post-hoc test for individual experimental conditions. APAP: acetaminophen; CH11: CD95/FAS-agonist to induce apoptosis; T3: triiodothyronine.