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2.2.

Pajzsmirigy

2.2.1. A pajzsmirigy hormonjai

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iEUD: A pajzsmirigy hormonjai a), b), c) (RUDAS-)5(1<Ï, 1995.)

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)21<Ï-LIGETI, 2008.).

2.2.1.1.

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iEUD: A pajzsmLULJ\KRUPRQRNELRV]LQWp]LVH*$È/, 2002.)

2.2.1.2.

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2.2.1.3.

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2.2.1.4.

A pajzsmirigyhormonok transzportja

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albumin N|WLPHJRUDAS-)5(1<Ï, 1995.; )21<Ï-LIGETI, 2008.).

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2.2.1.5.

$KRUPRQRNKDWiVPHFKDQizmusa

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DIILQLWiViQiO is kisebb. $SDM]VPLULJ\KRUPRQRNKDWiVDDJpQH[SUHVV]LyV]DEiO\R]iViQ alapul, H]pUW EHDGiVXNDW N|YHWĘHQ D KDWiV FVDN QpKiQ\ yUD HOWHOWpYHO MHOHQWNH]LN GH QDSRNRQ NHUHV]WOIHQQPDUDG$EHDGRWW73 KDWiVDYDODPLYHOKDPDUDEEMHOHQWNH]LNPLQWD74 KDWiVD )21<Ï-LIGETI, 2008.).

A magreceptorok a T3-PDO NDSFVRODWED NHUOYH WUDQV]NULSFLyV pV WUDQV]OiFLyV IRO\DPDWRNDW LQGtWDQDN HO pV D] HOVĘGOHJHV KRUPRQKDWiV yUiQ EHOO IHKpUMHV]LQWp]LVKH]

YH]HW $ PiVRGODJRV KRUPRQKDWiV VRUiQ ~MDEE WUDQV]NULSFLyV pV WUDQV]OiFLyV IRO\DPDWRN indulnak elPHO\HNWRYiEEL-HQ]LPUHQGV]HUPĦN|GpVpWEHIRO\iVROMiN

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2.2.2.

$SDM]VPLULJ\KRUPRQRNV]HUHSHDV]DSRURGiVLIXQNFLyNEDQ

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is V]NVpJYDQSDM]VPLULJ\KRUPRQUDWRYiEEiD]HOOpVXWiQLSHWHIpV]HNFLNOXV~MUDLQGXOiViEDQ LVIRQWRVV]HUHSNYDQ

6~O\RV KLSRWLUHy]LV SHWHIpV]HN-VRUYDGiVKR] LYDU]iV HOPDUDGiViKR] YH]HW YDODPLQW HPEULRQiOLV pV SRV]WQDWiOLV IHMOĘGpVL ]DYDURNDW RNR]KDW (GYė5))< %L]RQ\tWRWW KRJ\DWHUKHVVpJDODWWLQHPPHJIHOHOĘMyGHOOiWRWWViJYDODPLQWDN|YHWNH]PpQ\HVUHQGHOOHQHV DQ\DLV]pUXP74 szint a magzat idegrenGV]HUpQHNLQWUDXWHULQNiURVRGiVihoz vezet (ELAHI et al., 2005.).

A pajzsmirigyhormonok a GnRH-QHXURQRNRQ NHUHV]WO IHMWLN NL KDWiVXNDW PHO\HN GnRH-WHUPHOpV UpYpQ V]DEiO\R]]iN D] )6+- pV /+-WHUPHOpVW D] DGHQRKLSRIt]LVEHQ

*<ė5))<, 2008.).

2.2.3.

$SDM]VPLULJ\PĦN|GpVDWHUKHVVpJVRUiQ

2.2.3.1.

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$PiVRGLNHVHPpQ\VRUR]DWD]HOVĘWULPHV]WHUVRUiQV]LQWpQiWPHQHWL(QQHNRNDD]

DQ\DL SDM]VPLULJ\ N|]YHWOHQ VWLPXOiOiVD D KXPiQ FKRULRQ-gonadotropin (hCG) PHJQ|YHNHGHWW NRQFHQWUiFLyMD N|YHWNH]WpEHQ $ K&* NRQFHQWUiFLy Q|YHNHGpVKH] D KLSRIt]LV-SDM]VPLULJ\WHQJHO\UpV]OHJHVJiWOiVDWiUVXODpVKpWN|]|WWDV]pUXP 76+iWPHQHWLOHJFV|NNHQDPLHJ\EHHVLNDK&*FV~FVpUWpNHLYHOpVDV]pUXP76+pV K&*YiOWR]iViQDNSURILOMDLHJ\PiVWN|UNpSHL (GLINOER, 2001.) $V]pUXPV]DEDG T4 NRQFHQWUiFLyMD iWPHQHWLOHJ HPHONHGLN BURROW et al., 1994.). $ WHUKHVVpJHN N|UOEHOO-iEDQDK&*iOWDONLYiOWRWW76+FV|NNHQpViWPHQHWLOHJÄOHQ\RPKDWMD´

D ED]iOLV 76+ NRQFHQWUiFLyNDW pV D WLUHRWURSLQ HOYiODV]WiVW VHUNHQWĘ KRUPRQ 75+

thyreotropin releasing hormoniOWDOVWLPXOiOW76+YiODV]RNDWLVDQRUPiOWDUWRPiQ\

DOVyV]LQWMHDOi(]HQQĘNQHNN|UOEHOOHJ\WL]HGpQpOYDJ\LVDWHUKHVQĘN-iQiOD hCG-nek az anyai pajzsmirigyre gyakorolWWLUHRWURSKDWiVDD]~J\QHYH]HWWÄWHUKHVVpJL iWPHQHWLWLUHRWR[LNy]LV´-hoz vezethet (GLINOER, 2001.).

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- WtSXV~PRQRGHMRGLQi]0,'-1): a T4-HWDODNtWMD73-PiDNWLYLWiVDQHPPyGRVXO MHOHQWĘVHQ D WHUKHVVpJ DODWW (GLINOER, 2001.). 0LQG D NOVĘ PLQG D EHOVĘ J\ĦUĦNGHMRGLQiOiViWNDWDOL]iOMD)HOQĘWWHNQpODPiMEDQYHVpEHQSDM]VPLULJ\EHQ pVKLSRIt]LVEHQH[SUHVV]iOyGLN$V]pUXPEDQOpYĘ73QDJ\UpV]ppUWH] az enzim a IHOHOĘV .DWDOL]iOQL NpSHV a rT3 5¶-GHMRGLQiOiViW YDODPLQW D EHOVĘ J\ĦUĦ GHMRGLQiOiViWNO|Q|VHQD73-V]XOIiWpV D74-V]XOIiWHVHWpEHQBURROW et al., 1994.).

- WtSXV~ PRQRGHMRGLQi] 0,'-2): V]LQWpQ D 74-HW DODNtWMD 73-Pi D SODFHQWiEDQ H[SUHVV]iOyGLN pV HJ\ V]DEiO\R]y KRPHRV]WDWLNXV PHFKDQL]PXVW NpSYLVHO a T₃ WHUPHOpVKHO\LIHQQWDUWiViUDQp]YHDPLNRUD]DQ\ai T₄NRQFHQWUiFLyNFV|NNHQQHN, SpOGiXOKLSRWLUHy]LV YDJ\MyGKLiQ\VRUiQ(GLINOER, 2001.) ,O\HQNRUIRNR]yGLN D]DNWLYLWiVD. &VDNDNOVĘJ\ĦUĦQKDW$SODFHQWiQNtYOD]DJ\EDQKLSRIt]LVEHQ EDUQD ]VtUV]|YHWEHQ pV NHUDWLQRFLWiNEDQ is H[SUHVV]iOyGLN BURROW et al., 1994.).

- WtSXV~ PRQRGHMRGLQi] (MID-3): a T₄-et rT₃-Pi DODNtWMD A placenta nagy PHQQ\LVpJEHQWDUWDOPD]]DUHQGNtYOPDJDVDNWLYLWiVDDJHV]WiFLyPiVRGLNIHOpUH MHOOHP]Ę (GLINOER, 2001.), vaODPLQW QDJ\ PHQQ\LVpJEHQ PHJWDOiOKDWy az DJ\EDQpVaz epidermiszben is. A T4ĺ rT3 iWDODNXOiVPHOOHWWDT3ĺT2 iWDODNXOiVW LVNDWDOL]iOQLNpSHV (BURROW et al., 1994.).

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NRQFHQWUiFLyNDW $ WLUR[LQN|WĘ JOREXOLQ 7%* V]pUXPV]LQWMHLQHN HPHONHGpVH PLDWW QĘ D SDM]VPLULJ\HQNtYOL74 NpV]OHWGHH]DQ|YHNHGpVFVDNN|UOEHOO—J74-HWWHV]NLpV QDJ\UpV]WD]HOVĘWULPHV]WHUDODWt alakul ki. Mivel a fokozott T₄ LJpQ\DV]OpVLJIHQQPDUDG QHPYDOyV]tQĦKRJ\DWLUR[LQN|WĘJOREXOLQV]pUXPV]LQWMpQHNHPHONHGpVHOHQQHD]HJ\HGOL

PDJ\DUi]DWKR]]iMiUXOPpJYDOyV]tQĦOHJD74 OHERQWiVDDSODFHQWiEDQiWNHUOpVHD]DQ\iEyO DPDJ]DWEDpVDIRNR]RWWDQ\DLNOtUHQV]HLVBURROW et al., 1994.).

(J\HJpV]VpJHV, nem terhes IHOQĘWWQĘNE—JMRGLGRWKDV]QRVtWDSDMzsmirigyhormonok WHUPHOpVpKH]1HPWHUKHVQĘNHVHWpQKDDMyGEHYLWHOHOHJHQGĘQDSL—JDSDM]VPLULJ\D UHQGHONH]pVUHiOOyMyG-iWYHV]LIHO,O\HQN|UOPpQ\HNN|]|WWPHWDEROLNXVHJ\HQV~O\iOO IHQQpVDV]HUYH]HWNpSHVEĘVpJHVMyGUDNWiUDWIHQQWDUWDQLDSDM]VPLULJ\HQEHOO-20 mg-os QDJ\ViJUHQGEHQ(]]HOV]HPEHQ, KDDQDSLMyGEHYLWHO—J-UDNRUOiWR]yGLNDV]DEiO\R]y PHFKDQL]PXV N|YHWNH]WpEHQ IRNR]yGLN D PLULJ\ UHODWtY MyGIHOYpWHOH GH H] QHP HOHJHQGĘ D SDM]VPLULJ\KRUPRQRN V]LQWp]LVpKH] $ KLiQ\]y PHQQ\LVpJ NRPSHQ]iOiViKR] D SDM]VPLULJ\EHQWiUROWMyGRWKDV]QiOMDDV]HUYH]HWtJ\DQQDNV]LQWMHHJ\UHMREEDQFV|NNHQ+D D WiSOiONR]iVL V]RNiV QHP YiOWR]LN D YL]HOHWWHO W|UWpQĘ MyGYHV]WpV EL]RQ\RV PpUWpNĦ DONDOPD]NRGiVD HOOHQpUH HJ\ LGĘ XWiQ D PHWDEROLNXV HJ\HQV~O\ QHJDWtYYi YiOLN A SDM]VPLULJ\ PHJSUyEiO DONDOPD]NRGQL IRNR]RWW MyGIHOYpWHO D PLULJ\ KLSHUWUyILiMD pV D KLSRIt]LVIRNR]RWW76+HOYiODV]WiVDUpYpQ (GLINOER, 2004.).

2.2.3.2.

$MyGPHWDEROL]PXVD DWHUKHVVpJVRUiQ

$ WiSOiOpNNDO IHOYHWW MyG HOĘV]|U MRGLGGi UHGXNiOyGLN PDMG D EHOHNEĘO J\RUVDQ felsztYyGLN$WiSOiOpNEyOV]iUPD]yModid, valamint a pDM]VPLULJ\KRUPRQRNpVMyGWLURQLQRN GHMRGLQiOiV ~WMiQ W|UWpQĘ SHULIpULiV OHERQWiViEyO V]iUPD]y MRGLG DONRWMD D SDM]VPLULJ\HQ NtYOL V]HUYHWOHQ MyGNpV]OHWHW DPL GLQDPLNXV HJ\HQV~O\EDQ YDQ D SDM]VPLULJJ\HO pV D YHVpNNHO

7HUKHVVpJ VRUiQ NpW DODSYHWĘ YiOWR]iV PHJ\ YpJEH D MyG PHWDEROL]PXViEDQa jodid UHQiOLVNOtUHQV]H MHOHQWĘVHQIRNR]yGLN (kb. 1,3 ± 1,5±V]HUHVpUH D JORPHUXOXV ILOWUiFLyV UiWD (*)5 HPHONHGpVH PLDWW H]]HO HJ\LGHMĦOHJ D SDM]VPLULJ\KRUPRQ WHUPHOpV LJpQ\H WDUWyVDQ IRNR]yGLNNE-V]HUHVpUHQDSL—J-UyO—JKRUPRQiOLVMRGLGUD (GLINOER, 2004.).

$UHQiOLVKLSHUILOWUiFLypVDMRGLGYHVpQNHUHV]WOW|UWpQĘfokozott NLUOpVHa JHV]WiFLyHOVĘ heteLEHQ PHJNH]GĘGLN pV D WHUPLQXVLJ IHQQPDUDG HJ\ N|WHOH]Ę ÄMyGV]LYiUJiVW´ NpSH]YH (QQHNN|YHWNH]WpEHQD NHULQJpVEHQFV|NNHQDV]HUYHWOHQMRGLGV]LQWMHDPLDSDM]VPLULJ\EĘO W|UWpQĘMRGLG-UOpVkompenzaWRULNXVQ|YHNHGpVpWYiOWMDNL.

Az DQ\iW pULQWĘ MyGPHJYRQiVRN HJ\ PiVRGLN PHFKDQL]PXVD D JHV]WiFLy NpVĘEEL V]DNDV]iEDQ MHOHQWNH]LN $ UHQGHONH]pVUH iOOy MyG HJ\ UpV]H D] DQ\DL NHULQJpVEĘO iWNHUO D magzati-SODFHQWiULV HJ\VpJEH $ JHV]WiFLy N|]HSpUH D PDJ]DWL SDM]VPLULJ\ PHJNH]GL D pajzsmirLJ\KRUPRQRN WHUPHOpVpW PHO\HN QpONO|]KHWHWOHQHN D PDJ]DW PHJIHOHOĘ IHMOĘGpVpKH]GLINOER, 2001.)

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2.2.3.3.

A placenta, mint barrier

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$]RQNtYOKRJ\DSODFHQWDHOHYHFVHNpO\PpUWpNEHQiWMiUKDWyDSDM]VPLULJ\KRUPRQRNNDO V]HPEHQ NLPXWDWWiN KRJ\ D] DQ\iEyO PDJ]DWED W|UWpQĘ KRUPRQiWMXWiV VHEHVVpJpW W|EE WpQ\H]Ę LV PyGRVtWMD ~J\PLQW D] DQ\DL V]pUXPEDQ WDOiOKDWy 7%* D] DQ\DiOODt SDM]VPLULJ\pQHNiOODSRWDDPDJ]DWLSDM]VPLULJ\PĦN|GpVNiURVRGiVD pVDYHPKHVVpJDGRWW szakasza, YDODPLQW D MyGWLURQLQRN HQ]LPDWLNXV MyGWDODQtWiViQDN LQWHQ]LWiVD PDJiEDQ D SODFHQWiEDQBRZEZINSKA-SLEBODZINSKA et al., 1997.).

$ JHV]WiFLy - KHWpEHQ D] iWODJRV |VV]-T₄ NRQFHQWUiFLy D] DQ\DL V]pUXPEDQ ng/dl (146 nmol/l), az allantois IRO\DGpNEDQQJGOQPROOD]DPQLRQIRO\DGpNban

pedig 1,6 ng/dl (0,02 nmol/l). A allantois IRO\DGpNEDQ D] U73 NRQFHQWUiFLyN -szor, az DPQLRQ IRO\DGpNban pedig 15-V]|U PDJDVDEEDN PLQW D 74 koncentriFLyN $z allantois folyadpNEDQD74 NRQFHQWUiFLyN|]YHWOHQOD]DQ\DLV]pUXP74 NRQFHQWUiFLyMiYDODUiQ\RVDQ YiOWR]LN (BURROW et al., 1994.).

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NRQFHQWUiFLyMiKR] pV V]LQWH D PLQLPiOLVUD FV|NNHQWLN D PDJ]DWL KLSRWLUHy]LV KDWiVDLW (BURROW et al., 1994.).

2.2.3.4.

$PDJ]DWLSDM]VPLULJ\PĦN|GpVNLDODNXOiVD

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—JGO QPROO $ 7%* V]LQWMpQHN SURJUHVV]tY HPHONHGpVH IHOWHKHWĘHQ D PDJ]DWL PiM pUpVpW pV |V]WURJpQ iOWDOL VWLPXOiOiVVDO V]HPEHQL pU]pNHQ\VpJpW WNU|]L $PLQW D 7%*

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2.2.3.5.

$MyGWLURQLQRNPHWDEROL]PXVDDPDJ]DWEDQ

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2.2.3.6.

$MyGWLURQLQRNV]HUHSHD]DPQLRQIRO\DGpNban

Az DPQLRQIRO\DGpNpVD]DPQLRQUHJHJ\PiVRGLN~WYRQDODWEL]WRVtWD]DQ\DpVDPDJ]DW N|]|WWDIRO\DGpNpVDPROHNXOiNNLFVHUpOĘGpVpKH]

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$ WHUPLQXV LGHMpQ D 74 NRQFHQWUiFLy D] DPQLRQ IRO\DGpNEDQ —JGO N|UO YDQ QPROODPLVRNNDODODFVRQ\DEEPLQWD]DQ\DLYDJ\PDJ]DWLV]pUXPEDQ(]]HOV]emben az U7 NRQFHQWUiFLyMD NE KiURPV]RURVD D] DQ\DL V]pUXPEDQ OpYĘQHN pV QHJ\HGH D N|OG|N]VLQyUEyO V]iUPD]y YpUEHQ PpUW U73 NRQFHQWUiFLyQDN 9HOHV]OHWHWWHQ KLSRWLUHy]LVRV PDJ]DWRNQiO D] DPQLRQ IRO\DGpNEDQ PpUKHWĘ MyGWLURQLQ-NRQFHQWUiFLyN QDJ\UpV]W D] Dnyai SDM]VPLULJ\PĦN|GpVpWWNU|]LN$]DPQLRQIRO\DGpNEDQDIHKpUMHpVD7%* NRQFHQWUiFLyL alacsonyak, a szabad T₄ NRQFHQWUiFLy NLVVp PDJDVDEE PLQW D] DQ\DL YDJ\ D PDJ]DWL V]pUXPEDQ D V]DEDG U73 NRQFHQWUiFLy SHGLJ VRNNDO PDJDVDEE PLQW D] DQ\DL V]pUXPEDn (BURROW et al., 1994.).

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Az DPQLRQ IRO\DGpN pajzsmirigyhormon NRQFHQWUiFLyMD J\HQJpQ NRUUHOiO D PDJ]DWL SDM]VPLULJ\PĦN|GpVpYHOPEKONEN et al., 1984.).

2.2.4.

+LiQyos MyGHOOiWiVN|YHWNH]PpQ\HLDWHUKHVVpJDODWW

6]DNHPEHUHNV]HULQWD]RNRQDWHUOHWHNHQ± VNDQGLQiYRUV]iJRN6YiMF$XV]WULD86$

-DSiQ ± DKRO UpJyWD PĦN|GQHN QHP]HWL SURJUDPRN D] pWUHQGL MyGSyWOiVUD RWW D MyGKLiQ\RV NyUNpSHNQHPMHOHQWHQHNSUREOpPiNDW$]RQEDQHJ\~MDEEIHOPpUpVV]HULQWSpOGiXOD]86$- EDQD]XWyEELpYWL]HGEHQNLIHMH]HWWHQFV|NNHQWDMyGEHYLWHOHJ\pYWL]HGGHOH]HOĘWWYpJ]HWW IHOPpUpVHUHGPpQ\HLKH]YLV]RQ\tWYD (GLINOER, 2001.).

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2.2.4.1.

$WHUKHVVpJDODWWLJRO\YDNpS]ĘGpV

$ WHUKHVVpJ DODWWL DNiU HQ\KH MyGKLiQ\is fokozott pajzsmirigy-VWLPXOiOiVW HUHGPpQ\H]

DPHO\ PLQG D] DQ\iQiO PLQG D PDJ]DWQiO JRO\YDNpS]ĘGpVKH] YH]HW $ WHUKHVVpJ DODWWL JRO\YDNpS]ĘGpV D MyGKLiQ\ leggyakoribb jele $ IRJDP]iV HOĘWWL FVHNpO\ MyGNpV]OHW D SDM]VPLULJ\EHQDQDJ\REEMyGKDV]QRVXOiVLUiQWLIRNR]RWWLJpQ\DWHUKHVVpJNH]GHWpWĘOpVD JHV]WiFLy WHOMHV LGĘWDUWDPD DODWW IHQQiOOy HOpJWHOHQ QDSL MyGEHYLWHO HJ\WWHVHQ NpSYLVHOL D fokozott pajzsmirigy-VWLPXOiOiVpVD]HEEĘOHUHGĘWHUKHVVpJDODWWLJRO\YDNpS]ĘGpVKiURPIĘ NRPSRQHQVpWGLINOER, 2001.). $]RQEDQ.QXGVHQpVPXQNDWiUVDLYL]VJiODWDLNVRUiQDUUDD N|YHWNH]WHWpVUH MXWRWWDN KRJ\ W|EE N|UQ\H]HWL WpQ\H]Ę LV V]HUHSHW MiWV]KDW D JRO\YDNpS]ĘGpVEHQPHO\HNSRWHQFLiOyKDWiVVDOYDQQDNHJ\PiVUDMyGKLiQ\HJ\PiVWN|YHWĘ WHUKHVVpJHNGRKiQ\]iVKNUDSEN et al., 2002.).

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YLV]RQ\tWYDpVHFVHFVHPĘN-iQiOU|YLGGHODV]OHWpVXWiQpV]OHOKHWĘYROWDSDMzsmirigy KLSHUSOi]LiMDPtJDNH]HOWDQ\iN~MV]O|WWMHLN|]OHJ\QpOVHPGLINOER, 2001.).

$QQDN pUWpNHOpVpUH KRJ\ D SDM]VPLULJ\WpUIRJDW WHUKHVVpJ DODWWL YiOWR]iVDL UHYHU]LELOLVHN-e,

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W~O]RWWVWLPXOiOiVDDWHKHUEHHVpVXWiQ $]WKRJ\DJRO\YDNpS]ĘGpVPHJHOĘ]pVpKH]PHQQ\L MyGSyWOiVW NHOO DGQL KHO\LOHJ NHOO pUWpNHOQL pV H] QDJ\PpUWpNEHQ IJJ D] HOHYH IHQQiOOy MyGKLiQ\ PpUWpNpWĘO $ YpJVĘ FpO HJ\ NLHJ\HQV~O\R]RWW MyGVWiWXV] KHO\UHiOOtWiVD pV IHQQWDUWiVDPHO\KH]DOHJW|EEHVHWEHQQDSL-—JMyGEHYLWHOV]NVpJHVDWHUKHVVpJDODWW (GLINOER, 2001.).

2.2.4.2.

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$]HQGpPLiVNUHWpQL]PXVUDMHOOHP]ĘQHXUROyJLDLNpSHWDIHMOĘGĘDJ\DWpUĘNiURVtWyKDWiVRN RNR]]iNPHO\HNPiUDJHV]WiFLyHOVĘWULPHV]WHUHVRUiQIHOOpSQHNVNHWVpJGHW|EEQ\LUHD PiVRGLN WULPHV]WHU DODWW PtJ D NyURV NLVDJ\L HOYiOWR]iVRN SRV]WQDWiOLV KDWiVEyO V]iUPD]KDWQDN (]W DOiWiPDV]WMD D] D PHJILJ\HOpV KRJ\ D] HQGpPLiV NUHWpQL]PXV WHOMHV QHXUROyJLDLNpSHFVDNDNNRUHOĘ]KHWĘPHJKDDMyGKLiQ\NRUUHNFLyMiUDDWHUKHVVpJPiVRGLN WULPHV]WHUHHOĘWWNHUOVRUVĘWRSWLPiOLVHVHWEHQPpJIRJDP]iVHOĘWW (GLINOER, 2001).

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$MyGKLiQ\KR]WiUVXOyQHXUR-LQWHOOHNWXiOLVGHILFLWHNQHPNRUOiWR]yGQDNDV~O\RVMyGKLiQ\W pVHQGpPLiVNUHWpQL]PXVWPXWDWyWiYROLWHUOHWHNUH0pUVpNHOWYDJ\DNiUHQ\KHMyGKLiQ\RV WHUOHWHNHQ YpJ]HWW YL]VJiODWRN V]HULQW D NOLQLNDLODJ HXWLUHRLG QRUPiOLV SDM]VPLULJ\- PĦN|GpVĦ LVNROiVNRU~ J\HUHNHNQpO LV HOĘIRUGXOWDN IHMOĘGpVL UHQGHOOHQHVVpJHN 0pJ D KDWiUHVHWL MyGKLiQ\ LV FV|NNHQW LVNRODL WHOMHVtWPpQQ\HO MiUKDW OiWV]yODJ HJpV]VpJHV J\HUHNHNQpO (VITTI et al., 1992).

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NH]HOpV NpVOHOWHWpVH XJ\DQLO\HQ KDWiVVDO YDQ D] ,4-UD +D YHOHV]OHWHWW KLSRWLUHy]LVban V]HQYHGĘFVHFVHPĘNNH]HOpVpQHNHOVĘpYHVRUiQDODFVRQ\V]pUum T₄NRQFHQWUiFLyNPpUKHWĘN

~MV]O|WWHNQHPUpV]HVOQHNNH]HOpVEHQDNNRUpOHWNHOVĘ-KyQDSMiEDQKDYRQWD-5 IQ pontot ves]tWHQHN%8552: et al., 1994.).

A hipRWLUR[LQpPLDWHUKHVVpJDODWWRO\DQIRUPiEDQis jelen lehet, PHO\QHPN|]YHWOHQOD MyGKLiQQ\DO IJJ |VV]H KDQHP D SDM]VPLULJ\ DOXOPĦN|GpVpYHO NUyQLNXV DXWRLPPXQ WLUHRLGLWLV] HVHWpEHQ DKRO D PLULJ\ FV|NNHQW NDSDFLWiVD PLDWW QHP WXG PHJIHOHOĘHQ alkalmazkodQL D WHUKHVVpJJHO MiUy DQ\DJFVHUH-YiOWR]iVRNKR] (GLINOER ± DELANGE, 2000.).

2.2.5.

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Emberi DPQLRQ IRO\DGpNban a T4 szintje nagyon alacsony, a T3 NRQFHQWUiFLy SHGLJ D kiPXWDWKDWyViJ DOVy KDWiUiQ YDQEzzel szemben az rT3 szintje sokkal magasabb, mint az DQ\DL V]pUXPEDQ GH DODFVRQ\DEE PLQW D] ~MV]O|WW N|OG|N]VLQyUMiQDN V]pUXPiEDQ (BRZEZINSKA-SLEBODZINSKA et al., 1995.). 3DWNiQ\EDQ WHUPLQXV LGHMpQ D] U73 az egyetlen olyaQ MyGWLURQLQ DPHO\QHN D] DPQLRQ IRO\DGpNEDQ DODFVRQ\DEE NRQFHQWUiFLyMD PXWDWKDWy NL PLQW D PDJ]DWL V]pUXPEDQ ROTI et al., 1982.). Vemhes juhok amnion IRO\DGpNiEDQD]U73 NRQFHQWUiFLyMDPHJOHSĘHQDODFVRQ\YROW mind az anyai, mind a magzati V]pUXPKR] YLV]RQ\tWYD 6HUWpVPDJ]DWEDQ D 74, T₃ pV U73 V]pUXPV]LQWMHLQHN PLQWiMD kifejezetteQHOWpUDMXKPDJ]DWEDQWHUPLQXV LGHMpQPHJILJ\HOWPLQWiWyO$PDJ]DWLV]pUXP74

sokkal magasabb, a T3 pedig KDVRQOyYDJ\PDJDVDEEPtJD]U73 NRQFHQWUiFLyMDNE-kal DODFVRQ\DEEPLQWD]DQ\DLV]pUXPEDQ(BRZEZINSKA-SLEBODZINSKA et al., 1995.).

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PHJHOĘ]L D SDM]VPLULJ\ PĦN|GpVpQHN EHLQGXOiViW CALVO et al., 1992.; BRZEZINSKA- SLEBODZINSKA et al., 1995.).

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Az DPQLRQ IRO\DGpN T4 NRQFHQWUiFLyMiQDN JHV]WiFLy N|]HSpQ PpUW V]LJQLILNiQV HPHONHGpVHHJ\EHHVLNDPDJ]DWLSDM]VPLULJ\PĦN|GpVEHLQGXOiViYDO6HUWpVYHPKHVVpJpQHN PiVRGLN IHOpEHQ D] DPQLRQ IRO\DGpNEDQ PpUW UHODWtY VWDELO 74 NRQFHQWUiFLy KDVRQOtW D]

HPEHUQpOPpUWNRQFHQWUiFLyNUD, GHQHPKDVRQOtWDMXKRNQiOLOOHWYHSDWNiQ\RNQiOmegfigyelt hormonszintre.

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RNR]WDD]WKRJ\QHPYROWNLPXWDWKDWy73 az DPQLRQIRO\DGpNEDQpVDOODQWRLVIRO\DGpNban, PLYHOD5,$PyGV]HUUHOD73-V]XOIiWRWQHPWXGWiNPpUQL

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Az DPQLRQ IRO\DGpN pV DOODQWRLV IRO\DGpN T4 pV U73 NRQFHQWUiFLyN N|]|WW VHPPLO\HQ NRUUHOiFLyWQHPWDOiOWDNDPLDUUDXWDOKRJ\ DYHPKHVVpJVRUiQHNRPSDUWPHQWHNN|]|WWD SDM]VPLULJ\KRUPRQRNNLFVHUpOĘGpVHPLQLPiOLVPpUWpNĦ0iVUpV]UĘOD]RQEDQD]U73pVD¶- T₂SiUKX]DPRVYiOWR]iVDLD]WPXWDWMiNKRJ\D]U73¶-GHMRGLQiOiVDD]DOODQWRLVIRO\DGpNban is, mint az DPQLRQIRO\DGpNEDQIRQWRVV]XEV]WUiWRWMHOHQWHKKH]DGLMyGWLURQLQ-WHUPHOpVKH]

(BRZEZINSKA-SLEBODZINSKA et al., 1995.).

2.2.6.

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A magzatokban PpUWKRUPRQV]LQWHN

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Tiroxin

0 5 10 15 20 25 30 35 40

20-21 30 35 58-62 napok

nmol/l

anyai szérum allantois amnion

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Magzatok kora (nap)

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Allantois T4 iWOag “ SD (nmol/l)

Amnion T4 iWODJ“

SD (nmol/l)

20-21 31.11 “ 12.01 “ 9.46 “

30 26.89 “ 9.77 “ 8.52 “

35 37.02 “ 7.35 “ 10.63 “

58-62 38.61 “ 8.68 “ 10.28 “

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