Plummer effect: Difference between revisions
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The Plummer effect is one several feedforward mechanisms taking place in follicular cells of the thyroid gland and preventing the development of thyrotoxicosis in situations of extremely high supply with iodine.
History
In 1923 the American physician Henry Stanley Plummer discovered that high-dose iodine may be effective in the treatment of Graves’ disease [1]. Today, “Plummering” is one of several emergency measures in the management of severe thyrotoxicosis[2].
Mechanism
Unlike the Wolff–Chaikoff effect (where a high iodine concentration inhibits the uptake of iodine in thyroid cells and the formation of thyroid hormones) and the dehalogenase inhibition effect (where high iodine levels block deiodinases and other dehalogenases), the Plummer effect inhibits the proteolysis of thyroglobulin and the release of pre-formed thyroid hormones from follicles[3].
Clinical implications
Only the Wolff–Chaikoff effect is helpful to prevent the thyroid from uptaking radioactive iodine in the case of nuclear emergencies. Therefore, "plummering" with high-dose iodine is only effective in a short time window after the release of radionuclides[4]. Wrong timing of iodine use may even increase the risk by triggering the Plummer effect[5].
The Plummer effect is, however, helpful in the management of thyrotoxicosis, where the usage of Lugol’s solution helps to limit the release of thyroid hormones into the bloodstream[2].
See also
References
- ^ Plummer HS 1923 Results of administering iodine to patients having exophthalmic goiter. Journal of the American Medical Association 80 1955–1965
- ^ a b Reyes-Castano, John J.; Burman, Kenneth (2014). "Thyrotoxic Crisis: Thyroid Storm". Endocrine Emergencies: 77–97. doi:10.1007/978-1-62703-697-9_9.
- ^ Saller, B; Fink, H; Mann, K (1998). "Kinetics of acute and chronic iodine excess". Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association. 106 Suppl 3: S34-8. doi:10.1055/s-0029-1212044. PMID 9865552.
- ^ Zanzonico, PB; Becker, DV (June 2000). "Effects of time of administration and dietary iodine levels on potassium iodide (KI) blockade of thyroid irradiation by 131I from radioactive fallout". Health physics. 78 (6): 660–7. doi:10.1097/00004032-200006000-00008. PMID 10832925.
- ^ Meristoudis, G; Ilias, I (June 2022). "Caveats in the use of potassium iodide for thyroid blocking". European journal of nuclear medicine and molecular imaging. 49 (7): 2120–2121. doi:10.1007/s00259-022-05797-7. PMID 35403862.