Nonthionamide Drugs for the Treatment of Hyperthyroidism: From Present to Future

Figure 1

Mechanism of nonthionamide antithyroid drugs. Iodine-containing compounds mainly inhibit thyroid hormone release and transiently inhibit organification. Lithium also inhibits thyroid hormone release and may inhibit thyroid hormone synthesis. Perchlorate inhibits active iodide uptake by competitively binding with NIS. Glucocorticoid inhibits peripheral T4 to T3 conversion and may inhibit thyroid hormone secretion. MAbs act at the ectodomain of the TSH receptor while SMLs act at the transmembrane domain of the TSH receptor. MAbs: monoclonal antibodies; NIS: sodium iodide symporter; SMLs: small-molecule ligands; Tg: thyroglobulin; TSHR: thyroid-stimulating hormone receptor.