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Mechanism of Action KI has several mechanisms of action on thyroid function.KI floods the thyroid with non-radioactive iodine, preventing the uptake of the radioactive molecules and subsequently excreted in the urine.[14]
The precise mechanism by which KI acts against inflammatory dermatoses is unknown.Research demonstrates that iodine and dapsone can suppress the production of toxic oxygen intermediates by polymorphonuclear cells and thus exert its anti-inflammatory effect.[15] The precise mechanism by which KI kills fungi is also unknown.It results from a decrease in Na+/I- symporter (NIS) expression, except in abnormal autoregulation of the iodine in autoimmune thyroid disease.[13] The iodine organification persists and can result in or exacerbate hypothyroidism in patients with Hashimoto thyroiditis or ameliorate hyperthyroidism in Graves disease.The dermatoses treatable with KI usually display neutrophils in the early stages.
Original text
Mechanism of Action
KI has several mechanisms of action on thyroid function. In euthyroid patients, iodine has two effects at two different times. The most rapid (hours to days) effect, at pharmacologic doses of KI, decreases thyroglobulin proteolysis, thereby decreasing thyroid hormone secretion. The resulting slight reductions of T4 and T3 concentrations in serum cause transient increases of thyrotropin (TSH) concentrations in serum.[10] Secondly, KI inhibits thyroid hormone synthesis. The administration of KI leads to temporary inhibition of iodine organification in the thyroid gland, thereby decreasing thyroid hormone biosynthesis, a phenomenon called the Wolff-Chaikoff effect. However, within two to four weeks of continual exposure to excess iodine, organification, and thyroid hormone, biosynthesis resumes normally, called escape from the Wolff-Chaikoff effect.[11][12] This phenomenon is produced by lower iodide uptake during the escape from the acute Wolff–Chaikoff effect. It results from a decrease in Na+/I– symporter (NIS) expression, except in abnormal autoregulation of the iodine in autoimmune thyroid disease.[13] The iodine organification persists and can result in or exacerbate hypothyroidism in patients with Hashimoto thyroiditis or ameliorate hyperthyroidism in Graves disease. Thus, patients with Graves hyperthyroidism are more sensitive than normal subjects to the inhibitory effect of pharmacologic doses of iodine, making iodine treatment effective in some patients. Also, pharmacologic amounts of iodine may acutely ameliorate hyperthyroidism by blocking thyroid hormone release.[4] Furthermore, it is used in preparation for thyroidectomy because it decreases the vascularity of the thyroid gland. Therefore, this decreases the risk of post-thyroidectomy hemorrhaging.[1][2] KI should be administered at least one hour after administering thioamides to prevent new hormone synthesis since the new iodine substrate.
In the event of a nuclear accident, taken once daily, KI can decrease the mortality and morbidity of thyroid cancers provoked by radioactive iodine exposure because it directly blocks the radioiodine uptake in the thyroid gland. KI floods the thyroid with non-radioactive iodine, preventing the uptake of the radioactive molecules and subsequently excreted in the urine.[14]
The precise mechanism by which KI acts against inflammatory dermatoses is unknown. The dermatoses treatable with KI usually display neutrophils in the early stages. Research demonstrates that iodine and dapsone can suppress the production of toxic oxygen intermediates by polymorphonuclear cells and thus exert its anti-inflammatory effect.[15] The precise mechanism by which KI kills fungi is also unknown. It is unclear whether KI works against fungi by a fungicidal mechanism or enhancing the body's immunologic and nonimmunologic defense mechanisms. However, it is possible to assume that it has an important anti-inflammatory role since the patients that show better response also present systemic symptoms and increased C-reactive protein. It usually improves fast, with fever, pain, and erythema reduction in two days and complete remission in up to two weeks.[9]
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