1
|
Yehia Abdelzaher W, A Abdel-Gaber S, Atef Fawzy M, Hamid Sayed Abo Bakr Ali A, Ezzat Attya M, Geddawy A. Atorvastatin protects against cyclophosphamide-induced thyroid injury in rats via modulation of JNK/ ERK/ p38 MAPK signaling pathway. Int Immunopharmacol 2023; 124:111061. [PMID: 37844467 DOI: 10.1016/j.intimp.2023.111061] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/29/2023] [Accepted: 10/10/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Cancer chemotherapy is associated with various tissue toxicities that limit its use. Cyclophosphamide (CYC) is one of the most commonly used antineoplastic and immunosuppressive agent. Thyroid dysfunction is a critical side effect of anticancer drugs. Atorvastatin (ATV) is antihyperlipedemic drug with different tissue protective activities. The aim of this study was to determine the potential protective effect of ATV against CYC-induced thyroid injury in rats. METHODS ATV was administered in the presence and absence of CYC. Thirty-two adult Wistar rats were randomly divided into four groups: control group, ATV group (20 mg/kg/day, p.o. for 14 day), CYC group (200 mg/kg, i.p. on day 9) and ATV/CYC group. Triiodothyronine (T3), thyroxine (T4), reduced glutathione (GSH), malondialdehyde (MDA), total nitrite/nitrate (NOx), p38 mitogen-activated protein kinase (P38MAPK), extracellular signal-regulated kinase (ERK) and c-Jun N-terminal Kinase (JNK) were measured. In addition, thyroid histopathology and caspase 3 immunohistochemistry were performed. RESULTS CYC significantly increased thyroid MDA, NOx, P38MAPK, ERK and JNK with decrease in GSH, T3 and T4 levels. Histopathological features of thyroid lesions and increased caspase 3 immune expression were appeared. ATV significantly normalized distributed oxidative, inflammatory and apoptotic indicators, resulting in an improvement of histopathological features and reduction of caspase 3 immunoexpression. CONCLUSION These findings suggest that ATV protects against CYC-induced thyroid injury by regulating the JNK/ERK/p38-MAPK signaling pathway.
Collapse
Affiliation(s)
| | - Seham A Abdel-Gaber
- Department of Pharmacology, Faculty of Medicine Minia University, Minia 61111, Egypt.
| | - Michael Atef Fawzy
- Department of Biochemistry, Faculty of Pharmacy, Minia University, Minia, Egypt.
| | | | - Mina Ezzat Attya
- Department of Pathology, Faculty of Medicine, Minia University, Minia 61111, Egypt.
| | - Ayman Geddawy
- Department of Pharmacology, Faculty of Medicine Minia University, Minia 61111, Egypt; Department of Basic Medical Sciences, College of Medicine, Prince Sattam Bin Abdulaziz University, Al Kharj 11942, Saudi Arabia.
| |
Collapse
|
2
|
Alzghoul BN, Amer FN, Barb D, Innabi A, Mardini MT, Bai C, Alzghoul B, Al-Hakim T, Singh N, Buchanan M, Serchuck L, Gomez Manjarres D, Woodmansee WW, Maier LA, Patel DC. Prevalence and characteristics of self-reported hypothyroidism and its association with nonorgan-specific manifestations in US sarcoidosis patients: a nationwide registry study. ERJ Open Res 2021; 7:00754-2020. [PMID: 33816601 PMCID: PMC8005680 DOI: 10.1183/23120541.00754-2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/24/2020] [Indexed: 12/15/2022] Open
Abstract
Little is known about the prevalence, clinical characteristics and impact of hypothyroidism in patients with sarcoidosis. We aimed to determine the prevalence and clinical features of hypothyroidism and its relation to organ involvement and other clinical manifestations in patients with sarcoidosis. We conducted a national registry-based study investigating 3835 respondents to the Sarcoidosis Advanced Registry for Cures Questionnaire between June 2014 and August 2019. This registry is based on a self-reported, web-based questionnaire that provides data related to demographics, diagnostics, sarcoidosis manifestations and treatment. We compared sarcoidosis patients with and without self-reported hypothyroidism. We used multivariable logistic regression and adjusted for potential confounders to determine the association of hypothyroidism with nonorgan-specific manifestations. 14% of the sarcoidosis patients self-reported hypothyroidism and were generally middle-aged white women. Hypothyroid patients had more comorbid conditions and were more likely to have multiorgan sarcoidosis involvement, especially with cutaneous, ocular, joints, liver and lacrimal gland involvement. Self-reported hypothyroidism was associated with depression (adjusted odds ratio (aOR) 1.3, 95% CI 1.01-1.6), antidepressant use (aOR 1.3, 95% CI 1.1-1.7), obesity (aOR 1.7, 95% CI 1.4-2.1), sleep apnoea (aOR 1.7, 95% CI 1.3-2.2), chronic fatigue syndrome (aOR 1.5, 95% CI 1.2-2) and was borderline associated with fibromyalgia (aOR 1.3, 95% CI 1-1.8). Physical impairment was more common in patients with hypothyroidism. Hypothyroidism is a frequent comorbidity in sarcoidosis patients that might be a potentially reversible contributor to fatigue, depression and physical impairment in this population. We recommend considering routine screening for hypothyroidism in sarcoidosis patients especially in those with multiorgan sarcoidosis, fatigue and depression.
Collapse
Affiliation(s)
- Bashar N. Alzghoul
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, USA
| | - Farah N. Amer
- Dept of Internal Medicine, University of Central Florida/North Florida Regional Medical Center, Gainesville, FL, USA
| | - Diana Barb
- Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, USA
| | - Ayoub Innabi
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, USA
| | - Mamoun T. Mardini
- Dept of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
- Dept of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Chen Bai
- Dept of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Bara Alzghoul
- Dept of Internal Medicine, University of Kentucky, Lexington, KY, USA
| | | | - Noopur Singh
- Foundation for Sarcoidosis Research, Chicago, IL, USA
| | | | | | - Diana Gomez Manjarres
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, USA
| | - Whitney W. Woodmansee
- Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, USA
| | - Lisa A. Maier
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO, USA
- Division of Pulmonary Sciences and Critical Care Medicine, Dept of Medicine, School of Medicine, Dept of Environmental/Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Campus, Aurora, CO, USA
| | - Divya C. Patel
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, USA
| |
Collapse
|
3
|
Rivas AM, Larumbe-Zabala E, Diaz-Trastoy O, Schurr RN, Jones C, Abdulrahman R, Dar N, Lado-Abeal J. Effect of chemoradiation on the size of the thyroid gland. Proc AMIA Symp 2020; 33:541-545. [PMID: 33100524 DOI: 10.1080/08998280.2020.1786227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
We aimed to evaluate changes in thyroid gland size during the treatment of malignancies outside the head and neck with chemotherapy and/or external beam radiation. We performed a retrospective review of records of adult patients treated at our institution with external beam radiation to the chest and/or chemotherapy with taxanes, alkylating agents, and/or a topoisomerase II inhibitor. Neck and chest computed tomography (CT) images were used to calculate thyroid gland volume before and after therapy, using Vitrea® software or the volumetric ellipsoid method. Thirty-seven patients were included. After treatment, there was a significant reduction in thyroid gland volume of 14.0% (P < 0.01) using Vitrea and 17.1% (P < 0.05) using the volumetric ellipsoid method. Exposure to radiation or chemotherapy was not found to be associated with the degree of thyroid gland reduction, nor was the number of days between CT scans or the stage of the malignancy being treated. Finally, the degree of thyroid gland size reduction did not predict mortality. Our results showed that the treatment of malignancies outside the head and neck with chemotherapy and/or external beam radiation results in a reduction in thyroid gland size. The impact on thyroid gland function remains unknown.
Collapse
Affiliation(s)
- Ana Marcella Rivas
- Division of Endocrinology, Department of Internal Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Eneko Larumbe-Zabala
- Clinical Research Institute, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Olaia Diaz-Trastoy
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - Ryan Nicholas Schurr
- CTSI Oncology Solutions, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Catherine Jones
- Division of Medical Oncology, Department of Internal Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Ramzi Abdulrahman
- Division of Radiation Oncology, Department of Internal Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Nabeel Dar
- Department of Pathology, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Joaquin Lado-Abeal
- Division of Endocrinology, Department of Internal Medicine, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.,Division of Endocrinology, Department of Internal Medicine, Truman Medical Center, University of Missouri-Kansas City, Kansas City, Missouri
| |
Collapse
|
4
|
Affiliation(s)
- Salvatore Benvenga
- Sezione di Endocrinologia del Dipartimento Clinico-Sperimentale di Medicina e Farmacologia, University of Messina School of Medicine, Policlinico Universitario, padiglione H 4 piano, 98125 Messina, Italy
| | - Francesco Trimarchi
- Sezione di Endocrinologia del Dipartimento Clinico-Sperimentale di Medicina e Farmacologia, University of Messina School of Medicine, Policlinico Universitario, padiglione H 4 piano, 98125 Messina, Italy
| |
Collapse
|
5
|
Chin HB, Jacobson MH, Interrante JD, Mertens AC, Spencer JB, Howards PP. Hypothyroidism after cancer and the ability to meet reproductive goals among a cohort of young adult female cancer survivors. Fertil Steril 2015; 105:202-7.e1-2. [PMID: 26474733 DOI: 10.1016/j.fertnstert.2015.09.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 09/04/2015] [Accepted: 09/22/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine whether developing hypothyroidism after cancer treatment is associated with a decreased probability of women being able to meet their reproductive goals. DESIGN A population-based cohort study. SETTING Not applicable. PATIENT(S) A total of 1,282 cancer survivors, of whom 904 met the inclusion criteria for the analysis. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Three outcomes that may indicate reduced fertility, which include failure to achieve desired family size, childlessness, and not achieving pregnancy after at least 6 months of regular unprotected intercourse. RESULT(S) We used data from the Furthering Understanding of Cancer Health and Survivorship in Adult (FUCHSIA) Women's Study to examine the association between being diagnosed with hypothyroidism after cancer and meeting reproductive goals. After adjusting for age and other potential confounders, women reporting hypothyroidism after cancer treatment were twice as likely to fail to achieve their desired family size (adjusted odds ratio [aOR] 1.91; 95% confidence interval [CI], 1.09, 3.33) and be childless (aOR 2.13; 95% CI, 1.25, 3.65). They were also more likely to report having unprotected intercourse for at least 6 months without conceiving (aOR 1.37; 95% CI, 0.66, 2.83). CONCLUSION(S) Although cancer treatments themselves are gonadotoxic, it is important to consider other medical conditions such as hypothyroidism that occur after cancer treatment when counseling patients on the risks for impaired fertility or a shortened reproductive window.
Collapse
Affiliation(s)
- Helen B Chin
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
| | - Melanie H Jacobson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Julia D Interrante
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ann C Mertens
- Aflac Cancer Center, Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia
| | - Jessica B Spencer
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia
| | - Penelope P Howards
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| |
Collapse
|
6
|
Metzger ML, Hudson MM, Somes GW, Shorr RI, Li CS, Krasin MJ, Shelso J, Pui CH, Howard SC. White race as a risk factor for hypothyroidism after treatment for pediatric Hodgkin's lymphoma. J Clin Oncol 2006; 24:1516-21. [PMID: 16575001 DOI: 10.1200/jco.2005.05.0195] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Hypothyroidism frequently occurs after treatment for pediatric Hodgkin's lymphoma, but race has not been investigated as a risk factor for this delayed toxicity. The aim of this study was to determine whether race is an independent risk factor for hypothyroidism in survivors of pediatric Hodgkin's lymphoma. PATIENTS AND METHODS To identify differences between black and white patients in the development of hypothyroidism after treatment for Hodgkin's lymphoma, we conducted a retrospective study of consecutively treated pediatric patients with newly diagnosed Hodgkin's lymphoma treated at St Jude Children's Research Hospital (Memphis, TN) from January 1980 through December 2002. Clinical or biochemical hypothyroidism was defined by an above normal thyroxine-stimulating hormone concentration or by the need for thyroid hormone replacement therapy. RESULTS The 461 patients (388 white patients, 73 black patients) where followed for a median of 11.3 years (range, 1.8 to 24.9 years). Hypothyroidism developed in 196 (43%) of 461 patients after a median of 2.9 years (range, 0.7 to 11.3 years) after diagnosis of Hodgkin's lymphoma. Hypothyroidism developed in 47% of white patients but in only 21% of black patients (hazard ratio = 2.7; 95% CI, 1.6 to 4.6). After adjusting for other risk factors for hypothyroidism (thyroid radiation dose, sex, and nodular sclerosis histology), the risk of hypothyroidism in white patients was 2.5 times (95% CI, 1.5 to 4.3 times) the risk in black patients (P < .001). CONCLUSION White patients have a higher risk of hypothyroidism after neck irradiation for pediatric Hodgkin's lymphoma than black patients.
Collapse
Affiliation(s)
- Monika L Metzger
- Department of Hematology-Oncology, St Jude Children's Research Hospital, Memphis, TN 38105-2794, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Tauchmanovà L, Selleri C, De Rosa G, Esposito M, Di Somma C, Orio F, Palomba S, Lombardi G, Rotoli B, Colao A. Endocrine disorders during the first year after autologous stem-cell transplant. Am J Med 2005; 118:664-70. [PMID: 15922699 DOI: 10.1016/j.amjmed.2005.02.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2004] [Accepted: 11/15/2004] [Indexed: 11/16/2022]
Abstract
BACKGROUND Frequent endocrine disorders have been reported after allogeneic stem-cell transplant, but data on adult survivors of autologous transplants are still scarce. METHODS In this prospective study we investigated early (at 3 months) and late (at 12 months) endocrine dysfunctions in 95 consecutive autologous stem-cell transplant recipients (47 men and 48 women) aged 16 to 55 years. The functions of the hypothalamic-pituitary-gonadal/thyroid/adrenal/somatotroph axis were evaluated. RESULTS Three months after the transplant, insulin-like growth factor-1 values were below the normal range in 53 patients (56%); 37 of 40 women (93%) of reproductive age experienced precocious ovarian failure; 39 of 46 men (85%) showed high follicular stimulating hormone, and 17 men (37%) showed low testosterone levels. Adrenal insufficiency occurred in 28 patients (30%) during the peritransplant period after corticosteroid withdrawal. Transient subclinical hyperthyroidism was found in 15 patients (16%). Transient "low T(3)" syndrome was revealed in 29 patients (31%). Twelve months after the transplant, insulin-like growth factor-1 values were still low in 36 patients (38%). Menstrual cycles resumed in four women; follicular stimulating hormone, luteinizing hormone, and estradiol levels improved in 10 patients. Testosterone was low in only two men (4%). Seminal analysis revealed azoospermia in 32 (91%) of 35 men examined. Subclinical hypothyroidism was found in 11 patients (12%); eight of them had previously received radiotherapy for the upper half of the body. CONCLUSION This study documents frequent endocrine disorders during the first year after autologous stem-cell transplant. Despite a tendency to improve, in more than half of the cases, the complications persisted for more than 1 year. Therefore, to diagnose and correct early and late endocrine dysfunctions, endocrine screening is required during the first year in all patients undergoing autografting.
Collapse
Affiliation(s)
- Libuse Tauchmanovà
- Department of Molecular and Clinical Endocrinology and Oncology, "Federico II" University of Naples, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
van Santen HM, Thonissen NM, de Kraker J, Vulsma T. Changes in thyroid hormone state in children receiving chemotherapy. Clin Endocrinol (Oxf) 2005; 62:250-7. [PMID: 15670204 DOI: 10.1111/j.1365-2265.2005.02210.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The concentrations of thyroid function determinants may change during severe illness. Our goal was to quantify their changes in children with cancer during chemotherapy, and to correlate them to clinical condition and type of drugs. DESIGN During a 3-month period all patients admitted for chemotherapy to the paediatric oncology ward were evaluated for inclusion. Patients with brain tumours, neuroblastoma (cranio)spinal irradiation and use of dexamethasone before the first blood sample were excluded. MEASUREMENTS Plasma concentrations of T4, T3, rT3, thyroxine-binding globulin (TBG), thyroglobulin (Tg), TSH, IGF-1, cortisol, PRL and physical well-being by means of questionnaires were measured before and during chemotherapy. RESULTS In 19 children, 46 courses of chemotherapy and 123 plasma samples were analysed. During chemotherapy, mean concentrations of TSH, T3, Tg and cortisol decreased to 53, 67, 69 and 15% of the baseline value, respectively. Mean plasma rT3 increased to 217% of baseline. In 87% of all courses, one or more thyroid parameter(s) was aberrant. Furthermore, in 23 samples (19%) from 10 patients (53%), the concentration of IGF-1 was below the reference value (adjusted for sex and age). Small changes were seen in scores for clinical condition but none was related to a change in thyroid function determinant. Most changes in thyroid hormones could be attributed to using dexamethasone. CONCLUSIONS These results demonstrate that, in children, thyroid hormone state changes significantly during chemotherapy, apparently not related to physical well-being but to the drugs administered. Future investigations should focus on the impact for patient care and possibilities of (preventive) intervention.
Collapse
Affiliation(s)
- H M van Santen
- Department of Paediatric Endocrinology, Emma Children's Hospital, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | | | | | | |
Collapse
|
9
|
|