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Shahida B, Planck T, Singh T, Åsman P, Lantz M. Smoking enhances proliferation, inflammatory markers, and immunoglobulins in peripheral blood mononuclear cells from Graves' patients. Endocr Connect 2024; 13:e230374. [PMID: 38614122 PMCID: PMC11103748 DOI: 10.1530/ec-23-0374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 04/09/2024] [Indexed: 04/15/2024]
Abstract
Graves' disease (GD) and Graves' ophthalmopathy (GO) are complex autoimmune diseases. This study delved into the impact of cigarette smoke extract (CSE), simvastatin, and/or diclofenac on peripheral blood mononuclear cells (PBMCs). Specifically, we explored alterations in IL-1B, IL-6, PTGS2 expression, B- and T-lymphocyte proliferation, and Immunoglobulin G (IgG) production. We also assessed IGF1's influence on B- and T-lymphocyte proliferation. PBMCs from Graves' patients were exposed to CSE with/without simvastatin and/or diclofenac. Gene and protein expression was compared with untreated PBMCs. B- and T-lymphocyte proliferation was assessed following IGF1 treatment. PBMCs exposed to CSE exhibited increased expression of IL-1B (6-fold), IL-6 (10-fold), and PTGS2 (5.6-fold), and protein levels of IL-1B (4-fold), IL-6 (16-fold) and PGE2 (3.7-fold) compared with untreated PBMCs. Simvastatin and/or diclofenac downregulated the expression of PTGS2 (0.5-fold), IL-6 (0.4-fold), and IL-1B (0.6-fold), and the protein levels of IL-1B (0.6-fold), IL-6 (0.6-fold), and PGE2 (0.6-fold) compared with untreated PBMCs. CSE exposure in PBMCs increased the proliferation of B and T lymphocytes by 1.3-fold and 1.4-fold, respectively, compared with untreated. CSE exposure increased IgG (1.5-fold) in supernatant from PBMCs isolated from Graves' patients. IGF1 treatment increased the proliferation of B and T lymphocytes by 1.6-fold. Simvastatin downregulated the proliferation of B and T lymphocytes by 0.7-fold. Our study shows that CSE significantly upregulated the expression and release of the inflammatory markers PTGS2, IL-6 and IL-1B,the IgG levels, and the proliferation of B and T lymphocytes. Additionally, IGF1 increased the proliferation of B and T lymphocytes. Finally, these effects were decreased by diclofenac and/or simvastatin treatment.
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Affiliation(s)
- Bushra Shahida
- Department of Clinical Sciences, Genomics, Diabetes and Endocrinology, Lund University, Malmö, Sweden
- Department of Diabetes & Endocrinology, Skåne University Hospital, Malmö, Sweden
| | - Tereza Planck
- Department of Clinical Sciences, Genomics, Diabetes and Endocrinology, Lund University, Malmö, Sweden
- Department of Diabetes & Endocrinology, Skåne University Hospital, Malmö, Sweden
| | - Tania Singh
- Department of Clinical Sciences, Genomics, Diabetes and Endocrinology, Lund University, Malmö, Sweden
| | - Peter Åsman
- Department of Clinical Sciences Malmö, Ophthalmology, Lund University, Malmö, Sweden
- Department of Ophthalmology, Skåne University Hospital, Malmö, Sweden
| | - Mikael Lantz
- Department of Clinical Sciences, Genomics, Diabetes and Endocrinology, Lund University, Malmö, Sweden
- Department of Diabetes & Endocrinology, Skåne University Hospital, Malmö, Sweden
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Shahida B, Tsoumani K, Planck T, Modhukur V, Asp P, Sundlöv A, Tennvall J, Åsman P, Lindgren O, Lantz M. Increased risk of Graves´ophthalmopathy in patients with increasing TRAb after radioiodine treatment and the impact of CTLA4 on TRAb titres. Endocrine 2022; 75:856-864. [PMID: 34859391 PMCID: PMC8888513 DOI: 10.1007/s12020-021-02952-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/21/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Treatment of Graves´ disease (GD) with radioiodine increases the risk of developing Graves´ ophthalmopathy (GO), and the link between thyroid and orbital tissue may be the presence of TSH-receptors. Radioiodine increases the titers of TRAb and the aim was to investigate the relationship between GO and TRAb titers after treatment with radioiodine and to define the impact of risk genes. METHODS GD patients without ophthalmopathy or previous treatment with radioiodine were prospectively included at treatment with radioiodine for hyperthyroidism. A follow-up was performed 1 year later for the registration of GO development. The study was performed at a University Hospital Clinic; a referral center of all patients treated with radioiodine in the south of Sweden. The main outcome measures were the development of TRAb, anti-TPO, and anti-TG after 3 months and GO after 12 months and relationship to the genetic background (HLA, CTLA-4, and CYR61). RESULTS Three months of radioiodine TRAb titers increased in two thirds of patients (p < 0.0005) but not in the other third. Anti-TPO titers were associated with TRAb (R = 0.362, p < 0.0001) but not anti-TG. At follow-up 1 year later (n = 204) 32 patients developed GO with a proportion of 70% in the group increasing in TRAb titers and 30% in the group with unchanged or lower TRAb titers (p-value < 0.0005). Patients with GO had higher titers of TRAb than patients without GO. CTLA-4 (rs231775 SNP) was significantly (p < 0.005) associated with TRAb titers above the median three months after radioiodine. CONCLUSIONS The increase in TRAb titers after treatment with radioiodine is associated with GO and a genetic variation in CTLA-4 is associated with higher titers of TRAb.
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Affiliation(s)
- Bushra Shahida
- Department of Clinical Sciences Malmö, Diabetes and Endocrinology, Lund University, Malmö, Sweden
| | - Kleoniki Tsoumani
- Department of Endocrinology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö and Lund, Sweden
| | - Tereza Planck
- Department of Endocrinology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö and Lund, Sweden
| | - Vijayachitra Modhukur
- Department of Clinical Sciences Malmö, Diabetes and Endocrinology, Lund University, Malmö, Sweden
| | - Pernilla Asp
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | - Anna Sundlöv
- Department of Oncology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
| | - Jan Tennvall
- Department of Oncology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
| | - Peter Åsman
- Department of Clinical Sciences Malmö, Ophthalmology, Skåne University Hospital, Department of Ophthalmology, Lund University, Malmö, Sweden
| | - Ola Lindgren
- Department of Endocrinology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö and Lund, Sweden
| | - Mikael Lantz
- Department of Endocrinology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö and Lund, Sweden.
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Towards Drug Repurposing in Cancer Cachexia: Potential Targets and Candidates. Pharmaceuticals (Basel) 2021; 14:ph14111084. [PMID: 34832866 PMCID: PMC8618795 DOI: 10.3390/ph14111084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 12/11/2022] Open
Abstract
As a multifactorial and multiorgan syndrome, cancer cachexia is associated with decreased tolerance to antitumor treatments and increased morbidity and mortality rates. The current approaches for the treatment of this syndrome are not always effective and well established. Drug repurposing or repositioning consists of the investigation of pharmacological components that are already available or in clinical trials for certain diseases and explores if they can be used for new indications. Its advantages comparing to de novo drugs development are the reduced amount of time spent and costs. In this paper, we selected drugs already available or in clinical trials for non-cachexia indications and that are related to the pathways and molecular components involved in the different phenotypes of cancer cachexia syndrome. Thus, we introduce known drugs as possible candidates for drug repurposing in the treatment of cancer-induced cachexia.
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Patrinely JR, Hamilton KL, Parke RB, Patrinely JR, Soparkar CNS. Supraorbital Neuralgia Associated With Thyroid Eye Disease. Ophthalmic Plast Reconstr Surg 2021; 37:230-235. [PMID: 32618828 DOI: 10.1097/iop.0000000000001762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To identify the relationship between thyroid eye disease (TED) and supraorbital neuralgia (SON) and establish a reliable approach to the diagnosis and management of TED-associated SON. METHODS This retrospective study included 1,126 patients. Demographics, active and inactive phase status and duration, and reactivation rate were noted. TED clinical activity was determined using the vision, inflammation, strabismus, and appearance assessment system, and TED severity was classified using the European Group of Graves' Orbitopathy system. Subtypes of periorbital pain were identified, and suspected SON was confirmed by supraorbital nerve block. RESULTS Of the study's 1,126 patients, 935 (83%) were deemed "active" at some point during the follow up and 34 (3%) remained "active" at the study's conclusion. Of the 2,251 eyes studied, 1,193 (53%) underwent orbital decompression. Of the 1,126 patients, 946 (84%) reported a retrobulbar "pressure" or "aching," but a distinct, more debilitating pain suggestive of SON was reported in 91 (8%). All 91 patients were given a supraorbital nerve block, and all had complete pain resolution lasting from hours to weeks. Eighty-eight (97%) of the 91 patients with SON-type pain underwent orbital decompression compared to 496 (48%) of the 1,035 without SON-type pain (p < 0.00001). A difference was found in the rate of TED reactivation between those with SON-type symptoms (8%) as compared to those without (2%), p = 0.01. CONCLUSIONS SON of uncertain etiology appears to be a previously underreported but significant pain associated with TED. Paradoxically, although the SON does not appear to be related to the type or severity of TED on standard rating scales, the presence of SON was found to be associated with increased likelihood of both orbital decompression and TED reactivation.
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Kitaguchi Y, Ishihara K, Nishida K. Spontaneous resolution of euthyroid optic neuropathy. CANADIAN JOURNAL OF OPHTHALMOLOGY 2019; 54:e188-e192. [PMID: 31358166 DOI: 10.1016/j.jcjo.2018.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/22/2018] [Accepted: 10/28/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Yoshiyuki Kitaguchi
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
| | | | - Kohji Nishida
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
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Lindgren O, Asp P, Sundlöv A, Tennvall J, Shahida B, Planck T, Åsman P, Lantz M. The Effect of Radioiodine Treatment on TRAb, Anti-TPO, and Anti-TG in Graves' Disease. Eur Thyroid J 2019; 8:64-69. [PMID: 31192144 PMCID: PMC6514523 DOI: 10.1159/000495504] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 11/13/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In Graves' disease (GD), immunocompetent cells infiltrate thyroid tissue with release of TSH-receptor antibodies (TRAb), and radioiodine treatment is known to elicit an immune response with an increase in TRAb. OBJECTIVES The aim was to study if all patients treated with radioiodine respond with a release of TRAb, anti-thyroperoxidase (anti-TPO), and anti-thyroglobulin (anti-TG). METHODS This is a prospective observational study. GD patients (n = 131) were admitted for treatment with radioiodine. Thyroid antibodies were measured before and 3 months after iodine-131 treatment. RESULTS After 3 months, a fold change > 1.1 was found in 66% of the GD patients, while the remaining 34% did not have a change or decrease in in TRAb. Anti-TPO and anti-TG also increased; the former showed an increase in 73% and the latter of 52%, while 27 and 48% decreased/were unchanged. A significant positive correlation was found between TRAb and anti-TPO, but not between TRAb and anti-TG. In the group with an increase in TRAb, the median fold change was 5.1, but there were no additional effects of tobacco smoking. The proportion of females below the median age (51.5 years) was significantly higher in the group that increased in TRAb compared to the one that decreased/was unchanged (66 vs. 34%). CONCLUSIONS Treatment with radioiodine elicits an increase in thyroid antibodies, but not in all GD patients. The proportion of responders varied and was affected by age, resulting in a stronger immune response at younger age. However, there were no additional effects of smoking.
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Affiliation(s)
- Ola Lindgren
- Department of Endocrinology, Lund University, Malmö, Sweden
- Department of Clinical Sciences, Skåne University Hospital, Malmö, Sweden
| | - Pernilla Asp
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | - Anna Sundlöv
- Department of Oncology, Lund University, and Department of Clinical Sciences, Skåne University Hospital, Lund, Sweden
| | - Jan Tennvall
- Department of Oncology, Lund University, and Department of Clinical Sciences, Skåne University Hospital, Lund, Sweden
| | - Bushra Shahida
- Department of Clinical Sciences Malmö, and Diabetes and Endocrinology, Lund University, Malmö, Sweden
| | - Tereza Planck
- Department of Endocrinology, Lund University, Malmö, Sweden
- Department of Clinical Sciences, Skåne University Hospital, Malmö, Sweden
| | - Peter Åsman
- Department of Clinical Sciences Malmö, Ophthalmology, Lund University, and Department of Ophthalmology, Skåne University Hospital, Malmö, Sweden
| | - Mikael Lantz
- Department of Endocrinology, Lund University, Malmö, Sweden
- Department of Clinical Sciences, Skåne University Hospital, Malmö, Sweden
- *Mikael Lantz, Department of Endocrinolgy, Lund University, Jan Waldenströmsgata 24, SE–20502 Malmö (Sweden), E-Mail
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Jiang TJ, Cao XL, Luan S, Cui WH, Qiu SH, Wang YC, Zhao CJ, Fu P. Percentage and function of CD4+CD25+ regulatory T cells in patients with hyperthyroidism. Mol Med Rep 2017; 17:2137-2144. [PMID: 29207121 PMCID: PMC5783454 DOI: 10.3892/mmr.2017.8154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 06/28/2017] [Indexed: 11/06/2022] Open
Abstract
The current study observed the percentage of peripheral blood (PB) CD4+CD25+ regulatory T cells (Tregs) and the influence of CD4+CD25+ Tregs on the proliferation of naïve CD4 T cells in patients with hyperthyroidism. Furthermore, preliminary discussions are presented on the action mechanism of CD4+CD25+ Tregs on hyperthyroidism attacks. The present study identified that compared with the percentage of PB CD4+CD25+ Tregs in healthy control subjects, no significant changes were observed in the percentage of PB CD4+CD25+ Tregs in patients with hyperthyroidism (P>0.05). For patients with hyperthyroidism, CD4+CD25+ Tregs exhibited significantly reduced inhibition of the proliferation of naïve CD4 T cells and decreased secretion capacity on the cytokines of CD4 T cells, compared with those of healthy control subjects (P<0.05). In addition, it was demonstrated that thyroid function of patients with hyperthyroidism was significantly improved (P<0.05) subsequent to receiving medication. Compared with the percentage of PB CD4+CD25+ Tregs in patients with hyperthyroidism before treatment, no significant changes were observed in the percentage of PB CD4+CD25+ Tregs in hyperthyroidism patients following treatment (P>0.05). In the patients with hyperthyroidism, following treatment, CD4+CD25+ Tregs exhibited significantly increased inhibition of the proliferation of naïve CD4 T cells and increased secretion capacity of CD4 T cell cytokines, compared with those of the patients with hyperthyroidism prior to treatment (P<0.05). PB CD4+CD25+ Tregs function was decreased in patients with hyperthyroidism, and its non-proportional decrease may be closely associated with the occurrence and progression of hyperthyroidism.
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Affiliation(s)
- Ting-Jun Jiang
- Department of Nuclear Medicine, The Fourth Clinical Medical College of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Xue-Liang Cao
- Department of Nuclear Medicine, The Fourth Clinical Medical College of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Sha Luan
- Department of Nuclear Medicine, The Fourth Clinical Medical College of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Wan-Hui Cui
- Harbin Orthopedics Hospital, Harbin, Heilongjiang 150080, P.R. China
| | - Si-Huang Qiu
- Department of Nuclear Medicine, The Fourth Clinical Medical College of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Yi-Chao Wang
- Department of Nuclear Medicine, The Fourth Clinical Medical College of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Chang-Jiu Zhao
- Department of Nuclear Medicine, The Fourth Clinical Medical College of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Peng Fu
- Department of Nuclear Medicine, 1st Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
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Al-Majdoub M, Lantz M, Spégel P. Treatment of Swedish Patients with Graves' Hyperthyroidism Is Associated with Changes in Acylcarnitine Levels. Thyroid 2017; 27:1109-1117. [PMID: 28699427 DOI: 10.1089/thy.2017.0218] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Hyperthyroidism is associated with alterations in metabolism that are currently only partially understood. The objective of the study was to investigate changes in metabolism associated with reinstatement of euthyroidism in Swedish patients. METHODS Eighty metabolites in plasma were profiled from 10 subjects with Graves' disease (GD) at baseline and after 9 and 15 months of treatment to reinstate euthyroidism. Thyroid parameters, thyrotropin (TSH), TSH receptor antibodies, free triiodothyronine, and free thyroxine were followed. Main findings were validated in plasma from 20 subjects with GD at baseline and at three, six, and nine months. The study was conducted at the endocrinology clinic in Malmö, Sweden. RESULTS Euthyroidism was reinstated at three months, and thyroid status did not change further during the 15-month follow-up. This was paralleled by altered levels of 9/19 detected acylcarnitines (p < 0.05 after adjustment for multiple testing). Levels of short-chain acylcarnitines were decreased, intermediate-chain acylcarnitines elevated, and long-chain acylcarnitines unaltered. CONCLUSIONS GD and treatment of the disease is associated with pronounced acyl chain length-dependent alterations in acylcarnitine levels. These changes may be impacted by ethnicity and or dietary differences.
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Affiliation(s)
- Mahmoud Al-Majdoub
- 1 Unit of Molecular Metabolism, Department of Clinical Sciences in Malmö Lund University , Malmö, Sweden
| | - Mikael Lantz
- 1 Unit of Molecular Metabolism, Department of Clinical Sciences in Malmö Lund University , Malmö, Sweden
- 2 Department of Endocrinology, Skåne University Hospital , Malmö, Sweden
| | - Peter Spégel
- 1 Unit of Molecular Metabolism, Department of Clinical Sciences in Malmö Lund University , Malmö, Sweden
- 3 Centre for Analysis and Synthesis, Department of Chemistry, Lund University , Malmö, Sweden
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