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Luo J, Zhou L, Sun A, Yang H, Zhang P, Liu K, Yu X, Lin Y, Huang Y, Han L. Herbal medicine for Hashimoto's thyroiditis: A systematic review and network meta-analysis. JOURNAL OF ETHNOPHARMACOLOGY 2024; 323:117663. [PMID: 38181936 DOI: 10.1016/j.jep.2023.117663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 08/31/2023] [Accepted: 12/24/2023] [Indexed: 01/07/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Conventional treatments for Hashimoto's thyroiditis (HT) are limited. Herbal medicines (HM) are considered a potential intervention for the treatment of HT. AIM OF THE STUDY This study aimed to investigate the efficacy and safety of HM for HT. MATERIALS AND METHODS A Bayesian network meta-analysis was conducted for patients with HT in randomized controlled trials identified in PubMed, Cochrane Library, Web of Science, EMBASE, Chinese Clinical Trial Registry (Chi CTR), China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (the VIP), China Chinese Biomedical Database (CBM), and Wanfang Database were searched from their inception to Oct 1, 2022. Outcomes included the primary outcome (TPOAb), secondary outcomes (TSH, TGAb, FT3, FT4, and traditional Chinese medicine symptom scores), and adverse events. This study was registered in PROSPERO (CRD42022363640). RESULTS Sixteen trials were reviewed and 16 HM formulae were compared. Compared with non-drug therapy (NDT), all therapies, except for Tiaoqi-Qingjie Therapy, reduced the primary outcome of TPOAb with different levels of effectiveness, ranging from 0.01 (95%CI 0.00, 0.02) to 0.92 (95%CI 0.56, 1.53). Ranking probability analysis indicated that Yiqi Huayu Recipe, Liqi Xiaoying decoction, and Shugan Sanjie therapy reduced thyroid antibody levels the most, including TPOAb (100.0%, 90.9%, and 90.3%, respectively) and TGAb (98.3%, 94.4%, and 87.3%, respectively). All HMs displayed a significant effect on the TCM Symptom score and possibly benefitted the treatment of HT, ranging from 6.62 (95% CI 2.06, 21.24) to 94.50 (95% CI 15.97, 559.14). No serious adverse events were reported. CONCLUSIONS Herbal medicines may be effective in the treatment of HT, especially in reducing thyroid antibody levels and improving clinical symptoms without affecting thyroid function. However, these results should be considered preliminary and further verified using high-quality evidence.
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Affiliation(s)
- Jinli Luo
- Institute of Metabolic Diseases, Guang' Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China; Graduate College, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Ling Zhou
- Institute of Metabolic Diseases, Guang' Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China; Graduate College, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Aru Sun
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, 130117, China
| | - Haoyu Yang
- Institute of Metabolic Diseases, Guang' Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Pei Zhang
- Institute of Metabolic Diseases, Guang' Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Ke Liu
- Institute of Metabolic Diseases, Guang' Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Xiaotong Yu
- Institute of Metabolic Diseases, Guang' Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Yiqun Lin
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences (South Campus), Beijing, 100105, China.
| | - Yishan Huang
- Institute of Metabolic Diseases, Guang' Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| | - Lin Han
- Institute of Metabolic Diseases, Guang' Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
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Ushakov AV. Thyroid ultrasound pattern in primary hypothyroidism is similar to Graves' disease: a report of three cases. J Med Life 2024; 17:116-122. [PMID: 38737666 PMCID: PMC11080503 DOI: 10.25122/jml-2023-0507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 01/01/2024] [Indexed: 05/14/2024] Open
Abstract
Ultrasound can identify important characteristics in primary hypothyroidism and diffuse hyperthyroidism (Graves' disease). Therefore, sonologists are actively investigating ultrasound criteria to differentiate between these two conditions. Nevertheless, practice shows the absence of such ultrasonic landmarks. For the first time in the literature, three cases of primary hypothyroidism have demonstrated an ultrasound pattern identical to that of Graves' disease. This pattern includes the presence of goiter, marked total hypoechogenicity of the parenchyma, significantly or moderately increased blood flow intensity ('thyroid inferno'), and elevated peak systolic velocity of the superior thyroid arteries. These signs are less common in hypothyroidism compared to hyperthyroidism. Diagnostic data suggest that the pathogeneses of primary hypothyroidism and Graves' disease share the same mechanisms, leading to similar thyroid ultrasound patterns. One of these shared mechanisms is presumably thyroid overstimulation by the autonomic nervous system, which is adequate to the body's hormonal requirements in hypothyroidism but excessive in hyperthyroidism.
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Gómez-Lavín Fernández L, Comas Rovira M, Pina Pérez S, Moreno Baró A, Corripio Collado R, Zamora Lapiedra M, Lesmes Heredia C, Albert Fabregas L. Management of foetal hyperthyroidism in a mother with autoimmune hypothyroidism: A case report. ENDOCRINOL DIAB NUTR 2023; 70:511-516. [PMID: 37596010 DOI: 10.1016/j.endien.2023.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/24/2023] [Indexed: 08/20/2023]
Abstract
Foetal hyperthyroidism is mediated by transplacental passage of thyroid stimulating antibodies (TSAbs) and affects mothers with autoimmune (AI) thyroid disease. We report a case of a 33-year-old woman with a history of AI hypothyroidism and raised TSI after 2 stillbirths with suspect foetal hyperthyroidism. At 20.5 gestational weeks (GW) of her third pregnancy, foetal tachycardia and goitre were detected. TSI levels were 30.9mUI/mL. Methimazole (MMI) was started and adjusted based on ultrasound signs (foetal heart rate and thyroid gland vascularisation). The neonate was born at 35GW and cord blood revealed decreased TSH and normal free T4. MMI was started in the neonate at 2 days of life due to the appearance of asymptomatic hyperthyroidism. This case illustrates a rare recurrence of foetal hyperthyroidism in a mother with AI hypothyroidism. Pregestational thyroidectomy, TSAbs determination, early ultrasound diagnosis and foetal therapy helped us to improve obstetric outcomes.
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Affiliation(s)
- Lucía Gómez-Lavín Fernández
- Obstetrics and Gynaecology Department, Maternal-Foetal Unit, Parc Taulí Hospital Universitari, Institut d'Investigació i Inovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell (Barcelona), Spain
| | - Montserrat Comas Rovira
- Obstetrics and Gynaecology Department, Maternal-Foetal Unit, Parc Taulí Hospital Universitari, Institut d'Investigació i Inovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell (Barcelona), Spain.
| | - Silvia Pina Pérez
- Obstetrics and Gynaecology Department, Maternal-Foetal Unit, Parc Taulí Hospital Universitari, Institut d'Investigació i Inovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell (Barcelona), Spain
| | - Anna Moreno Baró
- Obstetrics and Gynaecology Department, Maternal-Foetal Unit, Parc Taulí Hospital Universitari, Institut d'Investigació i Inovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell (Barcelona), Spain
| | - Raquel Corripio Collado
- Paediatric Endocrinology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell (Barcelona), Spain
| | - Marc Zamora Lapiedra
- Obstetrics and Gynaecology Department, Maternal-Foetal Unit, Parc Taulí Hospital Universitari, Institut d'Investigació i Inovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell (Barcelona), Spain
| | - Cristina Lesmes Heredia
- Obstetrics and Gynaecology Department, Maternal-Foetal Unit, Parc Taulí Hospital Universitari, Institut d'Investigació i Inovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell (Barcelona), Spain
| | - Lara Albert Fabregas
- Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell (Barcelona), Spain
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Kawasumi M, Kubota M, Matsuura N, Kinoshita Y, Tominaga A. Long-Term Follow-Up Over 16 Years for Pituitary Hyperplasia Due to Primary Hypothyroidism With Positive Thyroid Stimulation Blocking Antibody: A Case Report. Cureus 2023; 15:e43823. [PMID: 37736453 PMCID: PMC10511211 DOI: 10.7759/cureus.43823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2023] [Indexed: 09/23/2023] Open
Abstract
Primary hypothyroidism is a known risk factor for pituitary hyperplasia, which develops symptoms due to compression of the optic chiasma and increased intracranial pressure. As pituitary hyperplasia is known to improve after levothyroxine replacement therapy, there are no reports of a long clinical course of pituitary hyperplasia due to primary hypothyroidism. We describe a case of follow-up over 16 years for pathologically diagnosed pituitary hyperplasia due to primary hypothyroidism with positive thyroid stimulation blocking antibody. Repeated enlargement and shrinkage were confirmed, but observations also suggested that the pituitary gland did not always return to normal size.
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Affiliation(s)
- Muneo Kawasumi
- Department of Endocrinology and Diabetes, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure, JPN
| | - Mitsunobu Kubota
- Department of Endocrinology and Diabetes, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure, JPN
| | - Noriaki Matsuura
- Department of Diagnostic Radiology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure, JPN
| | - Yasuyuki Kinoshita
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Atsushi Tominaga
- Department of Neurosurgery and Neuro-Endovascular Therapy, Hiroshima Prefectural Hospital, Hiroshima, JPN
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Nakamura F, Awaya T, Ohira M, Enomoto Y, Moroi M, Nakamura M. Graves' Disease after mRNA COVID-19 Vaccination, with the Presence of Autoimmune Antibodies Even One Year Later. Vaccines (Basel) 2023; 11:vaccines11050934. [PMID: 37243038 DOI: 10.3390/vaccines11050934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/17/2023] [Accepted: 04/30/2023] [Indexed: 05/28/2023] Open
Abstract
A 45-year-old man who had received his second mRNA COVID-19 vaccination one week earlier was presented to the emergency department with chest discomfort. Therefore, we suspected post-vaccination myocarditis; however, the patient showed no signs of myocarditis. After 2 weeks, he revisited the hospital complaining of palpitations, hand tremors, and weight loss. The patient exhibited high free thyroxine (FT4) (6.42 ng/dL), low thyroid-stimulating hormone (TSH) (<0.01 μIU/mL), and high TSH receptor antibody (17.5 IU/L) levels, and was diagnosed with Graves' disease. Thiamazole was administered, and the patient's FT4 levels normalized after 30 days. One year later, the patient's FT4 is stable; however, their TSH receptor antibodies have not become negative and thiamazole has continued. This is the first case report to follow the course of Graves' disease one year after mRNA COVID-19 vaccination.
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Affiliation(s)
- Fuminori Nakamura
- Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, 2-22-36 Ohashi, Meguro-ku, Tokyo 153-8515, Japan
| | - Toru Awaya
- Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, 2-22-36 Ohashi, Meguro-ku, Tokyo 153-8515, Japan
| | - Masahiro Ohira
- Department of Diabetes, Metabolism and Endocrinology, Toho University Ohashi Medical Center, Tokyo 153-8515, Japan
| | - Yoshinari Enomoto
- Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, 2-22-36 Ohashi, Meguro-ku, Tokyo 153-8515, Japan
| | - Masao Moroi
- Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, 2-22-36 Ohashi, Meguro-ku, Tokyo 153-8515, Japan
| | - Masato Nakamura
- Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, 2-22-36 Ohashi, Meguro-ku, Tokyo 153-8515, Japan
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Micali C, Russotto Y, Celesia BM, Santoro L, Marino A, Pellicanò GF, Nunnari G, Venanzi Rullo E. Thyroid Diseases and Thyroid Asymptomatic Dysfunction in People Living With HIV. Infect Dis Rep 2022; 14:655-667. [PMID: 36136821 PMCID: PMC9498502 DOI: 10.3390/idr14050071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Thyroid diseases (TDs) and thyroid asymptomatic dysfunctions (TADs) are correlated with Human Immunodeficiency virus (HIV) infection and Acquired ImmunoDeficiency Syndrome (AIDS) as well as many endocrine dysfunctions and dysregulation of hormonal axes. To date, available studies on People Living With HIV (PLWH) affected by thyroid diseases and asymptomatic dysfunctions are few and rather controversial. The purpose of the present non-systematic literature review is to recap the current knowledge on the main features of thyroid dysfunctions and disorders in PLWH. Large cohort studies are needed for a better comprehension of the impact, evolution and treatment of thyroid pathologies in the HIV-infected population.
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Affiliation(s)
- Cristina Micali
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy
| | - Ylenia Russotto
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy
- Correspondence: ; Tel.: +39-090-221-2032
| | - Benedetto Maurizio Celesia
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, 95131 Catania, Italy
| | - Laura Santoro
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy
| | - Andrea Marino
- Biomedical and Biotechnological Sciences Department, University of Catania, 95131 Catania, Italy
| | - Giovanni Francesco Pellicanò
- Department of Human Pathology of the Adult and the Developmental Age “G. Barresi”, University of Messina, 98124 Messina, Italy
| | - Giuseppe Nunnari
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy
| | - Emmanuele Venanzi Rullo
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy
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7
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Suzuki N, Watanabe N, Noh JY, Yoshimura R, Mikura K, Kinoshita A, Suzuki A, Mitsumatsu T, Fukushita M, Matsumoto M, Yoshihara A, Katoh R, Sugino K, Ito K. The Relationship Between Primary Thyroid Lymphoma and Various Types of Thyroid Autoimmunity: A Retrospective Cohort Study of 498 Cases, Including 9 Cases with Graves' Disease. Thyroid 2022; 32:552-559. [PMID: 35229626 DOI: 10.1089/thy.2021.0613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Primary thyroid lymphoma (PTL) is known to develop mostly in patients with Hashimoto's thyroiditis (HT), and it is rare for it to develop in patients with Graves' disease (GD). The objective of this study was to investigate the clinical features, pathological findings, and long-term outcomes of PTL patients, grouped according to the presence of GD, HT, or no autoimmune thyroid disease (AITDs). The GD group was of major interest due to limited knowledge of the relationship with PTL. Methods: In this single-center retrospective cohort study, we reviewed the medical records of all patients diagnosed with PTL between August 1979 and October 2021, and we characterized the patients according to the presence of HT, GD, or no AITDs. Pathological specimens were classified according to the World Health Organization classification. Staging was performed in accordance with the Ann Arbor classification. Results: During the 42-year period, 498 participants were diagnosed with PTL. The median age was 68 (interquartile range 61-76) years, and 221 patients were stage IE, whereas the remaining 277 patients were stage IIE. Of the PTL patients, 431 (86.6%) were diagnosed with HT, 9 (1.8%) were diagnosed with GD, and 58 (11.6%) did not have AITDs. All nine patients with GD were positive for anti-thyroglobulin antibody and/or anti-thyroid peroxidase antibody. All patients with GD were treated with anti-thyroid medication. There were no significant differences in the proportions of each subtype of PTL between the PTL patients with GD and all subjects with PTL (p = 0.51), PTL patients with HT (p = 0.51), or PTL patients without AITDs (p = 0.48). The median follow-up time was 6.2 (interquartile range 3.0-10.7) years after the diagnosis of PTL. The Kaplan-Meier curve analyses showed no significant differences in overall survival and event-free survival between PTL patients with GD and those with HT (p = 0.37), or between PTL patients with GD and those without AITDs (p = 0.43). Conclusions: The PTL was observed with HT in a majority of cases, and rarely with GD (1.8%). The proportions of each pathological subtype of PTL and the prognosis of PTL were not different between the patients with GD and those with HT or those without AITDs.
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Affiliation(s)
- Nami Suzuki
- Department of Internal Medicine, Ito Hospital, Shibuya, Japan
| | | | | | - Ran Yoshimura
- Department of Internal Medicine, Ito Hospital, Shibuya, Japan
| | - Kentaro Mikura
- Department of Internal Medicine, Ito Hospital, Shibuya, Japan
| | - Aya Kinoshita
- Department of Internal Medicine, Ito Hospital, Shibuya, Japan
| | - Ai Suzuki
- Department of Internal Medicine, Ito Hospital, Shibuya, Japan
| | | | - Miho Fukushita
- Department of Internal Medicine, Ito Hospital, Shibuya, Japan
| | | | - Ai Yoshihara
- Department of Internal Medicine, Ito Hospital, Shibuya, Japan
| | - Ryohei Katoh
- Department of Pathology, Ito Hospital, Shibuya, Japan
| | | | - Koichi Ito
- Department of Surgery, Ito Hospital, Shibuya, Japan
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Stojković M. Thyroid function disorders. ARHIV ZA FARMACIJU 2022. [DOI: 10.5937/arhfarm72-39952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Thyroid function disorders are the most common endocrine disorders in humans. They are frequently diagnosed, with prevalence varying between 2 and 6%, and a female to male ratio of up to 10:1. Disorders of thyroid function in the narrower sense are presented by its hyperactivity or underactivity, although there are conditions that lead to an increased concentration of thyroid hormones, without its increased activity. In iodine-sufficient regions, the most common cause of hyperthyroidism, as well as hypothyroidism, is an autoimmune disease of the thyroid. For hyperthyroidism, it is Graves' disease, with typical symptoms and signs of hypermetabolism. The diagnosis of hyperthyroidism is based on suppressed TSH and elevated fT4 (free, and in the differential diagnosis, elevated TSH-receptor-antibodies are crucial for Graves' disease. Management of Graves' disease relies on three equally potent approaches: medical therapy, ablative treatments with 131I-radiotherapy-RAI, and thyroidectomy. Hashimoto's thyroiditis is the most common cause of hypothyroidism in iodine-sufficient regions. Symptoms and signs of hypothyroidism are non-specific and correspond to the symptoms and signs of hypometabolism. The diagnosis is made based on elevated TSH with decreased fT4. Thyroxine-peroxidaseantibodies and thyroglobuline-antibodies are important in differential diagnosis. Sometimes elevated TRAb is found in Hashimoto's thyroiditis. The treatment of hypothyroidism is levothyroxine replacement therapy.
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Fang Y, Du WH, Zhang CX, Zhao SX, Song HD, Gao GQ, Dong M. The effect of radioiodine treatment on the characteristics of TRAb in Graves' disease. BMC Endocr Disord 2021; 21:238. [PMID: 34847904 PMCID: PMC8630916 DOI: 10.1186/s12902-021-00905-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Graves' disease (GD) is one of the most common autoimmune thyroid diseases (AITDs) in humans, and thyrotropin receptor antibody (TRAb) is a characterized autoantibody in GD. The use of radioactive iodine therapy (RAI) for GD treatment is increasing. OBJECTIVES We studied the biological properties of TRAb and evaluated the effect of RAI therapy on TRAb in GD patients. METHODS In total, 225 patients (22 onset GD patients without 131I therapy, 203 GD patients treated with 131I therapy) and 20 healthy individuals as normal controls were included in this study. Clinical assessments were performed, and we examined in vitro the biological properties of TRAb in the 22 onset GD patients and 20 controls as well as 84 GD patients with 131I therapy. RESULTS Serum TRAb and thyroid peroxidase antibody (TPOAb) levels increased in the initial year of RAI treatment, and both antibodies decreased gradually after one year. After 5 years from radioiodine treatment, TRAb and TPOAb levels decreased in 88% and 65% of GD patients, respectively. The proportion of patients positive for thyroid-stimulatory antibody (TSAb) was significantly higher in the 7-12-month group, and thyroid-blocking antibody (TBAb) levels were elevated after one year in half of the patients who received 131I treatment. CONCLUSIONS Treatment of GD patients with radioiodine increased TPOAb and TRAb (their main biological properties were TSAbs) within the first year after therapy, and the main biological properties of elevated TRAb were TBAbs after 1 year.
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Affiliation(s)
- Ya Fang
- Department of Molecular Diagnostics & Endocrinology, The Core Laboratory in Medical Center of Clinical Research, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China
| | - Wen-Hua Du
- Department of Endocrinology, Linyi People's Hospital, Linyi, China
| | - Cao-Xu Zhang
- Department of Molecular Diagnostics & Endocrinology, The Core Laboratory in Medical Center of Clinical Research, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China
| | - Shuang-Xia Zhao
- Department of Molecular Diagnostics & Endocrinology, The Core Laboratory in Medical Center of Clinical Research, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China
| | - Huai-Dong Song
- Department of Molecular Diagnostics & Endocrinology, The Core Laboratory in Medical Center of Clinical Research, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China.
| | - Guan-Qi Gao
- Department of Endocrinology, Linyi People's Hospital, Linyi, China.
| | - Mei Dong
- Department of Molecular Diagnostics & Endocrinology, The Core Laboratory in Medical Center of Clinical Research, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China.
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Napolitano G, Bucci I, Di Dalmazi G, Giuliani C. Non-Conventional Clinical Uses of TSH Receptor Antibodies: The Case of Chronic Autoimmune Thyroiditis. Front Endocrinol (Lausanne) 2021; 12:769084. [PMID: 34803929 PMCID: PMC8602826 DOI: 10.3389/fendo.2021.769084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/11/2021] [Indexed: 01/21/2023] Open
Abstract
Anti TSH receptor antibodies (TSHrAb) are a family of antibodies with different activity, some of them stimulating thyroid function (TSAb), others with blocking properties (TBAb), it is a common finding that antibodies with different function might coexist in the same patient and can modulate the function of the thyroid. However, most of the labs routinely detect all antibodies binding to the TSH receptor (TRAb, i.e. TSH-receptor antibodies detected by binding assay without definition of functional property). Classical use of TSHr-Ab assay is in Graves' disease where they are tested for diagnostic and prognostic issues; however, they can be used in specific settings of chronic autoimmune thyroiditis (CAT) as well. Aim of the present paper is to highlight these conditions where detection of TSHr-Ab can be of clinical relevance. Prevalence of TSHrAb is different in in the 2 main form of CAT, i.e. classical Hashimoto's thyroiditis and in atrophic thyroiditis, where TBAb play a major role. Simultaneous presence of both TSAb and TBAb in the serum of the same patient might have clinical implication and cause the shift from hyperthyroidism to hypothyroidism and vice versa. Evaluation of TRAb is recommended in case of patients with Thyroid Associated Orbitopathy not associated with hyperthyroidism. At present, however, the most relevant recommendation for the use of TRAb assay is in patients with CAT secondary to a known agent; in particular, after treatment with alemtuzumab for multiple sclerosis. In conclusion, the routine use of anti-TSH receptor antibodies (either TRAb or TSAb/TBAb) assay cannot be suggested at the present for diagnosis/follow up of patients affected by CAT; there are, however, several conditions where their detection can be clinically relevant.
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Affiliation(s)
- Giorgio Napolitano
- Department of Medicine and Sciences of Aging, Unit of Endocrinology, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
- Center for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti‐Pescara, Chieti, Italy
- *Correspondence: Giorgio Napolitano,
| | - Ines Bucci
- Department of Medicine and Sciences of Aging, Unit of Endocrinology, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
- Center for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti‐Pescara, Chieti, Italy
| | - Giulia Di Dalmazi
- Department of Medicine and Sciences of Aging, Unit of Endocrinology, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
- Center for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti‐Pescara, Chieti, Italy
| | - Cesidio Giuliani
- Department of Medicine and Sciences of Aging, Unit of Endocrinology, University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
- Center for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti‐Pescara, Chieti, Italy
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Peng H, Xiong S, Ding X, Tang X, Wang X, Wang L, Liu Y. Long non‑coding RNA expression profiles identify lncRNA‑XLOC_I2_006631 as a potential novel blood biomarker for Hashimoto's thyroiditis. Int J Mol Med 2020; 46:2172-2184. [PMID: 33125100 PMCID: PMC7595668 DOI: 10.3892/ijmm.2020.4755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 09/17/2020] [Indexed: 12/25/2022] Open
Abstract
Long non‑coding RNAs (lncRNAs) have been increasingly recognized as important immune checkpoints involved in the pathogenesis of autoimmune diseases. However, the exact role of lncRNAs in Hashimoto's thyroiditis (HT) has been rarely studied. The aim of the present study was to investigate the role of lncRNAs and the potential biomarkers in HT, a total of 33 patients with HT and 32 healthy volunteers were enrolled in the present study, and five patients and five healthy controls were investigated using next generation sequencing. A total of 218 dysregulated lncRNAs, including 94 upregulated and 124 downregulated lncRNAs, were identified and examined in the peripheral blood mononuclear cells (PBMCs) from patients with HT. The majority of the lncRNAs were intergenic and exonic (66.06%). Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analysis demonstrated that abnormally expressed lncRNAs were enriched in the 'NF‑kB expression', in the 'TGF‑β signaling pathway' and in the 'JAK‑STAT signaling pathway', which are associated with the immunopathogenic mechanisms of HT. In total, three lncRNAs (LOC729737, XLOC_I2_006631 and BC041964) were validated and had a trend identical to that detected by the sequencing results. The expression of lncRNA‑XLOC_I2_006631 was upregulated and was positively correlated with the serum concentrations of anti‑thyroperoxidase antibody in patients with HT. Methyl‑CpG‑binding protein 2 (MECP2) was identified as the potential regulatory gene of lncRNA‑XLOC_I2_006631 using a prediction program. The expression of MECP2 was increased and was positively correlated with the elevated expression levels of lncRNA‑XLOC_I2_006631 and anti‑thyroperoxidase antibody in patients with HT. Furthermore, lncRNA‑XLOC_I2_006631 was able to regulate MECP2 expression in vitro. Receiver operating characteristic curve analysis suggested that lncRNA‑XLOC_I2_006631 has a potential diagnostic value. Collectively, the present results indicated the important role of dysregulated lncRNAs in HT and demonstrated that lncRNA‑XLOC_I2_006631 functioned as a positive regulator of MECP2 expression, suggesting a potential mechanism. Thus, lncRNA‑XLOC_I2_006631 may be used as a biomarker of HT.
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Affiliation(s)
- Huiyong Peng
- Department of Laboratory Medicine, The Affiliated People's Hospital of Jiangsu University, Zhenjiang Medical School of Nanjing Medical University, Zhenjiang, Jiangsu 212002, P.R. China
| | - Si Xiong
- Department of Endocrinology, The Fifth People's Hospital of Wuhan, Wuhan, Hubei 430050, P.R. China
| | - Xiangmei Ding
- Department of Endocrinology, The Affiliated People's Hospital of Jiangsu University, Zhenjiang Medical School of Nanjing Medical University, Zhenjiang, Jiangsu 212002, P.R. China
| | - Xinyi Tang
- Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, MN 55902, USA
| | - Xuehua Wang
- Department of Endocrinology, The Affiliated People's Hospital of Jiangsu University, Zhenjiang Medical School of Nanjing Medical University, Zhenjiang, Jiangsu 212002, P.R. China
| | - Li Wang
- Department of Endocrinology, The Affiliated People's Hospital of Jiangsu University, Zhenjiang Medical School of Nanjing Medical University, Zhenjiang, Jiangsu 212002, P.R. China
| | - Yingzhao Liu
- Department of Endocrinology, The Affiliated People's Hospital of Jiangsu University, Zhenjiang Medical School of Nanjing Medical University, Zhenjiang, Jiangsu 212002, P.R. China
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Saito D, Nakajima R, Yasuda S. Examination of Malignant Findings of Thyroid Nodules Using Thyroid Ultrasonography. J Clin Med Res 2020; 12:499-507. [PMID: 32849938 PMCID: PMC7430871 DOI: 10.14740/jocmr4260] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/30/2020] [Indexed: 11/17/2022] Open
Abstract
Background It is important to distinguish benign thyroid nodules from malignant thyroid nodules. Hence, this study aimed to determine the characteristics of patients with thyroid cancer using thyroid ultrasonography. Methods We retrospectively examined the ultrasonographic findings of 327 patients with 457 thyroid nodules (age: 59.9 ± 14.3 years; sex, n (%): female 242 (74.0%)) at a single center from 2014 to 2016. Ultrasonography was used to determine the nodule size, shape, border, internal echogenicity, presence of coarse calcifications and microcalcifications within the nodule, internal blood flow and whether the nodule was solid or contained cystic structures. Thyroid fine needle aspiration cytology (FNAC) was performed in all patients. The ultrasonographic findings were compared between patients with benign nodules and those with papillary thyroid carcinoma (PTC). Furthermore, in the analysis of anti-thyroglobulin (Tg) antibody-negative patients with single nodules, values of serum Tg/nodule volume were calculated and compared between patients with benign nodules and those with PTC. Results There were 298 (65.2%) benign nodules, 33 (7.2%) PTCs and 126 (27.6%) others (104 follicular neoplasms, 19 masses of undetermined significance and three other malignant tumors). The nodules diagnosed as PTC had significantly lower internal echogenicity (P < 0.01), more microcalcifications (P < 0.01) and comprised more nodules rich in blood flow (P < 0.05) than benign nodules. Solid nodules were found significantly more in the PTC group (P < 0.01). The serum Tg/nodule volume ratio was significantly higher in the PTC group (P < 0.05). Conclusions Findings suggestive of PTC were found from images obtained using thyroid ultrasonography. In the diagnosis of PTC, the frequency of FNAC examinations should be reduced as this method is costly and invasive.
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Affiliation(s)
- Daigo Saito
- Department of Endocrinology and Diabetes, Saitama Medical University, Iruma-gun, Saitama 350-0495, Japan
| | - Ritsuko Nakajima
- Department of Endocrinology and Diabetes, Saitama Medical University, Iruma-gun, Saitama 350-0495, Japan
| | - Shigemitsu Yasuda
- Department of Endocrinology and Diabetes, Saitama Medical University, Iruma-gun, Saitama 350-0495, Japan
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Li F, Qi Z, Hua L, Wang X, Ling M, Juan D. The efficacy of acupuncture for the treatment and the fertility improvement in child-bearing period female with Hashimoto Disease: A randomized controlled study. Medicine (Baltimore) 2020; 99:e20909. [PMID: 32629685 PMCID: PMC7337562 DOI: 10.1097/md.0000000000020909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Hashimoto thyroiditis (HT) is highly prevalent among reproductive-aged women and has a substantial negative impact on fertility. Currently, there is no specific treatment for Hashimoto thyroiditis. We hypothesize that acupuncture can halt or delay the progression of HT and improve fertility in child-bearing period female. We therefore designed a randomized controlled trial to test this hypothesis by comparing the therapeutic effect of acupuncture vs sham acupuncture in patients with Hashimoto thyroiditis. METHODS In this randomized controlled study, a total of 284 eligible patients will be assigned to acupuncture group (n = 142) or sham acupuncture group (n = 142) in a 1:1 ratio. All patients will receive 36 sessions in total for 12 consecutive weeks with the same acupoint prescription (RN23, ST9, RN17, RN4, RN6, ST36, SP6, KI6). The primary assessment is the titers of thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibody (TGAb). Secondary outcomes include the thyroid function, ovarian function, the rate of primary ovarian insufficiency, and pregnancy outcome. The thyroid function and thyroid antibodies tests will be measured at weeks 0, 4, 8, and 12 after randomization. The ovarian function will be examined on the 2nd to 4th day of the menstrual period in the 1st month, 2nd month and 3rd month compared with baseline. Both the pregnancy outcome and the rate of primary ovarian insufficiency will be evaluated 1 year after treatment. DISCUSSION This will be the first large-scale trial specifically evaluating acupuncture therapy in child-bearing period female with Hashimoto thyroiditis. If the study confirms the effectiveness of acupuncture treatment, more consistent acupuncture therapy can be set up for clinical practice. TRIAL REGISTRATION Chinese Clinical Trials Register identifier, ChiCTR2000031320, registered on 27 March 2020.
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Affiliation(s)
- Fangyuan Li
- College of Clinical Medicine, Chengdu University of Traditional Chinese Medicine
| | - Zhang Qi
- College of Clinical Medicine, Chengdu University of Traditional Chinese Medicine
| | - Lu Hua
- College of Clinical Medicine, Chengdu University of Traditional Chinese Medicine
- Chengdu University of Traditional Chinese Medicine Affiliated Hospital
| | - Xinxin Wang
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Mi Ling
- Maternal and Child Reproductive Hospital affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, PR China
| | - Du Juan
- Maternal and Child Reproductive Hospital affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, PR China
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Chen X, Xu Q, Li X, Wang L, Yang L, Chen Z, Zeng T, Xue X, Xu T, Wang Y, Jia Y, Zhao Q, Wu J, Liang F, Tang X, Yang J, An Y, Zhao X. Molecular and Phenotypic Characterization of Nine Patients with STAT1 GOF Mutations in China. J Clin Immunol 2019; 40:82-95. [DOI: 10.1007/s10875-019-00688-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/02/2019] [Indexed: 11/25/2022]
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15
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Todorović J, Dinčić M, Nešović Ostojić J, Zaletel I, Lopičić S, Dundjerović D, Tatić S, Kovačević S, Paunović I, Puškaš N, Marković L. Differences in Chromatin Texture and Nuclear Fractal Dimension Between Hashimoto's and Lymphocytic Thyroiditis Lymphocytes. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2019; 25:762-768. [PMID: 30813976 DOI: 10.1017/s1431927619000163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Previous evidence suggested that lymphocytic thyroiditis (LT) was a variant of Hashimoto's thyroiditis (HT), thus the aim of the current study is to quantify structural changes in histological specimens taken from HT and LT patients. A total of 600 images containing a single lymphocyte nucleus (300 nuclei per group) were obtained from 20 patients with HT and LT. In order to quantify changes in the nuclear architecture of investigated lymphocytes, the fractal dimension (FD) and some gray-level co-occurrence matrix texture parameters (angular second moment, inverse difference moment, contrast, entropy, and correlation) were calculated for each nucleus. A statistically significant difference in the FD of the "binary-outlined" nucleus and that of the corresponding "black-and-white" nucleus was detected between HT and LT lymphocyte nuclei. In addition, there was also a statistically significant difference in contrast and correlation between HT and LT lymphocyte nuclei. In conclusion, the results of this study suggested that there was a difference in structural complexity between investigated lymphocyte nuclei; additionally, LT lymphocytes possessed probably more complex texture and larger variations as well as more asymmetrical nuclei compared with HT lymphocytes. Accordingly, these findings indicate that LT is probably not a variant of HT; however, more complex studies are necessary to estimate differences between these types of thyroiditis.
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Affiliation(s)
- Jasna Todorović
- Faculty of Medicine,Institute of Pathological Physiology, University of Belgrade,Serbia
| | - Marko Dinčić
- Faculty of Medicine,Institute of Pathological Physiology, University of Belgrade,Serbia
| | | | - Ivan Zaletel
- Faculty of Medicine,Institute of Histology and Embryology, University of Belgrade,Serbia
| | - Srdjan Lopičić
- Faculty of Medicine,Institute of Pathological Physiology, University of Belgrade,Serbia
| | - Duško Dundjerović
- Faculty of Medicine,Institute of Pathology, University of Belgrade,Serbia
| | - Svetislav Tatić
- Faculty of Medicine,Institute of Pathology, University of Belgrade,Serbia
| | - Sanjin Kovačević
- Faculty of Medicine,Institute of Pathological Physiology, University of Belgrade,Serbia
| | - Ivan Paunović
- Faculty of Medicine,Center for Endocrine Surgery, Clinical Center of Serbia, University of Belgrade,Serbia
| | - Nela Puškaš
- Faculty of Medicine,Institute of Histology and Embryology, University of Belgrade,Serbia
| | - Ljiljana Marković
- Faculty of Medicine,Institute of Pathological Physiology, University of Belgrade,Serbia
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16
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Cervelli R, Mazzeo S, Boni G, Boccuzzi A, Bianchi F, Brozzi F, Santini P, Vitti P, Cioni R, Caramella D. Comparison between radioiodine therapy and single-session radiofrequency ablation of autonomously functioning thyroid nodules: A retrospective study. Clin Endocrinol (Oxf) 2019; 90:608-616. [PMID: 30657603 DOI: 10.1111/cen.13938] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/11/2019] [Accepted: 01/13/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To compare the efficacy of Radioiodine (RI) and Radiofrequency ablation (RFA) in the treatment of autonomously functioning thyroid nodules (AFTNs). End-points: nodule volume reduction (NVR) and thyroid function normalization. DESIGN, PATIENTS AND MEASUREMENTS Twenty-two patients (2:20 M:F; 51.9 ± 13.9 years) affected by 25 AFTNs, treated by RFA were retrospectively compared with 25 patients (8:17 M:F; 57.2 ± 12.8 years) affected by a single AFTN treated by RI. Both group showed analogous characteristics as to age, gender, toxic/pretoxic phase and pretreatment nodule volume (calculated by the ellipsoid formula). Thyroid hormone levels and autoimmune thyroid profile were assessed before treatment. A fixed RI activity of 555 MBq (15 mCi) was administered. RFA was performed with an 18G, single-tipped electrode, by the "modified moving shot technique." Thyroid hormones were assessed and the nodule post-treatment volume calculated 12 months after treatment. RESULTS No statistical difference was found between the post-treatment NVR by comparing RI and RFA (P = 0.69). The volume reduction rates were 68.4 ± 28.9% and 76.4 ± 16.9% after RI and RFA, respectively. As to the thyroid function, 5/25 patients developed clinical hypothyroidism after RI. After RFA, all the 22 patients silenced their AFTN and normalized the thyroid hormones. Subclinical hypothyroidism was recorded in two patients after both RI and RFA. Thus, the functional therapeutic success, defined as the restoration of euthyroidism, was achieved in 18/25 (72%) patients treated by RI and in 20/22 (90.9%) treated by RFA. CONCLUSIONS No statistical difference in NVR was found between RI and RFA. All patients responded to RI but 5/25 were "over-treated" developing hypothyroidism. RFA was effective in all patients with no case of post-treatment clinical hypothyroidism. No radiation exposure and lower risk of post-treatment hypothyroidism might make RFA the favourite option especially for young patients.
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Affiliation(s)
- Rosa Cervelli
- Diagnostic and Interventional Radiology, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Salvatore Mazzeo
- Diagnostic and Interventional Radiology, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Boni
- Department of Nuclear medicine, University of Pisa, Pisa, Italy
| | - Antonio Boccuzzi
- Diagnostic and Interventional Radiology, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | | | - Federica Brozzi
- Department of Nuclear medicine, University of Pisa, Pisa, Italy
| | - Pierina Santini
- Department of Nuclear medicine, University of Pisa, Pisa, Italy
| | - Paolo Vitti
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Roberto Cioni
- Diagnostic and Interventional Radiology, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
| | - Davide Caramella
- Diagnostic and Interventional Radiology, Department of Translational Research and New Technologies in Medicine, University of Pisa, Pisa, Italy
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Liu J, Chen Z, Liu M, Jia Y, Yao Z, Wang G. Levothyroxine Replacement Alleviates Thyroid Destruction in Hypothyroid Patients With Autoimmune Thyroiditis: Evidence From a Thyroid MRI Study. Front Endocrinol (Lausanne) 2019; 10:138. [PMID: 30915035 PMCID: PMC6421258 DOI: 10.3389/fendo.2019.00138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 02/13/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Autoimmune thyroiditis (AIT) is the most frequent cause of hypothyroidism. Our previous studies have shown that magnetic resonance T1-mapping is a new technique for quantitatively evaluating the degree of thyroid destruction in AIT patients. This study aimed to evaluate the effect of levothyroxine on thyroid destruction in hypothyroid AIT patients using thyroid T1-mapping technique. Methods: This study recruited 29 hypothyroid AIT patients and 18 age- and sex-matched healthy individuals. Thyroid T1-mapping values were measured in all participants and repeated in the AIT patients at 3 months after they achieved a euthyroid state following levothyroxine treatment. Results: Thyroid T1-mapping values were higher in the AIT patients than in the healthy controls (1167.2 ± 163.2 vs. 779.6 ± 83.8 ms, P < 0.01), and levothyroxine treatment significantly decreased the thyroid T1-mapping values of AIT patients (1006.3 ± 114.6 vs. 1167.2 ± 163.2 ms, P < 0.01). Meanwhile, the reduced levels of anti-peroxidase antibody (TPOAb) and anti-thyroglobulin antibody (TgAb) were observed in the AIT patients after levothyroxine treatment [TPOAb: 257.6 (23.9-960.6) vs. 1,287.4 (12.6-2000.0) IU/mL, P < 0.01; TgAb: 53.54 (9.58-386.2) vs. 103.9 (34.2-1,596.8) IU/mL, P < 0.05]. High-sensitivity C-reactive protein (hsCRP) levels showed a descending tendency following levothyroxine treatment, although there was no statistical difference (P > 0.05). Conclusions: In the AIT patients, thyroid T1-mapping values were significantly increased, and levothyroxine treatment significantly decreased the thyroid T1-mapping values of the AIT patients. These results might suggest that levothyroxine treatment alleviates thyroid destruction in hypothyroid AIT patients.
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Affiliation(s)
- Jia Liu
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zhe Chen
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Min Liu
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Yumei Jia
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zhi Yao
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Guang Wang
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- *Correspondence: Guang Wang
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18
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Fan P, Luo ZC, Tang N, Wang W, Liu Z, Zhang J, Ouyang F. Advanced Maternal Age, Mode of Delivery, and Thyroid Hormone Levels in Chinese Newborns. Front Endocrinol (Lausanne) 2019; 10:913. [PMID: 31998241 PMCID: PMC6966407 DOI: 10.3389/fendo.2019.00913] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 12/16/2019] [Indexed: 12/22/2022] Open
Abstract
Objective: Thyroid hormones are essential for fetal growth and neurodevelopment, however, data on cord blood thyroid hormones are sparse in China where maternal age at childbearing is increasing in recent decades. We aimed to assess cord blood levels of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) in full-term Chinese newborns, and examine potential related perinatal factors. Methods: This study included 922 mother-newborn pairs from a prospective birth cohort enrolled in 2012-2013, Shanghai, China. Cord serum concentrations of FT3, FT4, TSH, and TPOAb were measured in newborns. Results: Newborns born via cesarean section had higher cord serum FT3 (mean ± SD: 1.90 ± 1.16 pmol/L) and lower cord serum TSH (5.15 ± 2.60 mIU/L) than those born via vaginal delivery (FT3: 1.62 ± 0.93 pmol/L; TSH: 9.27 ± 6.76 mIU/L). In cesarean section deliveries, the concentration of cord serum FT3 was 0.15 (95%CI: -0.03, 0.33; p = 0.10) pmol/L lower in infants of mothers aged 30-34 years, and 0.57 (95%CI: 0.22, 0.92; p = 0.002) pmol/L lower in infants of mothers ≥35 years compared to infants of mothers <30 years. Large-for-gestational-age (birth weight >90th percentile) was associated with higher TSH (p = 0.02). Similar results were also found in vaginal deliveries. Conclusions: In this Chinese term birth cohort, newborns born via cesarean section had higher cord serum FT3 and lower TSH than those born via vaginal delivery. Advanced maternal age was associated with lower fetal FT3. Further research is needed to understand whether this association may mediate the adverse impact of advanced maternal age on neurodevelopment in early life.
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Affiliation(s)
- Pianpian Fan
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhong-Cheng Luo
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Obstetrics and Gynecology, Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Ning Tang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiye Wang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiwei Liu
- Department of Neonatology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fengxiu Ouyang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Fengxiu Ouyang ;
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Barić A, Brčić L, Gračan S, Škrabić V, Brekalo M, Šimunac M, Lovrić VT, Anić I, Barbalić M, Zemunik T, Punda A, Boraska Perica V. Thyroglobulin Antibodies are Associated with Symptom Burden in Patients with Hashimoto's Thyroiditis: A Cross-Sectional Study. Immunol Invest 2018; 48:198-209. [PMID: 30332318 DOI: 10.1080/08820139.2018.1529040] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Hashimoto's thyroiditis (HT) is the most common form of autoimmune thyroid disorders characterized by lower production of thyroid hormones and positivity to autoantibodies to thyroglobulin (TgAb) and/or thyroid peroxidase (TPOAb). We performed a comprehensive phenotypic characterization of patients with HT, with specific focus on thyroid autoimmunity, to get better understanding of disease manifestation. METHODS We collected information on thyroid-specific phenotypes (TSH, T3, T4, fT4, TgAb, TPOAb, thyroid volume) and other clinical phenotypes (age, body surface area, number of hypothyroidism symptoms, blood pressure) from 290 patients with HT without levothyroxine (LT4) therapy with the aim to test for correlations between thyroid-specific and clinical phenotypes. RESULTS Our key and novel finding is the existence of significant positive correlation between TgAb levels and the number of symptoms (r = 0.25, p = 0.0001) in HT patients without LT4 therapy that remained significant after adjustment for TPOAb, T3, TSH levels and thyroid volume (β = 0.66, SE = 0.3, p = 0.0299). Increased TgAb levels are significantly associated with fragile hair (p = 0.0043), face edema (p = 0.0061), edema of the eyes (p = 0.0293) and harsh voice (p = 0.0349). CONCLUSIONS Elevated TgAb levels are associated with symptom burden in HT patients, suggesting a role of thyroid autoimmunity in clinical manifestations of HT. Based on these results, we recommend screening for TgAb antibodies in HT patients with symptom burden. We also suggest that further work on understandings of symptoms appearance due to their autoimmune or hypothyroid causation is needed.
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Affiliation(s)
- Ana Barić
- a Department of Nuclear Medicine , University Hospital Split , Split , Croatia
| | - Luka Brčić
- b Department of Medical Biology , University of Split, School of Medicine , Split , Croatia
| | - Sanda Gračan
- a Department of Nuclear Medicine , University Hospital Split , Split , Croatia
| | - Veselin Škrabić
- c Department of Pediatrics , University Hospital Split , Split , Croatia
| | - Marko Brekalo
- a Department of Nuclear Medicine , University Hospital Split , Split , Croatia
| | - Marta Šimunac
- a Department of Nuclear Medicine , University Hospital Split , Split , Croatia
| | | | - Iva Anić
- d School of Medicine , University of Split , Split , Croatia
| | - Maja Barbalić
- b Department of Medical Biology , University of Split, School of Medicine , Split , Croatia
| | - Tatijana Zemunik
- b Department of Medical Biology , University of Split, School of Medicine , Split , Croatia
| | - Ante Punda
- a Department of Nuclear Medicine , University Hospital Split , Split , Croatia
| | - Vesna Boraska Perica
- b Department of Medical Biology , University of Split, School of Medicine , Split , Croatia
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20
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Bothra N, Shah N, Goroshi M, Jadhav S, Padalkar S, Thakkar H, Toteja GS, Shivane V, Lila A, Bandgar T. Hashimoto's thyroiditis: relative recurrence risk ratio and implications for screening of first-degree relatives. Clin Endocrinol (Oxf) 2017; 87:201-206. [PMID: 28273382 DOI: 10.1111/cen.13323] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/27/2017] [Accepted: 03/02/2017] [Indexed: 11/30/2022]
Abstract
CONTEXT The relative recurrence risk ratio (λR ) for Hashimoto's thyroiditis (HT) has not been widely studied. The age at which thyroid function evaluation should be initiated for relatives of HT patients remains unclear. OBJECTIVE To study λR and age-related prevalence of HT in first-degree relatives of HT patients. METHODS First-degree relatives (n = 861) of 264 HT patients were evaluated for goitre, thyroid function tests, thyroid antibodies (TAb) and urinary iodide concentration (UIC). HT was defined as TAb positivity and hypothyroidism (subclinical/overt). λR was calculated as {number of index patients whose relatives (of particular subtype) had HT/number of index patients having relatives of same subtype}÷ population prevalence of HT (5·1%). The age-related prevalence of HT was studied using Kaplan-Meier method. RESULTS A total of 861 relatives (205 parents, 336 siblings and 320 offspring) participated in the study. About 38·3% were TAb positive. The prevalence of HT was 16·7% (22·9% in parents, 19·6% in siblings and 9·6% in offspring). TAb positivity (48·3% vs 33·1%) and HT (23·5% vs 13·6%) were significantly more common in the goitrous group (n = 267) vs nongoitrous group. The median UIC for the study population was 182·5 μg/l. Computed λR was 9·1 for any one relative being affected, 5·9 for parents, 6·3 for siblings and 3·1 for offspring. The prevalence of HT increased with age and exceeded the adult population prevalence of 5·1% at 20 years in females and 27 years in males. CONCLUSIONS Relatives of HT patients have a ninefold increased risk for developing HT as compared to the general population. The risk of developing HT exceeds that of the general population at 20 years in females and 27 years in males.
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Affiliation(s)
- Nikita Bothra
- Department of Endocrinology, Seth GSMC and KEM Hospital, Mumbai, India
| | - Nalini Shah
- Department of Endocrinology, Seth GSMC and KEM Hospital, Mumbai, India
| | - Manjunath Goroshi
- Department of Endocrinology, Seth GSMC and KEM Hospital, Mumbai, India
| | - Swati Jadhav
- Department of Endocrinology, Seth GSMC and KEM Hospital, Mumbai, India
| | - Sheetal Padalkar
- Department of Radiology, Seth GSMC and KEM Hospital, Mumbai, India
| | | | - Gurudayal Singh Toteja
- Scientist-'G' & Head (Nutrition), Indian Council of Medical Research, Department of Health Research, Ministry of Health & Family Welfare, Govt. of India, New Delhi, India
| | | | - Anurag Lila
- Department of Endocrinology, Seth GSMC and KEM Hospital, Mumbai, India
| | - Tushar Bandgar
- Department of Endocrinology, Seth GSMC and KEM Hospital, Mumbai, India
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21
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Zhang X, Schulze PC. MicroRNAs in heart failure: Non-coding regulators of metabolic function. Biochim Biophys Acta Mol Basis Dis 2016; 1862:2276-2287. [PMID: 27544699 DOI: 10.1016/j.bbadis.2016.08.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 08/10/2016] [Accepted: 08/11/2016] [Indexed: 12/14/2022]
Abstract
Heart failure (HF) is the inability of the heart to provide sufficient cardiac output for the energy demands of the body. Over the last decades, our understanding of the role of microRNAs (miRNAs), a class of small non-coding RNA regulators of gene expression at the post-transcriptional level, in cardiovascular diseases has expanded at a rapid rate. Importantly, multiple miRNAs have been specifically implicated in the progression of HF. Growing evidence suggests that miRNAs regulate central metabolic pathways and thus are highly implicated in the maintenance of energy homeostasis. In this review, we highlight recent discoveries of the mechanistic role of miRNAs in regulating metabolic functions in HF, with specific focus on the implication of miRNAs in metabolic rearrangements, discuss the potential value of miRNA profiles as novel HF biomarkers, and summarize the recent investigations on therapeutic approaches using miRNAs in heart disease. This article is part of a Special Issue entitled: The role of post-translational protein modifications on heart and vascular metabolism edited by Jason R.B. Dyck & Jan F.C. Glatz.
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Affiliation(s)
- Xiaokan Zhang
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, NY, USA
| | - P Christian Schulze
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, NY, USA; Department of Medicine I, Division of Cardiology, Angiology, Pneumology and Intensive Medical Care, Friedrich-Schiller-University Jena, University Hospital Jena, Jena, Germany.
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22
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Dogansen SC, Selcukbiricik OS, Bilir BE, Yarman S. The higher incidence of autoimmune thyroid disease in prolactinomas than in somatotrophinomas. Growth Horm IGF Res 2016; 29:45-49. [PMID: 27105040 DOI: 10.1016/j.ghir.2016.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 02/03/2016] [Accepted: 04/08/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Many studies have shown that prolactin (PRL) plays an important role in autoimmune diseases. The aim of this study was to compare the current frequency of autoimmune thyroid disease (ATD) in prolactinomas with another type of functional pituitary adenoma (FPA), somatotrophinoma. Another aim of the study was to evaluate possible factors related to thyroid autoimmunity and the process of ATD in FPAs. METHODS We retrospectively evaluated the presence of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) and thyroid morphologic findings in our patients with FPA (78 with acromegaly and 83 with prolactinoma). The relationship of autoantibody positivity with baseline PRL levels, activity of acromegaly, and treatment of dopamine agonists (DA) and hypogonadism was also assessed. Patients with ATD and hypothyroidism due to autoimmune thyroiditis were also evaluated. RESULTS ATD (Hashimoto's thyroiditis) was detected more frequently in patients with prolactinoma than in patients with acromegaly (33% and 17%, respectively; p=0.01). Thyroid autoantibody positivity was found more frequently in females in the whole group (p=0.02) and in the acromegaly group (p=0.008). There was no difference according to sex among the patients with prolactinoma (p=0.800). ATD was found not to be related with baseline PRL levels, treatment of DA, and presence of hypogonadism (p=0.232, p=0.435, p=0.464, respectively) in the prolactinoma group, and activity of acromegaly, presence of hypogonadism in the acromegaly group (p=0.753, p=0.654, respectively). Autoimmune hypothyroidism was more frequent in the prolactinoma group than in the acromegaly group among patients with thyroid autoantibody positivity (p=0.004). CONCLUSION Thyroid autoantibodies should be evaluated both at the time of diagnosis and during the course of treatment in patients with prolactinoma, and thyroid function tests should be closely monitored in patients with autoantibody positivity.
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Affiliation(s)
- Sema Ciftci Dogansen
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey.
| | - Ozlem Soyluk Selcukbiricik
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey
| | - Betul Ekiz Bilir
- Trakya University, Trakya Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Edirne, Turkey
| | - Sema Yarman
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey
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23
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Qi Y, Li X, Zhang Q, Huang F, Lin D, Zhou Y, Hong J, Cui B, Wang W, Ning G, Wang S. Increased chemokine (C-C motif) ligand 21 expression and its correlation with osteopontin in Graves' disease. Endocrine 2015; 50:123-9. [PMID: 25771884 DOI: 10.1007/s12020-015-0552-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 02/09/2015] [Indexed: 12/12/2022]
Abstract
Graves' disease (GD) is a chronic autoimmune process characterized by the production of auto-antibodies that presumably consequent to the lymphocytic infiltrates in the thyroid. Chemokine (C-C motif) ligand 21 (CCL21) is important for the circulation of CC-chemokine receptor 7 (CCR7)-expressing cells. Meanwhile, osteopontin (OPN) enhances the production of proinflammatory cytokines and chemokines through NF-κB and MAPK signaling pathways in GD. Although CCL21 has been reported to play a vital role in several autoimmune diseases, little is known about the relationship between CCL21 and GD development. This study aimed to detect the CCL21 level in GD and to examine the role of OPN in regulating CCL21 production. 40 initial GD patients, 15 euthyroid GD patients, 12 TRAb-negative GD patients, and 25 healthy control donors were recruited. CCL21 levels in plasma and culture supernatants were quantified by enzyme-linked immunosorbent assay (ELISA). CD4+ T cells were isolated from peripheral blood mononuclear cells using antibody-coated magnetic beads. Quantitative polymerase chain reaction was used to determine CCL21 expression levels in CD4+ T cells. We demonstrated for the first time that plasma CCL21 levels were overexpressed in GD patients and recovered in TRAb-negative GD patients. Moreover, CCL21 levels correlated with TRAb levels and plasma OPN concentrations. Furthermore, we demonstrated that recombinant OPN increased the expression of CCL21 in a dose- and time-dependent manner. These data indicated a clinical correlation between plasma CCL21 levels and GD. CCL21 could serve as a novel biomarker for GD as well as a potential target for TRAb-positive GD treatment.
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Affiliation(s)
- Yicheng Qi
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Ruijin Hospital, Affiliated to Shanghai Jiao-Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
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24
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Tanei T, Eguchi Y, Yamamoto Y, Hirano M, Takebayashi S, Nakahara N. Isolated adrenocorticotropic hormone deficiency associated with Hashimoto's disease and thyroid crisis triggered by head trauma. Case report. Neurol Med Chir (Tokyo) 2012; 52:44-7. [PMID: 22278027 DOI: 10.2176/nmc.52.44] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A 47-year-old man presented to our hospital after suffering transient loss of consciousness and falling to the floor. On admission, his Glasgow Coma Scale score was 11 (E3V3M5), and he exhibited restlessness. Blood examination revealed hyperthyroidism. Computed tomography showed slight traumatic subarachnoid hemorrhage. He developed fever and tachycardia, and was diagnosed with thyroid crisis. Magnetic resonance imaging showed a brain contusion in the right frontal lobe, and encephalopathy signs in the right frontal and insular cortex. Immunocytochemical examinations suggested Hashimoto's disease, and hormone examinations revealed plasma levels were undetectably low of adrenocorticotropic hormone (ACTH) and low of cortisol. Pituitary stimulation tests showed inadequate plasma ACTH and cortisol response, consistent with isolated ACTH deficiency (IAD). The final diagnosis was IAD associated with Hashimoto's disease. Hydrocortisone replacement therapy was continued, and the patient was nearly free from neurological deficits after 18 months. The neuroimaging abnormalities gradually improved with time.
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Affiliation(s)
- Takafumi Tanei
- Department of Neurosurgery, Nagoya Central Hospital, Japan.
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25
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Sholosh B, Borhani AA. Thyroid Ultrasound Part 1: Technique and Diffuse Disease. Radiol Clin North Am 2011; 49:391-416, v. [DOI: 10.1016/j.rcl.2011.02.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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