Xenotransplantation of cultured newborn pig thyroid tissue for the treatment of post-radioiodine hypothyroidism in rats

The aim of the present study was to develop atransplantation technique for restoration of thyroidfunction in rats with radioiodine-inducedhypothyroidism. Each Wistar rat received the dose of75.0 muCi of 131-iodine by intraperitonealinjection. The serum thyroxine and triiodothyroninevalues in all rats fell to low levels by 2.5 weeksafter radioiodine administration. Thexenotransplantation of 3-day-old newborn pig thyroidorgan culture was performed on day 18 afterradioactive ablation by injection into the fat tissueof anterior abdominal wall. Epithelial cell swarmswith follicular formation manifested themselves amongadipose tissue on day 7 as well as day 17 afterxenotransplantation. The serum thyroxine andtriiodothyronine values in the rats were generallywithin the euthyroid range by day 7-17 afterxenotransplantation. The thyroid gland of ratsreverted to the norm in morphofunctional appearance.These results indicated that the xenografted newbornpig thyroid organ culture allowed a restoration of thyroid function in Wistar rats with post-radioiodine hypothyroidism.

[Permanent hypoparathyroidism due to thyroid cancer surgical procedures in patients exposed to radiation in the Chernobyl, Ukraine, nuclear reactor accident]

BACKGROUND AND OBJECTIVE

Postoperative hypoparathyroidism is a rare, but complex endocrine disorder. The purpose of this case series study was to evaluate the symptoms, signs and sequelae of the disease in a major homogeneous patient group after the Chernobyl accident in the Ukraine.

PATIENTS AND METHODS

This study is based on a random sample of 25 patients with symptomatic permanent hypoparathyroidism after surgical procedures on the thyroid for carcinoma following the Chernobyl accident in May 1986. They underwent physical examination and their parathyroid hormone and calcium levels in serum were determined. The signs, symptoms and sequelae of their disease were systematically assessed by a validated specific questionnaire. The extent of individual distress by the symptoms and signs were analysed by using a Likert scale (points between 1 = no and 5 = maximal distress).

RESULTS

In 14 patients (56%) (age at time of operation: 18.24 +/- 4.26 years) paresthesias occurred at least every third day. Very frequent general symptoms were joint pains and hair loss (in 17 patients / 68%). 19 patients (76%) had enamel defects, 17 (68%) increasingly dry skin since the operation. Psychical symptoms like excitability (20 patients / 80%) and depressed mood since the operation (16 patients / 64%) were strikingly frequent. The patients were affected more by dry skin (2,76 on the Likert scale) than by paraesthesias (2,56) or joint pains (2,68) and most of all by depressive mood (2.96) and excitability (3.38). 4 patients (16%) had kidney stones, while osteoporosis and osteosclerosis occurred in 7 (28%) respectively 3 persons (12%). 6 patients (24%) had cataracts and 3 (12%) had basal ganglia calcification. Interestingly, 1/3 of all patients had only non-characteristic symptoms of the disease consistent with a latent form of hypoparathyroidism.

CONCLUSIONS

Our data partly show a severe form of hypoparathyroidism of very young persons in the Chernobyl region, a finding which strongly supports the need of exact diagnosis and interdisciplinary treatment options of this postoperative disorder.