The role of transforming growth factor beta in thyroid autoimmunity: current knowledge and future perspectives.

The complex mechanisms, which are related to the pathophysiology and the development of autoimmune thyroid diseases, involve transforming growth factor beta (TGF-ß) and its interplay with the immune system. The aim of this review is to examine the role of TGF-ß regarding thyroid autoimmunity and explore the potent role of this molecule either as a diagnostic or prognostic marker or a therapeutic target regarding autoimmune thyroid diseases. TGF-ß is clearly a master regulator of the immune response, exerting either inhibitory or facilitatory effects on cells of the immune system. Thus, this molecule is involved in the pathogenesis and development of autoimmune thyroid diseases. Recent research has revealed the involvement of TGF-ß in the pathophysiology of autoimmune thyroid diseases. The role of TGF-ß in the development of autoimmune thyroid diseases varies, depending on its concentrations, the type of the activated TGF-ß signalling pathway, the genetic predisposition of the patient and the pathophysiologic stage of the disease. TGF-ß could emerge as a useful diagnostic or prognostic marker for the evolution of thyroid autoimmunity. Promising perspectives for the effective therapeutic use of TGF-ß regarding thyroid autoimmunity exist. The main treatment approaches incorporate either enhancement of the immunosuppressive role of TGF-ß or inhibition of its facilitatory role in the autoimmune thyroid diseases. Further research towards deeper understanding of TGF-ß physiology and clinical application of its possible therapeutic role regarding thyroid autoimmunity is needed.

TGF-ß Physiology as a Novel Therapeutic Target Regarding Autoimmune Thyroid Diseases: Where Do We Stand and What to Expect.

Transforming growth factor beta (TGF-ß), as a master regulator of immune response, is deeply implicated in the complex pathophysiology and development of autoimmune thyroid diseases. Based on the close interplay between thyroid autoimmunity and TGF-ß, scientific interest was shifted to the understanding of the possible role of this molecule regarding the diagnosis, prognosis, and therapy of these diseases. The main aim of this review is to present research data about possible treatment options based on the role of TGF-ß in thyroid autoimmunity. Suggested TGF-ß-mediated therapeutic strategies regarding autoimmune thyroid diseases include either the enhancement of its immunosuppressive role or inhibition of its facilitatory role in thyroid autoimmunity. For example, the application of hr-TGF-ß can be used to bolster the inhibitory role of TGF-ß regarding the development of thyroid diseases, whereas anti-TGF-ß antibodies and similar molecules could impede its immune-promoting effects by blocking different levels of TGF-ß biosynthesis and activation pathways. In conclusion, TGF-ß could evolve to a promising, novel therapeutic tool for thyroid autoimmunity.

Hypokalemia: a clinical update.

Hypokalemia is a common electrolyte disturbance, especially in hospitalized patients. It can have various causes, including endocrine ones. Sometimes, hypokalemia requires urgent medical attention. The aim of this review is to present updated information regarding: (1) the definition and prevalence of hypokalemia, (2) the physiology of potassium homeostasis, (3) the various causes leading to hypokalemia, (4) the diagnostic steps for the assessment of hypokalemia and (5) the appropriate treatment of hypokalemia depending on the cause. Practical algorithms for the optimal diagnostic, treatment and follow-up strategy are presented, while an individualized approach is emphasized.