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1.
Klin Lab Diagn ; 64(9): 541-545, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31610106

RESUMO

The aim of the study was to determine the levels of thyroid antibodies and their relationship with thyroid hormones and thyroglobulin in euthyroid men and women, residents of the Arctic zone of the Russian Federation. A total of 208 apparently healthy people were enrolled in this study and classified into two groups depending on gender and level of autoantibodies in the blood. Serum hormones of the pituitary-thyroid system, thyroglobulin and antibodies concentration was measured by enzyme immunoassay. The prevalence of positive antibodies among various examined groups was determined and the characteristics of euthyroid subjects with abnormal thyroid antibodies levels were studied. Circulating positive thyroid antibodies were found in 20% of the surveyed residents of the Arctic zone of the Russian Federation. The median serum antibodies against thyroid peroxidase (AntiTPO) or thyroglobulin (AntiTG) levels and the percentage of people in general population with positive antibodies (i.e. AntiTPO ≥ 50 IU / ml and / or AntiTG ≥ 100 IU / ml) were statistically significant higher in women than in men, p < 0.01. Such thyroid antibodies levels were associated with a higher thyroid gland functional activity in women, which was demonstrated by significantly higher thyroxin level and lower thyroglobulin value in the peripheral blood. Part of women positive for AntiTPO increased with age from 18 to 33% (in groups aged 18-44 and 45-59 years, p = 0.04). The findings of the study reveal correlation between thyroid function test and thyroid antibodies levels, elaborating the clinical importance of thyroid antibodies in clinical examination and follow-up of patients with autoimmune thyroid disorders.


Assuntos
Autoanticorpos/sangue , Iodeto Peroxidase/imunologia , Tireoglobulina/imunologia , Glândula Tireoide , Adolescente , Adulto , Regiões Árticas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Federação Russa , Adulto Jovem
2.
Ann Surg Oncol ; 26(6): 1751-1758, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30937662

RESUMO

OBJECTIVE: The aim of this study was to explore the impact of thyroid antibody status on central lymph node metastases (CLNM) in papillary thyroid carcinoma (PTC) patients with Hashimoto's thyroiditis (HT). METHODS: A retrospective analysis was performed on 346 PTC patients with HT who underwent thyroidectomy and ipsilateral central lymph node dissection (CLND). Histopathological characteristics of the tumor and serum levels of thyroid hormone, as well as antibodies, were collected and analyzed. RESULTS: The multivariate logistic regression analysis showed that being male [odds ratio (OR) 3.269, 95% confidence interval (CI) 1.240-8.619], tumor size > 1 cm [1 cm < diameter (D) ≤ 2 cm: OR 6.947, 95% CI 2.886-16.722; 2 cm < D: OR 5.880, 1.937-17.846], and antibody status [thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) double negative: OR 3.791, 95% CI 1.391-10.331; TPOAb and TgAb double positive: OR 4.047, 95% CI 1.509-10.856; TgAb single positive: OR 6.024, 95% CI 2.019-17.970] were independent risk factors for CLNM. Additionally, a risk-score scale, including sex, antibody status, and tumor size, was established to predict CLNM. The sensitivity, specificity, positive predictive value, and negative predictive value were 55.7%, 84.4%, 74.4%, and 70%, respectively, when the cut-off point was chosen as 3. CONCLUSIONS: Antibody status is a critical independent risk factor for CLNM in PTC patients with HT. For the CLND strategy, a more conservative option could be considered in a low-risk cohort with the following characteristics: female sex, smaller tumor size, and TPOAb single positive.


Assuntos
Autoanticorpos/sangue , Carcinoma Papilar/secundário , Doença de Hashimoto/complicações , Tireoglobulina/imunologia , Neoplasias da Glândula Tireoide/patologia , Autoanticorpos/imunologia , Carcinoma Papilar/sangue , Carcinoma Papilar/etiologia , Feminino , Seguimentos , Doença de Hashimoto/sangue , Doença de Hashimoto/imunologia , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Neoplasias da Glândula Tireoide/sangue , Neoplasias da Glândula Tireoide/etiologia
3.
Neuro Endocrinol Lett ; 39(7): 489-495, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30860680

RESUMO

INTRODUCTION: The clinical characteristics of subacute thyroiditis (SAT) has been changing in recent years. There are more and more patients with painless SAT, and more cases of SAT with elevated levels of anti-thyroid antibodies were reported. The aim of the study was to evaluate the clinical characteristics of SAT patients with special regard to the differences between the previously described and currently observed features of the disease. MATERIAL AND METHODS: Clinical and laboratory data were retrospectively reviewed for 64 patients with confirmed SAT. RESULTS: Mean age of the patients was 42.67 years. The male to female ratio was 1:7. Neck or ear pain was reported by 93.75% of patients, while fever occurred in 65.63% of patients. The aTPO and aTg levels were increased in 15.5% and 33.3% of patients, respectively. TRAb level was increased in 6% of patients. Transient microhaematuria was present in 63% of analyzed cases. No statistically significant differences in clinical characteristics or laboratory results were found between the groups with- and without neck/ear pain, with- and without elevated TRAb, and with- and without elevated aTPO and/or aTg. CONCLUSION: In our study, several new features of current SAT course, different from what we used to know about the disease, were reported. Higher frequency of painless SAT than it was ever described, was observed. Moreover, in as much as one third of the patients aTPO and/or aTg were present, and in 6% of SAT cases the coexistence of TRAb was demonstrated. Transient microhaematuria was typical for the acute SAT phase.


Assuntos
Febre/epidemiologia , Hematúria/epidemiologia , Dor/epidemiologia , Tireoidite Subaguda/epidemiologia , Adulto , Idoso , Anticorpos/imunologia , Comorbidade/tendências , Feminino , Humanos , Iodeto Peroxidase/imunologia , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Receptores da Tireotropina/imunologia , Estudos Retrospectivos , Tireoglobulina/imunologia , Adulto Jovem
4.
Endocr Pract ; 25(5): 454-460, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30720350

RESUMO

Objective: Epidemiologic studies on the relationship between iodine and thyroid antibodies are inconsistent. Iodine nutrition, genetic, and environmental factors have been shown to modify the effects of iodine on thyroid autoimmunity. We investigated the relationship between urinary iodine concentration (UIC) and thyroglobulin antibodies (TgAbs) in individuals living in iodine-sufficient areas in this cross-sectional study. Methods: A total of 15,008 participants were recruited according to the age range of the population of China in our study. An oral questionnaire was administered to collect basic demographic information. Serum thyrotropin (TSH), thyroid peroxidase antibodies (TPOAbs), TgAbs, and UIC were measured, and thyroid ultrasonography was performed in all subjects. Participants were further divided according to the level of UIC and the status of TgAb, and logistic regression was applied to determine the relationship between UIC and TgAbs. Results: The median UIC of the study population was 205.23 (95% confidence interval [CI], 65.7 to 537.67) µg/L. A total of 17.6% of participants had UIC <100 µg/L. With the increase in UIC, the prevalence of positive TgAbs decreased gradually. UIC level was lowest in subjects with high TgAb titer (median, 182.36 µg/L; 95% CI, 52.88 µg/L to 506.71 µg/L) and highest in the TgAb-negative group (median, 207.16 µg/L; 95% CI, 66.94 µg/L to 538.72 µg/L). Multilinear correlation analysis showed that gender (ß = 37.632; P<.001), age (ß = 0.467; P = .038), TSH (ß = 13.107; P<.001), TPOAb (ß = 1.150; P<.001), thyroid volume (ß = 2.883; P<.001), and UIC (ß = -0.047; P = .032) were independent predictors of TgAb variations. Low UIC (<100 µg/L) was associated with increased risk of positive TgAbs (adjusted odds ratio = 1.255 [1.004 to 1.568]). Conclusion: Low UIC is an independent risk factor for positive TgAb in individuals living in iodine-sufficient areas. Abbreviations: CI = confidence interval; CV = coefficient of variation; FT3 = free triiodothyronine; FT4 = free thyroxine; OR = odds ratio; TgAb = thyroglobulin antibody; TPOAb = thyroid peroxidase antibody; TSH = thyrotropin; UIC = urinary iodine concentration; USI = universal salt iodization.


Assuntos
Tireoglobulina/imunologia , China , Estudos Transversais , Humanos , Iodo , Tireotropina , Tiroxina
6.
J Endocrinol Invest ; 42(4): 481-487, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30182359

RESUMO

PURPOSE: Selenium (Se), an essential trace element, has been implicated in pathogenesis of autoimmune thyroiditis (AIT). Most studies attributed the immune modulating effects of Se to its antioxidant properties. However, there is insufficient evidence to support the use of selenium supplementation or other antioxidants in patients with AIT. This clinical trial was designed to investigate the impact of Se and vitamin C supplementation on antithyroid peroxidase antibody (TPO-Ab) level in patients with AIT. METHODS: One hundred and two subjects aged 15-78 years were randomized into three groups. Group one (GI) (n = 38) was treated with 200 µg/day sodium selenite, group two (GII) (n = 36) received 500 mg vitamin C/day, and group three (GIII) (n = 28) received placebo over a 3-month period. Thyroid stimulating hormone (TSH), TPO-Ab, antithyroglobulin antibody (Tg-Ab) and Se concentrations were once measured before treatment and at the end of the study. RESULTS: After 3 months, TPO-Ab concentrations decreased within Se and vitamin C-treated groups, but did not change in the placebo subjects. In this regard, there was no significant difference between the groups. We also did not find any statistically significant difference in TSH and Tg-Ab levels within and between the groups. At the end of the study, Se level was significantly higher in GI compared with GII and GIII. CONCLUSION: Our findings supported the hypothesis of antioxidant beneficial effects of Se in AIT. However, it was not superior to vitamin C, regarding its effects on thyroid-specific antibodies.


Assuntos
Ácido Ascórbico/administração & dosagem , Autoanticorpos/sangue , Iodeto Peroxidase/imunologia , Selênio/administração & dosagem , Tireoidite Autoimune/sangue , Tireoidite Autoimune/prevenção & controle , Adolescente , Adulto , Idoso , Antioxidantes/administração & dosagem , Antioxidantes/metabolismo , Ácido Ascórbico/sangue , Autoanticorpos/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Selênio/sangue , Método Simples-Cego , Tireoglobulina/imunologia , Tireoidite Autoimune/imunologia , Tireotropina/imunologia , Vitaminas/administração & dosagem , Vitaminas/sangue , Adulto Jovem
7.
Endocr J ; 66(2): 193-198, 2019 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-30568076

RESUMO

There is a great deal of research interest regarding the underlying causes of slightly elevated TSH values in patients with subclinical hypothyroidism (SH) without abnormal findings on ultrasonography or anti-thyroid antibodies. Twelve infertile women with thyroglobulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb)-negative nongoitrous SH were referred to our department of endocrinology between September 2007 and September 2015. None had been diagnosed with autoimmune thyroid disease or had any possible causes of SH. In all cases, LT4 was prescribed to bring TSH value below 2.5 mIU/L. Among those with infertility treatments, six (50%) became pregnant and gave birth to infants. Here, we report three of these six women who successfully became pregnant with infertility treatments and were found to have thyroid autoimmunity on data obtained during the postpartum period. Two developed postpartum thyroiditis, and the remaining one woman was temporarily weakly positive for TPOAb at 9 months postpartum. We describe three infertile subclinically hypothyroid women without goiter or anti-thyroid antibodies with potential thyroid autoimmunity. Thyroid autoimmunity is one of the most important issues for management of pregnant women, and thus, our findings are noteworthy for the care of infertile women with SH. This report provides valuable insights into the presence of autoimmunity in nongoitrous thyroid-associated antibody-negative SH patients.


Assuntos
Autoanticorpos/imunologia , Hipotireoidismo/complicações , Infertilidade Feminina/complicações , Glândula Tireoide/imunologia , Tireoidite Autoimune/complicações , Adulto , Autoimunidade/imunologia , Feminino , Humanos , Hipotireoidismo/imunologia , Infertilidade Feminina/imunologia , Iodeto Peroxidase/imunologia , Tireoglobulina/imunologia , Tireoidite Autoimune/imunologia
8.
J Microbiol Immunol Infect ; 52(3): 480-486, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28712818

RESUMO

BACKGROUND: To investigate the association of systemic lupus erythematosus (SLE) with thyroid diseases in a medical center in central Taiwan. METHODS: This is a retrospective cohort of 2796 SLE patients in a tertiary referral medical center from 2000 to 2013. We screened SLE by catastrophic illness registration from national insurance bureau; and thyroid diseases by ICD 9 codes, then confirmed by thyroid function test, auto-antibody, medical and/or surgical intervention. We compared the rate of hyperthyroidism, hypothyroidism and autoimmune thyroid disease (AITD) in SLE patients and the 11,184 match controls. We calculated the rate of these thyroid diseases and positive antibodies to thyroglobulin (ATGAb), thyroid peroxidase (TPOAb) in SLE patients grouped by the presence of overlap syndrome and anti-dsDNA antibody. We also compared the association of thyroid diseases to severe SLE conditions, including renal, central nervous system (CNS) involvement, and thrombocytopenia. RESULTS: Compared to the matched controls, the cumulative incidence of thyroid disease, including hyperthyroidism, hypothyroidism and AITD, were all higher in SLE patients (p < 0.0001). The average age of SLE patients with thyroid diseases patients were older than those without thyroid diseases (p = 0.002). Those had euthyroid AITD were younger than other patients with thyroid diseases (p = 0.02). Up to 30.3% SLE patients had overlap syndrome and had higher relative risk of thyroid diseases than those without overlap syndrome, in terms of hypothyroidism and AITD, but not hyperthyroidism. SLE patients with thyroid diseases also carry higher risk for severe complications such as renal involvement (p = 0.024) central nervous system involvement (p < 0.0001). CONCLUSION: SLE patients had significantly higher rate of hyperthyroidism, hypothyroidism, and AITD than the matched control. Among lupus patients, the risks of thyroid diseases are even higher in the presence of overlap syndrome. SLE patients with thyroid diseases had higher risk of renal and CNS involvement.


Assuntos
Lúpus Eritematoso Sistêmico/epidemiologia , Doenças da Glândula Tireoide/epidemiologia , Adulto , Distribuição por Idade , Autoanticorpos/imunologia , Autoantígenos/imunologia , Estudos de Coortes , DNA/imunologia , Feminino , Humanos , Hipertireoidismo/epidemiologia , Hipertireoidismo/imunologia , Hipotireoidismo/epidemiologia , Hipotireoidismo/imunologia , Incidência , Iodeto Peroxidase/imunologia , Proteínas de Ligação ao Ferro/imunologia , Lúpus Eritematoso Sistêmico/imunologia , Masculino , Estudos Retrospectivos , Risco , Taiwan/epidemiologia , Tireoglobulina/imunologia , Doenças da Glândula Tireoide/imunologia , Tireoidite Autoimune/epidemiologia , Tireoidite Autoimune/imunologia , Doenças do Tecido Conjuntivo Indiferenciado/epidemiologia , Doenças do Tecido Conjuntivo Indiferenciado/imunologia
9.
Biol Trace Elem Res ; 187(2): 383-391, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29938384

RESUMO

To evaluate the relationship between smoking and both antithyroperoxidase antibody (TPOAb) and antithyroglobulin antibody (TgAb) positivity in subjects from Panshan, Zhangwu, and Huanghua with mildly deficient, more than adequate, and excessive iodine intake, respectively. Smoking-related data were collected by questionnaire, and laboratory measurements of TPOAb, TgAb, and thyrotropin (TSH) were determined at baseline and follow-up. (1) A 1.48-fold increased risk of TPOAb positivity was found in smokers than in non-smokers after adjusting for confounders (age, sex, and areas) (OR[95% CI] = 1.48[1.12-1.95], p = 0.01). (2) Among female subjects, the prevalence of thyroid autoantibodies in smokers was increased than that in non-smokers in Panshan, Zhangwu, and Huanghua (TPOAb): 16.79 vs. 8.89%, 14.14 vs. 11.09%, 19.53 vs. 9.57%; TgAb 15.32 vs. 9.29%, 12.79 vs. 11.94%, 17.19 vs. 10.55%, respectively). The difference was significant in Panshan after adjusting for age. (3) Female long-term smokers (> 20 years) had an increased frequency of thyroid autoantibody positivity than non-smokers after adjusting for confounders (TPOAb OR[95% CI] = 1.60[1.10-2.34]; TgAb OR[95% CI] = 1.31[0.88-1.94]). (4) There was no difference in the incidence of thyroid autoantibodies among non-smokers, new smokers, and long-term smokers at follow-up. (5) TSH was greater in TPOAb-positive subjects than in seronegative smokers (1.56 vs. 1.20 mU/L, p < 0.001) and non-smokers (1.97 vs. 1.58 mU/L, p < 0.001). However, TSH was also greater in non-smokers than in smokers, regardless of whether subjects were positive (1.97 vs. 1.56 mU/L, p = 0.04) or negative (1.58 vs. 1.20 mU/L, p < 0.001) for TPOAb. Long-term smoking could increase the prevalence of thyroid autoantibodies in a population with mildly deficient iodine intake. TSH levels were lesser in smokers than in non-smokers and greater in subjects with thyroid autoantibody positivity than in seronegative subjects. The influence of smoking on TSH levels was independent of thyroid autoantibody levels.


Assuntos
Anticorpos/imunologia , Iodeto Peroxidase/imunologia , Iodo/imunologia , Fumar/imunologia , Tireoglobulina/imunologia , Adulto , Feminino , Humanos , Iodeto Peroxidase/metabolismo , Iodo/administração & dosagem , Iodo/deficiência , Modelos Logísticos , Masculino
10.
Immunol Invest ; 48(2): 198-209, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30332318

RESUMO

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 (ß = 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.


Assuntos
Autoanticorpos/imunologia , Doença de Hashimoto/epidemiologia , Doença de Hashimoto/etiologia , Tireoglobulina/imunologia , Biomarcadores , Estudos Transversais , Feminino , Doença de Hashimoto/diagnóstico , Humanos , Masculino , Fenótipo , Prognóstico
11.
Korean J Intern Med ; 33(6): 1050-1057, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30396251

RESUMO

Thyroglobulin antibody (TgAb) is a class G immunoglobulin and a conventional marker for thyroid autoimmunity. From a clinical perspective, TgAb is less useful than thyroid peroxidase antibodies for predicting thyroid dysfunction. However, TgAb is found more frequently in differentiated thyroid cancer (DTC) and can interfere with thyroglobulin (Tg) measurements, which are used to monitor the recurrence or persistence of DTC. Recent studies suggested a small but consistent role for preoperative TgAb in predicting DTC in thyroid nodules, and in reflecting adverse tumor characteristics or prognosis, including lymph node metastasis, but this is still controversial. Postoperative TgAb can serve as a biomarker for remnant thyroid tissue, so follow-up measures of TgAb are useful for predicting cancer recurrence in DTC patients. Since high serum TgAb levels may also affect the fine needle aspiration washout Tg levels from suspicious lymph nodes of DTC patients, it is important to use caution when interpreting the washout Tg levels in patients who are positive for TgAb.


Assuntos
Autoanticorpos/sangue , Biomarcadores Tumorais/sangue , Tireoglobulina/sangue , Neoplasias da Glândula Tireoide/imunologia , Nódulo da Glândula Tireoide/imunologia , Biomarcadores/sangue , Biópsia por Agulha Fina , Diferenciação Celular , Detecção Precoce de Câncer/métodos , Humanos , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Tireoglobulina/imunologia , Testes de Função Tireóidea , Neoplasias da Glândula Tireoide/sangue , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Nódulo da Glândula Tireoide/sangue , Nódulo da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/cirurgia , Tireoidectomia , Resultado do Tratamento
12.
Mol Med Rep ; 18(5): 4303-4312, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30221664

RESUMO

Chronic lymphocytic thyroiditis (CLT), also known as Hashimoto's thyroiditis, is an autoimmune disease in which the thyroid gland is gradually destroyed. To date, only a limited number of agents can effectively suppress thyroiditis development in CLT patients. The aim of the current study was to investigate the protective effect of emodin on experimental autoimmune thyroiditis (EAT) in mice, which is considered an excellent model for CLT. NaI was used to induce the EAT model in non­obese diabetic (NOD) mice. An ELISA method was employed to detect the TgAb level (thyroid inflammation) in the serum of the EAT mice. The T cell subsets in peripheral blood and spleen were detected by flow cytometry. The histopathological study revealed that the thyroid inflammatory cell infiltration was significantly reduced by emodin compared with the model group. In addition, ELISA assays indicated that the NaI­induced serum TgAb upregulation was dramatically revered by emodin. Moreover, the level of serum IFN­Î³ and the cell populations of CD3+CD4+IL­4+, CD3+CD4+ IFN­Î³+, CD3+CD8+IL­4+, CD3+CD8+ IFN­Î³+ T cells in peripheral blood monocytes and splenic lymphocytes were significantly increased by NaI in the model group compared with in the normal group. Nevertheless, this type of increase was markedly attenuated by emodin. To conclude, the EAT model was successfully established by treating NOD mice with NaI. Emodin indicated an inhibitory effect on the autoimmune response that was significantly different in EAT compared with control mice. Furthermore, the anti­inflammatory action of emodin on EAT mice may be mediated via the inhibition of the secretion of IFN­Î³ and the cell numbers of CD3+CD4+IL­4+, CD3+CD4+ IFN­Î³+, CD3+CD8+IL­4+ and CD3+CD8+ IFN­Î³+ T cells in the peripheral blood monocytes and splenic lymphocytes. Therefore, the data may offer valuable insight on the efficacy of treatment of CLT with emodin.


Assuntos
Emodina/farmacologia , Iodeto de Sódio/efeitos adversos , Subpopulações de Linfócitos T/efeitos dos fármacos , Subpopulações de Linfócitos T/imunologia , Tireoidite Autoimune/etiologia , Tireoidite Autoimune/metabolismo , Animais , Biópsia , Modelos Animais de Doenças , Doença de Hashimoto/etiologia , Doença de Hashimoto/metabolismo , Doença de Hashimoto/patologia , Imuno-Histoquímica , Imunofenotipagem , Camundongos , Camundongos Endogâmicos NOD , Baço/imunologia , Baço/metabolismo , Subpopulações de Linfócitos T/metabolismo , Tireoglobulina/imunologia , Tireoidite Autoimune/tratamento farmacológico , Tireoidite Autoimune/patologia
13.
Curr Opin Endocrinol Diabetes Obes ; 25(5): 347-352, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30124478

RESUMO

PURPOSE OF REVIEW: To review the latest developments concerning the role of iodine in the pathophysiology of autoimmune thyroiditis. RECENT FINDINGS: Recent studies have provided evidence that in areas with excess iodine intake, increased incidence of autoimmune thyroiditis marked by high titers of thyroid peroxidase and thyroglobulin antibodies has occurred. Investigations in the NOD.H2h4 mouse, a strain prone to AIT, showed that they are better adapted to the Wolff-Chaikoff effect. SUMMARY: To provide an overview of the studies conducted during the last few years implicating iodine in the development and manifestation of autoimmune thyroiditis.


Assuntos
Homeostase/efeitos dos fármacos , Iodo/efeitos adversos , Iodo/metabolismo , Tireoidite Autoimune/etiologia , Tireoidite Autoimune/metabolismo , Animais , Autoanticorpos/metabolismo , Homeostase/fisiologia , Humanos , Iodeto Peroxidase/metabolismo , Iodetos/metabolismo , Iodo/fisiologia , Camundongos , Camundongos Endogâmicos NOD , Tireoglobulina/imunologia , Tireoidite Autoimune/imunologia , Tireoidite Autoimune/patologia
14.
Autoimmunity ; 51(5): 238-244, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30016121

RESUMO

Non-alcoholic fatty liver disease (NAFLD) has been studied with inflammation and immune, but the link with thyroid autoimmunity is unreported. This study aimed to explore the direct association of NAFLD with thyroid autoimmune disease (AITD) among participants with normal thyroid stimulating hormone (TSH) levels. The data were obtained from a cross-sectional study (SPECT-China). A total of 7982 participants were enrolled. Participants underwent several checkups including peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), thyroid, and liver ultrasonography (US). The prevalence of NAFLD was higher in TPOAb and/or TgAb positive [TPO/TgAb (+)] group and TPOAb and/or TgAb together with US positive [TPO/TgAb (+) and US (+)] group for both genders. After full adjustment, binary logistic analysis showed the presence of NAFLD was positively associated with the serum level of TPOAb in men (p < .001) and TgAb in women (p = .001). Both TPO/TgAb (+) and TPO/TgAb (+) and US (+) were associated with an increased risk of NAFLD in both genders [TPO/TgAb (+): odds ratio (OR) 1.474, 95% confidence interval (CI) 1.102, 1.970 in men and OR 1.308, 95%CI 1.061, 1.612 in women; TPO/TgAb (+) and US (+): OR 1.796, 95%CI 1.143, 2.820 in men and OR 1.380, 95%CI 1.058, 1.801 in women]. Thus, we got a conclusion that the prevalence of NAFLD was positively associated with the level and the positivity of TPOAb and TgAb among participants with normal TSH levels. This is the first report suggesting that there might exist common pathways in the pathogenesis of NAFLD and thyroid autoimmunity.


Assuntos
Autoanticorpos/sangue , Autoantígenos/imunologia , Iodeto Peroxidase/imunologia , Proteínas de Ligação ao Ferro/imunologia , Hepatopatia Gordurosa não Alcoólica/imunologia , Tireoglobulina/imunologia , Adulto , Autoanticorpos/imunologia , Autoantígenos/metabolismo , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Iodeto Peroxidase/metabolismo , Proteínas de Ligação ao Ferro/metabolismo , Fígado/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Prevalência , Fatores Sexuais , Tireoglobulina/metabolismo , Glândula Tireoide/imunologia , Glândula Tireoide/metabolismo , Ultrassonografia
15.
Front Immunol ; 9: 1197, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29915579

RESUMO

Background: Inflammasomes, which mediate maturation of interleukin-1ß (IL-ß) and interleukin-18 (IL-18) and lead to pyroptosis, have been linked to various autoimmune disorders. This study investigated whether they are involved in the pathogenesis of autoimmune thyroiditis (AIT). Methods: We collected thyroid tissues from 50 patients with AIT and 50 sex- and age-matched controls. Serum levels of free T3, free T4, thyrotropin, thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb) were measured by electrochemiluminescent immunoassays. Expression of several inflammasome components, the NOD-like receptor (NLR) family pyrin domain containing 1 (NLRP1), NLRP3, CARD-domain containing 4 (NLRC4), absent in melanoma 2 (AIM2), the apoptosis-associated speck-like protein that contains a caspase recruitment domain (ASC), caspase-1, IL-1ß, and IL-18 was determined by real-time PCR and western blot. Immunohistochemistry was used to localize the expression of NLRP1, NLRP3, NLRC4, and AIM2. The Nthy-ori 3-1 thyroid cell line was stimulated with tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-17A, interleukin-6, and poly(dA:dT). The levels of IL-18 and IL-1ß in the cell supernatant were measured by enzyme-linked immunosorbent assay, and lactate dehydrogenase was quantified by absorptiometry. ASC specks were examined by confocal immunofluorescence microscopic analysis. Cell death was examined by flow cytometry, and the N-terminal domain of gasdermin D was detected by western blot analysis. Results: Expression of NLRP1, NLRP3, NLRC4, AIM2, ASC, caspase-1, pro IL-1ß, pro IL-18, mRNA, and protein was significantly increased in thyroid tissues from patients with AIT, and enhanced posttranslational maturation of caspase-1, IL-18 and IL-1ß was also observed. Expression of NLRP1, NLRP3, NLRC4, and AIM2 was localized mainly in thyroid follicular cells adjacent to areas of lymphatic infiltration. The thyroid mRNA level of NLRP1 and ASC was correlated to the serum TPOAb and TgAb levels in the AIT group. TNF-α and IFN-γ had a priming effect on the expression of multiple inflammasome components in thyroid cells. IFN-γ was found to strengthen poly(dA:dT)-induced cell pyroptosis and bioactive IL-18 release. Conclusion: Our work has demonstrated for the first time that multiple inflammasomes are associated with AIT pathogenesis. The identified NLRP3, NLRP1, NLRC4, AIM2 inflammasomes and their downstream cytokines may represent potential therapeutic targets and biomarkers of AIT.


Assuntos
Doença de Hashimoto/metabolismo , Inflamassomos/metabolismo , Células Epiteliais da Tireoide/fisiologia , Tireoidite Autoimune/metabolismo , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Proteínas Reguladoras de Apoptose/metabolismo , Autoanticorpos/sangue , Proteínas Adaptadoras de Sinalização CARD/metabolismo , Proteínas de Ligação ao Cálcio/metabolismo , Caspase 1/metabolismo , Células Cultivadas , Citocinas/metabolismo , Proteínas de Ligação a DNA/metabolismo , Regulação da Expressão Gênica , Doença de Hashimoto/imunologia , Humanos , Iodeto Peroxidase/imunologia , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Piroptose , Tireoglobulina/imunologia , Tireoidite Autoimune/imunologia
16.
Thyroid ; 28(10): 1349-1358, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29943679

RESUMO

BACKGROUND: While overt thyroid disease is a well known risk factor for infertility, the potential consequences of mild thyroid dysfunction or thyroid autoimmunity remain unknown. Experimental studies suggest a considerable role for thyroid hormone in the physiological mechanisms of ovarian reserve, but translation of such findings to human studies remains rare. A potential role for thyroid function in female reproduction could be especially relevant when the cause of infertility remains unknown, such as in women with diminished ovarian reserve (DOR) or unexplained infertility. The aims of this study were to investigate the association of thyroid function and autoimmunity with markers of ovarian reserve day 3 follicle-stimulating hormone (FSH) concentrations and antral follicle count (AFC), and to investigate whether thyroid function or autoimmunity may have different effects in women with DOR or unexplained infertility. METHODS: Thyrotropin, free thyroxine, thyroxine, free triiodothyronine (fT3), triiodothyronine, thyroid peroxidase antibodies (TPOAbs), and thyroglobulin antibodies (TgAbs), as well as AFC and the day 3 FSH concentration, were measured among women seeking fertility treatment at the Massachusetts General Hospital Fertility Center. Multiple linear or mixed regression models were used to study the association of thyroid function or autoimmunity with AFC or day 3 FSH. RESULTS: In the total study population (436 women, 530 AFC measurements), there was no association of thyroid function or TPOAb positivity with AFC. However, TgAb positivity was associated with a higher AFC (mean difference = 3.4 [95% confidence interval (CI) 1.8-5.1], p < 0.001). In women with DOR or unexplained infertility, lower fT3 and TPOAb positivity were associated with a lower AFC (fT3: continuous nonlinear association, p = 0.009; TPOAb positivity: -2.3 follicles [confidence interval -3.8 to -0.5], p = 0.01), while TgAb positivity was not associated with AFC. Neither thyroid function nor thyroid antibody positivity was associated with the day 3 FSH concentration. CONCLUSIONS: This study found that lower fT3 and TPOAb positivity are associated with a lower AFC in women with DOR or unexplained infertility. Future studies are required to replicate these findings and further elucidate the role of TgAbs and underlying mechanisms through which thyroid function and autoimmunity is associated with ovarian reserve.


Assuntos
Autoimunidade/fisiologia , Infertilidade Feminina/fisiopatologia , Reserva Ovariana/fisiologia , Glândula Tireoide/fisiopatologia , Adulto , Autoanticorpos/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/imunologia , Tireoglobulina/imunologia , Testes de Função Tireóidea , Glândula Tireoide/imunologia , Tiroxina/sangue , Tri-Iodotironina/sangue
17.
Thyroid ; 28(7): 871-879, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29860933

RESUMO

BACKGROUND: Thyroglobulin (Tg) antibodies (TgAb) can interfere with Tg measurement and can be used as "Tg surrogate" in patients with differentiated thyroid cancer (DTC) treated with total thyroidectomy (TTx) and radioiodine remnant ablation (RRA). In contrast, few data, and in patients usually followed for a short-term follow-up, have been reported about the changes of TgAb levels in patients treated with TTx but without RRA. The aims of this study were to evaluate the changes of TgAb levels in DTC patients treated with TTx but not RRA and to identify the factors that influence these changes. METHODS: The change in TgAb levels in 107 DTC (<1 cm) patients submitted to TTx but not RRA was evaluated. Patients were followed for a median of 6.3 years, and all had at least three determinations of TgAb and neck ultrasound (nUS). RESULTS: TgAb levels showed a progressive decrease during follow-up. Initial TgAb levels and degree of lymphocytic infiltration influenced the time but not the rate of TgAb disappearance. No influence on time and rate of the decrease in TgAb was observed when the association with thyroperoxidase antibodies (TPOAb) levels were considered. A TgAb cutoff value of 61.9 IU/mL at first postoperative evaluation was a good indicator for disappearance of the TgAb within six years. No tumor recurrence was observed in the series. In one case, the progressive increase in TgAb anticipated the reappearance of benign thyroid tissue with lymphocytic infiltration. CONCLUSIONS: TgAb levels decline in the majority of DTC patients treated with TTx but not ablated with radioiodine. The levels decrease rapidly after the surgical treatment and continue to decrease over time. The time of disappearance is influenced by the initial TgAb levels and the degree of lymphocytic infiltration. No influence of the actual TPOAb levels has been observed. An increase in TgAb levels should not be overlooked, since it can indicate the presence or reappearance of either normal thyroid tissue or tumor recurrence.


Assuntos
Autoanticorpos/sangue , Carcinoma Papilar/imunologia , Tireoglobulina/imunologia , Neoplasias da Glândula Tireoide/imunologia , Adulto , Idoso , Carcinoma Papilar/patologia , Carcinoma Papilar/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Função Tireóidea , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Resultado do Tratamento , Adulto Jovem
19.
J Formos Med Assoc ; 117(8): 691-696, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29653880

RESUMO

BACKGROUND/PURPOSE: Behcet's disease (BD) patients should have recurrent aphthous stomatitis (RAS) but they may or may not have atrophic glossitis (AG). This study mainly assessed the frequencies of serum gastric parietal cell antibody (GPCA), thyroglobulin antibody (TGA), and thyroid microsomal antibody (TMA) positivities in 30 AG-positive RAS/BD (AG+RAS/BD) and 33 AG-negative RAS/BD (AGÖ¾RAS/BD) patients. METHODS: The frequencies of serum GPCA, TGA, and TMA positivities in 30 AG+RAS/BD patients, 33 AGÖ¾RAS/BD patients, and 126 healthy control subjects were calculated and compared. RESULTS: We found that 20.0%, 30.0%, and 26.7% of 30 AG+RAS/BD patients, 9.1%, 12.1%, and 15.2% of 33 AGÖ¾RAS/BD patients, and 1.6%, 2.4%, and 2.4% of 126 healthy control subject had the presence of GPCA, TGA, and TMA in their sera, respectively. The 30 AG+RAS/BD patients had significantly higher frequencies of serum GPCA, TGA, and TMA positivities than healthy control subjects (all P-values < 0.001). The 33 AGÖ¾RAS/BD patients had a higher frequency of serum TGA positivity (P = 0.051, marginal significance) and a significantly higher frequency of serum TMA positivity (P = 0.011) than healthy control subjects. Although the 30 AG+RAS/BD patients had higher frequencies of serum GPCA, TGA, and TMA positivities than the 33 AGÖ¾RAS/BD patients, the differences were not significant. CONCLUSION: AG+RAS/BD patients do have significantly higher frequencies of serum GPCA, TGA, and TMA positivities than healthy control subjects. This finding indicates that the concomitant presence of AG may result in significantly elevated frequencies of serum GPCA, TGA, and TMA positivities in BD patients.


Assuntos
Autoanticorpos/sangue , Síndrome de Behçet/sangue , Glossite/sangue , Glossite/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Células Parietais Gástricas/imunologia , Taiwan , Tireoglobulina/imunologia , Glândula Tireoide/imunologia , Adulto Jovem
20.
Endocr Relat Cancer ; 25(6): 643-652, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29559552

RESUMO

We aimed to explore the role of the diagnostic accuracy of F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for the detection of recurrent and/or metastatic diseases in differentiated thyroid cancer (DTC) patients with progressively and/or persistently elevated TgAb levels and negative radioactive iodine whole-body scan (RI-WBS) through a systematic review and meta-analysis. The MEDLINE, EMBASE and Cochrane Library database, from the earliest available date of indexing through June 30, 2017, were searched for studies evaluating the diagnostic performance of F-18 FDG PET/CT for the detection of recurrent and/or metastatic diseases in DTC patients with progressively and/or persistently elevated TgAb levels and negative RI-WBS. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-). Across 9 studies (515 patients), the pooled sensitivity for F-18 FDG PET/CT was 0.84 (95% CI; 0.77-0.89) a pooled specificity of 0.78 (95% CI; 0.67-0.86). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 3.8 (95% CI; 2.5-5.7) and negative likelihood ratio (LR-) of 0.21 (95% CI; 0.14-0.30). The pooled diagnostic odds ratio (DOR) was 18 (95% CI; 10-34). The area (AUC) under the hierarchical summary receiver-operating characteristic (HCROC) curve was 0.88 (95% CI: 0.85-0.90). F-18 FDG PET or PET/CT demonstrated moderate sensitivity and specificity for the detection of recurrent and/or metastatic diseases in DTC patients with progressively and/or persistently elevated TgAb levels and negative RI-WBS.


Assuntos
Anticorpos/imunologia , Tomografia por Emissão de Pósitrons , Tireoglobulina/imunologia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Fluordesoxiglucose F18 , Humanos , Neoplasias da Glândula Tireoide/imunologia
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