Abstract
BackgroundIn order to assess safety of radioactive iodine administration in the treatment of thyrotoxicosis, we measured concentrations of matrix metalloproteinase-2 (MMP-2), its main inhibitor – TIMP-2 (tissue inhibitor of MMP-2), matrix metalloproteinase-9 (MMP-9), its main inhibitor – TIMP-1, adiponectin, as well as pro-inflammatory and procancerogenic thrombospondin-1 (TSP-1).Design and patientsThe study involved 23 patients treated with radioiodine for thyrotoxicosis. Serum concentrations of TSH, free T4, free T3, MMP-2, MMP-9, TIMP-1, TIMP-2, total adiponectin and TSP-1 were measured by immunoassays just before radioiodine administration (visit 1), and subsequently, after 7 days (visit 2), 3 months (visit 3), 6 to 8 months (visit 4) and 15–18 months after radioiodine administration (visit 5).ResultsThere were no acute changes in serum concentrations of MMP-2, MMP-9, TIMP-1, TIMP-2, adiponectin and TSP-1 (visit 1 vs. 2). Subsequently, there was an increase in MMP-2 (from 393±106 ng/ml to 774±424 ng/ml), TIMP-1 (from 177±76 ng/ml to 296±118 ng/ml), and adiponectin (from 16442±9490 ng/ml to 23518±9840 ng/ml), visit 1 to 5, respectively (p < 0.01). Further analysis revealed no significant change in MMP-2/TIMP-2 ratio, but there was a significant decrease in MMP-9/TIMP-1 ratio (p < 0.05), suggestive of possible decrease in free MMP-9 concentrations.ConclusionsOur data reveal a significant and sustained increase in serum adiponectin, as well as possible decrease of free MMP-9 concentration after radioiodine administration. In contrast, there was no significant change of TSP-1. This might indicate overall safety of radioiodine treatment of thyrotoxicosis in terms of the risks of subsequent cardiovascular and neoplastic disease.
Highlights
In order to assess safety of radioactive iodine administration in the treatment of thyrotoxicosis, we measured concentrations of matrix metalloproteinase-2 (MMP-2), its main inhibitor – TIMP-2, matrix metalloproteinase-9 (MMP-9), its main inhibitor – TIMP-1, adiponectin, as well as pro-inflammatory and procancerogenic thrombospondin-1 (TSP-1)
Following radioiodine treatment there was a fall in free T4 between visit 2 and visit 3 (p < 0.01), as patients later developing hypothyroidism were treated with L-thyroxine, the concentrations of free T4 remained stable at subsequent visits
There were no acute changes in serum concentrations of matrix metalloproteinases (MMPs)-2, MMP-9, TIMP-1, TIMP-2, adiponectin and TSP-1
Summary
In order to assess safety of radioactive iodine administration in the treatment of thyrotoxicosis, we measured concentrations of matrix metalloproteinase-2 (MMP-2), its main inhibitor – TIMP-2 (tissue inhibitor of MMP-2), matrix metalloproteinase-9 (MMP-9), its main inhibitor – TIMP-1, adiponectin, as well as pro-inflammatory and procancerogenic thrombospondin-1 (TSP-1). The term matrix metalloproteinases (MMPs) refers to a group of enzymes that physiologically remodel extracellular matrix, and contribute to development of various pathological states, such as neoplasms, inflammatory and cardiovascular diseases [1]. There is ample evidence demonstrating that adiponectin has anti-inflammatory, anti-atherosclerotic and vasoprotective actions, affects signaling in myocardial cells and exerts beneficial actions on the heart after pressure overload and ischemiareperfusion injury [6,7]. TSP-1 is highly correlated with adipose inflammation [8]; and is decreased by pioglitazone [9], though there is evidence of possible protective properties in circumstances, such as cardiac remodeling after injury [10]. Thrombospondin has been found to be secreted by thyrocytes in a pattern that is opposite to thyroglobulin [11], and subsequently TSP-1 has been identified as a potential regulator of angiogenesis and tumour progression [12]
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