The Effect of Thionamide to TRH, TSH, IL-4, T-REG, and Anti-TPO in Graves’ Disease

Eva Decroli,Dwitya Elvira,Dinda Aprilia

doi:10.14499/indonesianjpharm30iss2pp122-127

Abstract

The most common cause of hyperthyroidism is Graves' disease. TRH and TSH are hormonal factors that modulate and control thyroid function in Graves' disease. In the immunological aspect, Graves' disease is played by the role of T-reg, IL-4, and anti-TPO. Graves' disease treatment goal is to inhibit thyroid hormone secretion by administering thionamide. The evaluation of this treatment is its hormonal and immunological aspects. To describe the effect of thionamide on serum TRH, TSH, IL-4, T-reg, and anti-TPO levels in Graves' disease. This study is a clinical trial study in 25 study participants. All study participants were given thionamide, namely PTU 300mg for three months and blood samples were taken for laboratory tests. Serum TRH, TSH, IL-4, T-reg FOXP3, and anti-TPO levels were examined by ELISA. The mean levels at the beginning and after three months of therapy are: serum TRH 92.589pg/mL and 115.944pg/mL; serum TSH 0.041mU/L and 0.223mU/L; serum IL-4 19.759pg/mL and 23.040pg/mL; T-reg FOXP3 gene polymorphism 0.621ng/mL and 0.518 ng/mL; serum anti-TPO 2697.539pg/mL and 2604.710pg/mL. Increased levels of serum TRH and TSH levels were statistically significant. The change in serum IL-4, T-reg FOXP3 gene polymorphism, and anti-TPO levels were not statistically significant. The administration of thionamide in Graves' disease for three months will significantly decrease Wayne index and serum FT4 levels, increase serum TRH and TSH levels.

Highlights

The most common cause of hyperthyroidism in the world is Graves' disease
Thyroid-stimulating hormone (TSH) circulating in the tissues is controlled by thyrotropin-releasing hormone (TRH) levels and the feedback effect of thyroid hormone levels on the tissues
Thyroid hormone levels are controlled by TSH, which is produced by the anterior pituitary gland

Summary

INTRODUCTION

The most common cause of hyperthyroidism in the world is Graves' disease. Graves' disease occurs in 2 - 2.5% of women and 0.2 - 0.6% of men. In the immunological aspect of Graves' disease, at higher level, is controlled by T-regulator (T-reg) cells. Thyroid hormone levels are controlled by TSH, which is produced by the anterior pituitary gland. After achieving normal serum FT4 levels, maintenance therapy begins by reducing the dose of thionamide by 50% (Davies et al, 2011; Elvira et al, 2016; Decroli et al, 2014). The Wayne index, serum FT4 and TSH levels are evaluated in the treatment of Graves' disease. The effect of therapy on Graves' disease should influence the factors that play a role in immunological aspects, such as T-reg, IL-4, and anti-TPO. We want to see the effect of thionamide on levels of TRH, TSH, IL-4, T-reg, and anti-TPO in Graves' disease (Davies et al, 2011; Elvira et al, 2016; Decroli et al, 2014)

MATERIAL AND METHODS

Methods

Findings

AND DISCUSSION