Hashimoto's Disease Research Articles

Does Epstein-Barr virus and intracellular Toll-like receptors affect the course of Hashimoto's disease? Findings from studies on newly diagnosed patients.

Epstein-Barr virus (EBV) reactivation is increasingly recognized as a potential exacerbator of autoimmune diseases, including Hashimoto's thyroiditis (HT). This study examined the association between EBV reactivation and intracellular Toll-like receptors (TLRs) expression in newly diagnosed, untreated HT patients. The aim was to determine whether EBV reactivation and specific TLRs (TLR3, TLR7, TLR8, and TLR9) contribute to the pathogenesis and progression of HT. A cohort was 54 newly diagnosed, untreated patients with HT and 20 healthy volunteers (HV). Also, the HV were similarin age and gender. Blood samples were collected to assess EBV viral load and intracellular expression levels of TLR3, TLR7, TLR8, and TLR9 using flow cytometry. Specific anti-EBV antibodies (e.g., VCA IgM, VCA IgG, EBNA-1 IgM, EBNA-1 IgG) were measured to identify signs of EBV reactivation, while soluble TLRs (sTLR3, sTLR7, sTLR8, and sTLR9) were quantified in serum using ELISA. Notably, this study's patients with Hashimoto's thyroiditiswere not euthyroid, as they exhibited significantly lower TSH levels and elevated fT3 and fT4 levels compared to healthy controls. Results showed a significant increase in EBV reactivation among HT patients, with 26 of 54 (48.1%) testing positive for EBV DNA, compared to none in the control group. HT patients with reactivated EBV showed significantly higher levels of intracellular expression of TLR3, TLR7, and TLR9, with TLR3+ cells constituting an average of 4.72% of CD4+ lymphocytes compared to 0.69% in the control group, suggesting a potential synergistic effect. In addition, soluble TLR levels were increased in HT patients with reactivated EBV, suggesting a potential role in potentiating autoimmune responses. These findings highlight the importance of considering both viral reactivation and TLR activity in the treatment of HT. Understanding the interplay between EBV and intracellular TLRs may lead to the development of new therapeutic approaches to mitigate the impact of these factors on disease progression. Further research is warranted to investigate the mechanisms underlying this interaction and its implications for treatment strategies.

Application of Human Plasma Targeted Lipidomics and Analysis of Toxic Elements to Capture the Metabolic Complexities of Hypothyroidism.

Hypothyroidism (HT) affects millions worldwide and can lead to various lipid disorders. The metabolic complexity and the influence of toxic elements in autoimmune and non-autoimmune HT subtypes are not fully understood. This study aimed to investigate the relationships between plasma lipidome, toxic elements, and clinical classifications of HT in unexposed individuals. Samples were collected from 120 adults assigned to a study group with Hashimoto's disease and non-autoimmune HT, and a healthy control group. Quantification of 145 pre-defined lipids was performed by using triple quadrupole tandem mass spectrometry (TQ MS/MS) in multiple reactions monitoring (MRM) mode via positive electrospray ionization (ESI). Levels of toxic elements were determined using inductively coupled plasma mass spectrometry (ICP-MS). Significant associations between altered levels of several components of the plasma lipidome and Al, Cd, Ni, As, and Pb with HT were found. We show metabolic differences in lysophosphatidylcholines (LPC) and phosphatidylcholines (PC) between HT and controls, with distinct predicted activation patterns for lysolecithin acyltransferase and phospholipase A2. There are significant changes in the lipidome profiles of healthy subjects compared to euthyroid HT patients treated with L-thyroxine, which are related to the type of hypothyroidism and non-occupational exposure to toxic elements.

The Influence of an Anti-Inflammatory Gluten-Free Diet with EPA and DHA on the Involvement of Maresin and Resolvins in Hashimoto's Disease.

The potential modulation of thyroid inflammatory conditions via a gluten-free diet has been suggested after establishing a link between Hashimoto's thyroiditis (HT) and celiac disease. However, the majority of targeted studies in this field do not support the general recommendation of prescribing a gluten-free diet (GFD) for all HT patients. This study aims to analyze data regarding the impact of a GFD supplemented with eicosapentaenoic (EPA) and docosahexaenoic acid (DHA), along with vegetables, on the course of inflammation involving long-chain fatty acid mediators. The study cohort consisted of 39 Caucasian female patients with autoimmune HT. Metabolite separations were performed using a liquid chromatograph with a DAD detector. Absorption peaks were read at 210 nm for resolvin E1, protectin DX, and maresin 1 and at 302 nm for resolvin D1. The introduction of a gluten-free diet completed with omega-3, including EPA and DHA, may contribute to a reduction in the inflammatory state in HT patients. This effect is supported by the elevation in the levels of anti-inflammatory mediators derived from long-chain fatty acids with anti-inflammatory properties but not by eliminating gluten. Significant statistical changes in the levels of all derivatives were observed before and after the implementation of the diet. It is worth noting that this effect was not observed in anti-TPO and anti-TG levels. The induction of anti-inflammatory changes can be achieved by supplementing the diet with EPA, DHA and vegetables with increased anti-inflammatory potential.

Development of Hashimoto's disease in patients with vitiligo

The aim of this paper is to review the available scientific literature on the relationship between vitiligo and the development of Hashimoto's disease, with particular emphasis on possible pathogenetic mechanisms and clinical implications of this correlation. The relationship between vitiligo and thyroid diseases, especially Hashimoto's disease, has intrigued researchers for years. Numerous clinical observations suggested that patients with vitiligo more often struggle with thyroid problems, but only extensive epidemiological studies allowed for a precise estimate of the scale of this phenomenon.

Predictive factors for lymph node metastasis in papillary thyroid cancer patients undergoing neck dissection: insights from a large cohort study.

This study aimed to investigate the risk factors and metastatic patterns in papillary thyroid cancer (PTC) patients undergoing lymph node dissection, offering guidance for clinical practice. A total of 924 PTC patients who underwent thyroidectomy with central neck dissection (CND) or lateral neck dissection (LND) between January 2021 and November 2022 were included in the analysis. The study investigated the relationships between clinicopathological characteristics, lymph node metastasis, and various risk factor. Among the 924 PTC patients, the cervical lymph node metastasis rate was 59.1% (546 patients). Of these patients, 381 had central neck metastasis (CNM, 41.2%), while the remaining 165 patients had lateral neck metastasis (LNM, 17.9%). Factors associated with increased risk of CNM and LNM included larger tumor diameter, presence of multiple tumors, and capsular invasion (p<0.05). Male sex, age <55 years, larger tumor diameter (>0.85 cm), multiple tumors, capsular invasion, and absence of Hashimoto's disease were identified as independent risk factors for CNM (p<0.05), with an AUC value of 0.722. CNM, maximum diameter >1.15 cm, and multiple tumors were independent risk factors for LNM (p<0.05), with an AUC of 0.699. These findings suggest that tailored neck dissection based on individual risk factors is crucial, particularly in cases of suspected LNM with larger tumors, CNM, multiple tumors, and capsular invasion.

8171 Analysis of Inflammatory Bowel Disease and Hashimoto's Disease: A Nationwide Study

Abstract Disclosure: C. Yang: None. L. Joo: None. B. Blair: None. Analysis of Inflammatory Bowel Disease and Hashimoto’s Disease: A Nationwide Study Introduction: The U.S. population is aging rapidly. There is limited data specifically for patients with Hashimoto’s disease who are older than or equal to 80 years old. We sought to examine the national inpatient sample database to describe in-hospital outcomes among these older patients. Methods: Data were extracted from the National Inpatient Sample (NIS) Database for the years 2019 and 2020. The NIS was searched for hospitalizations of adult patients with Hashimoto's disease using international classification of diseases 10th revision codes. We then examined the outcomes in patients who were older than or equal to 80 years old (YO) vs. younger than 80 years old. Linear regression and multivariate logistic was used accordingly to adjust for confounders. The primary outcome was inpatient mortality. Secondary outcomes were hospital length of stay (LOS), and total hospital charges (TOTHCG). SPSS software was used for statistical analysis. Results: This study included 48,649 patients with Hashimoto’s disease, of which 3,038(6.2%) patients were over or equal to the age of 80. Admissions with Hashimoto’s and old age had higher prevalence of hypertension (12.3% Vs 11.3 %, p&amp;lt;0.001), diabetes mellitus (14.8% VS 11.4% p &amp;lt;0.001), and obesity (6.9% Vs 3.1%, p&amp;lt;0.001). In-hospital mortality was higher among the older cohort (2.6% Vs 0.87, p&amp;lt; 0.001). On linear regression analysis, increased age was associated with increased in-hospital mortality (p&amp;lt;0.001). On multivariable regression, age &amp;gt;80 years was associated with higher odds of inpatient mortality (OR1.229, CI 1.174-1.286, p&amp;lt;0.001)). It was also shown that older Hashimoto’s patients pay significantly more total hospital charges ($82,361vs $70,231) with higher length of stay (7.4 days vs 5.6 days, p&amp;lt;0.001). On secondary analysis, it has shown that Hashimoto’s patients aged more than or equal to 80 years old had higher odds of having Crohn’s Disease (OR 1.032, CI 1.014-1.049, p&amp;lt;0.001) and Ulcerative Colitis (OR 1.025, CI 0.991-1.061, p&amp;lt;0.001). Conclusion: In this nationally representative population-based retrospective cohort study, aging was associated with higher mortality and worse outcomes among patients with Hashimoto’s disease. These results were distinguished in patients with inflammatory bowel disease. Presentation: 6/2/2024

ROLE OF INDIVIDUAL MICROELEMENTS AND VITAMINS IN HASHIMOTO'S DISEASE

Introduction and objective. Hashimoto's disease is a chronic autoimmune thyroiditis. The chronic process of this disease leads to hypothyroidism. Various micronutrients and vitamins play an important role in the course of the disease and may have a significant impact on the development and treatment of Hashimoto's disease. The aim of this study is to review the literature to fully assess the impact of micronutrients on symptoms, prognosis and dynamics of change in the context of Hashimoto's disease. Articles were searched by entering keywords in PubMed databases. Scientific articles covering the period from 2016 to 2024 represent 76% of the items included in the literature. Studies from specialized research centers including meta-analyses, double-blinded randomized trials, large cross-sectional studies were considered. Studies from inexperienced centers with methodological flaws were discarded. Abbreviated description of the state of knowledge. Current treatment of clinically overt hypothyroidism is based on the use of levothyroxine. The dose of substitution treatment is determined individually for the patient depending on the symptoms observed, TSH values and age. Currently, there are no recommendations for supplementation of microelements for the disease, which is due to the need to expand research and determine which micronutrients are worth taking to increase the quality of life of patients. Conclusion. The number of cases of Hashimoto's disease is steadily increasing worldwide. Increasing attention is being paid to elements of the patient's diet and environment, in addition to the substitution treatment itself. The modification of a broadly defined lifestyle and the influence of environmental factors may in the near future find a place in the standard therapeutic management of patients with chronic autoimmune thyroiditis.

The Impact of Thyroiditis on the Immune Profile in Young Patients with Uncomplicated Type 1 Diabetes.

Autoimmune thyroid disease (AIT) is the most frequently linked autoimmune condition to type 1 diabetes (T1D). The analysis of immune profiles could provide valuable insights into the study of these diseases. This knowledge could play a crucial role in understanding the relationship between immune profiles and microcirculation structures and functions. The present study aimed to test the hypothesis that cytokine levels in T1D patients without and those with comorbid Hashimoto's disease differ significantly. The total study group (total T1D) consisted of 62 diabetic young patients: 43 T1D and 19 T1D + AIT matched for age, age at onset, and duration of diabetes. The control group consisted of 32 healthy young subjects. The levels of cytokines (including TNF-α, IL-35, IL-4, IL-10, IL-18, IL-12, VEGF, and angiogenin) were quantified throughout this investigation. A comparative assessment of the cytokines profiles between the control group and total T1D revealed a statistically significant elevation in the levels of IL-4, TNF-α, IL-18, VEGF, and angiogenin, accompanied by a notable decline in IL-10. However, IL-35 and IL-12 exhibited comparable levels between the two groups. A comparison of cytokine levels between T1D + AIT and T1D groups revealed that only angiogenin levels were statistically significantly higher in T1D + AIT. The results of our study indicated that the alterations in cytokine levels associated with AIT did not correspond to the observed changes in T1D-related outcomes. The sole notable observation was the elevation of angiogenin expression, an angiogenic factor.

The role of diet and supplementation in the therapy of Hashimoto's disease: A systematic review

The role of diet and supplementation in the therapy of Hashimoto's disease: A systematic review

Total Antioxidant Capacity, Salivary Catalase, and Superoxide Dismutase in Hashimoto's Thyroiditis Patients

Hashimoto's thyroiditis (HT) is one of the common causes of hypothyroidism. Although various factors are involved in its development, recently the role of oxidative stress in its pathogenesis has been known. The present study aimed to investigate the level of total antioxidant capacity (TAC), catalase (CAT), and salivary superoxide dismutase (SOD) in patients with HT compared with the control group. The present case-control design included patients aged 18-80 years suffering from HT referred to the endocrine clinic. Eligible patients were selected by the available sampling method. Complete unstimulated saliva was collected under a rest state in a comfortable room between 10:00 AM and 12:00 AM and a checklist was used to collect data. The chi-square, t-test, and Mann-Whitney U tests were used for data analysis using SPSS 22 software. The mean age of the participants was 36.55±9.37 years (range: 20-56). The two groups were the same in terms of age and gender (P&gt;0.05). The findings indicated that the difference in the means CAT between the two groups was 22.63 which was strongly and statistically significant (P&lt;0.001). In this study, the level of TAC and SOD in Hashimoto's thyroid patients was decreased and the level of CAT was increased. These initial findings show that oxidative stress can be associated with Hashimoto's thyroid disease or the possibility of developing this disease increase.

Stem Cell Therapy for Hashimoto's Disease - a Promising Treatment Method?

Stem Cell Therapy for Hashimoto's Disease - a Promising Treatment Method?

Low echogenicity of Hashimoto's disease could be useful in detecting early phase of thyroid lymphomas, especially diffuse large B cell lymphomas

BackgroundHashimoto's disease, characterized by low echogenicity on ultrasonography, is associated with thyroid lymphomas. Most thyroid lymphomas are diffuse large B cell lymphomas (DLBCLs) and mucosa-associated lymphoid tissue (MALT) lymphomas. DLBCLs have a worse prognosis than MALT lymphomas. This study aimed to evaluate the early signs, especially the low echogenicity, of Hashimoto's disease and thyroid lymphomas. MethodsThis retrospective cohort study was conducted at Noguchi Thyroid Clinic and Hospital Foundation. A total of 9008 cases were operated on between 2008 and 2016, of which 162 had operated with suspected thyroid lymphoma, because of low echogenicity and aspiration biopsy cytology. The final diagnosis revealed 28 Hashimoto's disease, 134 thyroid lymphomas (91 MALT lymphomas and 43 DLBCLs). The primary outcomes were clinicopathological characteristics including low echogenicity of the thyroid. Early signs of thyroid lymphomas, especially DLBCLs were also investigated. ResultsAge, echo pattern, echogenicity anti-thyroid peroxidase antibody (TPOAb) and lactate dehydrogenase (LDH) were significantly different between Hashimoto's disease and thyroid lymphomas. Echogenicity, echo pattern and age were significant early signs of thyroid lymphomas. Age, echogenicity, soluble interleukin-2 receptor (IL2R), lactate dehydrogenase (LDH), and the neutrophil-to-lymphocyte ratio were significantly different between MALT lymphomas and DLBCLs. Echogenicity, and IL2R were significant early signs of DLBCL. The ROC analysis of low echogenicity for thyroid lymphomas compared to Hashimoto's disease revealed that Area Under the Curve (AUC) was 0.80 and the ROC analysis for DLBCL compared to Hashimoto's disease and MALT lymphoma revealed that the AUC was 0.73. ConclusionsLow echogenicity of Hashimoto's disease could be a useful early sign of thyroid lymphomas, especially DLBCL. Data availabilityThe data that supports the findings of this study are available in the supplementary material of this article.

Effect of DNA methylation at the CTLA4 gene on the clinical status of autoimmune thyroid diseases

The pathogenesis and manifestation of autoimmune thyroid diseases (AITDs), Graves' disease (GD), and Hashimoto's disease (HD) are associated with T cell activation. Cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) plays a crucial role in the regulation of T cell activation. DNA methylation levels of eight CpG sites in the CTLA4 gene and expression levels of soluble CTLA-4 were examined. Methylation levels of +22 CpG and CT60 CpG-SNPs in patients with GD and HD with the CT60 GG genotype were lower than those in control subjects. Methylation levels of the-15 CpG sites were lower in patients with intractable GD than those in GD patients in remission. These results suggest that demethylation of +22 CpG and CT60 CpG-SNPs may be associated with susceptibility to GD and HD in subjects with the CTLA4 CT60 GG genotype, and that demethylation of −15 CpG may be associated with the intractability of GD.

The Impact of Nutritional and Dietary Factors on Hashimoto's Thyroiditis: A Comprehensive Review

Introduction. Hashimoto's disease (HD) is the main cause of hypothyroidism in countries where there is no iodine deficiency in the diet. Characteristic antibodies for it are anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) and their level positively correlates with the severity of HD. Whereas its occurrence is related to genetic, environmental and existential factors. Aim of study. The aim of this study was to analyze dietary factors (protein, fat, vitamin D, iodine, selenium, gluten) and intestinal microbiota on the risk of developing Hashimoto's disease and the influence of each of these factors on its course. Materials and methods. More than 90 articles addressing these issues were analyzed. They were found using the PubMed search engine, and the time frame of these publications covered the last 10 years. Results. Excess iodine is the most important environmental factor influencing the development of Hashimoto's disease. Also, selenium deficiency contributes to the development of HD. On the other hand, the concentration of vitamin D is lower in patients with Hashimoto's disease than in the general population. Furthermore, Vitamin D supplementation reduces the concentration of anti-Tg antibodies. In addition, different types of dietary fat affect thyroid hormone levels differently and a deficiency of protein in the diet causes an increase in TSH and a decrease in thyroid hormones. Moreover, changes in the gut microbiome have been observed in people suffering from Hashimoto's disease. Conclusions. The risk of developing Hashimoto's disease can be increased and decreased by diet and diet allows for the modification of hormone levels in the hypothalamus-pituitary-thyroid axis.

Surgical management of papillary thyroid carcinoma coexisting with Hashimoto's disease: a single-center retrospective cohort study.

The mechanism and impact of Hashimoto's disease (HT) in patients with papillary thyroid carcinoma (PTC) remains a subject of ongoing debate. The optimal extent of thyroid resection is also controversial in cases of low-risk PTC. To investigate the clinical outcomes and prognoses associated with different extents of surgical resection in patients diagnosed with PTC coexisting with HT. We retrospectively analyzed data on the clinical features and treatment outcomes of patients with PTC concomitant with HT who underwent lobectomy with isthmusectomy and those who underwent total thyroidectomy at Peking University International Hospital between December 2014 and August 2023. Twenty-one patients in group A underwent lobectomy with isthmusectomy and prophylactic central neck dissection, whereas twenty patients in group B underwent total thyroidectomy with prophylactic central lymph node (LN) dissection, except one who did not undergo LN dissection. Group A demonstrated shorter surgery time (105.75 min ± 29.35 vs. 158.81 min ± 42.01, p = 0.000), higher parathyroid hormone (PTH) levels on postoperative day 1 [26.96 pg/ml (20.25, 35.45) vs. 9.01 pg/ml (2.48, 10.93), p = 0.000] and a shorter postoperative hospital stay [2.95 d (2.0, 4.0) vs. 4.02 d (3.0, 5.0), p = 0.008] than those of group B, with statistically significant differences. Both groups exhibited similar recovery patterns in terms of PTH [32.10 pg/ml (22.05, 46.50) vs. 20.47 pg/ml (9.43, 34.03), p = 0.192] and serum calcium (2.37 mmol/L ± 0.06 vs. 2.29 mmol/L ± 0.19, p = 0.409) after 1 montsh following the surgery. According to the Kaplan-Meier curves, no significant difference in the 5-year disease-free survival rates were observed between patients in group A (100%) and group B (97.1%) (Log rank test: p = 0.420, Breslow test: p = 0.420). Lobectomy with isthmusectomy and prophylactic central neck dissection is a safe and feasible treatment option for patients with low-risk PTC coexisting with HT. http://www.chictr.org.cn, identifier ChiCTR2300079115.

Bioactive components in prunella vulgaris for treating Hashimoto's disease via regulation of innate immune response in human thyrocytes

BackgroundHashimoto's thyroiditis (HT) is a thyroid autoimmune disease characterized by lymphocytic infiltration and thyroid destruction. Prunella vulgaris (PV) is a traditional Chinese herbal medicine with documented clinical efficacy in treating HT. We previously reported an immunoregulatory effect of PV in thyrocytes; however, the bioactive components of PV remained unclear. This study aimed to elucidate key components of PV for treating HT and their acting mechanisms. MethodsNetwork pharmacology was used to predict key PV components for HT. The predicted components were tested to determine whether they could exert an immunoregulatory effect of PV in human thyrocytes. Limited proteolysis-mass spectrometry (Lip-MS) was used to explore interacting proteins with PV components in human thyrocytes. Microscale thermophoresis binding assay was used to evaluate the affinity of PV components with the target protein. ResultsEleven PV components with 192 component targets and 3415 HT-related genes were gathered from public databases. With network pharmacology, a ‘component-target-disease’ network was established wherein four flavonoids including quercetin, luteolin, kaempferol, morin, and a phytosterol, β-sitosterol were predicted as key components in PV for HT. In stimulated primary human thyrocytes or Nthy-ori-31 cells, key components inhibited gene expressions of inflammatory cytokines including tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), and interferon-β (IFN-β), cellular apoptosis, and activation of nuclear factor κB (NF-κB) and interferon regulatory factor 3 (IRF-3). Heat shock protein 90 alpha, class A, member 1 (HSP90AA1), was identified to interact with flavonoids in PV by Lip-MS. Morin had the highest affinity with HSP90AA1 (KD = 122.74 μM), followed by kaempferol (KD = 168.53 μM), luteolin (KD = 293.94 μM), and quercetin (KD = 356.86 μM). ConclusionQuercetin, luteolin, kaempferol, morin, and β-sitosterol reproduced an anti-inflammatory and anti-apoptosis effect of PV in stimulated human thyrocytes, which potentially contributed to the treatment efficacy of PV in HT.

Role of Micronutrient Supplementation in the Management of Hashimoto's Thyroiditis: A Review of Current Evidence and Potential Mechanisms of Action

Introduction and objective: Hashimoto's thyroiditis (HT), the most prevalent autoimmune disorder and a primary cause of hypothyroidism globally, leads to thyroid gland damage through lymphocyte infiltration. Pharmacological treatment of HT involves the use of levothyroxine, which in most cases must be taken for life. However, supplementation with micronutrients is often overlooked. Several studies have examined the impact of substances such as selenium, zinc, vitamin B12, and vitamin D on the course of Hashimoto's disease. Review methods: Review and summary of research studies available in open-source format on Google Scholar, PubMed. Abbreviated description of the state of knowledge: Supplementation with selenium, zinc, vitamin D, and B12 shows potential benefits for patients with Hashimoto's disease. Summary: Regular monitoring and tailored supplementation of selenium, zinc, vitamin D, and vitamin B12 can enhance overall health and disease management. Therefore, it is worth considering the supplementation of these micronutrients in the daily routine of patients with Hashimoto's thyroiditis. However, it should be noted that these supplements do not constitute a treatment for Hashimoto's disease and their effect cannot replace the intake of levothyroxine.

The effect of vitamin D on the development of Hashimoto's disease and the reduction of the inflammatory process in its course - review

Introduction Hashimoto's disease is an autoimmune chronic lymphocytic thyroiditis. It is a common condition, more frequent in women. Its diagnosis is based on the presence of specific antithyroid antibodies in the patient's blood which lead to the destruction of the thyroid gland. This can result in the development of hypothyroidism, requiring levothyroxine replacement therapy. Aim of the review A summary of the information gathered so far on the involvement of vitamin D in the development and course of Hashimoto's disease. Results The articles analyzed have mixed results. Most of them show a positive correlation between vitamin D and Hashimoto's disease, paying particular attention to the contribution of vitamin D in moderating the inflammatory process in HT. Other studies show significant differences in vitamin D levels between groups with different HT severity. Others show a negative correlation between vitamin D levels and the development of Hashimoto's disease. Conclusions Large well-controlled randomized double blind trials are needed in order to determine the exact role of vitamin D in Hashimoto’s disease.

Iron and ferritin deficiency in women with hypothyroidism and chronic lymphocytic thyroiditis - systematic review.

Iron is one of the essential microelements necessary for maintaining the body's homeostasis. It serves various roles, including being a crucial component in the proper structure of many enzymes and supporting the transport of oxygen and electrons. Its deficiency can lead to anaemia, which is a common clinical condition often associated with thyroid diseases. Iron deficiency is one of the most common nutritional deficiencies, and its prevalence is strongly associated with socioeconomic status. It is the primary cause of anaemia in 42% of children and 50% of women. Importantly, iron deficiency is placed among the top 5 causes of disability in women. Thyroid peroxidase (TPO) is an enzyme essential for the production of thyroid hormones, and iron is a key factor in its proper functioning. Therefore, in the case of iron deficiency, the activity of this enzyme is also reduced. Iron is also a factor that is important in epigenetic modification processes, and its deficiency may contribute to genomic changes potentially promoting the development of autoimmune thyroid diseases. Adequate supplementation in patients with Hashimoto's disease is one of the crucial elements of effective therapy. In addition to iodine, selenium, and magnesium supplementation, attention should be paid to proper iron intake. Iron is an element that is a component of the heme enzyme- thyroid peroxidase, which owes its activity to the binding of haem, and its function is the production of thyroid hormones. Iron can be delivered to the body in haem and non-haem forms. The haem form is found particularly in haemoglobin-rich red meat, but also in eggs, fish, and poultry. On the other hand, non-haem iron can be found in legumes, grains, fruits, and vegetables. Our study aimed to gather and summarise knowledge from scientific literature regarding iron deficiency anaemia and its association with hypothyroidism in women, as well as the possible mechanisms and pathogenesis of these conditions. The paper also aims to highlight that considering the high risk of iron deficiency, assessing iron status along with ferritin should be an integral part of additional diagnostic measures in cases of hypothyroidism, particularly Hashimoto's disease.

STAT3 single-nucleotide variants in autoimmune thyroid disease in the Pakhtun population of Khyber Pakhtunkhwa, Pakistan

The current study was conducted to assess the relationship between the STAT3 gene variants rs744166 and rs2293152 and autoimmune thyroid disorder in the Pakhtun population of the province, of Khyber Pakhtunkhwa, Pakistan. Blood was collected from 100 healthy individuals and 400 thyroid-disordered patients. Of these, one hundred were diagnosed with Hashimoto's thyroiditis (HT), while 32 were confirmed as Grave's disease (GD) patients. T3, T4, and TSH serum levels were checked to diagnose thyroid disorders. The blood was analyzed for anti-thyroid peroxidase antibodies (Anti-TPOAb) (AESKULISA- ATPO - elisa kit), (Germany), and thyroid stimulating hormone receptor antibodies (TSHRAb), TSHR Ab elisa kit (Diametra Italy), respectively. PCR was used to amplify the targeted STAT3 gene polymorphisms from rs744166 (301 bp) and rs2293152 (365 bp) sequences and then digested by specific restriction endonucleases (AluI) and AciI respectively. The disease displayed a female predominance. The genotype TC and CC of rs744166 showed a significant relationship with Grave's disease (p = 0.002, OR = 0.28, 95 % CI = 0.11–0.77) in patients. The C allele contributed significantly to the disease in GD patients. The SNP rs2293152 significantly differed between GD patients and control (p = 0.032, OR = 0.29, 95 % CI = 0.09–0.86). Similarly, the G and C alleles showed a significant (p = 0.02) difference between GD patients and the control. No significant association was found for both SNPs in Hashimoto's thyroiditis disease. It is concluded that the STAT3 gene (rs744166 and rs2293152) was found to have a potential role in autoimmunity in GD patients. Still, it needs further studies with larger sample sizes in the Pakhtun population to understand this relationship.