Autoimmune Hashimoto's Thyroiditis Research Articles

Role of proinflammatory cytokines in Hashimoto's thyroiditis associated with psychiatric disorders

Mental disorders often accompany autoimmune diseases, for example, since 1949 it has been known about “myxedematous madness”, a psychosis caused by hypothyroidism. The most common cause of hypothyroidism is Hashimoto's autoimmune thyroiditis. It is also known about another neuropsychiatric disorder associated with autoimmune thyroiditis, Hashimoto's encephalopathy. It is a severe dysfunction of the central nervous system, the pathogenesis of which is not associated with hormonal disorders. Cytokines are regulators and participants of inflammation, including autoimmune. Certainly, when we are talking about high concentrations cytokines, we mean systemic inflammation. The minimal or mediocre fluctuations in cytokines within the ranges that are characteristic of healthy status or normergic acute phase response in disease cannot be interpreted from the point of view of binary endocrinological logic. In the CNS, cytokines are able to influence on the neuroendocrine control of systemically regulated functions. It is also important that glial cells (astroglia, microglia) are capable of producing a number of cytokines and can affect neurons and develop behavioral changes. In addition, the ability of a number of cytokines outside the CNS itself to act on vagal afferents and through them to convey information to the CNS, affecting its state and functions, has been proven. It is reasonable to assume that minimal fluctuations in cytokine levels may also affect the state and function of the CNS. The aim of the study was to investigate the levels of cytokines in patients with thyroiditis; in patients with thyroiditis associated with mental disorders; in a group of healthy individuals; and evaluate the effect of cytokine levels on clinical manifestations. In the group of patients with thyroiditis and mental disorders, the levels of CCL20/MIP3α, IL-13, IL-2, IL-27, IL-5 were significantly higher than in other groups. At the same time, no positive correlation was found between the clinical manifestations of mental disorders and the levels of cytokines. A positive correlation was found between the levels of some cytokines and free triiodothyronine, as well as the level of antithyroid antibodies. Mental disorders associated with autoimmune thyroiditis may be associated with changes in the cytokine profile and result from neuroinflammation.

Clonally expanded, thyrotoxic effector CD8+ T cells driven by IL-21 contribute to checkpoint inhibitor thyroiditis.

Autoimmune toxicity occurs in up to 60% of patients treated with immune checkpoint inhibitor (ICI) therapy for cancer and represents an increasing clinical challenge for expanding the use of these treatments. To date, human immunopathogenic studies of immune-related adverse events (IRAEs) have relied on sampling of circulating peripheral blood cells rather than affected tissues. Here, we directly obtained thyroid specimens from individuals with ICI-thyroiditis, one of the most common IRAEs, and compared immune infiltrates with those from individuals with spontaneous autoimmune Hashimoto's thyroiditis (HT) or no thyroid disease. Single-cell RNA sequencing revealed a dominant, clonally expanded population of thyroid-infiltrating cytotoxic CXCR6+ CD8+ T cells (effector CD8+ T cells) present in ICI-thyroiditis but not HT or healthy controls. Furthermore, we identified a crucial role for interleukin-21 (IL-21), a cytokine secreted by intrathyroidal T follicular (TFH) and T peripheral helper (TPH) cells, as a driver of these thyrotoxic effector CD8+ T cells. In the presence of IL-21, human CD8+ T cells acquired the activated effector phenotype with up-regulation of the cytotoxic molecules interferon-γ (IFN-γ) and granzyme B, increased expression of the chemokine receptor CXCR6, and thyrotoxic capacity. We validated these findings in vivo using a mouse model of IRAEs and further demonstrated that genetic deletion of IL-21 signaling protected ICI-treated mice from thyroid immune infiltration. Together, these studies reveal mechanisms and candidate therapeutic targets for individuals who develop IRAEs.

Relationship between low vitamin D levels with Hashimoto thyroiditis

Introduction/Objective. Vitamin D not only plays a role in calcium and phosphorus metabolism, but also has antiproliferative, prodifferentiation, anti-inflammatory and immunomodulatory effects. The aim of this study was to investigate the association between vitamin D deficiency in individuals with autoimmune Hashimoto?s thyroiditis. Methods. A total of 156 patients were enrolled and divided into two groups. First group included 108 patients with 25 (OH) D insufficiency, and second included 48 individuals with normal 25 (OH) D levels. All participants underwent a detailed clinical examination, laboratory tests for thyroid function [T3, fT4, TSH, thyroid antibodies (TPO-Ab, and TG-Ab)], as well as ultrasound scanning (thyroid volume and Doppler characteristics). Results. The patients with vitamin D insufficiency (n = 108 (69.2%)) were predominantly female and had a higher body mass index than the patients with normal vitamin D levels. The group with vitamin D insufficiency had statistically significantly higher TSH levels. The prevalence of positive thyroid antibodies was higher in the vitamin D insufficiency group, while thyroid volume, superior thyroid artery, and inferior thyroid arteries resistance index, as well as the prevalence of positive circular dichroism signals, were significantly higher in the vitamin D insufficiency group. Out of the 156 subjects, 44 were diagnosed with thyroiditis (28.2%). The mean serum level of 25 (OH) D was statistically notably lower in patients with thyroiditis (20.23 ? 8.10 ng/mL) than in the group without thyroiditis (25.44 ? 8.38 ng/mL), p < 0.001. Conclusion. There was an association between vitamin D insufficiency and hypothyroidism in subjects with Hashimoto?s thyroiditis.

Einfluss der traumazentrierten Psychotherapie mit EMDR-Therapie auf somatische Komorbiditäten

Results of modern research show a relationship between emotional stress and the occurrence of autoimmune diseases as a comorbidity. The authors use EMDR therapy (Eye Movement Desensitization and Reprocessing) to treat trauma disorders. They wondered whether and to what extent this treatment also affects autoimmune processes. Parallel to the trauma-focused psychotherapy with EMDR, the thyroid hormone substitution dose was documented in patients with active Hashimoto's autoimmune thyroiditis requiring substitution. Hashimoto's autoimmune thyroiditis had already been diagnosed by a specialist and drug treatment had been initiated before starting outpatient psychotherapy. So far in five cases a decrease in autoimmune activity and a stability of the results in the follow-up between six months and one year could be observed. It is now necessary to examine whether these results can be confirmed in a larger number of patients and a diversity of therapists and whether these observations can be transferred to other somatic comorbidities.

RELATIONSHIP BETWEEN ULTRASOUND CHANGES IN THE LIVER AND HYPOTHYROIDISM IN PATIENTS WITH AUTOIMMUNE THYROIDITIS

Hashimoto's autoimmune thyroiditis (AIT) is one of the most frequent causes of hypothyroidism, which leads to the development of dysfunctions of various body systems. Since the hepatobiliary system is closely related to the thyroid gland, a decrease in thyroid function is considered one of the factors in the development of non-alcoholic fatty liver disease. Early detection of changes in the liver in patients with hypothyroidism makes it possible to start therapy in time and prevent the development of complications, such as fatty dystrophy, inflammation, damage to hepatocytes, fibrosis, cirrhosis.
 The aim. Determine the relationship between hypothyroidism and ultrasound changes in the liver in patients with AIT.
 Methods. 62 patients with AIT and hypothyroidism were examined. The first group included 32 patients with a history of AIT up to two years, the second group included 30 patients with a history of the disease for more than two years, and the control group included 30 patients without signs of thyroid pathology. Thyroid function was assessed based on the results of a hormone levels blood test. Multiparametric ultrasound examination of the liver and thyroid gland was performed on Siemens Acuson S2000 and S3000 devices in B-mode, color doppler mapping, pulse-wave doppler and shear-wave elastography (SWE) modes.
 Results. Ultrasound changes in the liver were more often observed in patients with subclinical hypothyroidism on the background of AIT. It was found that the number of patients with sonographic signs of liver damage is greater in the second group than in the first. Sonographic signs of the hepatobiliary system damage included an increase in the size of the liver, an increase in the echogenicity of its parenchyma, not homogeneous structure and dilatation of the portal vein.
 The analysis of the level of shear wave speed in the parenchyma of the thyroid gland showed that it was higher in second groups and its increase was also noted in patients with subclinical and clinical hypothyroidism.
 The results of SWE of the liver demonstrated a positive correlation between the stiffness of the liver parenchyma and the duration of AIT. Also, significantly higher values of SWE were observed in patients who, at the time of examination, had laboratory signs of thyroid dysfunction and the high level of shear wave velocity in the thyroid gland parenchyma. The analysis of the number of cases of liver fibrosis in two groups showed that it is more often detected during the long course of the disease. The percentage of patients with F1-F2 in the first group was 32% and in the second group - 53%.
 Conclusions. The established relationship between sonographic signs of diffuse changes in the liver parenchyma and hypothyroidism determines the expediency of using multiparametric ultrasound examination of the hepatobiliary system in patients with AIT to assess its condition, early diagnosis of fibrosis and determine the need for correction of treatment tactics.

Молекулярні механізми патогенезу автоімунного тиреоїдиту Хашимото (огляд літератури)

The purpose of the study was to systematize and analyze material of recent studies on molecular mechanisms of pathogenesis of autoimmune Hashimoto's thyroiditis. Materials and methods. Analytical and bibliosemantic methods were used in the study. Results and discussion. Autoimmune Hashimoto's thyroiditis is a chronic inflammatory disease of the thyroid gland of autoimmune genesis in which impaired tolerance to thyroid autoantigens results in chronic progressive lymphoid infiltration followed by gradual destruction of thyroid parenchyma. The disease is more often observed at the age of 45-65 years and is multifactorial – both genetic predisposition and environmental factors contribute to its development. The ratio of female to male patients is approximately 10-20:1, and in recent years, the prevalence of autoimmune Hashimoto's thyroiditis has increased more than tenfold. On morphological examination, the section of the thyroid is diffusely enlarged, the surface of the section is pale, yellow-brown in color, dense and nodular. Microscopic examination reveals numerous large mononuclear inflammatory infiltrates in the parenchyma, consisting of small lymphocytes and plasma cells, well-formed germinal centers. A twin method is used to assess the degree of contribution of genetic and environmental factors. Studies demonstrate significantly greater concordance in monozygotic twins than in dizygotic twins, confirming the important role of genetic factors in the etiology. Among the main immune mechanisms of damage are: direct action of CD8+ cytotoxic T cells on thyrocytes by binding through the Fas-receptor – Fas ligand system; the influence of cytokines, in particular – interferon γ, produced by TH1 cells and leading to macrophage activation with subsequent damage to follicles, antibody-dependent cell-mediated cytotoxicity, in which Fc fragments of antibodies previously bound to thyroid cells are binding sites to cells that commit killing, in particular – to the natural killer cells. In terms of thyroid cell damage, cytokines produced by the lymphocytic infiltrate play a key role. These include differentiation, signal transduction, and stimulation of other cells to release proinflammatory mediators or synthesize antibodies. Their ability to stimulate the thyroid cells themselves to release inflammatory mediators should be noted, thereby enhancing and perpetuating the autoimmune process. Researchers have identified other mechanisms, and the ratio of their contribution to the overall pathological process is a matter of debate and may vary from patient to patient. One explanation may be the multifactorial nature of the disease. In particular, different genetic mutations can lead to different disorders of intracellular and intercellular signaling, but the resulting factor will be one – immune autoaggression. Conclusion. The pathogenesis of autoimmune Hashimoto's thyroiditis is complex and multifaceted, involving both humoral and cellular immunity. The disease may be provoked both by mutations in the mechanisms of immune regulation, by mutations in the thyroid cells themselves, and by environmental factors

Dijetarni faktori i tiroidna disfunkcija

Besides iodine deficiency, autoimmune Hashimoto thyroiditis is the leading cause of hypothyroidism globally, characterized by the increased titer of thyroid autoantibodies and destruction of thyroid cells. Graves' disease is the most common etiology of hyperthyroidism worldwide. Patients with thyroid dysfunction often require dietary modifications. Popular interventions include supplementation with certain vitamins and minerals, as well as trace elements such as iodine and selenium. The intake of food containing goitrogens should be limited. Goitrogens are substances of plant origin that interfere with the production of thyroid hormones, increasing the risk for goiter and hypothyroidism. The primary dietary sources of goitrogens are cruciferous vegetables, soy products, starchy plants, and some fruits. Beyond essential nutrients, there has been an increasing interest in using specific nutraceuticals, including myoinositol, Lcarnitine, melatonin, and resveratrol, as potential preventive and therapeutic agents in thyroid diseases. Even though current evidence promotes some beneficial outcomes of these nutraceuticals, further investigations are needed to clarify dose-dependent effects, duration of supplementation, combination in different clinical settings, and the exact mechanism of their action in thyroid disorders.

The association between leptin level and lipid profile in women with Hashimoto’s disease

Rationale: Weight gain is a well-known side effect of Hashimoto's autoimmune thyroiditis [1]. As body weight increases, one can expect increased levels of circulating leptin and deleterious changes in lipid profile [2]. The study aimed to assess concentrations of leptin, cholesterol fractions, and triglycerides in women with Hashimoto's disease (HD) and in healthy subjects.

Hashimoto autoimmune thyroiditis in surgical practice

Hashimoto autoimmune thyroiditis in surgical practice

IODINE INTAKE AND CANCER

Objectives: Iodine is a trace element that is essential for the synthesis of thyroid hormone. Both chronic iodine deficiency or iodine excess have been associated with hypertrophy and hyperplasia of follicular cells in thyroid gland and the influence of thyroid hormone (T3, T4) and thyrotropin (TSH) secretion. Increase rates of the thyroid cancer are increasing after radiation exposure to 131I in children or aldolescents. Methodology: In respective published reports in literature and in combination of our previous study, dietary iodine excess goiter, iodine induced hyperthyroidism (IIH) and IIT, Iodine intake and the prevalence of papillary carcinoma (PTC), as well as the case-control and cohort studies of thyroid cancer and intake of seafood and milk products, were systematically reviewed. Relative factors that should be considered when studying the effect of dietary iodine in the development of thyroid cancer include screening programs, pathological criteria, diagnostic techniques, radioactive iodine, and standard of medical care in the studied population. Results and conclusion: In current surveys, papillary thyroid carcinoma forms the largest group of thyroid malignancies, after iodine intake excess or iodine prophylaxis where an increase in the papillary: follicular carcinoma ratio was uncovered. Also, there is clear temporal relationship in many countries between introduction of iodine intake excess especially as to radioactive iodine and an increase in incidence of PTC. Iodine goiter, IIH and IIT were also noted. Autoimmune hashimoto's thyroiditis are linked to dietary iodine. Dietary iodine intake is another care of environmental relevance factor in thyroid diseases and papillary carcinoma. Available evidence of oncogenic thyroid hormone receptor mutants from animal experiments and clinical investigation have been a shift toward the oncogenic function of human thyroid carcinoma, and also its target therapy. Peer Review History: Received: May 2021; Revised: June; Accepted: June, Available online: 15 July 2021 Academic Editor: Ahmad Najib, Universitas Muslim Indonesia, Makassar, Indonesia, ahmad.najib@umi.ac.id UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewer(s) detail: Prof. Dr. A. Hakan AKTAŞ, Süleyman Demirel University, Faculty of Science and Art, Department of Chemistry, Isparta-Turkey, hakanaktas@sdu.edu.tr Dr. Vladimir Zaichick, Radionuclide Diagnostics Department, Medical Radiological Research Centre, Obninsk, 249036, Russia. vzaichick@gmail.com Dr. U. S. Mahadeva Rao, Universiti Sultan Zainal Abidin, Terengganu Malaysia, raousm@gmail.com Similar Articles: TREATMENT OF PATIENTS WITH ADVANCED CANCER FOLLOWING CHEMOTHERAPY AND TRADITIONAL MEDICINE - LONG TERM FOLLOW UP OF 75 CASES EpCAM- AN OLD CANCER ANTIGEN, TURNED ONCOGENIC RECEPTOR AND ITS TARGETING IMMUNOTHERAPY

Impact of dehydroepiandrosterone on thyroid autoimmunity and function in men with autoimmune hypothyroidism.

Background Testosterone administration was found to have a protective effect on thyroid autoimmunity in men with autoimmune (Hashimoto's) thyroiditis. Objective The present study was aimed at assessing whether oral dehydroepiandrosterone affects thyroid autoimmunity and hypothalamic-pituitary-thyroid axis activity in men with subclinical hypothyroidism induced by Hashimoto's thyroiditis. Setting The study was conducted at Medical University of Silesia, Katowice, Poland. Method The study enrolled 32 elderly men with autoimmune hypothyroidism and low dehydroepiandrosterone-sulfate levels. Based on patient preference, the participants either received oral dehydroepiandrosterone (50mg daily; n = 16) or remained untreated (n = 16). Apart from measuring antibody titers and hormone levels, we calculated baseline and post-treatment values of three structure parameters of thyroid homeostasis. Main outcome measure Serum titers of thyroid peroxidase and thyroglobulin antibodies. Results At baseline, there were no significant differences in the investigated parameters between both groups of men. All participants completed the study. Oral dehydroepiandrosterone increased dehydroepiandrosterone-sulfate and testosterone levels, as well as had a neutral effect on estradiol levels. The increase in dehydroepiandrosterone-sulfate correlated with treatment-induced changes in serum testosterone. Moreover, dehydroepiandrosterone reduced titers of thyroid peroxidase and thyroglobulin antibodies, decreased serum thyrotropin levels, reduced Jostel's thyrotropin index as well as increased thyroid's secretory capacity. Treatment-induced changes in thyroid antibody titers, thyrotropin levels, Jostel's thyrotropin index and thyroid's secretory capacity correlated with the increase in dehydroepiandrosterone-sulfate and testosterone levels. Conclusion The obtained results show that exogenous dehydroepiandrosterone may exert a beneficial effect on thyroid autoimmunity and hypothalamic-pituitary-thyroid axis activity in men with autoimmune thyroiditis and subclinical hypothyroidism.

Anti-Thyroid Peroxidase and Anti-Thyroglobulin Autoantibodies in the Cerebrospinal Fluid of Patients with Unipolar Depression.

Introduction: The risk of developing depression is increased in patients with autoimmune thyroiditis. Autoimmune Hashimoto thyroiditis is diagnosed using the serum markers anti-thyroid peroxidase (TPO) and anti-thyroglobulin (TG) antibodies. In rare cases, patients with autoimmune thyroiditis can also suffer from the heterogeneous and ill-defined syndrome of Hashimoto encephalopathy. Biomarkers for Hashimoto encephalopathy or for any brain involvement of autoimmune thyroiditis are currently lacking. The aim of the present descriptive study was therefore to determine whether a subgroup of seropositive patients shows intrathecal anti-thyroid antibody synthesis in the cerebrospinal fluid (CSF). Participants and methods: Paired serum and CSF samples from 100 patients with unipolar depression were examined for anti-TPO and anti-TG antibodies using enzyme-linked immunosorbent assays. Antibody-specific indices (ASIs) were calculated for seropositive samples. These ASIs allow the differentiation between the brain-derived fraction of antibodies and antibodies which are passively diffused from the serum. ASIs >1.4 were assessed as positive for brain-derived antibodies. Additionally, for explorative evaluations, a stricter ASI limit of >2 was applied. Results: Anti-TPO antibodies were increased in the serum of 16 patients (16%); increased anti-TPO ASIs (>1.4) were detected in 11 of these patients (69%). Anti-TG antibodies in the serum were detected in three patients (3%), with two of them (67%) showing increased ASIs (>1.4). Overall, the authors found increased anti-thyroid antibodies in 17 of 100 patients (17%), with 13 out of 17 patients showing increased ASIs (76%; range 1.4–4.1). Choosing ASI levels of >2 led to positive findings in six out of 16 patients (38%) with anti-TPO antibodies in their serum but no increase in ASIs in three patients (0%) who were seropositive for anti-TG antibodies. The patients with elevated ASIs (N = 13) were younger than the ASI-negative patients (N = 87; p = 0.009); no differences were noted in the frequency of CSF, electroencephalography, and/or magnetic resonance imaging alterations. Discussion: A subgroup of seropositive patients showed intrathecal synthesis of anti-TPO and, more rarely, of anti-TG antibodies, which might be an indication of central autoimmunity in a subgroup of patients with unipolar depression. The confirmation of elevated ASIs as a biomarker for Hashimoto encephalopathy must await further studies. The relevance of the findings is limited by the study’s retrospective and uncontrolled design.

Melkersson-Rosenthal syndrome associated to Hashimoto’s thyroiditis

Melkersson-Rosenthal syndrome (MRS) is a rare neuromucocutaneous granulomatous disorder classically defined by the triad: fissured tongue (lingua plicata), recurrent orofacial edema, and relapsing facial paralysis. Association with other dysimmune disorders was reported suggesting an immunological origin to this syndrome. The association with autoimmune thyroiditis remains exceptional and unusual. We report the original case of an MRS associated with Hashimoto autoimmune thyroiditis in a 39-year-old Tunisian man with favorable outcome under thyroxine and systemic glucosteroids. A dosage of thyroid hormones and a screening for anti-thyroid antibodies would be useful in patients with an MRS.

Polymorphism of toll-like receptor genes and autoimmune endocrine diseases.

In recent years, there has been a significant amount of interest and vigorous studies on mutations related to innate immunity receptor genes such as Toll-like receptors (TLR), which is driven by the identification of many associations between these mutations and development of various disorders leading, in particular, to autoimmune diseases. It has been proven that the occurrence of single nucleotide polymorphisms in DNA sequences encoding TLRs causes malfunction of some key signaling pathways, and, as a result, increases the risk of autoimmune diseases. The identification of these polymorphisms can lead to the understanding of the pathogenesis of autoimmune diseases, which subsequently will create effective methods for the prevention and treatment thereof. This article examines the current state of the art, in particular summarizes data on the role of polymorphisms in Toll-like receptor genes in a number of autoimmune endocrine diseases, including type 1 diabetes mellitus, Graves' disease and Hashimoto's autoimmune thyroiditis. The search for relevant scientific data was carried out by entering search queries based on keywords: TLR, SNP, autoimmunity, Graves' disease, Type 1 diabetes mellitus, Hashimoto's autoimmune thyroiditis. The search was conducted through PubMed, MEDLINE, Elsevier journals, Science Direct and Russian Index of Scientific Citation, as well as other highly cited publications on Genetics, Immunology, and Pathophysiology - related to the topic.

Hashimoto Thyroiditis and Dyslipidemia in Childhood: A Review

Hashimoto autoimmune thyroiditis (AIT) is the most common cause of acquired hypothyroidism in the pediatric population. Development of AIT is mediated mainly by cellular immune response directed toward thyroid autoantigens, leading to inflammation and impaired function of thyroid gland. Both thyroid dysfunction and inflammation affect the metabolism of plasma lipoproteins. The alterations in lipid profile worsen with the advancement of hypothyroidism, ranging from discrete changes in euthyroid AIT patients, to atherogenic dyslipidemia in the overt hypothyroidism. In this review, characteristics of dyslipidemia in pediatric AIT patients, and the consequences in respect to the risk for cardiovascular disease (CVD) development are discussed. Additionally, benefit of L-thyroxine treatment on serum lipid profile in pediatric AIT patients is addressed. Finally, potential usefulness of novel lipid biomarkers, such as proprotein convertase subtilisin/kexin type 9 (PCSK9), non-cholesterol sterols, low-density lipoprotein particle size and number, and high-density lipoprotein structure and functionality in AIT patients is also covered. Further longitudinal studies are needed in order to elucidate the long-term cardiovascular outcomes of dyslipidemia in pediatric patients with Hashimoto AIT.

Human herpesvirus 6A active infection in patients with autoimmune Hashimoto's thyroiditis

BackgroundHypothyroidism due to Hashimoto's thyroiditis (HT) is the commonest autoimmune endocrine illness in which antibodies against thyroid organ result in inflammation. The disease has a complex etiology that involves genetic and environmental influences. Viral infections may be involved in triggering of the disease as their molecular mimicry enhance autoimmune responses. Human herpesvirus-6 (HHV-6) is recognized for its contribution to some autoimmune diseases. ObjectiveIn the current study, the prevalence of HHV-6 active infection in patients with HT and with non-autoimmune thyroid disorders were compared with patients with euthyroidism. In addition, a correlation between presence of HHV-6 infections and HT was investigated. MethodsA total of 151 patients with clinically and laboratory confirmed HT, 59 patients with non-autoimmune thyroid disorders, and 32 patients with normal thyroid function were included in the study. For further confirmation of HT disease, all the precipitants were tested for anti-thyroid peroxidase (TPO), and anti-thyroglobulin (TG) antibodies. For detection of both HHV-6 types A and B, nested PCR and restriction enzyme digestion were used. HHV-6 DNA positive samples were further investigated by DNA sequencing analysis. ResultsHHV-6A DNA was found in serum sample of 57 out of 151 patients (38%) with HT, which was significantly more often than in patients with non-autoimmune thyroid disorders (p=0.001). However, HHV-6 DNA was not detected in serum samples of euthyroid subjects. ConclusionsThe results support a possible role for active HHV-6A infection, demonstrated by the presence of HHV-6 DNA in sera, in the development of HT.

Potential role of IL-37 signaling pathway in feedback regulation of autoimmune Hashimoto thyroiditis.

IL-37, the anti-inflammatory cytokine of the IL-1 family, plays several key roles in the regulation of autoimmune diseases. Yet, its role in Hashimoto's thyroiditis (HT) is not clear. In the present study, we found that, in tissues from HT patients, most of the follicular epithelial cells were positive for both IL-37 and single Ig IL-1-related receptor (SIGIRR) by immunohistochemical staining, while the infiltrating lymphocytes and other inflammatory cells hardly expressed any. Meanwhile, mRNA expression levels of IL-37 in peripheral blood mononuclear cells (PBMC) of HT patients were significantly higher than those in normal controls measured by quantitative real-time PCR. Finally, we studied the possible role of IL-37 in IFN-γ-stimulated rat FRTL-5 cells. The results showed that IL-1β, TNF-α, and MCP-1 mRNA levels were significantly decreased, while the expression of IL-4 mRNA was dramatically up-regulated in IFN-γ-stimulated rat thyroid cell line FRTL-5 pre-treated with IL-37. The current study, for the first time, demonstrated that the IL-37 network is involved in Hashimoto's thyroiditis, and IL-37 signaling pathway may ameliorate the excessive autoimmune responses in this chronic lymphocytic thyroiditis.

Thyroid papillary carcinoma and hashimoto's autoimmune thyroiditis in patients operated on thyroid diseases in the precarpathian endemic goiter region.

Background. A feature of thyroid pathology in the endemic goiter region is the combination in one patient of several diseases of the thyroid gland, in particular thyroid papillary carcinoma and Hashimoto’s autoimmune thyroiditis. Objective. To determine the frequency and morphological features of thyroid papillary carcinoma and Hashimoto's autoimmune thyroiditis in surgically treated patients with thyroid diseases in the Precarpathian endemic goiter region. Methods. The results of pathohistological examinations of 1348 patients operated on thyroid diseases at the Lviv Regional Clinical Hospital and the Military Medical Clinical Center of the Western Region in 2014-2018 were analyzed. Results. Among 1348 patients operated on for thyroid disease Hashimoto's autoimmune thyroiditis was found in 61 cases (4.5 %), focal thyroiditis - in 114 cases (8.5 %), thyroid papillary carcinoma - in 245 cases (18.2%), thyroid papillary carcinoma of all histological variants except papillary microcarcinoma - in 204 cases (15.1 %) and papillary microcarcinoma - in 41 cases (3.0 %). Among the total number of operated patients in 70 cases (5.2%), in each individual patient both Hashimoto's autoimmune thyroiditis or focal thyroiditis in association with thyroid papillary carcinoma were detected. Conclusion. Residents of the Precarpathian endemic goiter region operated on thyroid diseases often have cases of a combination of Hashimoto's autoimmune thyroiditis and focal thyroiditis with thyroid papillary carcinoma. These cases need further study to improve their diagnosis and treatment.

Levothyroxine treatment of subclinical (SH) and overt (OH) hypothyroidism in children with autoimmune hashimoto thyroiditis (AHT): defining the TSH cut-off level

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Selenium Treatment Effect in Auto-Immune Hashimoto Thyroiditis in Macedonian Population

Background: Selenium (Se), a necessary trace mineral for humans, has the highest concentration in the thyroid gland and is known of its anti-oxidant and anti-inflammatory properties. Many studies have reported that Se has a close relationship with auto-immune Hashimoto’s thyroiditis (HT), characterized by the presence of anti-thyroid peroxidase (aTPO) auto-antibodies. Methods: Five hundred thyroid patients, males and females, mean age 46 ± 19 years, with diagnosed HT, were included in the study. Euthyroid forms of HT were treated with Se only, while patients with thyroid-stimulating hormone (TSH) > 10 µIU/mL were treated with both substitutional therapy of levothyroxine and Se. Results: In around 37% of the patients treated with Se 3 × 50 µg/day with aTPO > 1,000 IU/mL, aTPO remained unchanged after 12 months, while 24.16% had aTPO 1,000 IU/mL, while 79.20% with aTPO between 500 and 1,000 IU/mL. In euthyroid group (Se only), the biggest response (30.56%) was seen in patients with the highest titer of aTPO > 1,000 IU/mL. Conclusion: Se treatment is effective in reducing the levels of aTPO in patients with HT, alone or in combination with levothyroxine. This is due to the anti-inflammatory and anti-oxidant effect of Se. Our study promotes the concept of Se treatment in patients with euthyroid or hypothyroid state, with increased titers of aTPO. J Endocrinol Metab. 2019;9(1-2):22-28 doi: https://doi.org/10.14740/jem551