Thyroiditis Patients Research Articles

Assessment of Visual and Brainstem Auditory Evoked Potentials in Patients with Hashimoto's Thyroiditis.

Background The present study was aimed to evaluate parameters of visual and brainstem auditory evoked potentials (VEP, BAEP) in euthyreotic Hashimoto's thyroiditis (HT) patients without central nervous system involvement. Methods 100 HT patients (92 women, 8 men), mean age 46.9 years, and 50 healthy controls. They underwent a neurological examination, thyroid hormone levels, thyroid autoantibody titers, and brain imaging. Latencies and amplitudes of the N75, P100, and N145 component of VEP and the I-V components of BAEP were analyzed. Results The neurological examination revealed in 31 patients signs of increased neurovegetative excitability. Brain resonance imaging showed no abnormalities in HT patients. The mean P100, relative P100, and N145 VEP latencies were significantly longer, and P100 amplitude significantly higher in HT patients than the controls. HT patients also had a longer mean wave BAEP V latency and mean wave III-V and I-V interpeak latencies, and significantly lower mean wave I and V amplitudes. Abnormal VEP and BAEP were recorded in 34% of the patients. There were no statistically significant correlations between the mean VEP parameters and thyroid profile and the applied dose of L-thyroxine. There was a relationship between the level of TSH and the wave BAEP III-V interpeak latency. Conclusions There were changes in the brain's bioelectrical activity in one-third of the patients with HT without nervous system involvement. The increased amplitude of the VEP may indicate increased cerebral cortex activity. Disorders of the brain's bioelectrical activity in the course of HT may be associated with an autoimmune process.

Correlation between serum 25-(OH)D3 level and immune imbalance of Th1/Th2 cytokines in patients with Hashimoto's thyroiditis and its effect on autophagy of human Hashimoto thyroid cells.

The study aimed to determine the relationship between serum 25-(OH)D3 and Th1/Th2 cytokine immune imbalance, and the effect of 25-(OH)D3 on the autophagy of human Hashimoto thyroid cells. Western blot analysis was used to detect the expression levels of microtubule-associated protein 1 light chain 3 (LC3) and autophagy-associated protein mammalian target protein of rapamycin (mTOR) in thyroid tissues of 20 Hashimoto's thyroiditis (HT) patients and normal tissues of 20 benign thyroid adenomas. Nthy-ori3-1 cells (normal cells of human thyroid follicular epithelium) were treated with different concentrations of 25-(OH)D3 for 24 h. The expression of LC3, mTOR and caspase-3 protein in the cells was detected by western blot analysis. The apoptosis and proliferation levels were detected by flow cytometry and MTT assay, respectively. The levels of FT3, FT4 and IL-10 in the HT group were lower than those in the healthy control group. The serum levels of 25-(OH)D3, TPOAb and TGAb in the HT group were lower than those in the healthy control group. Serum 25-(OH)D3 level in the HT group was negatively correlated with IL-2 and IFN-γ, and positively correlated with IL-4. In Hashimoto's thyroiditis tissues, the expression of mTOR was higher while the expression of LC3B-II was lower than that of normal thyroid tissue. With the increase in 25-(OH)D3 concentration, the expression level of mTOR increased, the expression level of LC3B-II decreased and the apoptosis rate was significantly increased. The cell proliferation rate decreased with the increase in 25-(OH)D3 concentration. The serum 25-(OH)D3 level in HT hypothyroidism patients was significantly lower than that of the control group. Thus, 25-(OH)D3 may be involved in the disease progression by upregulating the levels of Th1 cytokines and downregulating the levels of Th2 cytokines. 25-(OH)D3 can inhibit autophagy of thyroid cells, induce apoptosis and participate in the pathogenesis of Hashimoto's thyroiditis.

Obesity in Association of Autoimmune Thyroid Diseases and Type 2 Diabetes

Background: Autoimmune thyroid diseases are frequent in patients with type 1 diabetes mellitus. Objective: The aim of our study was to determine the phenotype of chronic autoimmune thyroiditis (CAT) in the different groups of patients with and without diabetes mellitus. We also focused our attention on the factors that influence the risk of thyroid diseases incidence in type 2 diabetics. Patients and methods: This is a cross- sectional study. We examined 92 patients with CAT: Group 1 includes 46 diabetics (38 women and 8 men, mean age = 45 ± 8,5 years) and a group (G) 2 includes 46 non- diabetics patients (32 women and 14 men, mean age = 41 ± 4,5 years). Results: A higher prevalence of female gender and family history of thyroid diseases in diabetics was observed. Chronic autoimmune thyroiditis is discovered precociously in diabetics. Obesity is frequently found in all patients particularly in diabetic patients (G1: 86,95% vs G2 : 65%, p=0,022). Discussion: Our results show a chronic autoimmune thyroiditis in patients with type 2 diabetes (T2D) resulting in recommendation of careful follow-up of diabetic patients for presence of thyroid autoimmunity. Although T2D is not an autoimmune disorder, there have been many reports showing a higher occurrence of thyroid diseases, particularly hypothyroidism, among people with T2D. The association between T2D and thyroid disorder, however, remains unexplained.

Role of the Specialized Pro-resolving Mediator Resolvin D1 in Hashimoto's Thyroiditis.

Resolvins are produced by the catabolism of polyunsaturated fatty acids (PUFAs) and play vital roles in inflammation resolution. Resolvins have been associated with autoimmune disorders. This study aimed to measure the level of Resolvin D1 (RVD1) in the serum of Hashimoto's thyroiditis (HT) patients and healthy controls (HCs) and to further analyse its correlation with thyroid autoantibodies and inflammatory factors. Sixty-three participants were recruited, namely, 30 untreated HT patients and 33 sex- and age-matched HCs. Serum RVD1 and inflammatory chemokine (MCP-1 and IP-10) levels were measured by ELISA according to the manufacturer's protocol. Serum total T3 (TT3), TT4, free T3 (FT3), FT4, thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb) and thyroid-stimulating hormone (TSH) levels were measured using an electrochemiluminescence immunoassay. Thyroid homeostasis parameters, including the thyroid secretory capacity (SPINA-GT), the total deiodinase activity (SPINA-GD), Jostel's TSH index (TSHI) and the thyrotroph thyroid hormone sensitivity index (TTSI), were calculated. Serum RVD1 levels in HT patients (134.76, 85.35-201.36 pg/mL) were significantly lower than those in HCs (187.64, 131.01-326.85 pg/mL) (P=0.004). As the TPOAb level increased, the RVD1 level showed a decreasing trend (P for trend=0.002). Both multinomial and ordinal logistics analyses revealed that serum RVD1 levels were negatively correlated with TPOAb levels in the adjusted models. Moreover, RVD1 showed a negative correlation with the inflammatory chemokine IP-1 0 (r=-0.276, P=0.034), TSHI (r=-0.269, P=0.036) and TTSI (r=-0.277, P=0.031). Thyroid autoimmunity may be associated with low levels of RVD1. Decreased RVD1 levels indicate impaired resolution of inflammation in HT patients.

Subacute Thyroiditis Associated with COVID-19: A Case Report

<i>Background</i>: Subacute Thyroiditis is a self-limiting thyroidal illness caused by viral infection with clinical course divided into three phases: hyperthyroidism, hypothyroidism followed by euthyroidism. Several viral infections have been linked to be associated with subacute thyroiditis but often no etiology can be found. <i>Objective</i>: The aim of this study is to explore a possible link between subacute thyroiditis and Coronavirus disease (COVID-19) infection. <i>Method</i>: Here we describe a case of subacute thyroiditis which occurred during the recovery phase of initial flu like illness. The initial illness was mild and was treated symptomatically. Later, the patient presented with features of hyperthyroidism and neck pain during recovery of initial flu like illness. <i>Result</i>: Two weeks after the onset of initial illness, the patient presented with neck pain, palpitation, sweating, and weight loss along with mid-line tenderness in neck. Thyroid function test revealed suppressed TSH and elevated free T4 along with reduced uptake on radionuclide thyroid scan. He was treated with NSAIDs and B-blocker which resulted in dramatic improvement in neck pain. <i>Conclusion</i>: Since Subacute thyroiditis is a self limiting disorder, it is often under reported. But It is important to recognize the disorder as it can directly impact on the morbidity and mortality related to other associated primary disorder like respiratory illness. Clinician must be aware about the possibility of thyroiditis in patient developing fever and neck pain and look for it.

Research on Renal Injury in Hashimoto&amp;apos;s Thyroiditis Patients with Different Thyroid Function

Objective: To assess the relationship between thyroid function and renal injury in Patients with Hashimoto's Thyroiditis. Method: To select 156 diagnosed HT patients as the research object, according to whether there is renal injury, they were divided into renal injury group with 21 cases and non-renal injury group with 135 cases. According to the thyroid function, they were divided into HT hyperthyroidism group (Group A) with 19 cases, normal HT thyroid function group (Group B) with 37 cases, HT subclinical hypothyroidism group (Group C) with 61 cases, and HT hypothyroidism group (Group D) with 39 cases. Besides, 40 cases of healthy check-up people are selected as the control group. ECLIA is adopted to test the thyroid function index of each group, Serum cystatin C and 24-hour urinary microalbumin were measured by immunoturbidimetry, serum creatinine was measured by creatine oxidase method, and the endogenous creatinine clearance rate was calculated. Result: TSH, TPOAb and TGAb in renal injury group were distinctly higher than those in non-renal injury group, while FT3 and FT4 were distinctly lower than those in non-renal injury group; Comparison of serum creatinine in Hashimoto groups, Group D is significantly higher than other groups, Group C is obviously higher than Group A, Group B, and the control group, Group B is obviously higher than Group A, Group A is significantly lower than other groups; Comparison of cystatin C and creatinine clearance of each group, Group D is significantly lower than other groups, Group C is obviously lower than Group A, Group B, and the control group, Group B is obviously lower than Group A, Group A is significantly higher than other groups; Comparison of 24-hour urinary microalbumin of each group, Group D is significantly higher than other groups, Group C is obviously higher than Group A, Group B, and the control group, and the differences have statistic significance (P<0.05). The correlation analysis shows that FT3, FT4 are in negative correlation with serum creatinine and in positive correlation with cystatin C and creatinine clearance; TSH, TPOAb, TGAb is in positive correlation with 24-hour urinary microalbumin. Conclusion: There are obvious differences in renal function indexes of HT patients with different thyroid function states, which may be related to the effect of thyroid hormones and autoantibodies.

Study on Th17/Treg Cells and Cytokines in Hashimoto&amp;apos;s Thyroiditis with Different Iodine Nutrition Status

<i>Background</i>: The incidence of AITDs increased with the increase of iodine nutrient levels in the population. HT is one of the most common AITDs. The role of thyroid function stratification, antibody titer, Th17/Treg cells and related factors in the pathogenesis of HT under different iodine nutritional conditions is still unclear. <i>Objective</i>: To investigate the correlation between the thyroid function stratification, autoantibody titer and Th17 cells, Treg cells, cytokines and transcription factors in hashimoto thyroiditis patients with different iodine nutritional status. <i>Methods</i>: Thyroid hormone, autoantibody and urinary iodine levels were measured in 100 hashimoto's thyroiditis (HT) patients and 60 healthy subjects by electrochemical immunoluminescence and iodine-catalyzed arseniummethod. Meanwhile, the proportion and ratio of Th17 cells and Tregs cells in peripheral blood mononuclear cells (PBMC) were determined by immunofluorescence labeling and flow cytometry. The qRT-PCR was used to detect the expression of ROR-γt mRNA and Foxp3 mRNA. Serum IL-17 and TGF-β levels were detected by ELISA. <i>Results</i>: Th17 cell proportion, serum IL-17 and ROR-γt mRNA expression levels in PBMC of HT patients with different iodine nutritional status were all higher than those in the control group (<i>P</i><0.05), while Tregs cell proportion, serum TGF-β and Foxp3 mRNA level were all lower than those in the control group (<i>P</i><0.05). <i>Conclusions</i>: The thyroid function, autoantibodies, Th17/Tregs cell proportion, cytokines and transcription factors of HT patients with different iodine nutrition status were changed, hich were involved in the development and progression of HT.

Correlation Analysis of Th17/Treg Cells and PTPN22 Gene Polymorphism in HT Patients with Different Iodine Nutritional Status

Background: The incidence of Hashimoto's thyroiditis (HT) may be related to environmental, immune, and genetic factors. Different iodine nutritional status can affect thyroid function. Th17/Treg cell imbalance is involved in the pathogenesis of autoimmune thyroid diseases, and PTPN22 is an important susceptibility gene related to autoimmune diseases. To study the relationship between Th17/Treg cells and cytokines and PTPN22 gene polymorphism in HT patients with different iodine nutritional status is to determine the role of immune and genetic factors in the pathogenesis of HT. Objective: To investigate the correlation between Th17/Treg cells and factors protein tyrosine phosphatase non-receptor type 22 (PTPN22) gene-1123G>C site (rs2488457) polymorphism in peripheral blood mononuclear cells (PBMC) of Hashimoto's thyroiditis (HT) patients with different iodine nutritional status. Methods: 100 HT patients and 60 healthy subjects in Cang Zhou are selected from 2019 to 2020. Flow cytometry and real-time fluorescent quantitative PCR are used to detecting the proportion and ratio of Th17 and Treg cells in PBMC, as well as retinoic acid-related orphan receptor-γt (ROR-γt) and fork head/winged spiral transcription factor 3 (Foxp3) mRNA expression levels. Single allele-specific primer-polymerase chain reaction (SASP-PCR) technology is taken to sequence PTPN gene promoter-1123SNP leading to calculate the gene Type and allele frequency. Results: Th17 and Treg cells and factors in the PBMC of HT patients have a certain correlation with the-1123G>C locus of PTPN22 gene (rs2488457). The distribution frequency of rs2488457 genotype is consistent with Hardy Weinberg's law of genetic equilibrium. The distribution frequencies of various genotypes and alleles are significantly different between HT patients and the control group (P<0.05). PTPN22 gene-1123G>C site C/G, C/C genotype can increase of the risk of HT, while G/G genotype can decrease of the risk of HT. In Conclusion: The polymorphism of rs2488457 is related to susceptibility to HT. Carrying C/G and C/C genotypes may be risk factors for HT, and G/G genotypes may be protective factors for HT, but it has nothing to do with iodine nutrition status.

SERUM ZONULIN LEVELS IN HYPOTHYROID AND EUTHYROID PATIENTS WITH HASHIMOTO'S THYROIDITIS - A PILOT STUDY.

Human zonulin is a protein that regulates the intercellular tight junctions in various tissues and organs of the human body. Hashimoto's thyroiditis (HT) is one of the most common endocrine autoimmune disorder, but the role of increased intestinal permeability in its pathogenesis is still being studied. This pilot cross-sectional study investigates serum zonulin concentration in adults with Hashimoto's thyroiditis and assesses the relationship between zonulin levels, clinical hormonal and immunological characteristics. A group of 62 adults with HT participated in this study and were divided into three groups: hypothyroid (n=33) euthyroid (n=25) and hyperthyroid (n=4). Serum zonulin was determined using an ELISA method. Age, gender and BMI were different between groups (hypothyroid and euthyroid ones). Serum zonulin values ranged from 2.6 to 198.0 ng/mL in participants. A direct positive correlation was found between serum zonulin levels and weight and BMI (r = 0.351, p = 0.008 and r = 0.236, p = 0.05, respectively). There is no correlation between zonulin and thyroid hormones or autoantibodies in Hashimoto thyroiditis patients. There is a difference in zonulin levels between the studied groups, but they are not statistically significant.

Correlation Analysis Between Thyroid Function and Autoantibodies in Hashimoto Thyroiditis Patients with Different Iodine Nutritional Status

Objective: In order to discuss the correlation between thyroid function stratification and autoantibody titer in HT patients under different iodine nutritional status. Methods: The serum TH, antibody and urinary iodine levels were measured by the electrochemical immune-luminescent apparatus and iodine-catalyzed arsenic-cerium method in 100 HT patients (HT-A, HT-B, HT-C) with different thyroid functions and 60 healthy subjects. Results: The urinary iodine level of HT patients from HT-A increased in turn along with the progression of the disease, while the levels of FT3, FT4, TT3, TT4 decreased gradually and the levels of TSH and thyroid autoantibodies increased gradually. The urinary iodine level of HT-C group was negatively correlated with the serum FT3, FT4, TT3 and TT4 (P<0.05), while the urinary iodine level of HT-B group was negatively correlated with the serum FT3 and TT4 (P<0.05), and positively correlated with TSH (P<0.05). Along with the progression of HT disease, the levels of serum TPOAb and TGAb increased successively, and there were significant differences among each group (P<0.01). The serum TSH level of high TPOAb group and high TgAb group were respectively higher than those of low TPOAb group, low TgAb group and the control group, the levels of FT3 and FT4 were respectively lower than the low TPOAb group and low TGAb group, but there were no statistically significant on the differences between the FT3 of low TgAb and the levels of T3 and T4 of the control group, high TPOAb group, high TGAb group, low TPOAb group and low TGAb group. Conclusions: Under different iodine nutritional status, if the TH and autoantibody levels of HT patients with different thyroid functions changed correspondingly, it could indicate that the iodine nutritional status is involved in the occurrence and development process of HT of different thyroid functions and antibody levels, and plays an important role in it.

Unique Features of Hashimoto’s Thyroiditis in Coastal South India – a study from a tertiary care hospital

Background: Hashimoto’s thyroiditis is an autoimmune disorder of thyroid gland. It is one of thecommon causes of hypothyroidism and is common in females. Generally, Hashimoto’s thyroiditisclinically presents as diffuse enlargement of the thyroid and nodular lesions are uncommon. But fewrecent studies from South India have shown that Hashimoto’s frequently presents as nodularenlargement of the thyroid. Such lesions can be easily confused with nodular goitre. Objectivesand Aim: Aim of the study is to study the clinicopathological features of Hashimoto’s thyroiditis andto estimate the frequency of nodular lesions in Hashimoto’s thyroiditis in a tertiary care healthcentre in coastal South India. Materials and Methods: The present study was done retrospectivelyon patients diagnosed as Hashimoto’s thyroiditis by fine-needle aspiration cytology during the periodJune 2017 to June 2020. Their clinical details, clinical examination findings including diffuse/nodularnature of the swelling, thyroid hormone status and ultrasound findings were studied. Results: In thepresent study, 102 cases of Hashimoto’s thyroiditis were included, which includes 91 females and 11males. Patients age ranged from 15 to 63 years with a peak in the fourth decade. Fifty-five cases(53.9%) were hypothyroid and 43 (42.2%) were euthyroid. Fifty cases (49%) presented as nodularlesion out of which 47 cases had multiple nodules. Conclusion: Nodular enlargement of the thyroidis a common finding in Hashimoto’s thyroiditis patients. Such cases should not be mistaken fornodular goitre as there is a risk of malignancy in Hashimoto’s thyroiditis.

Association between serum thyroid hormone balance and thyroid volume in patients treated with levothyroxine monotherapy for hypothyroidism.

Many previous studies including ours have reported that athyreotic patients on levothyroxine (LT4) have relatively low serum free triiodothyronine (FT3) levels, whereas patients with large goitrous diseases often have high serum FT3 levels. Here we investigated Hashimoto thyroiditis (HT) patients on LT4 to study the relationship between thyroid volume (TV) and thyroid hormone status in hypothyroid patients on LT4. We retrospectively studied 408 euthyroid HT patients treated with LT4 for hypothyroidism; divided them as per TV and compared serum levels of free thyroxine (FT4) and FT3 and the FT3/FT4 ratio in each patient group with those in euthyroid matched control group. We also evaluated the association between serum FT3 level and FT3/FT4 ratio and TV among HT patients on LT4. In patients with TV <15 mL, serum FT3 levels were significantly lower than those in controls. In patients with TV 15-80 mL, serum FT3 levels were equivalent to those in controls. In patients with TV ≥80 mL, the serum FT3 levels were significantly higher than those in controls. The serum FT3 level (r = 0.35, p < 0.01) and FT3/FT4 ratio (r = 0.42, p < 0.01) showed a positive correlation with TV. TVs in HT patients on LT4 caused differences in serum thyroid hormone balance, as increasing volume increases the serum FT3 level and FT3/FT4 ratio. Serum thyroid hormone balance in HT patients with smaller thyroids was similar to that in athyreotic patients. Mild thyrotropin suppression with LT4 is needed to achieve normal FT3 levels in such patients.

Coeliac disease is a risk factor for the development of seronegative arthritis in patients with autoimmune thyroid disease.

Hashimoto's thyroiditis is known to cluster with other systemic autoimmune disorders. Rheumatic manifestations, such as a seronegative non-erosive polyarthritis have been described. The aim of this study was to evaluate the characteristics and the prevalence of rheumatic features in thyroiditis patients, and to ascertain whether the association with systemic autoimmune disorders improved the arthritis manifestations. In total, 180 thyroiditis patients were enrolled. Major clinical and demographic characteristics have been recorded. Patients underwent a rheumatological clinical assessment and extra-articular manifestations allowing for a differential diagnosis with systemic autoimmune diseases and spondyloarthropathy. Presence of systemic autoimmune diseases was recorded. A total of 8.33% of thyroiditis patients shown a peripheral inflammatory arthritis (P = 0.002). Female gender (P = 0.042) and thyroid peroxidase (TPOAbs) positivity (P = 0.001) were more frequent. In total, 37 patients had systemic autoimmune diseases (P = 0.0003). A significant high prevalence of coeliac disease and Addison disease was found (P = 0.034 and P = 0.049, respectively). In patients with coeliac disease, the articular manifestations were more frequent (21.21%) (P = 0.001) and the risk to develop joint involvement was 2.96. Although we found an articular involvement in about one-third of thyroiditis patients, the prevalence of inflammatory arthropathy was only 8.33%. The prevalence of other coexisting autoimmune disorders was 34.26% with a significant prevalence of coeliac disease (7.41%). Thyroiditis patients with coeliac disease have an articular involvement more frequently than those without. In these patients, we have found a high risk of developing arthritis than patients with only thyroiditis, suggesting cumulative autoimmune effects in the developing articular involvement.

Hashimoto's Thyroiditis Induces Hippocampus-Dependent Cognitive Alterations by Impairing Astrocytes in Euthyroid Mice.

Background: Although studies have reported an increased risk for cognitive disorders in Hashimoto's thyroiditis (HT) patients, even in the euthyroid state, the mechanisms involved remain unclear. The hippocampus is a classic brain region associated with cognitive function, among which the formation of long-term potentiation (LTP) in the Schaffer collateral-CA1 pathway plays an important role in the process of learning and memory. Therefore, this study established a euthyroid HT model in mice and investigated whether and how HT itself has the ability to trigger LTP alterations accompanied by learning and memory abnormality. Methods: An experimental euthyroid HT model was established in NOD mice through immunization with porcine thyroglobulin (Tg). Morris water maze was measured to determine mice spatial learning and memory. We investigated the effect of HT on synaptic transmission and high-frequency stimulation-induced LTP in the Schaffer collateral-CA1 synapse of mice hippocampus in vivo. Then, animals were sacrificed for thyroid-related parameter measure as well as detection of cellular and molecular events associated with the induction of LTP. Results: HT mice showed intrathyroidal lymphocyte infiltration and rising serum thyroid autoantibody levels accompanied by normal thyroid function. The HT mice had poorer performance in Morris water maze than controls. These alterations were mirrored by abnormalities in synaptic plasticity in the Schaffer collateral-CA1 synapses of the hippocampus in vivo. The integrity of the synaptic structure is the premise for the production of LTP. As detected by transmission electron microscopy, the ultrastructure of synapse and astrocyte in the hippocampus were impaired in euthyroid HT mice. Additionally, Western blot and real-time polymerase chain reaction analyses confirmed that in HT mice, GS, GLAST, and GLT-1, key elements in glutamate-glutamine circulation located in astrocyte, were downregulated, accompanied by elevated levels of glutamate in the hippocampus, which impaired the material basis for LTP induction. NMDR2B expression in the hippocampus was also downregulated. Conclusion: HT can induce damage of LTP in the hippocampal Schaffer collateral-CA1 pathway in the euthyroid state, and this can be attributed, at least partly, to astrocytes impairment, which may underlie the deleterious effects of HT itself on hippocampal-dependent learning and memory function.

The Importance of Vitamin D Level in Subacute Thyroiditis Disease and the Effect of Vitamin D on Disease Prognosis

Subacute thyroiditis (SAT) is an inflammatory thyroid disease that manifests with severe pain. The presence of the vitamin D receptor in immune system cells shows that vitamin D deficiency can trigger inflammatory diseases. The aim of the present study was to determine the prevalence of vitamin D deficiency in SAT patients, and the relationship between vitamin D level and permanent hypothyroidism and recurrence rate. In this retrospective study, 25-hydroxyvitamin D (25&lsqb;OH]D) levels of 170 SAT patients and 86 control subjects were compared. The 25(OH)D levels were significantly lower in the SAT patients, and there was no seasonal difference. A negative correlation was determined between the erythrocyte sedimentation rate and 25(OH)D, but no significant relationship was found between vitamin D level and prognosis. As a result of this study, it was shown that vitamin D levels in subacute thyroiditis patients were significantly lower than in the healthy control group. Although there is no relationship between vitamin D level and disease prognosis, vitamin D deficiency may increase the rate of respiratory tract infections (especially, influenza, coxsackievirus, measles, adenovirus, retroviruses) and eventually SAT development.

The pathogenic role of circulating Hashimoto's Thyroiditis-derived TPO-positive IgG on fetal loss in naïve mice.

Antibody-mediated autoimmune diseases, such as autoimmune thyroid diseases (ATD), systemic lupus erythematosus (SLE), and antiphospholipid syndrome (APS), often are associated with recurrent fetal loss. One of the ATD is Hashimoto's thyroiditis which recently showed association with complications of pregnancy with increased levels of circulating autoantibodies reactive with epitopes on thyroid tissue such as thyroid peroxidase (anti-TPO). In retrospective study of sera analyses in patients with Hashimoto's thyroiditis, all patients had mainly elevated circulating anti-TPO autoantibodies. We assessed the potential of human anti-TPO highly positive IgG, derived from patients with Hashimoto's thyroiditis sera associated with complications of pregnancy, to cause directly complications of pregnancy in murine model. Naïve ICR female mice, infused intravenously with 100μg of anti-TPO-positive IgG, showed increased fetal loss and embryo small for date (P<.001) in comparison with mice passively transferred with commercial IgG or PBS. Moreover, we observed embryos small for date in the mice passively transferred with anti-TPO-positive IgG, exemplified by reduced weight of embryos and placentae (P=.001). Histopathological examination revealed delay in fetal development in 50% cases of anti-TPO-positive IgG-treated mice. Importantly, pathological changes in the transition zone, state of glycogen cells, and significant structural changes in the labyrinth part of placenta were observed in all anti-TPO-positive IgG samples. The current study shows in the first time, a direct proof of concept, on the association of human TPO-positive IgG from Hashimoto's thyroiditis patients on fetal loss induction in murine model.

Selenium supplementation for the reduction of thyroid antibodies in Hashimoto’s thyroiditis patients: a systematic review

Objective Menopause symptoms have significant negative effects on the quality of life of women and vindicate the need for evaluating various therapeutic options. Therefore, the present study was conducted to investigate the effect of Vitex Agnus-Castus (VAC) extract on hot flushes, night sweats, sleep disorders, and some other symptoms in postmenopausal women.

The substantiation of differentiated therapy of the combined disgormonal pathology of reproductive organs in women of reproductive age with comorbid conditions

The objective: substantiation of the differentiated therapeutic approaches to the treatment of the combined dyshormonal pathology of the reproductive organs, taking into account the comorbidity of the patients.Materials and methods. The study involved 300 women of reproductive age (20 - 42 years, an average of 29.9±5.6 years). The examination included ultrasonographic examination of the pelvic organs, mammary glands, thyroid gland, determination of the levels of pituitary tropic hormones and ovarian steroid hormones, thyroid hormones, antibodies to thyroperoxidase, serum levels 25 (OH) D. Results. Obesity of varying degrees was observed in 31.0% of the patients examined. The prevalence of autoimmune thyroiditis in patients with a dyshormonal pathology of the reproductive system was 36.0%, and subclinical hypothyroidism was diagnosed in 21.3% of women, but among patients with autoimmune thyroiditis, the incidence of subclinical hypothyroidism was 59.3% with 3.7% of manifest hypothyroidism. Insufficiency of vitamin D was detected in 34.0% of patients with dyshormonal pathology, vitamin D deficiency in 44.3%, severe deficit in 21.7%. Сonclusions. The use of complex differentiated pharmacotherapy for treatment of combin dyshormonal pathology of reproductive organs with correction of comorbid states allows to achieve a higher efficacy in comparison with usual practice (normalization of MCs 97.2% at 73.3%, reduction of pain syndrome 94.7% at 60.6% and cyclic mastodynia – 93,9% at 43,9%, reduction of vegetative-vascular and non-specific symptoms – 94,8±3,9% at 24,3±16,7%), to reduce the frequency of relapses during 6 months of observation from 14, 5% to 4.1% (p=0.0128), to achieve the desired pregnancy without stimulants and the ART and ovulation in 64.1% of patients compared with 30.6% (p=0.0079) in case of usual practice.

Vasoactive intestinal peptide axis is dysfunctional in patients with Graves\u2019 disease

Vasoactive intestinal peptide (VIP) is a neuropeptide with potent immunoregulatory properties. Reduced serum VIP levels and alterations in VIP receptors/signaling on immune cells have been associated with different inflammatory/autoimmune diseases. However, its role in autoimmune thyroid diseases (AITD) remains unknown. This study examined the interrelationship between VIP system, autoimmune background and thyroid hormones in peripheral immune cells in patients with AITD. Only Graves’ disease (GD) patients showed significantly lower serum VIP levels when compared to healthy subjects and to Hashimoto’s thyroiditis patients. Serum VIP levels were lower at the onset of GD, showing a significant negative correlation with thyroid hormone levels. The expression of VIP receptors, VPAC1 and VPAC2, was significantly upregulated in peripheral blood mononuclear cells (PBMC) from GD patients. There was an impairment of VIP signalling in these patients, probably attributable to a dysfunction of VPAC1 with preservation of VPAC2. The correlation between VPAC1 and thyroid hormone receptor expression in PBMC from healthy subjects was lost in GD patients. In summary, the VIP system is altered in peripheral immune cells of GD patients and this finding is associated with different thyroid hormone receptor patterns, showing a dynamic inter-regulation and a prominent role of VIP in this setting.

Serum cystatin C is closely associated with euthyroid Hashimoto's thyroiditis in adult female Chinese patients.

ObjectiveThe aim of our study was to explore the association between serum cystatin C (CysC) and euthyroid Hashimoto’s thyroiditis.MethodsThere were 119 female euthyroid Hashimoto’s thyroiditis patients and 225 healthy controls who were recruited. Serum CysC, thyroid function, thyroid autoantibodies, fasting glucose, liver enzymes, and lipid profile were determined. Clinical parameters were compared between two groups.ResultsSerum CysC levels were significantly higher in euthyroid Hashimoto’s thyroiditis patients compared with controls. In the lowest, middle, and highest tertile groups of CysC, the percentage of Hashimoto’s thyroiditis was 15.9%, 34.2%, and 53.5%, respectively. The percentage of Hashimoto’s thyroiditis was significantly higher in the highest tertile than in the lowest and middle tertiles. Spearman’s correlation analysis showed that serum CysC levels were negatively correlated with free triiodothyronine (FT3), and positively correlated with serum thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb). Logistic regression analysis showed that serum CysC was independently related to the status of euthyroid Hashimoto’s thyroiditis.ConclusionsThe present study shows the first evidence suggesting that serum CysC levels are positively correlated with TPOAb and TGAb. Serum CysC might underlie the pathophysiologic features of euthyroid Hashimoto’s thyroiditis.