Autoimmune disorders and thyroid function in patients with rheumatoid arthritis after biological treatment

Abstract

Rheumatoid arthritis (RA) and autoimmune diseases of the thyroid gland (AITD) often occur together. As autoimmune diseases, they share common pathological pathways, reflecting the fact that the treatment of the underlying disease can influence the course of thyroid disorders. The pharmacotherapy of RA is based on the supply of disease-modifying anti-inflammatory drugs with an increasing focus on biologics. This article aims to review the available literature describing the effects of biological treatments on thyroid function. The use of biologi-cal drugs may have the potential benefit of regulating the level of anti-thyroid antibodies. On the other hand, tumour necrosis factor-alpha (TNF-a) inhibitors are not indifferent to thyroid function and may increase the incidence of subacute thyroiditis. The coexistence of AITD and RA prompts consideration of the need for routine thyroid screening in RA patients and for RA screening in patients with thyroid disease who report joint problems.

The Role of Toll-like Receptor 2 (TLR2) in the Development and Progression of Hashimoto’s Disease (HD): A Case Study on Female Patients in Poland

“…The causes of hypothyroidism and thus the development of HD are many, ranging from genetic factors and hormonal changes to environmental factors, as well as the presence of other comorbidities, especially those of autoimmune origin [ 10 , 11 , 12 , 13 ]. HD itself is classified as a subunit of autoimmune diseases, which means that its development is closely related to the deregulation of the immune system, and, more specifically, to the development of inflammation caused by the host’s immune cells (in particular T lymphocyte-induced apoptosis of thyroid follicular cells) that attack the thyroid [ 14 , 15 , 16 ]. The consequence of this is the gradual destruction of this gland, leading to disorders in the production of triiodothyronine (T3) and thyroxine or tetraiodothyronine (T4) hormones, as well as the thyroid-stimulating hormone (TSH) that controls them [ 17 , 18 , 19 , 20 ].…”

Association of Anti-Thyroglobulin and Anti-Thyroid Peroxidase Antibodies in Patients with Primary Hypothyroidism

“…Autoimmune thyroid diseases (AITD) are the most common organ-specific autoimmune disorders of the body, with the resultant thyroid gland dysfunction (hypo-or hyperthyroidism) [7]. These thyroid antibodies are associated with a spectrum of disorders ranging from hypothyroidism (Hashimotos Thyroiditis) to hyperthyroidism (Graves Disease).…”

What does immunology say to rheumatologists that it does not say to others?

“…The excellent example may serve the development of psoriasis after anti-tumour necrosis factor (TNF) therapy or generation of anti-nuclear antibodies and the development of lupus-like disorders. In this issue Sawicka-Gutaj and colleagues reviewed the current concepts on development of autoimmune thyroid diseases caused by treatment with biologics [3]. The development of autoimmune reaction is a well-known clinical entity since the introduction of biologics to general clinical practice.…”