Comparison of pre- and post-levothyroxine high-sensitivity c-reactive protein and fetuin-a levels in subclinical hypothyroidism

Bilgir, Oktay; Bilgir, Ferda; Çalan, Mehmet; Çalan, Özlem Gürsoy; Yüksel, Arif

doi:10.6061/clinics/2015(02)05

Cited by 42 publications

(38 citation statements)

References 37 publications

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“…CRP levels are correlated with the level of inflammation, and its concentration level is not affected by factors such as age, sex, and physical condition [16]. CRP levels can activate the complement and enhance phagocytosis, thus clearing the pathogenic microorganisms invading the body.…”

Section: Discussionmentioning

confidence: 99%

C-reactive protein levels in the early stage of COVID-19

Wang¹

2020

Médecine et Maladies Infectieuses

596

471

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Section: Discussionmentioning

confidence: 99%

C-reactive protein levels in the early stage of COVID-19

Wang¹

2020

Médecine et Maladies Infectieuses

596

471

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“…Christ-Crain et al [ 27 ] first reported increased CRP in patients with OH or SCH citing it as an additional risk factor for development of coronary heart disease in those patients, but further studies have shown conflicting results. Some studies have detected elevated CRP in individuals with hypothyroidism [ 5 , 19 , 24 – 26 , 29 , 37 – 39 ], while others have not [ 30 , 40 , 41 ]. Regarding the effect of LRT on CRP, in the current study, in accordance with the first report of Christ-Crain et al [ 27 ] and others [ 30 , 31 , 37 , 39 , 41 ], the CRP level was unaffected.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have detected elevated CRP in individuals with hypothyroidism [ 5 , 19 , 24 – 26 , 29 , 37 – 39 ], while others have not [ 30 , 40 , 41 ]. Regarding the effect of LRT on CRP, in the current study, in accordance with the first report of Christ-Crain et al [ 27 ] and others [ 30 , 31 , 37 , 39 , 41 ], the CRP level was unaffected. However, other studies have shown that normalization of thyroid state by LRT seems to effectively reduce serum CRP [ 19 , 29 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

Improvement of blood inflammatory marker levels in patients with hypothyroidism under levothyroxine treatment

et al. 2015

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BackgroundThere are several specific inflammatory and oxidative correlates among patients with hypothyroidism, but most studies are cross-sectional and do not evaluate the change in parameters during the treatment. The aim of this study was to investigate the effect of levothyroxine replacement therapy on biomarkers of oxidative stress (OS) and systemic inflammation in patients with hypothyroidism.MethodsIn this prospective open-label study, 17 patients with recently diagnosed primary hypothyroidism due to Hashimoto’s thyroiditis who were not taking levothyroxine were included. The following parameters were measured before and at 6 and 12 months of levothyroxine treatment with an average dose of 1.5 to 1.7 μg/kg/day: thyroid-stimulating hormone (TSH), free thyroxine (FT4), high-sensitivity C-reactive protein (hs-CRP), interleukin 1 (IL-1), IL-6, IL-10, interferon gamma (INF-γ), tumor necrosis factor alpha (TNF-α), thiobarbituric acid-reactive substances (TBARS), activity of aminolevulinic acid dehydratase (δ-ALA-D), nonprotein and total thiol (NP-SH and T-SH) groups, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG). Generalized estimating equation (GEE) modeling was used to analyze the effects of LRT (at pre-treatment, 6 months and 12 months) on those variables. The hypothyroidism status (i.e., overt or subclinical hypothyroidism) was included as a confounder in all analyses. An additional GEE post hoc analysis was made to compare time points.ResultsThere was a significant decrease in TSH over time (P < 0.0001), (initial levels were on average 32.4 μIU/mL and 10.5 μIU/mL at 12 months). There was a significant increase in FT4 (P < 0.0001) (initial levels were on average 0,8 ng/dL and 2.7 ng/dL at 12 months). There were significant changes in interleukin levels over time, with a significant increase in IL-10 (P < 0.0001) and significant decreases in IL-1 (P < 0.0001), IL-6 (P < 0.0001), INF-γ (P < 0.0001) and TNF-α (P < 0.0001). No significant difference in hs-CRP over time was observed (P < 0.284). There was a significant reduction in NP-SH (P < 0.0001).ConclusionsThis study observed significant changes in the inflammatory profile in hypothyroid patients under treatment, with reduction of pro-inflammatory cytokines and elevation of anti-inflammatory cytokine. In these patients, a decrease in low-grade chronic inflammation may have clinical relevance due to the known connection between chronic inflammation, atherosclerosis and cardiovascular events.

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“…As such, this is an important index for the diagnosis and assessment of severe pulmonary infectious diseases 47,48 . In the early stage of COVID-19, CRP levels could reflect lung lesions and disease severity 49 as such levels correlate with the level of inflammation 46 . Herein we detected a significant reduction in CRP in patients after two administrations of HeberFERON (see figure 3).…”

Section: Discussionmentioning

confidence: 99%

Effect of combination of interferon alpha-2b and interferon-gamma or interferon alpha-2b alone for elimination of SARS-CoV-2 viral RNA. Preliminary results of a randomized controlled clinical trial

Idelsis

Perez-Escribano

Duncan-Roberts³

et al. 2020

Preprint

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Objectives: IFN-alpha2b and IFN-gamma combination has demonstrated favorable pharmacodynamics for genes underlying antiviral activity which might be involved in the defense of the organism from a SARS-CoV-2 infection. Considering this we conducted a randomized controlled clinical trial for efficacy and safety evaluation of subcutaneous IFN-alpha2b and IFN-gamma administration in patients positive to SARS-CoV-2. Methods: We enrolled 19-82 years-old inpatients at the Military Central Hospital Luis Diaz Soto, Havana, Cuba. They were hospitalized after confirmed diagnosis for SARS-CoV-2 RNA by real-time reverse transcription polymerase chain reaction. Patients were randomly assigned in a 1:1 ratio to receive either, subcutaneous treatment with a co-lyophilized combination of 3.0 MIU IFN-alpha2b and 0.5 MIU IFN-gamma (HeberFERON, CIGB, Havana, Cuba), twice a week for two weeks, or thrice a week intramuscular injection of 3.0 MIU IFN-alpha2b (Heberon Alpha R, CIGB, Havana, Cuba). Additionally, all patients received lopinavir-ritonavir 200/50 mg every 12 h and chloroquine 250 mg every 12 h (standard of care). The primary endpoints were the time to negativization of viral RNA and the time to progression to severe COVID-19, from the start of treatment. The protocol was approved by the Ethics Committee on Clinical Investigation from the Hospital and the Center for the State Control of Medicines, Equipment and Medical Devices in Cuba. Informed consent was obtained from each participant. Results: A total of 79 patients with laboratory-confirmed SARS-CoV-2 infection, including symptomatic or asymptomatic conditions, fulfilled the inclusion criteria and underwent randomization. Thirty-three subjects were assigned to the HeberFERON group, and 33 to the Heberon Alpha R group. Sixty-three patients were analyzed for viral negativization, of them 78.6% in the HeberFERON group negativized the virus after 4 days of treatment versus 40.6% of patients in the Heberon Alpha R groups (p=0.004). Time to reach the negativization of the SARS-CoV-2 measured by RT-PCR in real time was of 3.0 and 5.0 days for the HeberFERON and Heberon Alpha R groups, respectively. A significant improvement in the reduction of time for negativization was attributable to HeberFERON (p=0.0027, Log-rank test) with a Hazard Ratio of 3.2 and 95% CI of 1.529 to 6.948, as compared to Heberon Alpha R treated group. Worsening of respiratory symptoms was detected in two (6.6%) and one (3.3%) patients in HeberFERON and IFN-alpha2b groups, respectively. None of the subjects transit to severe COVID-19 during the study or the epidemiological follow-up for 21 more days. RT-PCR on day 14 after the start of the treatment was negative to SARS-CoV-2 in 100% and 91% of patients of the combination of IFNs and IFN-alpha2b, respectively. Negativization for HeberFERON treated patients was related to a significant increase in lymphocytes counts and an also significant reduction in CRP as early as 7 days after commencing the therapeutic schedule. All the patients in both cohorts recover by day 14 and were in asymptomatic condition and laboratory parameters return to normal values by day 14 after treatment initiation. Adverse events were identified in 31.5% of patients, 28.5% in the control group, and 34.4% in the HeberFERON group, and the most frequent were headaches (17.4%). Conclusions: In a cohort of 63 hospitalized patients between 19 to 82 years-old with positive SARS-CoV-2, HeberFERON significantly negativized the virus on day 4 of treatment when comparing with IFN-alpha2b. Heberon Alpha R also showed efficacy for the treatment of the viral infection. Both treatments were safe and positively impact on the resolution of the symptoms. None of the patients developed severe COVID-19. Key words: COVID-19, treatment, drug, virus negativization, antiviral, interferon combination, SARS CoV-2.

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Comparison of pre- and post-levothyroxine high-sensitivity c-reactive protein and fetuin-a levels in subclinical hypothyroidism

Cited by 42 publications

References 37 publications

C-reactive protein levels in the early stage of COVID-19

C-reactive protein levels in the early stage of COVID-19

Improvement of blood inflammatory marker levels in patients with hypothyroidism under levothyroxine treatment

Effect of combination of interferon alpha-2b and interferon-gamma or interferon alpha-2b alone for elimination of SARS-CoV-2 viral RNA. Preliminary results of a randomized controlled clinical trial

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