Histometry of lymphoid infiltrate in the thyroid of primary thyrotoxicosis patients. Relation of extent of thyroiditis to preoperative drug treatment and postoperative hypothyroidism.

Young, R. J.; Sherwood, M B; Simpson, John G.; Nicol, A.; Michie, W.; Beck, J. Swanson

doi:10.1136/jcp.29.5.398

Cited by 25 publications

(6 citation statements)

References 12 publications

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“…comparison of thyrotoxic glands in groups of patients pretreated with carbimazole or propranolol tends to invalidate the thesis that histological evidence of lymphoid infiltration is an index of increased risk of postoperative hypothyroidism. The glands pretreated with propranolol contain substantially more lymphoid infiltrate than do those prepared with carbimazole [14]. We found no correlation between the extent of lymphoid infiltrate in the thyroid and the development of postoperative hypothyroidism either between or within the two treatment groups.…”

contrasting

confidence: 65%

Invited commentary

Michie¹

1977

World j. surg.

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contrasting

confidence: 65%

Invited commentary

Michie¹

1977

World j. surg.

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“…Furthermore, patients with Graves' disease treated with subtotal thyroidectomy after being rendered euthyroid by ATD therapy will manifest at histological examination a markedly reduced lymphocytic infiltration of the thyroid compared to patients prepared by propranolol therapy instead of ATD [32]. Moreover, McLachlan et al [33] observed that cultures of intrathyroidal lymphocytes taken from surgical thyroid specimens of GD patients who had been treated with ATD in the past will not thrive in culture.…”

Section: Arguments Suggesting An Immuosuppressive Effect Of Atdmentioning

confidence: 96%

The Immunomodulatory Effects of Anti-thyroid Drugs are Mediated via Actions on Thyroid Cells, Affecting Thyrocyte-immunocyte Signalling A Review

Volpé

2001

CPD

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The mechanism of action of the immunosuppressive effects of antithyroid drugs has remained a matter of controversy, despite our earlier contention that such effects in vivo were indirect; ie., it was our view that the drugs were acting on the thyroid cells, reducing their thyroid hormone production and other activities, with a consequent reduction in thyrocyte-immunocyte signalling. The reduction in the activation of CD4+ cells,the increased number and activation of CD8+ (and CD8+CDllb+) cells, and the reduction of soluble interleukin-2 receptors, thought once to be direct effects of the medication, are now shown to be due to amelioration of the hyperthyroidism. Thus the reduction in thyroid hormone production induced by the drugs is central to these actions. In addition, the iodination of thyroglobulin is inhibited by these agents, which may affect antigen presentation by the thyrocyte. Furthermore, there is now evidence that the thionamides interfere with thyrocyte expression of such molecules as Class I antigen, interleukin-1, interleukin-6, prostaglandin E2, and heat shock protein. The expression of thyrocyte Class II antigen is probably not inhibited by these drugs, although one group has shown that lectin-stimulated thyrocyte Class II expression is diminished by this treatment; this group postulated that this effect might be mediated by reduced interferon gamma production by T lymphocytes, but in vitro experiments do not corroborate this proposal. In any event, the actions as described of the effects of antithyroid drugs on the thyroid cells (particularly normalization of thyroid function) would certainly suffice to explain the diminution of thyroid antibodies (including thyroid stimulating antibody), the reduced immunological response, and the increased remission rate in Graves disease as a consequence of antithyroid drug therapy, without the need to invoke a direct immunosuppressive effect.

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“…Whether antithyroid drugs have immunosuppressive actions is a matter of debate. The immunosuppression theory is based on the observation that thyroid antibodies of patients with Graves disease decrease during carbimazole treatment (McGregor et al, 1980) and the finding that patients with Graves disease who are treated with methimazole have less prominent intrathyroidal lymphocytic infiltration compared with those treated with propranolol (Young et al, 1976). Several in vitro findings (Weetman et al, 1984), such as the inhibition of immunoglobulin-secreting cells by antithyroid drugs (Weiss and Davies, 1981), support this theory.…”

Section: Antithyroid Drugsmentioning

confidence: 99%

Therapy of Hyperthyroidism

Miehle¹,

Paschke²

2003

Exp Clin Endocrinol Diabetes

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Hyperthyroidism is a common disorder and affects approximately 2 % of women and 0.2 % of men. The review focuses on the therapy of overt hyperthyroidism with special emphasis on treatment strategies in Germany and Europe. Current treatment schedules for the different causes of hyperthyroidism are described and new therapeutic aspects are discussed. Special sections deal with the treatment of hyperthyroidism in pregnancy, neonates and children, and the treatment of thyrotoxic storm.

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Histometry of lymphoid infiltrate in the thyroid of primary thyrotoxicosis patients. Relation of extent of thyroiditis to preoperative drug treatment and postoperative hypothyroidism.

Cited by 25 publications

References 12 publications

Invited commentary

Invited commentary

The Immunomodulatory Effects of Anti-thyroid Drugs are Mediated via Actions on Thyroid Cells, Affecting Thyrocyte-immunocyte Signalling A Review

Therapy of Hyperthyroidism

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