Iodine-131 therapy alters the immune/inflammatory responses in the thyroids of patients with Graves' disease

Wen, Du; Dong, Qingyu; Lu, Xiaoting; Liu, Xiaomeng; Wang, Yue-Li; Li, Wenxia; Pan, Zhenyu; Gong, Qian; Liang, Cuige; Gao, Guan-Qi

doi:10.3892/etm.2017.4047

Cited by 7 publications

(10 citation statements)

References 29 publications

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“…This difference in results may be attributed to the fact that subsequent RAI therapy may evoke a different immunological response. 2 In the present paper, TRAb at baseline level correlated with 4 h, 24 h and 48 h RAIU, confirming the immunological origin of GD. This finding proves that RAIU and thyroid scanning still enable a definitive assessment of thyroid physiology.…”

Section: Discussionsupporting

confidence: 83%

“…1 In view of a significant reduction of ThV after RAI therapy, one question worth considering is the influence of the therapy on the final level of anti-thyroid antibodies (ATA). 2,3 Another issue to examine is the possible relationship between the level of ATA and radioiodine turnover, specifically the tracer uptake, radioactive iodine uptake -RAIU and thyroidal 131 I effective half-life (EHL). 4 The connection of these factors with the use of steroid protection and the potential subsequent dose of thyroid replacement therapy (TRT) due to post-therapeutic hypothyroidism is another issue to be explored.…”

Section: Introductionmentioning

confidence: 99%

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Influence of high tissue-absorbed dose on anti-thyroid antibodies in radioiodine therapy of Graves’ disease patients

Listewnik¹,

Piwowarska-Bilska²,

Jasiakiewicz³

et al. 2021

Adv Clin Exp Med

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Background. The results of radioactive iodine (RAI) treatment for Graves' disease (GD) are related to the choice of diagnostic and dosimetry protocols, the steroid protection used, and the subsequent 131 I dose. The effect of a high tissue-absorbed dose on the level of anti-thyroid antibodies (ATA) has been rarely considered.Objectives. To estimate the effect of the first RAI therapy with a dose of 250 Gy on anti-thyreoperoxidase (anti-TPO) and anti-thyroid-stimulating hormone (TSH) receptor thyrotropin receptor antibody -TRAb levels in GD patients. Materials and methods.The analysis encompassed 46 consecutive patients with clinical presentation of GD. We examined the serum levels of TSH, free thyroxine (FT4), anti-TPO, TRAb, thyroid volume (ThV), 131 I effective half-life (EHL), introduction of steroid protection, levothyroxine dose used in thyroid replacement therapy -TRT, and effectiveness of treatment.Results. As a result of RAI treatment, hypothyroidism was found in 35 patients (76.1%), euthyroidism in 7 patients (15.2%) and hyperthyroidism in 4 patients (8.7%). After RAI, we observed ThV reduction and increased anti-TPO (p = 0.001 and p = 0.001, respectively). It was found that a shorter EHL correlated with a higher baseline TRAb concentration and lower final anti-TPO serum concentration (p = 0.03 and p = 0.01, respectively). Lower final TRAb was found in patients with steroid protection (p = 0.049). Intergroup comparison of patients without steroid protection showed significantly higher final anti-TPO concentation (p = 0.02). Intergroup comparison of patients with TRT revealed significantly higher final anti-TPO concentration (p = 0.04). Conclusions.The application of a high absorbed dose of 250 Gy in GD resulted in high efficacy of RAI therapy at 1-year follow-up. An increased ATA level and its relationships with EHL and ThV reduction were observed at 1-year follow-up. There is a possible relationship between steroid protection and anti-TPO concentration.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Influence of high tissue-absorbed dose on anti-thyroid antibodies in radioiodine therapy of Graves’ disease patients

Listewnik¹,

Piwowarska-Bilska²,

Jasiakiewicz³

et al. 2021

Adv Clin Exp Med

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“…The CDC has indicated that patients with bone marrow suppression are at higher risk for COVID-19 severity and complications (US Department of Health & Human Services 2020). I 131 itself can modulate the immune system with cytokines dysregulation observed following I-131 treatment for Graves' disease (Du et al 2017). In those thyroid cancer patients with thyroid autoimmunity, treatment with I 131 can increase IL-6, a cytokine implicated in severe respiratory disease and death from COVID-19.…”

Section: Predilection For Thyroid Cancer In Covid-19 Patientsmentioning

confidence: 99%

Thyroid cancer in the age of COVID-19

Tsang

Gild

Glover

et al. 2020

Endocrine-Related Cancer

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COVID-19 has modified the way we practice medicine. For thyroid cancer, there have been several significant impacts. Firstly, diagnosis has been delayed due to social isolation, reduced access to investigations and staff redeployment. Secondly, treatment planning has needed to take into account the risk to patients and/or staff of nosocomial transmission of the virus. Finally, there are some specific concerns with respect to interactions between the virus, its treatments and cancer. This mini review aims to address each of these impacts and to provide some guidance and confidence to our patients and colleagues during this challenging time.

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“…Several issues concerning the impact of DTC treatment on COVID-19 outcome await clarification. First, a cautious patient selection for RAI treatment might be essential in the COVID-19 era due to the potential RAI-driven attenuation of immune responses in parallel with the concern about the safety/efficacy balance of RAI for most intermediate-risk and low-risk subgroups of (D)TC [ 121 , 122 , 123 ]. Second, whether L-T4 binding to integrin αvβ3 can diminish the integrin αvβ3-mediated internalization of the SARS-CoV-2 is yet to be investigated.…”

Section: Future Perspectivesmentioning

confidence: 99%

Charting the Unknown Association of COVID-19 with Thyroid Cancer, Focusing on Differentiated Thyroid Cancer: A Call for Caution

Deligiorgi

Siasos

Vakkas

et al. 2021

Cancers

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Background: Conceived of as the “silver lining” of the dark cloud of the coronavirus disease 2019 (COVID-19) pandemic, lessons taught by this catastrophe should be leveraged by medical authorities and policy makers to optimize health care globally. A major lesson is that resilient health systems should absorb sudden shocks incited by overwhelming health emergencies without compromising the continuum of care of chronic diseases, especially of cancer. Methods: The present review dissects the association between COVID-19 and thyroid cancer (TC), especially with differentiated TC (DTC), focusing on available data, knowledge gaps, current challenges, and future perspectives. Results: Obesity has been incriminated in terms of both COVID-19 severity and a rising incidence of TC, especially of DTC. The current conceptualization of the pathophysiological landscape of COVID-19–(D)TC association implicates an interplay between obesity, inflammation, immunity, and oxidative stress. Whether COVID-19 could aggravate the health burden posed by (D)TC or vice versa has yet to be clarified. Improved understanding and harnessing of the pathophysiological landscape of the COVID-19–(D)TC association will empower a mechanism-guided, safe, evidence-based, and risk-stratified management of (D)TC in the COVID-19 era and beyond. Conclusion: A multidisciplinary patient-centered decision-making will ensure high-quality (D)TC care for patients, with or without COVID-19.

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Iodine-131 therapy alters the immune/inflammatory responses in the thyroids of patients with Graves' disease

Abstract: Abstract. The aim of the present study was to evaluate the serum levels of interleukin-6 (IL-6), CXC chemokine ligand-10

Cited by 7 publications

References 29 publications

Influence of high tissue-absorbed dose on anti-thyroid antibodies in radioiodine therapy of Graves’ disease patients

Influence of high tissue-absorbed dose on anti-thyroid antibodies in radioiodine therapy of Graves’ disease patients

Thyroid cancer in the age of COVID-19

Charting the Unknown Association of COVID-19 with Thyroid Cancer, Focusing on Differentiated Thyroid Cancer: A Call for Caution

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