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Wpływ suplementacji diety selenem na przebieg autoimmunologicznego zapalenia tarczycy – przegląd badań klinicznych przeprowadzonych w populacji europejskiej. POSTEP HIG MED DOSW 2021. [DOI: 10.2478/ahem-2021-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstrakt
Wiele obserwacji wskazuje na zależność między zmniejszonymi zasobami selenowymi organizmu a różnymi schorzeniami tarczycy, w tym także autoimmunologicznym zapaleniem tarczycy (AZT). W większości prac poświęconych temu zagadnieniu zmiana stężenia przeciwciał anty-TPO była główną miarą oceny skuteczności suplementacji selenem (Se) diety pacjentów z AZT. Stężenie przeciwciał anty-TPO ma wpływ na intensywność nacieków limfocytarnych w gruczole tarczowym i stopień jego uszkodzenia, dlatego zmniejszenie ich stężenia w wyniku zwiększonego spożycia Se może się przyczynić do skuteczniejszego leczenia AZT. W części prac omówionych w artykule ewaluacja immunoregulacyjnego działania Se w przebiegu AZT została rozpatrzona w odniesieniu do szerszego zakresu parametrów biochemicznych i immunologicznych (głównie dotyczy to zmian w wytwarzaniu cytokin i chemokin). Wielu autorów potwierdziło wpływ Se na zmniejszanie stężenia przeciwciał anty-TPO, jednak wyniki wszystkich prac nie są jednoznaczne. Przyczyną rozbieżności może być odmienny stopień wysycenia tarczycy Se i jodem w różnych grupach pacjentów, różny stopień zaawansowania choroby, różne dawki Se podawanego pacjentom, stosowanie lub niestosowanie jednoczesnej terapii L-tyroksyną oraz polimorfizmy pojedynczych nukleotydów (SNP) występujące w genach kodujących poszczególne selenobiałka.
Na podstawie dostępnej literatury można wnioskować, iż zagadnienie dotyczące roli Se w AZT jest nadal słabo poznane. Istnieje potrzeba kontynuowania badań oceniających wpływ suplementacji diety Se na przebieg tej choroby, które powinny obejmować poza anty-TPO inne parametry kliniczne. Dopiero wyniki tak szeroko ujętych badań mogą być pomocne w formułowaniu nowych wytycznych dotyczących wspomagania leczenia przez odpowiednią modyfikację diety z uwzględnieniem suplementacji Se.
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Sun C, Zhu M, Li L, Fan H, Lv F, Zhu D. Clinical Observation of Levothyroxine Sodium Combined with Selenium in the Treatment of Patients with Chronic Lymphocytic Thyroiditis and Hypothyroidism and the Effects on Thyroid Function, Mood, and Inflammatory Factors. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:5471281. [PMID: 34745288 PMCID: PMC8566043 DOI: 10.1155/2021/5471281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/13/2021] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to investigate the therapeutic effects of levothyroxine sodium combined with selenium treatment and single levothyroxine sodium treatment on patients with chronic lymphocytic thyroiditis and hypothyroidism and to analyze the effects of different treatment regimens on patients' thyroid function, mood, and inflammatory factors, with the aim of providing a reference for clinical treatment. The subjects of the current study were 138 chronic lymphocytic thyroiditis (CLT) patients with hypothyroidism admitted to our hospital from May 2016 to September 2019 and were randomly divided into a control group taking levothyroxine sodium (LT4) treatment and a combined group of LT4 combined with selenium treatment, with 69 cases each. Patients in both groups were evaluated for efficacy after 3 months of treatment, and their thyroid function was observed by total triiodothyronine (TT3), total thyroxine (TT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and thyroid globulin antibody (TGAb), and their mood changes were observed by Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores. The levels of inflammatory factors such as interleukin-2 (IL-2), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α) were measured, and the occurrence of adverse drug reactions during the treatment period was observed and recorded in all patients. The results showed that the total effective rate of the combined group was significantly higher than that of the control group. The levels of TT3, TT4, TSH, TgAb, and TPOAb, SAS and SDS scores, and levels of inflammatory factors such as IL-2, IL-10, and TNF-α were significantly improved in both groups after treatment. Compared with the control group, TGAb, TPOAb, IL-2, TNF-α levels, and SAS and SDS scores decreased more and IL-10 levels increased more in the combined group, while the differences of other indexes were not statistically significant. This suggests that LT4 has certain efficacy in treating CLT with hypothyroidism, and the combined selenium treatment can improve the therapeutic effect of LT4 and can play a greater role in improving patients' mood and immune and inflammatory responses.
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Affiliation(s)
- Chunping Sun
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Anhui Gerietric Institute, Hefei, Anhui 230022, China
| | - Min Zhu
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Anhui Gerietric Institute, Hefei, Anhui 230022, China
| | - Li Li
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Anhui Gerietric Institute, Hefei, Anhui 230022, China
| | - Hua Fan
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Anhui Gerietric Institute, Hefei, Anhui 230022, China
| | - Fang Lv
- Department of Endocrinology, The Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China
| | - Defa Zhu
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Anhui Gerietric Institute, Hefei, Anhui 230022, China
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Mojadadi A, Au A, Salah W, Witting P, Ahmad G. Role for Selenium in Metabolic Homeostasis and Human Reproduction. Nutrients 2021; 13:3256. [PMID: 34579133 PMCID: PMC8469766 DOI: 10.3390/nu13093256] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/16/2021] [Accepted: 09/16/2021] [Indexed: 02/06/2023] Open
Abstract
Selenium (Se) is a micronutrient essential for life. Dietary intake of Se within the physiological range is critical for human health and reproductive functions. Selenium levels outside the recommended range have been implicated in infertility and variety of other human diseases. However, presently it is not clear how different dietary Se sources are processed in our bodies, and in which form or how much dietary Se is optimum to maintain metabolic homeostasis and boost reproductive health. This uncertainty leads to imprecision in published dietary guidelines and advice for human daily intake of Se and in some cases generating controversies and even adverse outcomes including mortality. The chief aim for this review is to describe the sources of organic and inorganic Se, the metabolic pathways of selenoproteins synthesis, and the critical role of selenprotenis in the thyroid gland homeostasis and reproductive/fertility functions. Controversies on the use of Se in clinical practice and future directions to address these challenges are also described and discussed herein.
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Affiliation(s)
- Albaraa Mojadadi
- Molecular Biomedicine, Charles Perkins Centre, School of Medical Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.M.); (A.A.); (W.S.); (P.W.)
- Department of Anatomy, College of Medicine, King AbdulAziz University, Rabigh 21589, Saudi Arabia
| | - Alice Au
- Molecular Biomedicine, Charles Perkins Centre, School of Medical Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.M.); (A.A.); (W.S.); (P.W.)
| | - Wed Salah
- Molecular Biomedicine, Charles Perkins Centre, School of Medical Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.M.); (A.A.); (W.S.); (P.W.)
- Department of Anatomy, College of Medicine, Jeddah University, Jeddah 21959, Saudi Arabia
| | - Paul Witting
- Molecular Biomedicine, Charles Perkins Centre, School of Medical Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.M.); (A.A.); (W.S.); (P.W.)
| | - Gulfam Ahmad
- Molecular Biomedicine, Charles Perkins Centre, School of Medical Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.M.); (A.A.); (W.S.); (P.W.)
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Qiu Y, Xing Z, Xiang Q, Yang Q, Zhu J, Su A. Insufficient evidence to support the clinical efficacy of selenium supplementation for patients with chronic autoimmune thyroiditis. Endocrine 2021; 73:384-397. [PMID: 33774780 DOI: 10.1007/s12020-021-02642-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/18/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND This study critically reappraises the documentation on the clinical efficacy of selenium supplementation in chronic autoimmune thyroiditis (AIT) with the goal of improving the normalization of the treatment of this disease. METHODS A literature search was performed in the Medline, Embase, and Cochrane Library databases. Twenty-three trials conducted in adults with AIT comparing the efficacy of selenium with or without levothyroxine (LT4) versus placebo and/or LT4 were eligible. The assessed outcomes were primarily pooled using a random- or fixed effects model based on the results of the heterogeneity test. The quality of evidence was assessed per outcome. RESULTS In LT4-treated populations, patients receiving selenium demonstrated lower thyroid peroxidase antibody (TPOAb) levels at 3 months (mean difference [MD], -236.88; 95% confidence interval [CI], -353.35 to -120.41; p < 0.0001), 6 months (MD, -407.17; 95% CI, -623.60 to -190.73; p = 0.0002), and 12 months (MD, -327.03; 95% CI, -613.78 to -40.28; p = 0.0254), while thyroglobulin antibody (TgAb) levels only decreased at 12 months. In non-LT4-treated population, the selenium group demonstrated significantly lower TPOAb levels after 3 months (MD, -203.07; 95% CI, -395.44 to -10.70; p = 0.0385) and 6 months (MD, -322.27; 95% CI, -597.50 to -47.04; p = 0.0217) but not after 12 months, while TgAb levels only decreased at 3 months. There was no significant change in thyroid stimulating hormone (TSH) levels. Lower thyroid echogenicity was observed in all patients receiving selenium at 3, 6, and 12 months. However, these participants had a significantly higher risk of reported adverse effects. CONCLUSIONS Current evidence does not justify the emerging use of selenium supplementation in the treatment of AIT, despite it resulting in a decrease in autoantibody levels.
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Affiliation(s)
- Yuxuan Qiu
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China
- Center of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Zhichao Xing
- Center of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Qiao Xiang
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China
| | - Qianru Yang
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Jingqiang Zhu
- Center of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Anping Su
- Center of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China.
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Pobłocki J, Pańka T, Szczuko M, Telesiński A, Syrenicz A. Whether a Gluten-Free Diet Should Be Recommended in Chronic Autoimmune Thyroiditis or Not?-A 12-Month Follow-Up. J Clin Med 2021; 10:3240. [PMID: 34362024 PMCID: PMC8347530 DOI: 10.3390/jcm10153240] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/19/2021] [Accepted: 07/19/2021] [Indexed: 01/08/2023] Open
Abstract
Elimination diets have recently become extremely popular among people with autoimmune diseases. A gluten-free diet is indicated in celiac disease (CD), but some studies show its effectiveness in cases of autoimmunity. The aim of this study was to assess whether the use of a gluten-free diet is also effective in patients with chronic autoimmune thyroid disease (cAITD), which is the most common thyroid autoimmune pathology associated with chronic inflammation, over-reactivity of the immune system, auto-destruction of thyrocytes and hypothyroidism. The final analysis of the study included 62 Caucasian women randomized into a control group (CG: n = 31) and an experimental group on a gluten-free diet (GFDG: n = 31), were subject to a 12-month follow-up, during which the concentrations of thyrotropin (TSH), free triiodothyronine (fT3), free thyroxine (fT4), anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies were assessed at baseline and after 3, 6 and 12 months. During the 12-month follow-up between the CG and the GFDG, no differences were found in anti-TPO and anti-TG antibodies, fT3 or fT4 levels, except a significant reduction in TSH levels in the GFDG. Additionally, performed analysis between individual appointments presented no significant differences in changes in the median concentrations of anti-TPO, anti-TG or fT3, but confirmed a significant decrease in TSH and showed accessory an increase in fT4 after 12 months in GFDG. Statistical analyses performed separately for both groups indicated a constant reduction of anti-TG concentrations in the GFDG. In conclusion, a GFD may be administered in cAITD after ruling out celiac disease, but it is necessary to perform more studies to assess if cAITD patients achieve the benefits of following a GFD. Patients with cAITD should be offered proper nutrition education combined with a healthy lifestyle promotion.
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Affiliation(s)
- Jakub Pobłocki
- Department of Endocrinology, Metabolic Diseases and Internal Diseases, Pomeranian Medical University, 70-252 Szczecin, Poland; (T.P.); (A.S.)
| | - Tamara Pańka
- Department of Endocrinology, Metabolic Diseases and Internal Diseases, Pomeranian Medical University, 70-252 Szczecin, Poland; (T.P.); (A.S.)
| | - Małgorzata Szczuko
- Department of Human Nutrition and Metabolomic, Pomeranian Medical University, 71-460 Szczecin, Poland
| | - Arkadiusz Telesiński
- Department of Bioengineering, Faculty of Environmental Management and Agriculture, West Pomeranian University of Technology, 71-434 Szczecin, Poland;
| | - Anhelli Syrenicz
- Department of Endocrinology, Metabolic Diseases and Internal Diseases, Pomeranian Medical University, 70-252 Szczecin, Poland; (T.P.); (A.S.)
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Larsen CB, Riis KR, Winther KH, Larsen EL, Ellervik C, Hegedüs L, Brix TH, Poulsen HE, Bonnema SJ. Treatment of Hyperthyroidism Reduces Systemic Oxidative Stress, as Measured by Markers of RNA and DNA Damage. J Clin Endocrinol Metab 2021; 106:e2512-e2520. [PMID: 33901280 DOI: 10.1210/clinem/dgab273] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Whole-body oxidative stress can be estimated by the urine excretion of oxidized guanosine species, 8-oxo-7,8-dihydroguanosine (8-oxoGuo) and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG), derived from RNA and DNA, respectively. These oxidative stress markers are not well explored in thyroid disorders. OBJECTIVE We aimed to determine whether treatment of hyperthyroid patients affects the levels of these oxidative stress markers. METHODS Urinary excretion of 8-oxoGuo and 8-oxodG was measured in 51 hyperthyroid patients (toxic nodular goiter [TNG], n = 30; Graves disease [GD], n = 21) before or shortly after initiation of therapy and when stable euthyroidism had been achieved for at least 12 months. RESULTS Adjusting for age, the baseline urinary excretion of oxidative stress markers correlated positively with plasma thyroxine (8-oxoGuo, P = 0.002; 8-oxodG, P = 0.021) and was significantly higher in GD than in TNG patients (P = 0.001 for both oxidative stress markers). Restoration of euthyroidism significantly affected the excretion of the oxidative stress markers. In TNG, 8-oxoGuo decreased from geometric mean 2.11 nmol/mmol creatinine (95% CI, 1.85-2.39) to 1.91 nmol/mmol (95% CI, 1.67-2.19; P = 0.001), while 8-oxodG decreased from 1.65 nmol/mmol (95% CI, 1.41-1.93) to 1.48 nmol/mmol (95% CI, 1.27-1.74; P = 0.026). In GD, 8-oxoGuo decreased from 2.25 nmol/mmol (95% CI, 1.95-2.59) to 1.79 nmol/mmol (95% CI, 1.63-1.97; P = 0.0003), while 8-oxodG decreased from 2.02 nmol/mmol (95% CI, 1.73-2.38) to 1.54 nmol/mmol (95% CI, 1.31-1.81; P = 0.001). In the euthyroid state, there were no differences between groups. CONCLUSION Restoration of euthyroidism in patients with hyperthyroidism significantly decreased the systemic oxidative stress load by 10% to 25%. Our findings may help to explain the higher morbidity and mortality linked to hyperthyroid diseases, as shown in observational studies.
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Affiliation(s)
- Camilla B Larsen
- Department of Endocrinology, Odense University Hospital, Denmark
- Department of Clinical Research, University of Southern Denmark, Denmark
| | - Kamilla R Riis
- Department of Endocrinology, Odense University Hospital, Denmark
- Department of Clinical Research, University of Southern Denmark, Denmark
| | | | - Emil L Larsen
- Department of Clinical Pharmacology, Bispebjerg Frederiksberg Hospital, Copenhagen, Denmark
| | - Christina Ellervik
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
- Department of Research, Region Zealand, Sorø, Denmark
| | - Laszlo Hegedüs
- Department of Endocrinology, Odense University Hospital, Denmark
- Department of Clinical Research, University of Southern Denmark, Denmark
| | - Thomas H Brix
- Department of Endocrinology, Odense University Hospital, Denmark
- Department of Clinical Research, University of Southern Denmark, Denmark
| | - Henrik E Poulsen
- Department of Clinical Pharmacology, Bispebjerg Frederiksberg Hospital, Copenhagen, Denmark
| | - Steen J Bonnema
- Department of Endocrinology, Odense University Hospital, Denmark
- Department of Clinical Research, University of Southern Denmark, Denmark
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Lumyongsatien M, Bhaktikamala U, Thongtong P, Sintuwong S, Nimitwongsakul O, Kanokkantapong J, Pongpirul K. Relative selenium insufficiency is a risk factor for developing severe Graves' orbitopathy: a case-control study. BMJ Open Ophthalmol 2021; 6:e000713. [PMID: 34041363 PMCID: PMC8112433 DOI: 10.1136/bmjophth-2021-000713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 04/02/2021] [Accepted: 05/01/2021] [Indexed: 11/08/2022] Open
Abstract
Background/aims Selenium (Se), an antioxidant agent, is effective in preventing mild Graves’ orbitopathy (GO) deterioration. However, the significant risk of low serum Se concentration for GO progression has not been identified. Here, we aimed to investigate the risk of relative Se insufficiency and to identify its optimal cut-off value in the development of disease severity in patients with GO. Methods Serum Se levels were prospectively measured in 100 consecutive patients with GO. The patients were classified into groups with mild and severe GO (logistic regression analysis outcome). A receiver operating characteristic (ROC) curve and the minimum p value corresponding to χ2 statistics were analysed to select the optimal cut-off Se level for the diagnosis of severe orbitopathy. Results Thirty-two patients (32%) had mild GO and 68 (68%) had severe GO. The ROC revealed a cut-off Se level of 93 µg/L. Se levels ≤93 µg/L were observed in 48.5% and 12.5% of the patients in the severe and mild (p<0.001) groups, respectively. The risk estimate (OR) for an Se level ≤93 µg/L was 8.14 (95% CI 2.39 to 27.75). It remained a significant risk factor after adjusting for age, sex, thyroid status, smoking status, thyroidectomy and radioactive iodine. Conclusion Relative Se insufficiency (≤93 µg/L) is a potential risk factor for severe GO development. An evaluation of Se status is recommended in patients with GO for predicting disease progression and guiding supplementation therapy.
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Affiliation(s)
- Mingkwan Lumyongsatien
- Department of Ophthalmology, Metta Pracharak Hospital Wat Rai Khing, Nakhon Pathom, Thailand
| | - Unnkade Bhaktikamala
- Department of Ophthalmology, Metta Pracharak Hospital Wat Rai Khing, Nakhon Pathom, Thailand
| | - Pennung Thongtong
- Department of Ophthalmology, Metta Pracharak Hospital Wat Rai Khing, Nakhon Pathom, Thailand
| | - Sunisa Sintuwong
- Department of Ophthalmology, Metta Pracharak Hospital Wat Rai Khing, Nakhon Pathom, Thailand
| | - Ornvenus Nimitwongsakul
- Department of Ophthalmology, Metta Pracharak Hospital Wat Rai Khing, Nakhon Pathom, Thailand
| | | | - Krit Pongpirul
- Department of Preventive and Social Medicine, Chulalongkorn University, Bangkok, Thailand
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Hu W, Zhao C, Hu H, Yin S. Food Sources of Selenium and Its Relationship with Chronic Diseases. Nutrients 2021; 13:nu13051739. [PMID: 34065478 PMCID: PMC8160805 DOI: 10.3390/nu13051739] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 12/16/2022] Open
Abstract
Selenium (Se) is an essential micronutrient for mammals, and its deficiency seriously threatens human health. A series of biofortification strategies have been developed to produce Se-enriched foods for combating Se deficiency. Although there have been some inconsistent results, extensive evidence has suggested that Se supplementation is beneficial for preventing and treating several chronic diseases. Understanding the association between Se and chronic diseases is essential for guiding clinical practice, developing effective public health policies, and ultimately counteracting health issues associated with Se deficiency. The current review will discuss the food sources of Se, biofortification strategies, metabolism and biological activities, clinical disorders and dietary reference intakes, as well as the relationship between Se and health outcomes, especially cardiovascular disease, diabetes, chronic inflammation, cancer, and fertility. Additionally, some concepts were proposed, there is a non-linear U-shaped dose-responsive relationship between Se status and health effects: subjects with a low baseline Se status can benefit from Se supplementation, while Se supplementation in populations with an adequate or high status may potentially increase the risk of some diseases. In addition, at supra-nutritional levels, methylated Se compounds exerted more promising cancer chemo-preventive efficacy in preclinical trials.
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Abstract
It is 70 years since Noel Rose embarked on his pioneering studies that lead to the discovery of autoimmune thyroiditis and the elucidation of Hashimoto's thyroiditis. This short review to honour his passing focuses on the developments in our understanding of the causes and pathogenesis of HT over the last five years. Recent genetic studies have reported heritability estimates for HT and associated diseases for the first time, and emphasised the complexity of the genetic factors involved, including monogenic forms of HT. Environmental factors continue to be elucidated, especially as a side effect of drugs which modulate the immune system therapeutically. Regarding pathogenetic mechanisms, multiple cytokine networks have been identified which involve the thyroid cells in a circuit of escalating proinflammatory effects, such as the expression of inflammasome components, and an array of different defects in T regulatory cells may underlie the loss of self-tolerance to thyroid autoantigens. Finally, a number of studies have revealed fresh insights into disease associations with HT which may have both pathological and clinical significance, the most intriguing of which is a possible direct role of the autoimmune process itself in causing some of the persistent symptoms reported by a minority of patients with levothyroxine-treated HT.
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Affiliation(s)
- A P Weetman
- Department of Oncology and Metabolism, Faculty of Medicine, Dentistry and Health, University of Sheffield, The Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
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Song J, Sun R, Zhang Y, Ke J, Zhao D. Serum resolvin E1 levels and its relationship with thyroid autoimmunity in Hashimoto's thyroiditis: a preliminary study. BMC Endocr Disord 2021; 21:66. [PMID: 33849519 PMCID: PMC8045210 DOI: 10.1186/s12902-021-00730-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 04/04/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Omega-3 polyunsaturated fatty acids (PUFAs) produce lipid mediators with both anti-inflammatory and pro-resolution properties, including resolvins. The purpose of this study was to detect serum resolvin E1 (RVE1) levels in Hashimoto's thyroiditis (HT) patients and healthy controls (HCs) and to evaluate the relationship of RVE1 with thyroid autoimmunity. METHODS A total of 57 participants were recruited, including 30 untreated HT patients and 27 age- and sex-matched HCs. The levels of RVE1 in serum were measured via enzyme-linked immunosorbent assay (ELISA). An electrochemiluminescence immunoassay was used for the measurement of thyroid-stimulating hormone (TSH), total T4 (TT4), TT3, free T4 (FT4), FT3, anti-thyroid peroxidase antibody (TPOAb) and anti-thyroglobulin antibody (TgAb) levels. Hemogram tests and routine biochemical analyses were performed on each sample. RESULTS The serum level of RVE1 of HT patients (24.09, 15.76-34.38 pg/mL) was significantly lower than that of healthy controls (28.51, 20.76-51.23 pg/mL) (P = 0.027). RVE1 levels showed a downward trend with increasing TgAb levels (P for trend = 0.001). Multivariable ordinal logistic regression analysis showed that RVE1 levels were negatively correlated with increasing TgAb levels in both the unadjusted (OR = 0.9446, 95 % CI = 0.9111-0.9782, P = 0.002) and adjusted models (OR = 0.9380, 95 % CI = 0.8967-0.9811, P = 0.005). CONCLUSIONS Decreased RVE1 levels might be a sign that HT is associated with inflammatory resolution dysfunction. RVE1 may serve as a protective factor against increased TgAb levels.
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Affiliation(s)
- Jing Song
- Beijing Key Laboratory of Diabetes Research and Care, Center for Endocrine Metabolism and Immune Diseases, Lu He Hospital Capital Medical University, Beijing, China
| | - Rongxin Sun
- Beijing Key Laboratory of Diabetes Research and Care, Center for Endocrine Metabolism and Immune Diseases, Lu He Hospital Capital Medical University, Beijing, China
| | - Yuanyuan Zhang
- Beijing Key Laboratory of Diabetes Research and Care, Center for Endocrine Metabolism and Immune Diseases, Lu He Hospital Capital Medical University, Beijing, China
| | - Jing Ke
- Beijing Key Laboratory of Diabetes Research and Care, Center for Endocrine Metabolism and Immune Diseases, Lu He Hospital Capital Medical University, Beijing, China
| | - Dong Zhao
- Beijing Key Laboratory of Diabetes Research and Care, Center for Endocrine Metabolism and Immune Diseases, Lu He Hospital Capital Medical University, Beijing, China.
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Hu Y, Feng W, Chen H, Shi H, Jiang L, Zheng X, Liu X, Zhang W, Ge Y, Liu Y, Cui D. Effect of selenium on thyroid autoimmunity and regulatory T cells in patients with Hashimoto's thyroiditis: A prospective randomized-controlled trial. Clin Transl Sci 2021; 14:1390-1402. [PMID: 33650299 PMCID: PMC8301566 DOI: 10.1111/cts.12993] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 12/16/2022] Open
Abstract
Selenium (Se) is an essential trace element in human. Recent studies of Se supplementation on the effect of Hashimoto's thyroiditis (HT) have been reported, but the exact benefit is unclear as well as the underlying immunologic mechanism. We aimed to evaluate the clinical effect of Se supplement in patients with HT, and explore the potential mechanism against thyroid autoimmunity. A prospective, randomized-controlled study was performed in patients with HT assigned to two groups. Se-treated group (n = 43) received selenious yeast tablet (SYT) for 6 months, whereas no treatment in control group (n = 47). The primary outcome is the change of thyroid peroxidase antibody (TPOAb) or thyroglobulin antibody (TGAb). Second, thyroid function, urinary iodine, Se, Glutathione peroxidase3 (GPx3), and Selenoprotein P1 (SePP1) levels were measured during the SYT treatment. Meanwhile, regulatory T cells (Tregs) and their subsets activated Tregs (aTregs), resting Tregs, and secreting Tregs, as well as Helios and PD-1 expression on these cells were also detected. The results showed that SYT treatment significantly decreased TPOAb, TGAb, and thyroid stimulating hormone (TSH) levels, accompanied with the increased Se, GPx3, and SePP1, compared with the control group. Subgroup analysis revealed that subclinical HT may benefit more from this treatment in the decrease of TSH levels by interaction test. Moreover, the percentage of aTregs, Helios/Tregs, and Helios/aTregs were significantly higher in the Se-treated group than control. In conclusion, Se supplementation may have a beneficial effect on thyroid autoantibodies and thyroid function by increasing the antioxidant activity and upregulating the activated Treg cells.
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Affiliation(s)
- Yifang Hu
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wenwen Feng
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huanhuan Chen
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - He Shi
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lin Jiang
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xuqin Zheng
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoyun Liu
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wensong Zhang
- Department of Pharmacy, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yaoqi Ge
- Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yun Liu
- Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Department of Medical Informatics, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
| | - Dai Cui
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Mannucci C, Casciaro M, Sorbara EE, Calapai F, Di Salvo E, Pioggia G, Navarra M, Calapai G, Gangemi S. Nutraceuticals against Oxidative Stress in Autoimmune Disorders. Antioxidants (Basel) 2021; 10:antiox10020261. [PMID: 33567628 PMCID: PMC7914737 DOI: 10.3390/antiox10020261] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/29/2021] [Accepted: 02/04/2021] [Indexed: 02/06/2023] Open
Abstract
Antioxidant mechanisms are constituted of enzymes, endogenous, and non-enzymatic, exogenous, which have the role of counterbalancing oxidative stress. Intake of these compounds occurs in the diet. Vegetables, plants, and fruits contain a wide range of alkaloids, polyphenols, and terpenoids which are called “phytochemicals”. Most of these substances are responsible for the positive properties of fruits and vegetables, which are an essential part of a healthy life with roles in ameliorating chronic illnesses and favoring longevity. Nutraceuticals are substances contained in a food or fragment of it influencing health with positive effects on health helping in precenting or treating disorders. We conducted a review illustrating the principal applications of nutraceuticals in autoimmune disorders. Literature reported several studies about exogenous dietary antioxidant supplementation in diverse autoimmune diseases such as rheumatoid arthritis, lupus, diabetes, and multiple sclerosis. In these pathologies, promising results were obtained in some cases. Positive outcomes were generally associated with a reduction of oxidative stress parameters and a boost to antioxidant systems, and sometimes with anti-inflammatory effects. The administration of exogenous substances through food derivates or dietary supplements following scientific standardization was demonstrated to be effective. Further bias-free and extended studies should be conducted that include ever-increasing oxidative stress biomarkers.
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Affiliation(s)
- Carmen Mannucci
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy; (C.M.); (E.E.S.); (G.C.)
| | - Marco Casciaro
- Department of Clinical and Experimental Medicine, Unit and School of Allergy and Clinical Immunology, University of Messina, 98125 Messina, Italy;
- Correspondence: ; Tel.: +39-090-221-2013
| | - Emanuela Elisa Sorbara
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy; (C.M.); (E.E.S.); (G.C.)
| | - Fabrizio Calapai
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98168 Messina, Italy; (F.C.); (M.N.)
| | - Eleonora Di Salvo
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy;
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164 Messina, Italy;
| | - Michele Navarra
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98168 Messina, Italy; (F.C.); (M.N.)
| | - Gioacchino Calapai
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy; (C.M.); (E.E.S.); (G.C.)
| | - Sebastiano Gangemi
- Department of Clinical and Experimental Medicine, Unit and School of Allergy and Clinical Immunology, University of Messina, 98125 Messina, Italy;
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Song J, Sun R, Zhang Y, Fu Y, Zhao D. Role of the Specialized Pro-resolving Mediator Resolvin D1 in Hashimoto's Thyroiditis. Exp Clin Endocrinol Diabetes 2021; 129:791-797. [PMID: 33465800 DOI: 10.1055/a-1345-0173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE 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. METHODS 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. RESULTS 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). CONCLUSIONS Thyroid autoimmunity may be associated with low levels of RVD1. Decreased RVD1 levels indicate impaired resolution of inflammation in HT patients.
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Affiliation(s)
- Jing Song
- Beijing Key Laboratory of Diabetes Research and Care, Center for Endocrine Metabolism and Immune Diseases, Lu He Hospital Capital Medical University, Beijing, China
| | - Rongxin Sun
- Beijing Key Laboratory of Diabetes Research and Care, Center for Endocrine Metabolism and Immune Diseases, Lu He Hospital Capital Medical University, Beijing, China
| | - Yuanyuan Zhang
- Beijing Key Laboratory of Diabetes Research and Care, Center for Endocrine Metabolism and Immune Diseases, Lu He Hospital Capital Medical University, Beijing, China
| | - Ying Fu
- Beijing Key Laboratory of Diabetes Research and Care, Center for Endocrine Metabolism and Immune Diseases, Lu He Hospital Capital Medical University, Beijing, China
| | - Dong Zhao
- Beijing Key Laboratory of Diabetes Research and Care, Center for Endocrine Metabolism and Immune Diseases, Lu He Hospital Capital Medical University, Beijing, China
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Li Y, Zuo X, Hua C, Zhao Y, Pei X, Tian M. Effects of Selenium Supplement on B Lymphocyte Activity in Experimental Autoimmune Thyroiditis Rats. Int J Endocrinol 2021; 2021:9439344. [PMID: 34422046 PMCID: PMC8373486 DOI: 10.1155/2021/9439344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 08/01/2021] [Accepted: 08/04/2021] [Indexed: 12/02/2022] Open
Abstract
METHODS 45 healthy and adult female SD rats were randomly divided into three groups: normal control group, EAT model group, and selenium yeast supplement EAT group. The EAT model rats were induced by subcutaneous injection of porcine thyroglobulin and fed with high iodine water. The concentrations of serum thyroid-stimulating hormone (TSH), TGAb, TPOAb, and B cell activating factor (BAFF) were detected in each group by enzyme-linked immunosorbent assay (ELISA), and the expression of interleukin-10 (IL-10) in thyroid tissue was detected by immunohistochemistry. B cells and regulatory B cells (Bregs) ratios in the spleen of rats were analyzed by flow cytometry. RESULTS In contrast with the EAT model group, the levels of serum TSH, TGAB, TPOAb, and BAFF were decreased, while IL-10 expression was increased in thyroid tissue, and Bregs ratio was upregulated in the spleen (all p < 0.05) in the selenium yeast supplement EAT group. CONCLUSION Selenium yeast supplement could partially attenuate immune imbalance in EAT rats, which may be related to the mechanism of modulating B lymphocyte activity.
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Affiliation(s)
- Yang Li
- Thyroid Center of Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430070, China
- Hubei Province Academy of Traditional Chinese Medicine, Wuhan 430074, China
- Hubei University of Traditional Chinese Medicine, Wuhan 430061, China
| | - Xinhe Zuo
- Thyroid Center of Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430070, China
- Hubei Province Academy of Traditional Chinese Medicine, Wuhan 430074, China
- Hubei University of Traditional Chinese Medicine, Wuhan 430061, China
| | - Chuan Hua
- Thyroid Center of Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430070, China
- Hubei Province Academy of Traditional Chinese Medicine, Wuhan 430074, China
- Hubei University of Traditional Chinese Medicine, Wuhan 430061, China
| | - Yong Zhao
- Thyroid Center of Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430070, China
- Hubei Province Academy of Traditional Chinese Medicine, Wuhan 430074, China
- Hubei University of Traditional Chinese Medicine, Wuhan 430061, China
| | - Xun Pei
- Thyroid Center of Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430070, China
- Hubei Province Academy of Traditional Chinese Medicine, Wuhan 430074, China
- Hubei University of Traditional Chinese Medicine, Wuhan 430061, China
| | - Man Tian
- Thyroid Center of Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430070, China
- Hubei Province Academy of Traditional Chinese Medicine, Wuhan 430074, China
- Hubei University of Traditional Chinese Medicine, Wuhan 430061, China
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Planck T, Lantz M, Perros P, Papini E, Attanasio R, Nagy EV, Hegedüs L. Use of Thyroid Hormones in Hypothyroid and Euthyroid Patients: A 2020 THESIS Questionnaire Survey of Members of the Swedish Endocrine Society. Front Endocrinol (Lausanne) 2021; 12:795111. [PMID: 34938274 PMCID: PMC8687360 DOI: 10.3389/fendo.2021.795111] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/15/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The standard treatment of hypothyroidism is levothyroxine (LT-4). However, there are several controversies regarding treatment of hypothyroid patients. AIM To investigate the Swedish endocrinologists' use of thyroid hormones in hypothyroid and euthyroid individuals. METHODS Physician members of the Swedish Endocrine Society (SEF) were invited by e-mail to participate in an online survey investigating this topic. RESULTS Out of the eligible 411 members, 116 (28.2%) responded. The majority (98.9%) stated that L-T4 is the treatment of choice. However, around 50% also prescribed liothyronine (L-T3) or a combination of L-T4+L-T3 in their practice. Combination therapy was mostly (78.5%) used in patients with persistent hypothyroid symptoms despite biochemical euthyroidism on L-T4 treatment. Most respondents prescribed L-T4 tablets and did not expect any major changes with alternative formulations such as soft-gel capsules or liquid formulations in situations influencing the bioavailability of L-T4. In euthyroid patients, 49.5% replied that treatment with thyroid hormones was never indicated, while 47.3% would consider L-T4 for euthyroid infertile women with high thyroid peroxidase (TPO) antibody levels. CONCLUSION The treatment of choice for hypothyroidism in Sweden is L-T4 tablets. Combination therapy with L-T4+L-T3 tablets was considered for patients with persistent symptoms despite biochemical euthyroidism. Soft-gel capsules and liquid solutions of L-T4 were infrequently prescribed. Swedish endocrinologists' deviation from endocrine society guidelines merits further study.
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Affiliation(s)
- Tereza Planck
- Department of Endocrinology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- *Correspondence: Tereza Planck,
| | - Mikael Lantz
- Department of Endocrinology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Petros Perros
- Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Enrico Papini
- Department of Endocrinology and Metabolism, Regina Apostolorum Hospital, Rome, Italy
| | - Roberto Attanasio
- Endocrine Unit, Institutes for Care and Scientific Research (IRCCS) Orthopedic Institute Galeazzi, Milan, Italy
| | - Endre V. Nagy
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Laszlo Hegedüs
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
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Pace C, Tumino D, Russo M, Le Moli R, Naselli A, Borzì G, Malandrino P, Frasca F. Role of selenium and myo-inositol supplementation on autoimmune thyroiditis progression. Endocr J 2020; 67:1093-1098. [PMID: 32669509 DOI: 10.1507/endocrj.ej20-0062] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Previous reports indicate that selenium supplementation may be useful to reduce cell oxidative stress. In particular, selenium may decrease the level of thyroid autoantibodies in patients with Hashimoto's thyroiditis (HT). Recent studies also indicate that myo-inositol may have beneficial effects on thyroid function in patients with HT. Hence, the aim of the present study is to evaluate whether myo-inositol may enhance the protective effect of selenium on HT progression to hypothyroidism. The study was designed as observational and retrospective. Thyroid hormones were evaluated in patients with HT who were either euthyroid or subclinically hypothyroid. These patients were subdivided into three groups: untreated, treated with selenomethionine alone (Se-meth: 83 μg/day) and treated with Se-meth plus myo-inositol (Se-meth + Myo-I: 83 μg/day + 600 mg/day). Outcome evaluation was performed at baseline and after 6 and 12 months of treatment. High-resolution ultrasound of the thyroid gland was performed to evaluate changes in thyroid echoic pattern during the study. Compared to baseline, levels of thyroid-stimulating hormone (TSH) increased significantly in untreated patients but decreased by 31% and 38%, respectively, in those treated with Se-meth and Se-meth + Myo-I. Moreover, in the latter group the TSH reduction was observed earlier than in the Se-meth-treated group. Densitometric analysis of thyroid ultrasonography showed an echoic pattern improvement in both treated groups compared to untreated patients, although this difference was not statistically significant. Thus, Se-meth treatment is effective in patients with HT and its effect may be improved in combination with Myo-I through earlier achievement of TSH levels closer to physiological concentrations.
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Affiliation(s)
- Cinzia Pace
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Center, Via Palermo 636, 95122 Catania, Italy
| | - Dario Tumino
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Center, Via Palermo 636, 95122 Catania, Italy
| | - Marco Russo
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Center, Via Palermo 636, 95122 Catania, Italy
| | - Rosario Le Moli
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Center, Via Palermo 636, 95122 Catania, Italy
| | - Adriano Naselli
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Center, Via Palermo 636, 95122 Catania, Italy
| | - Graziella Borzì
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Center, Via Palermo 636, 95122 Catania, Italy
| | - Pasqualino Malandrino
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Center, Via Palermo 636, 95122 Catania, Italy
| | - Francesco Frasca
- Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Center, Via Palermo 636, 95122 Catania, Italy
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Khan SZA, Lungba RM, Ajibawo-Aganbi U, Veliginti S, Perez Bastidas MV, Saleem S, Cancarevic I. Minerals: An Untapped Remedy for Autoimmune Hypothyroidism? Cureus 2020; 12:e11008. [PMID: 33094039 PMCID: PMC7574993 DOI: 10.7759/cureus.11008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
For decades, the focus of managing autoimmune hypothyroidism has been on thyroxine replacement. Correcting lab parameters such as thyroid stimulating hormone (TSH) has been a primary goal. The increasing prevalence of Hashimoto’s thyroiditis (HT) continues to impact the quality of life in patients. We believe a holistic approach to this disease entity, considering its underlying complex etiopathogenesis, would benefit patients. Nutraceuticals are combinations of essential nutrients and are becoming a part of novel medical treatments despite the lack of regulation. This review aims to present a concise summary of recent developments regarding minerals such as zinc, selenium, magnesium, iron, and their potential clinical benefit as nutraceuticals in patients with HT. We have explored the potential benefits and associations of these minerals in HT and thyroid function. We reviewed relevant articles, metanalyses, and clinical trials in literature platforms such as PubMed, PubMed Central, and Google Scholar. Significant data found in the literature suggesting a potential health benefit of these minerals in HT though there were many studies to the contrary. Many trials demonstrated the restoration of residual symptoms, reversal of HT-associated thyroid morphological changes, and improvement in thyroid functions. Many of these trials lack statistical power due to the small sample sizes, and their external validity may be questionable due to unaccounted confounding factors. In our opinion, to support an evidence-based holistic clinical approach, further scientific evidence is needed. The association of these elements in thyroid function necessitates more large scale pragmatic trials to elucidate the benefits of nutraceuticals in HT.
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Affiliation(s)
- Seyad Zulficar Ali Khan
- Research and Development, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.,Primary Care & Emergency, Ministry of Health Oman, Salalah, OMN
| | - Rayan M Lungba
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Uvie Ajibawo-Aganbi
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Swathi Veliginti
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Maria V Perez Bastidas
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sania Saleem
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ivan Cancarevic
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Talebi S, Ghaedi E, Sadeghi E, Mohammadi H, Hadi A, Clark CCT, Askari G. Trace Element Status and Hypothyroidism: A Systematic Review and Meta-analysis. Biol Trace Elem Res 2020; 197:1-14. [PMID: 31820354 DOI: 10.1007/s12011-019-01963-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/29/2019] [Indexed: 12/20/2022]
Abstract
The relationship between thyroid hormones metabolism and trace element levels has biological plausibility; however, previous reports that compared trace element levels in patients with hypothyroidism and healthy individuals yielded conflicting results. Therefore, the aim of this meta-analysis was to investigate the association between selected trace elements (i.e., selenium (Se), zinc (Zn), iron (Fe), manganese (Mn), copper (Cu), lead (Pb)), and magnesium (Mg) concentrations in patients with hypothyroidism and healthy controls. Electronic databases, including PubMed, Scopus, Embase, and Science Direct, were searched systematically until September 2019. Thirty-two observational studies were included in the final analyses. Hedges' g tests were used to estimate effect sizes, as trace element concentrations were reported using different measurement units across the studies. Selenium (Hedges' g = - 0.52; 95% CI = [- 1.05, - 0.002]; P = 0.049) and Zn (Hedges' g = - 0.86; 95% CI = [- 1.66, - 0.06]; P = 0.035) concentrations were significantly lower, whereas Pb concentrations were significantly higher (Hedges' g = 0.34; 95% CI = [0.10, 0.59]; P = 0.006) in patients with hypothyroidism compared with healthy controls. There were no differences in the concentrations of Fe, Cu, Mn, and Mg between the groups. Patients with hypothyroidism exhibited lower Se and Zn and increased Pb concentrations compared with healthy controls. High-quality studies with larger sample sizes are required to explicate the link between trace element status and hypothyroidism.
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Affiliation(s)
- Sepide Talebi
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ehsan Ghaedi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Erfan Sadeghi
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
- Department of Biostatistics and Epidemiology, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamed Mohammadi
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, PO Box 81745, Isfahan, Iran
| | - Cain C T Clark
- Faculty Research Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK
| | - Gholamreza Askari
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, PO Box 81745, Isfahan, Iran.
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Hashimoto's thyroiditis: An update on pathogenic mechanisms, diagnostic protocols, therapeutic strategies, and potential malignant transformation. Autoimmun Rev 2020; 19:102649. [PMID: 32805423 DOI: 10.1016/j.autrev.2020.102649] [Citation(s) in RCA: 166] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 03/21/2020] [Indexed: 01/01/2023]
Abstract
Hashimoto's thyroiditis, characterized by thyroid-specific autoantibodies, is one of the commonest autoimmune disorders. Although the exact etiology has not been fully elucidated, Hashimoto's thyroiditis is related to an interaction among genetic elements, environmental factors and epigenetic influences. Cellular and humoral immunity play a key role in the development of the disease; thus, a T and B cells inflammatory infiltration is frequently found. Histopathologic features of the disease include lymphoplasmacytic infiltration, lymphoid follicle formation with germinal centers, and parenchymal atrophy. Moreover, the occurrence of large follicular cells and oxyphilic or Askanazy cells is frequently associated to Hashimoto's thyroiditis. Clinically, Hashimoto's thyroiditis is characterized mainly by systemic manifestations due to the damage of the thyroid gland, developing a primary hypothyroidism. Diagnosis of Hashimoto's thyroiditis is clinical and based on clinical characteristics, positivity to serum antibodies against thyroid antigens (thyroid peroxidase and thyroglobulin), and lymphocytic infiltration on cytological examination. The mainstream of treatment is based on the management of the hypothyroidism with a substitution therapy. A relationship between Hashimoto's thyroiditis and a possible malignant transformation has been proposed in several studies and involves immunological/hormonal pathogenic links although specific correlation is still debated and needs to be further investigated with prospective studies.
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Jia X, Zhai T, Zhang JA. Metformin reduces autoimmune antibody levels in patients with Hashimoto's thyroiditis: A systematic review and meta-analysis. Autoimmunity 2020; 53:353-361. [PMID: 32741222 DOI: 10.1080/08916934.2020.1789969] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND In the past few years, an increasing number of studies have proposed the idea of extending the therapeutic range of metformin from traditional hypoglycaemic to autoimmune diseases, and confirmed in a variety of autoimmune diseases. However, whether metformin can be used to treat Hashimoto's thyroiditis (HT), which is characterised by thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb), is unknown. Therefore, we conducted a systematic review and meta-analysis to evaluate whether metformin can reduce the levels of TPOAb and TgAb in patients with HT or subclinical hypothyroidism (SH), so as to provide a theoretical basis for metformin treatment of these diseases. METHODS PubMed, Web Of Science and Embase were searched for observational studies investigating the changes of TPOAb and TgAb in patients with HT after metformin treatment. Two authors extracted data from eligible studies and classified them as HT and subclinical hypothyroidism subgroups. The calculation was then performed by weighted mean difference (WMD) combined with a fixed-effects model analysis or standard mean difference (SMD) with a random-effects model analysis, based on the measurement of the outcome. RESULTS Metformin significantly reduced TPOAb levels and TgAb levels in patients with HT and SH, especially TPOAb (HT: p TPOAb = .009, p TgAb = .046; SH: p TPOAb = .034, p TgAb = .066). In addition, metformin also reduced the levels of thyroid stimulating hormone (TSH), homeostasis model assessment of insulin resistance (HOMA-IR) in patients with HT and SH (HT: p TSH = .000 and p HOMA-IR = .000; SH: p TSH = .000 and p HOMA-IR = .000, respectively). CONCLUSION Metformin significantly reduces TPOAb level and TgAb level in patients with HT and SH, especially TPOAb. This study is the first to provide a preliminary theoretical basis for the clinical application of metformin in the treatment of HT.
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Affiliation(s)
- Xi Jia
- Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Tianyu Zhai
- Department of Endocrinology and Metabolism, Zhongshan Hospital of Fudan University, Shanghai, China
| | - Jin-An Zhang
- Department of Endocrinology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
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71
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Krysiak R, Kowalcze K, Okopień B. Hyperprolactinaemia attenuates the inhibitory effect of vitamin D/selenomethionine combination therapy on thyroid autoimmunity in euthyroid women with Hashimoto’s thyroiditis: A pilot study. J Clin Pharm Ther 2020; 45:1334-1341. [DOI: 10.1111/jcpt.13214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/30/2020] [Accepted: 06/09/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology Medical University of Silesia Katowice Poland
| | - Karolina Kowalcze
- Department of Pediatrics in Bytom School of Health Sciences in KatowiceMedical University of Silesia Katowice Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology Medical University of Silesia Katowice Poland
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72
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Kaličanin D, Brčić L, Ljubetić K, Barić A, Gračan S, Brekalo M, Torlak Lovrić V, Kolčić I, Polašek O, Zemunik T, Punda A, Boraska Perica V. Differences in food consumption between patients with Hashimoto's thyroiditis and healthy individuals. Sci Rep 2020; 10:10670. [PMID: 32606353 PMCID: PMC7327046 DOI: 10.1038/s41598-020-67719-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 06/12/2020] [Indexed: 12/23/2022] Open
Abstract
Food is considered as important environmental factor that plays a role in development of Hashimoto's thyroiditis (HT). The goal of our study was to identify food groups, assessed by food frequency questionnaire, that differ in consumption frequency between 491 patients with HT and 433 controls. We also analysed association of food groups with the wealth of HT-related clinical traits and symptoms. We found significantly increased consumption of animal fat (OR 1.55, p < 0.0001) and processed meat (OR 1.16, p = 0.0012) in HT cases, whereas controls consumed significantly more frequently red meat (OR 0.80, p < 0.0001), non-alcoholic beverages (OR 0.82, p < 0.0001), whole grains (OR 0.82, p < 0.0001) and plant oil (OR 0.87, p < 0.0001). We also observed association of plant oil consumption with increased triiodothyronine levels in HT patients (β = 0.07, p < 0.0001), and, association of olive oil consumption with decreased systolic blood pressure (β = − 0.16, p = 0.001) in HT patients on levothyroxine (LT4) therapy. Analysis of food consumption between HT patients with and without LT4 therapy suggest that patients do not tend to modify their diet upon HT diagnosis in our population. Our study may be of relevance to nutritionists, nutritional therapists and clinicians involved in developing dietary recommendations for HT patients.
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Affiliation(s)
- Dean Kaličanin
- Department of Medical Biology, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia
| | - Luka Brčić
- Department of Medical Biology, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia
| | - Katija Ljubetić
- Department of Clinical Nutrition, Faculty of Health Studies, University of Rijeka, 51000, Rijeka, Croatia
| | - Ana Barić
- Department of Nuclear Medicine, University Hospital Split, 21000, Split, Croatia
| | - Sanda Gračan
- Department of Nuclear Medicine, University Hospital Split, 21000, Split, Croatia
| | - Marko Brekalo
- Department of Nuclear Medicine, University Hospital Split, 21000, Split, Croatia
| | - Vesela Torlak Lovrić
- Department of Nuclear Medicine, University Hospital Split, 21000, Split, Croatia
| | - Ivana Kolčić
- Department of Public Health, University of Split School of Medicine, 21000, Split, Croatia
| | - Ozren Polašek
- Department of Public Health, University of Split School of Medicine, 21000, Split, Croatia
| | - Tatijana Zemunik
- Department of Medical Biology, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia
| | - Ante Punda
- Department of Nuclear Medicine, University Hospital Split, 21000, Split, Croatia
| | - Vesna Boraska Perica
- Department of Medical Biology, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia.
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73
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Kim JB, Yang EY, Woo J, Kwon H, Lim W, Moon BI. Sodium Selenite Enhanced the Anti-proliferative Effect of MEK-ERK Inhibitor in Thyroid Cancer Cells. In Vivo 2020; 34:185-190. [PMID: 31882478 DOI: 10.21873/invivo.11760] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND/AIM MEK-ERK pathway plays major roles in the progression of thyroid cancer, while the use of MEK-ERK inhibitors has been limited by its toxicity. We investigated the effect of sodium selenite as an adjunct for MEK-ERK inhibitors to avoid the toxicity of ERK inhibitors. MATERIALS AND METHODS TPC1, 8505C and HTori-3 cells were treated with U0126 (MEK-ERK inhibitor) and cell viability was counted in the Neubauer chamber. The synergistic effects of sodium selenite and U0126 were also measured. The expression of ERK, p-ERK, and p90RSK was determined by western blot. RESULTS Treatment with U0126 inhibited proliferation of TPC1 and 8505C cells in a dose-dependent manner. When 5 μM sodium selenite was added to 1 μM U0126, relative cell survival further decreased. Decreased expression of p90RSK indicated that sodium selenite down-regulated ERK signaling in thyroid cancer cells. CONCLUSION The combination of U0126 and sodium selenite inhibited proliferation of thyroid cancer cells through ERK inhibition.
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Affiliation(s)
- Jong Bin Kim
- Department of Surgery, Ewha Womans University School of Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea
| | - Eun Yeol Yang
- Department of Surgery, Ewha Womans University School of Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea
| | - Joohyun Woo
- Department of Surgery, Ewha Womans University School of Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea
| | - Hyungju Kwon
- Department of Surgery, Ewha Womans University School of Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea
| | - Woosung Lim
- Department of Surgery, Ewha Womans University School of Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea
| | - Byung-In Moon
- Department of Surgery, Ewha Womans University School of Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea
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74
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Gärtner R. [Elevated TSH: when and how to treat]. MMW Fortschr Med 2020; 162:46-48. [PMID: 32578091 DOI: 10.1007/s15006-020-0616-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Roland Gärtner
- Medizinische Klinik IV, Ludwig-Maximilians-Universität München, Ziemssenstr. 1, D-80336, München, Deutschland.
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75
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Xiong X, Zhang Y, Xing H, Xu S. Ameliorative Effect of Selenomethionine on Cadmium-Induced Hepatocyte Apoptosis via Regulating PI3K/AKT Pathway in Chickens. Biol Trace Elem Res 2020; 195:559-568. [PMID: 31506910 DOI: 10.1007/s12011-019-01858-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 07/31/2019] [Indexed: 12/31/2022]
Abstract
Selenium (Se) is a trace element for human and animal health. Cadmium (Cd) is a known human carcinogen. The effects of Cd on the environment and humans are well known. Because chickens are at the top of the food chain, it is a good experimental animal model for assessing heavy metal toxicity and its potential threat to humans. Selenomethionine (Se-met) is a suitable form for nutritional Se supplementation. Therefore, the toxicity of Cd to the chicken liver and the antagonistic effects of Se-met on Cd were examined at the molecular level in the present study. The results showed that oxidative stress indicators (apoptosis-related genes, P13K/AKT pathway-related genes, and heat shock proteins (HSPs)-related genes) in the Cd group have changed significantly, indicating Cd induced hepatocyte stress and apoptosis. Interestingly, the changes in oxidative stress indicators (apoptosis-related genes, P13K/AKT pathway-related genes, and HSPs-related genes) in the Cd-Se-met group were mitigated compared with the control group. Our results indicated that Cd can induce hepatocyte apoptosis and stress in the chickens. Se-met has an ameliorative effect on Cd-induced apoptosis of chicken hepatocyte by regulating PI3K/AKT pathway. Our findings will provide a new insight for better understanding of the detoxification function of Se-met to heavy metals.
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Affiliation(s)
- Xiaoyu Xiong
- College of Veterinary Medicine, Northeast Agricultural University, 59 Mucai Street, Harbin, 150030, China
| | - Yu Zhang
- College of Animal Science and Technology, Northeast Agricultural University, 59 Mucai Street, Harbin, 150030, China
- Heilongjiang Agricultural and Rural Department, 4-1 Wenfu Street, Harbin, 150060, China
| | - Houjuan Xing
- College of Animal Science and Technology, Northeast Agricultural University, 59 Mucai Street, Harbin, 150030, China.
| | - Shiwen Xu
- College of Veterinary Medicine, Northeast Agricultural University, 59 Mucai Street, Harbin, 150030, China.
- Key Laboratory of Animal Cellular and Genetic Engineering of Heilongjiang Province, Northeast Agricultural University, 59 Mucai Street, Harbin, 150030, China.
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76
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Kim MJ, Kim SC, Chung S, Kim S, Yoon JW, Park YJ. Exploring the role of copper and selenium in the maintenance of normal thyroid function among healthy Koreans. J Trace Elem Med Biol 2020; 61:126558. [PMID: 32480050 DOI: 10.1016/j.jtemb.2020.126558] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/11/2020] [Accepted: 05/14/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Selenium and iodine are trace elements well known to have important roles in the synthesis and metabolism of thyroid hormones. However, the effects of other trace elements on thyroid hormones are still inconclusive. We investigated the association between several trace elements and thyroid hormones. METHODS The data of 448 subjects who were measured for both, trace elements and TSH/free T4, at the Heath Checkup Center were retrospectively reviewed. The presence of thyroiditis (from thyroid echogenicity) and thyroid nodules were reviewed in the subjects who underwent thyroid ultrasonography. RESULTS Blood concentrations of manganese, copper, selenium, and molybdenum were associated with TSH or free T4. After adjusting for age, sex, BMI, smoking, and alcohol consumption, blood copper levels were positively associated with free T4 in both sexes and selenium levels were positively associated with free T4 in women. There was no association between trace elements and thyroiditis. Blood copper concentration had a weak non-linear association with the presence of thyroid nodules. CONCLUSIONS This study demonstrated that blood concentrations of copper and selenium were significantly associated with free T4 in healthy Korean subjects with sufficient iodine intake suggesting their role in maintaining normal thyroid function.
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Affiliation(s)
- Min Joo Kim
- Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Soo Chin Kim
- Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Soie Chung
- Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Serim Kim
- Department of Laboratory Medicine, Green Cross Laboratories, Yongin, Gyeonggi, Republic of Korea
| | - Ji Won Yoon
- Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
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Ruggeri RM, D'Ascola A, Vicchio TM, Campo S, Gianì F, Giovinazzo S, Frasca F, Cannavò S, Campennì A, Trimarchi F. Selenium exerts protective effects against oxidative stress and cell damage in human thyrocytes and fibroblasts. Endocrine 2020; 68:151-162. [PMID: 31889242 DOI: 10.1007/s12020-019-02171-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 12/21/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE Selenium, incorporated into specific seleno-enzymes, is essential to proper thyroid function and protect cells from oxidative damage induced by H2O2 during thyroid hormone synthesis. Several studies indicated that low selenium levels are associated with thyroid autoimmunity and related disorders, but real effectiveness of selenium supplementation in such diseases is still controversial. We evaluated the effect of selenium on oxidative damage in human thyrocytes and thyroid fibroblasts in vitro. METHODS To induce oxidative stress, primary cultures were exposed to H2O2, in the presence or the absence of selenium, as either selenomethionine or selenite. We performed the following assays: cell viability, caspase-3 activity, BCL-2/BAX gene expression, DNA fragmentation, malondialdehyde levels, and glutathione peroxidase (GPx) activity measurements. RESULTS Thyrocytes and thyroid fibroblasts exposed to H2O2 and preincubated with both selenocompounds displayed a significant dose-dependent increase in cell viability compared to cells incubated with H2O2 alone. Pretreatment with selenomethionine and selenite significantly reduced caspase-3 activity and BAX mRNA levels and increased BCL-2 mRNA levels in a dose-dependent manner. Accordingly, H2O2 induced a diffuse pattern of DNA degradation and an increase in malondialdehyde levels, which was prevented by the pretreatment with both selenomethionine and selenite. Both selenocompounds induced an increase in GPx activity, suggesting that these protective effects may be, almost in part, mediated by these selenoproteins. CONCLUSION In human thyrocytes and fibroblasts in vitro, selenium exerts protective effects against H2O2 in a dose-dependent manner, being selenite effective at lower doses than selenomethionine.
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Affiliation(s)
- Rosaria M Ruggeri
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
- Endocrine Unit, University Hospital AOU Policlinico G. Martino, Messina, Italy.
| | - Angela D'Ascola
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Teresa M Vicchio
- Endocrine Unit, University Hospital AOU Policlinico G. Martino, Messina, Italy
| | - Salvatore Campo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Fiorenza Gianì
- Department of Clinical and Experimental Medicine, Endocrinology Unit, University of Catania, Catania, Italy
| | | | - Francesco Frasca
- Department of Clinical and Experimental Medicine, Endocrinology Unit, University of Catania, Catania, Italy
| | - Salvatore Cannavò
- Endocrine Unit, University Hospital AOU Policlinico G. Martino, Messina, Italy
- Department of Human Pathology DETEV, University of Messina, Messina, Italy
| | - Alfredo Campennì
- Department of Biomedical and Dental Sciences and Morfo-Functional Images, Unit of Nuclear Medicine, University of Messina, Messina, Italy
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Schomburg L. The other view: the trace element selenium as a micronutrient in thyroid disease, diabetes, and beyond. Hormones (Athens) 2020; 19:15-24. [PMID: 31823341 DOI: 10.1007/s42000-019-00150-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 10/21/2019] [Indexed: 02/08/2023]
Abstract
Antibiotics are provided for infections caused by bacteria, and statins help to control hypercholesterolemia. When hungry, you need to eat, and when you are deficient in a particular nutrient, the diet should be chosen wisely to provide what is missing. In the matter of providing the essential trace element selenium (Se), there are two different but partly overlapping views on its nature and requirements. Some consider it a medication that should be given to a subset of more or less well-defined (thyroid) patients only, in order to alleviate symptoms, to improve the course of the disease or even to provide a cure, alone or in an adjuvant mode. Such treatment attempts are conducted for a short time period, and potential medical benefits and side effects are evaluated thoroughly. One could also approach Se in medicine in a more holistic way and evaluate primarily the nutritional status of the patient before considering supplementation. The available evidence for positive health effects of supplemental Se can be interpreted as the consequence of correcting deficiency instead of speculating on a direct pharmaceutical action. This short review provides a novel view on Se in (thyroid) disease and beyond and offers an alternative explanation for its positive health effects, i.e., its provision of the substrate needed for allowing adequate endogenous expression of those selenoproteins that are required in certain conditions. In Se deficiency, the lack of the trace element constitutes the main limitation for the required adaptation of selenoprotein expression to counteract health risks and alleviate disease symptoms. Supplemental Se lifts this restriction and enables the full endogenous response of selenoprotein expression. However, since Se does not act as a pharmacological medication per se, it should not be viewed as a dangerous drug, and, importantly, current data show that supplemental Se does not cause diabetes.
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Affiliation(s)
- Lutz Schomburg
- Institute for Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
- Freie Universität Berlin, Berlin, Germany.
- Humboldt-Universität zu Berlin, Berlin, Germany.
- Berlin Institute of Health, Berlin, Suedring 10, D-13353, Berlin, Germany.
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Bednarczuk T, Schomburg L. Challenges and perspectives of selenium supplementation in Graves' disease and orbitopathy. Hormones (Athens) 2020; 19:31-39. [PMID: 31721133 PMCID: PMC7033064 DOI: 10.1007/s42000-019-00133-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 09/09/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE This review focuses on the results of prospective randomized clinical trials and the conclusions from respective meta-analyses in order to summarize experiences with adjuvant selenium (Se) supplementation in Graves' hyperthyroidism and orbitopathy, while identifying ambiguous findings and highlighting important open research issues. METHODS We searched the PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) through May 31, 2019, for relevant studies. RESULTS The available evidence concerning routine use of Se in the treatment of Graves' hyperthyroidism remains ambiguous. Results of meta-analyses, including ten RCTs, suggest that adjuvant Se supplementation can enhance the restoration of biochemical euthyroidism. Unfortunately, these results must be judged cautiously owing to several important limitations. Moreover, an in-depth analysis of relevant long-term clinical measures of therapeutic success (such as remission rate after antithyroid drug treatment), besides surrogate markers (for example, hormone or autoantibody concentrations), is generally missing. Based on a single study, Se supplementation is recommended in patients with mild orbitopathy of short duration because it may decrease inflammation and eye-specific symptoms while also achieving a marked improvement in disease-specific quality of life. The effects of Se supplementation on moderate-to-severe orbitopathy remain as yet unknown. CONCLUSIONS Additional randomized clinical trials with clinically relevant endpoints are urgently needed to further aid in clinical decision-making, including better stratification of Graves' disease patients, who are most likely to benefit from Se supplementation.
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Affiliation(s)
- Tomasz Bednarczuk
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, ul. Banacha 1a, 02-097, Warsaw, Poland.
| | - Lutz Schomburg
- Institute for Experimental Endocrinology, Charité-Universitätsmedizin Berlin, Suedring 10, 13353, Berlin, Germany.
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Mehl S, Sun Q, Görlich CL, Hackler J, Kopp JF, Renko K, Mittag J, Schwerdtle T, Schomburg L. Cross-sectional analysis of trace element status in thyroid disease. J Trace Elem Med Biol 2020; 58:126430. [PMID: 31835129 DOI: 10.1016/j.jtemb.2019.126430] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/25/2019] [Accepted: 11/01/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND The synthesis of thyroid hormone depends on a set of trace elements, most importantly selenium and iodine. The dietary supply with certain micronutrients is limited in many areas of the world, including central Europe and large parts of Asia and Africa. Moreover, both thyroid disease risk and therapy effects are modulated by trace element supply and status. OBJECTIVE Assessment of trace element status in thyroid patients in a European metropolis. MATERIAL AND METHODS Adult patients visiting a medical praxis in Berlin, Germany, were enrolled into a cross-sectional analysis, and serum samples were obtained from thyroid patients (n = 323) with different conditions including goitre, hypothyroidism, malignancy or autoimmune thyroid disease. Trace elements (iodine, selenium, copper and zinc) were assessed by ICP-MS/MS or total reflection X-ray analysis, along with two protein biomarkers of selenium status (selenoprotein P, glutathione peroxidase), and compared to the clinical phenotype. RESULTS The patients displayed relatively low serum zinc and selenium concentrations as compared to a set (n = 200) of healthy subjects (zinc; 1025+/-233 vs. 1068+/-230 μg/L, p < 0.01, selenium; 76.9+/18.8 vs. 85.1+/-17.4 μg/L, p < 0.0001). A high fraction of patients (37.5%) was classified as selenium-deficient (serum selenium concentrations <70 μg/L), in particular the patients with thyroid malignancy (59%). Serum copper was not different between the groups, and total serum iodine concentrations were unrelated to thyroid disease. Explorative statistical analyses yielded no significant interactions between the trace elements and disease parameters, except for free thyroxine inversely correlating to the copper/selenium ratio. CONCLUSIONS In adult thyroid patients, there is no relation of circulating copper, iodine, selenium or zinc concentrations to thyroid hormone. However, a large fraction of German thyroid patients displays a considerable selenium deficit, known to constitute a disease risk potentially impairing convalescence and aggravating autoimmune disease processes. It appears advisable to testing thyroid patients for selenium deficiency, and once diagnosed, an increased supply via dietary counselling or active supplementation should be considered.
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Affiliation(s)
- Sebastian Mehl
- Institute for Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Berlin, D-13353, Germany
| | - Qian Sun
- Institute for Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Berlin, D-13353, Germany
| | - Christian L Görlich
- Institute for Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Berlin, D-13353, Germany
| | - Julian Hackler
- Institute for Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Berlin, D-13353, Germany; DFG-Research Group #2558 TraceAGE, Potsdam, Berlin, Jena, Germany
| | - Johannes F Kopp
- Institute of Nutritional Science, Department of Food Chemistry, University of Potsdam, Arthur-Scheunert-Allee 114-116, Nuthetal, D-14558, Germany; DFG-Research Group #2558 TraceAGE, Potsdam, Berlin, Jena, Germany
| | - Kostja Renko
- Institute for Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Berlin, D-13353, Germany
| | - Jens Mittag
- Center of Brain, Behavior and Metabolism (CBBM), Universität zu Lübeck, Ratzeburger Allee 160, Lübeck, D-23562, Germany
| | - Tanja Schwerdtle
- Institute of Nutritional Science, Department of Food Chemistry, University of Potsdam, Arthur-Scheunert-Allee 114-116, Nuthetal, D-14558, Germany; DFG-Research Group #2558 TraceAGE, Potsdam, Berlin, Jena, Germany
| | - Lutz Schomburg
- Institute for Experimental Endocrinology, Charité - Universitätsmedizin Berlin, Berlin, D-13353, Germany; DFG-Research Group #2558 TraceAGE, Potsdam, Berlin, Jena, Germany.
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Winther KH, Rayman MP, Bonnema SJ, Hegedüs L. Selenium in thyroid disorders - essential knowledge for clinicians. Nat Rev Endocrinol 2020; 16:165-176. [PMID: 32001830 DOI: 10.1038/s41574-019-0311-6] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2019] [Indexed: 12/14/2022]
Abstract
In the 1990s, selenium was identified as a component of an enzyme that activates thyroid hormone; since this discovery, the relevance of selenium to thyroid health has been widely studied. Selenium, known primarily for the antioxidant properties of selenoenzymes, is obtained mainly from meat, seafood and grains. Intake levels vary across the world owing largely to differences in soil content and factors affecting its bioavailability to plants. Adverse health effects have been observed at both extremes of intake, with a narrow optimum range. Epidemiological studies have linked an increased risk of autoimmune thyroiditis, Graves disease and goitre to low selenium status. Trials of selenium supplementation in patients with chronic autoimmune thyroiditis have generally resulted in reduced thyroid autoantibody titre without apparent improvements in the clinical course of the disease. In Graves disease, selenium supplementation might lead to faster remission of hyperthyroidism and improved quality of life and eye involvement in patients with mild thyroid eye disease. Despite recommendations only extending to patients with Graves ophthalmopathy, selenium supplementation is widely used by clinicians for other thyroid phenotypes. Ongoing and future trials might help identify individuals who can benefit from selenium supplementation, based, for instance, on individual selenium status or genetic profile.
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Affiliation(s)
| | - Margaret Philomena Rayman
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Steen Joop Bonnema
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
| | - Laszlo Hegedüs
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.
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Winther KH, Papini E, Attanasio R, Negro R, Hegedüs L. A 2018 European Thyroid Association Survey on the Use of Selenium Supplementation in Hashimoto's Thyroiditis. Eur Thyroid J 2020; 9:99-105. [PMID: 32257959 PMCID: PMC7109430 DOI: 10.1159/000504781] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 11/14/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To investigate clinical practice regarding the use of selenium supplementation in patients with Hashimoto's thyroiditis (HT) among members of the European Thyroid Association (ETA). METHODS ETA members were invited to participate in an online survey investigating the use of selenium supplementation across the spectrum of benign thyroid diseases. Of 872 invited members, 242 (28%) completed the survey. After exclusion of basic scientists and non-European members, survey data from 212 respondents were eligible for further analyses. Responses from 65 (31%) individuals who did not at all recommend selenium, or only considered its use in the setting of a clinical trial, were not included in the final analysis of survey data from 147 respondents. RESULTS While only a minority of respondents (29 of 147, 20%) stated that the available evidence warrants the use of Se in patients with HT, a statistically significant majority (95 of 147; 65%, p < 0.001) used Se occasionally or routinely. Se was predominantly recommended for patients with HT not receiving LT4 (102 of 147; 69%) to reduce circulating thyroid autoantibody levels. Very few respondents routinely recommended Se to pregnant patients with HT. CONCLUSIONS A minority of responding ETA members stated that the available evidence warrants the use of Se in HT, but a majority recommended it to some extent, especially to patients not yet receiving LT4. This is questionable, and selenium is not recommended to patients with HT according to current ETA guidelines. Ongoing and future trials may lead to the reversal of current medical practice.
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Affiliation(s)
- Kristian Hillert Winther
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
- *Kristian Hillert Winther, Department of Endocrinology and Metabolism, Odense University Hospital, Kløvervænget 4–6, DK–5000 Odense C (Denmark), E-Mail
| | - Enrico Papini
- Department of Endocrinology and Metabolism, Ospedale Regina Apostolorum, Rome, Italy
| | | | - Roberto Negro
- Division of Endocrinology, V. Fazzi Hospital, Lecce, Italy
| | - Laszlo Hegedüs
- Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark
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Selenium supplementation in patients with subclinical hypothyroidism affected by autoimmune thyroiditis: Results of the SETI study. ENDOCRINOL DIAB NUTR 2020; 67:28-35. [DOI: 10.1016/j.endinu.2019.03.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/21/2019] [Accepted: 03/24/2019] [Indexed: 01/09/2023]
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84
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Tian X, Li N, Su R, Dai C, Zhang R. Selenium Supplementation May Decrease Thyroid Peroxidase Antibody Titer via Reducing Oxidative Stress in Euthyroid Patients with Autoimmune Thyroiditis. Int J Endocrinol 2020; 2020:9210572. [PMID: 32676110 PMCID: PMC7345605 DOI: 10.1155/2020/9210572] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 05/28/2020] [Accepted: 06/15/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Selenium, as an antioxidant, has been implicated in the development of autoimmune thyroiditis (AIT). Many studies showed selenium supplementation could decrease thyroid autoantibodies in patients with AIT. However, the underlying mechanisms have not been well determined. Therefore, we performed a clinical study to investigate the possible mechanism of beneficial effects of selenium treatment on AIT patients. METHODS Forty euthyroid patients with AIT were randomized into two groups. Group I was treated with 200 μg/day selenium supplementation, and group II received a placebo over a 3-month period. Thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), antithyroglobulin antibody (TgAb), malondialdehyde (MDA), total antioxidant capacity (TAC), and superoxide dismutase (SOD) were measured before and 3 months after treatments. Additionally, twenty healthy volunteers also served as a control group for the evaluation of such parameters in basic condition. RESULTS Totally, 32 patients (group I, n = 18; group II, n = 14) completed the clinical study and were incorporated into the statistics. MDA level was higher and SOD activity and TAC were lower in patients compared to healthy individuals. After 3 months, TPOAb titer significantly decreased within group I (P < 0.001) but did not change within group II (P=0.001). There were also no statistically significant changes in TSH and TgAb titers within the two groups (all P > 0.05). Additionally, decreased MDA level (from 6.8 ± 1.3 nmol/ml to 4.9 ± 0.7 nmol/ml; P < 0.001) and increased TAC (from 10.0 ± 1.9 mmol/l to 12.9 ± 3.1 mmol/l; P=0.003) and SOD activity (from 72.3 ± 10.3 U/ml to 84.3 ± 13.2 U/ml; P=0.007) were simultaneously observed after 3 months' selenium treatment. Moreover, there was a negative correlation between TAC and TgAb/TPOAb and a positive correlation between MDA and TgAb/TPOAb in AIT patients. CONCLUSIONS Our findings support the hypothesis that selenium treatment could decrease TPOAb titer via enforcing the defense against oxidative stress in euthyroid patients with AIT, which may be a potential underlying mechanism.
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Affiliation(s)
- Xun Tian
- Tianjin Institute of Hepatology, Tianjin Second People's Hospital, Tianjin, China
| | - Ning Li
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Rui Su
- Tianjin Institute of Hepatology, Tianjin Second People's Hospital, Tianjin, China
| | - Chenyang Dai
- Tianjin Institute of Hepatology, Tianjin Second People's Hospital, Tianjin, China
| | - Ruiguo Zhang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
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85
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Min Y, Wang X, Chen H, Yin G. The exploration of Hashimoto's Thyroiditis related miscarriage for better treatment modalities. Int J Med Sci 2020; 17:2402-2415. [PMID: 33029083 PMCID: PMC7532476 DOI: 10.7150/ijms.48128] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/21/2020] [Indexed: 12/25/2022] Open
Abstract
Hashimoto's thyroiditis (HT) is the most prevalent autoimmune thyroid disease (ATD) worldwide and is strongly associated with miscarriage and even recurrent miscarriage (RM). Moreover, with a deepening understanding, emerging evidence has shown that immune dysfunctions caused by HT conditions, including imbalanced subsets of CD4+ T-helper cells, B regulatory (Breg) cells, high expression levels of CD56dim natural killer (NK) cells, and cytokines, possibly play an important role in impairing maternal tolerance to the fetus. In recent years, unprecedented progress has been made in recognizing the specific changes in immune cells and molecules in patients with HT, which will be helpful in exploring the mechanism of HT-related miscarriage. Based on these findings, research investigating some potentially more effective treatments, such as selenium (Se), vitamin D3, and intravenous immunoglobulin (IVIG), has been well developed over the past few years. In this review, we highlight some of the latest advances in the possible immunological pathogenesis of HT-related miscarriage and focus on the efficacies of treatments that have been widely introduced to clinical trials or practice described in the most recent literature.
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Affiliation(s)
- Yu Min
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, No.74, Linjiang Rd, Yuzhong Dist, Chongqing 404100, China
| | - Xing Wang
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, No.74, Linjiang Rd, Yuzhong Dist, Chongqing 404100, China
| | - Hang Chen
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, No.74, Linjiang Rd, Yuzhong Dist, Chongqing 404100, China
| | - Guobing Yin
- Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, No.74, Linjiang Rd, Yuzhong Dist, Chongqing 404100, China
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86
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Wojtas N, Wadolowska L, Bandurska-Stankiewicz E. Evaluation of Qualitative Dietary Protocol (Diet4Hashi) Application in Dietary Counseling in Hashimoto Thyroiditis: Study Protocol of a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4841. [PMID: 31810194 PMCID: PMC6926951 DOI: 10.3390/ijerph16234841] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 11/27/2019] [Accepted: 11/29/2019] [Indexed: 01/12/2023]
Abstract
The current state of knowledge related to diet in Hashimoto thyroiditis (HT) is far from satisfactory, as many HT subjects experience several disorders and report reduced quality of life. There are three aims of the study: (1) to develop a qualitative dietary protocol (QDP; 'Diet4Hashi') as a simple, graphic-text tool dedicated to TH subjects, (2) to evaluate the use of the QDP in dietetic counseling compared to conventional dietetic counseling (CDC) in HT women, and (3) to assess the impact of both the QDP and the CDC on the diet quality, quality of life, adiposity, and metabolic parameters of HT women. The QDP is based on subject self-monitoring supported with a graphic-text tool to help them in food selection and adequate food frequency consumption, while the CDC on oral explanation and printed sample menus were provided by a dietician. The QDP contains two lists: (A) foods recommended for consumption and (B) foods with limited consumption, along with indicated consumption frequency per day/week/month. Both approaches include the same dietary recommendations for HT extracted from the literature but differ in subject-dietician cooperation. To summarize the evidence regarding dietary recommendations in HT, the PubMed, Embase, and Cochrane Library databases (to March 2019) and the bibliographies of key articles were searched. The study is designed as a dietary intervention lasting six months in two parallel groups: experimental and control. In the experimental group, the QDP will be applied, while in the control group, the CDC will be applied. In total, the study will include a baseline of 100 women with diagnosed HT. The subjects will be randomly allocated into the experimental/control groups (50/50). Data related to diet quality and other lifestyle factors, nutrition knowledge, quality of life, thyroid function, body composition, blood pressure, serum fasting glucose, and lipid profile at baseline and after a six-month follow-up will be collected. This study was conducted to develop a dietary protocol (Diet4Hashi) that is easy to follow for HT subjects, and it will contribute to providing valuable data that are useful to dieticians and physicians. It is anticipated that this graphic-text qualitative dietary protocol, by improving food selection and diet quality, may reduce adiposity and improve metabolic parameters and the quality of life of HT women.
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Affiliation(s)
- Natalia Wojtas
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland;
| | - Lidia Wadolowska
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland;
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Krysiak R, Kowalcze K, Okopień B. The effect of testosterone on thyroid autoimmunity in euthyroid men with Hashimoto's thyroiditis and low testosterone levels. J Clin Pharm Ther 2019; 44:742-749. [PMID: 31183891 DOI: 10.1111/jcpt.12987] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 05/02/2019] [Accepted: 05/17/2019] [Indexed: 01/23/2023]
Abstract
WHAT IS KNOWN AND OBJECTIVE Thyroid autoimmune diseases occur much more frequently in women than men. Unfortunately, no previous study has determined whether sex hormones produce any effect on thyroid antibody titres. The primary study aim was to assess whether exogenous testosterone affects thyroid autoimmunity in men with Hashimoto's thyroiditis and low testosterone levels. METHODS The study population consisted of 34 euthyroid men with autoimmune thyroiditis and testosterone deficiency. On the basis of patient preference, these patients were either treated with oral testosterone undecanoate (120 mg daily; n = 16) or remained untreated (n = 18). Circulating levels of thyrotropin, free thyroxine, free triiodothyronine, prolactin and total testosterone, as well as serum titres of thyroid peroxidase and thyroglobulin antibodies, were measured at the beginning of the study and 6 months later. The structure parameters of thyroid homeostasis (Jostel's thyrotropin index, SPINA-GT and SPINA-GD) were also calculated. Moreover, semen analyses were performed in eight patients in each group. RESULTS AND DISCUSSION In testosterone-naïve men, serum hormone levels and antibody titres remained at the similar levels throughout the study. Apart from increasing serum testosterone levels, testosterone undecanoate reduced titres of thyroid peroxidase and thyroglobulin antibodies and increased SPINA-GT. The drug produced a neutral effect on circulating levels of thyrotropin, free thyroid hormones, prolactin and testosterone, Jostel's thyrotropin index, SPINA-GD and semen parameters. Testosterone-induced changes in antibody titres correlated with the effect of treatment on SPINA-GT and with serum testosterone levels. WHAT IS NEW AND CONCLUSION This study is the first one to have shown that exogenous testosterone may have a protective effect on thyroid autoimmunity in men with Hashimoto's thyroiditis and testosterone deficiency.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
| | - Karolina Kowalcze
- Department of Paediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
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Krysiak R, Kowalcze K, Okopień B. The Effect of Selenomethionine on Thyroid Autoimmunity in Euthyroid Men With Hashimoto Thyroiditis and Testosterone Deficiency. J Clin Pharmacol 2019; 59:1477-1484. [DOI: 10.1002/jcph.1447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 04/29/2019] [Indexed: 12/23/2022]
Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical PharmacologyMedical University of Silesia Katowice Poland
| | - Karolina Kowalcze
- Department of Paediatrics in BytomSchool of Health Sciences in KatowiceMedical University of Silesia Katowice Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical PharmacologyMedical University of Silesia Katowice Poland
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Krysiak R, Szkróbka W, Okopień B. Atorvastatin potentiates the effect of selenomethionine on thyroid autoimmunity in euthyroid women with Hashimoto's thyroiditis. Curr Med Res Opin 2019; 35:675-681. [PMID: 30354702 DOI: 10.1080/03007995.2018.1541314] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE In many studies, selenium supplementation decreased serum titers of thyroid antibodies. The aim of the study was to investigate whether statin therapy determines selenium action on thyroid autoimmunity. METHODS This prospective case-control study enrolled 42 euthyroid women with Hashimoto's thyroiditis and normal vitamin D status, 20 of whom had been treated with atorvastatin (40 mg daily) for at least 6 months. All patients received selenomethionine (200 µg daily) for 6 months. Plasma levels of lipids, serum titers of thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) antibodies, as well as serum levels of thyrotropin, free thyroid hormones, and 25-hydroxyvitamin D were determined at the beginning and at the end of the study. RESULTS At baseline, there were no differences between both treatment arms in plasma lipids, titers of thyroid antibodies, serum levels of thyrotropin, free thyroid hormones, and 25-hydroxyvitamin D. Selenometionine decreased titers of TPOAb (from 843 ± 228 to 562 ± 189 U/mL) and TgAb (from 795 ± 286 to 501 ± 216 U/mL) in atorvastatin-treated women, as well as titers of TPOAb (from 892 ± 247 to 705 ± 205 U/mL) and TgAb (from 810 ± 301 to 645 ± 224 U/mL) in statin-naive women. The changes in antibody titers were more pronounced in women receiving atorvastatin (between-group difference: 94 [32-156] [TPOAb]; 129 [52-206] [TgAb]). Treatment-induced changes in TPOAb and TgAb correlated positively with baseline thyroid antibody titers. Circulating levels of lipids, free thyroxine, free triiodothyronine, and 25-hydroxyvitamin D remained at similar levels throughout the study. CONCLUSIONS The obtained results indicate that the decrease in titers of thyroid antibodies was potentiated by atorvastatin use.
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Affiliation(s)
- Robert Krysiak
- a Department of Internal Medicine and Clinical Pharmacology , Medical University of Silesia , Katowice , Poland
| | - Witold Szkróbka
- a Department of Internal Medicine and Clinical Pharmacology , Medical University of Silesia , Katowice , Poland
| | - Bogusław Okopień
- a Department of Internal Medicine and Clinical Pharmacology , Medical University of Silesia , Katowice , Poland
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90
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Bachiega P, de Almeida E, Salgado JM, Arruda MAZ, Lehmann EL, Morzelle MC, de Carvalho HWP. Benchtop and Handheld Energy-Dispersive X-Ray Fluorescence (EDXRF) as Alternative for Selenium Concentration Measurement in Biofortified Broccoli Seedling. FOOD ANAL METHOD 2019. [DOI: 10.1007/s12161-019-01489-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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91
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Krysiak R, Kowalcze K, Okopień B. Selenomethionine potentiates the impact of vitamin D on thyroid autoimmunity in euthyroid women with Hashimoto's thyroiditis and low vitamin D status. Pharmacol Rep 2018; 71:367-373. [PMID: 30844687 DOI: 10.1016/j.pharep.2018.12.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/14/2018] [Accepted: 12/14/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Both exogenous vitamin D and selenium reduce thyroid antibody titers. The aim of the study was to investigate whether the impact of vitamin D on thyroid autoimmunity is affected by selenium intake. METHODS The study included 47 euthyroid women with Hashimoto's thyroiditis and low vitamin D status, 23 of whom had been treated with selenomethionine (200 μg daily) for at least 12 months before the beginning of the study. During the study, all patients were treated with vitamin D preparations (4000 IU daily). Serum titers of thyroid peroxidase and thyroglobulin antibodies, as well as circulating levels of thyrotropin, free thyroid hormones and 25-hydroxyvitamin D were measured before vitamin D supplementation and 6 months later. Moreover, at the beginning and at the end of the study, we calculated Jostel's thyrotropin index, the SPINA-GT index and the SPINA-GD index. RESULTS With the exception of the free triiodothyronine/free thyroxine ratio and the SPINA-GD index, there were no differences between the study groups. In both groups, vitamin D increased 25-hydroxyvitamin D levels, reduced thyroid peroxidase and thyroglobulin antibody titers, as well as increased the SPINA-GT index. The effects on antibody titers and the SPINA-GT index were more pronounced in women receiving selenomethionine. Neither in selenomethionine-treated nor in selenomethionine-naïve women vitamin D affected serum hormone levels, Jostel's index and the SPINA-GD index. CONCLUSIONS The results of the study suggest that selenium intake enhances the effect of vitamin D on thyroid autoimmunity.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
| | - Karolina Kowalcze
- Department of Paediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
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92
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Wang W, Mao J, Zhao J, Lu J, Yan L, Du J, Lu Z, Wang H, Xu M, Bai X, Zhu L, Fan C, Wang H, Zhang H, Shan Z, Teng W. Decreased Thyroid Peroxidase Antibody Titer in Response to Selenium Supplementation in Autoimmune Thyroiditis and the Influence of a Selenoprotein P Gene Polymorphism: A Prospective, Multicenter Study in China. Thyroid 2018; 28:1674-1681. [PMID: 30398407 DOI: 10.1089/thy.2017.0230] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background: Recent intervention studies have suggested that selenium (Se) is an effective treatment for autoimmune thyroiditis (AIT). However, the exact effect of Se on AIT is unclear as well as the mechanism of action. The aim of the present study was to explore the effect of Se on thyroid peroxidase antibody (TPOAb) titers in patients with AIT and to analyze the potential impact of the genetic background on the effect of Se supplementation. Methods: This was a randomized, placebo-controlled, double-blind trial. Three hundred and sixty-four patients with elevated TPOAb (>300 IU/mL) were recruited and randomized to receive Se yeast 200 μg/day supplementation or placebo. Urinary iodine concentration, serum thyrotropin, free thyroxine, TPOAb, Se, malondialdehyde, and serum glutathione peroxidase activity were measured at baseline and follow-up. Ninety-six patients were genotyped for single nucleotide polymorphism r25191G/A in the selenoprotein P (SEPP1/SELENOP) gene. Results: The median urinary iodine concentration was 182 μg/L. Serum Se increased significantly (p < 0.001) after Se treatment. TPOAb titer decreased by 10.0% at 3 months and by 10.7% at 6 months after Se supplementation, while there was a moderate increase in TPOAb titers over the follow-up period in patients receiving placebo. Glutathione peroxidase activity significantly increased (p < 0.001), and malondialdehyde significantly decreased (p < 0.001) after 6 months of Se supplementation. TPOAb titers decreased to variable extents in patients with different genotypes of single nucleotide polymorphism r25191G/A after Se supplementation. Serum TPOAb titers in patients with the AA genotype showed a more significant decrease (by 46.2%) than those with the GA and GG genotypes (by 14.5 and 9.8% respectively) at 3 months of Se supplementation (p = 0.070). Conclusions: Se supplementation significantly reduced TPOAb titers in patients with AIT, and there may be an important genetic component influencing interindividual differences in the decrease in TPOAb titers.
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Affiliation(s)
- Weiwei Wang
- The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Department of Endocrinology and Metabolism, The First Hospital of China Medical University, Shenyang, China
| | - Jinyuan Mao
- The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Department of Endocrinology and Metabolism, The First Hospital of China Medical University, Shenyang, China
| | - Jiajun Zhao
- Department of Endocrinology and Metabolism, ShanDong Provincial Hospital, JiNan, China
| | - Juming Lu
- Department of Endocrinology and Metabolism, The General Hospital of the People's Liberation Army, Bejing, China
| | - Li Yan
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jianling Du
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Zhaohui Lu
- Department of Endocrinology and Metabolism, The General Hospital of the People's Liberation Army, Bejing, China
| | - Hai Wang
- Department of Endocrinology and Metabolism, ShanDong Provincial Hospital, JiNan, China
| | - Mingtong Xu
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xue Bai
- The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Department of Endocrinology and Metabolism, The First Hospital of China Medical University, Shenyang, China
| | - Lin Zhu
- The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Department of Endocrinology and Metabolism, The First Hospital of China Medical University, Shenyang, China
| | - Chenling Fan
- The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Department of Endocrinology and Metabolism, The First Hospital of China Medical University, Shenyang, China
| | - Hong Wang
- The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Department of Endocrinology and Metabolism, The First Hospital of China Medical University, Shenyang, China
| | - Hongmei Zhang
- The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Department of Endocrinology and Metabolism, The First Hospital of China Medical University, Shenyang, China
| | - Zhongyan Shan
- The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Department of Endocrinology and Metabolism, The First Hospital of China Medical University, Shenyang, China
| | - Weiping Teng
- The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Department of Endocrinology and Metabolism, The First Hospital of China Medical University, Shenyang, China
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93
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Krysiak R, Szkróbka W, Okopień B. The effect of vitamin D and selenomethionine on thyroid antibody titers, hypothalamic-pituitary-thyroid axis activity and thyroid function tests in men with Hashimoto's thyroiditis: A pilot study. Pharmacol Rep 2018; 71:243-247. [PMID: 30818086 DOI: 10.1016/j.pharep.2018.10.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 09/22/2018] [Accepted: 10/23/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Both selenium and vitamin D were found to reduce thyroid antibody titers in women with Hashimoto's thyroiditis. METHODS The study enrolled 37 young drug-naïve euthyroid men with autoimmune thyroiditis, who were treated for 6 months with either exogenous vitamin D (group A, n = 20) or selenomethionine (group B, n = 17). Serum titers of thyroid peroxidase and thyroglobulin antibodies, serum levels of thyrotropin and free thyroid hormones, serum levels of 25-hydroxyvitamin D, as well Jostel's thyrotropin, the SPINA-GT and the SPINA-GD indices were determined at the beginning and at the end of the study. RESULTS At baseline, there were no differences between the study groups. Both vitamin D and selenomethionine reduced antibody titers and increased the SPINA-GT index. Only selenomethionine affected the SPINA-GD index, while only vitamin D increased 25-hydroxyvitamin D levels. Neither selenomethionine nor vitamin D significantly affected thyrotropin and free thyroid hormone levels. The effect of vitamin D on antibody titers correlated with baseline and treatment-induced changes in serum levels of 25-hydroxivitamin D. CONCLUSIONS Both vitamin D and selenomethionine have a beneficial effect on thyroid autoimmunity in drug-naïve men with Hashimoto's thyroiditis.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
| | - Witold Szkróbka
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
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Kyrgios I, Giza S, Kotanidou EP, Kleisarchaki A, Tsinopoulou VR, Papadopoulou A, Markantonatou AM, Kanellidou E, Giannakou A, Galli-Tsinopoulou A. l
-selenomethionine supplementation in children and adolescents with autoimmune thyroiditis: A randomized double-blind placebo-controlled clinical trial. J Clin Pharm Ther 2018; 44:102-108. [DOI: 10.1111/jcpt.12765] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 08/25/2018] [Accepted: 09/11/2018] [Indexed: 01/04/2023]
Affiliation(s)
- Ioannis Kyrgios
- 4th Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Papageorgiou General Hospital; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Styliani Giza
- 4th Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Papageorgiou General Hospital; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Eleni P. Kotanidou
- 4th Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Papageorgiou General Hospital; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Angeliki Kleisarchaki
- 4th Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Papageorgiou General Hospital; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Vasiliki Rengina Tsinopoulou
- 4th Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Papageorgiou General Hospital; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Anastasia Papadopoulou
- 4th Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Papageorgiou General Hospital; Aristotle University of Thessaloniki; Thessaloniki Greece
| | | | - Eleni Kanellidou
- Department of Immunology; Papageorgiou General Hospital; Thessaloniki Greece
| | - Anastasia Giannakou
- Department of Immunology; Papageorgiou General Hospital; Thessaloniki Greece
| | - Assimina Galli-Tsinopoulou
- 4th Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Papageorgiou General Hospital; Aristotle University of Thessaloniki; Thessaloniki Greece
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95
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Santos LR, Neves C, Melo M, Soares P. Selenium and Selenoproteins in Immune Mediated Thyroid Disorders. Diagnostics (Basel) 2018; 8:diagnostics8040070. [PMID: 30287753 PMCID: PMC6316875 DOI: 10.3390/diagnostics8040070] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 09/21/2018] [Accepted: 09/29/2018] [Indexed: 01/16/2023] Open
Abstract
Selenium is an essential micronutrient that is required for the synthesis of selenocysteine-containing selenoproteins, processing a wide range of health effects. It is known that the thyroid is one of the tissues that contain more selenium. The “selenostasis” maintenance seems to contribute to the prevention of immune mediated thyroid disorders. Prospective, observational studies, randomized, controlled studies evaluating selenium supplementation, and review articles that are available in Medline and PubMed have undergone scrutiny. The differences concerning methodology and results variability have been analyzed. Several authors support the idea of a potential efficacy of selenium (mainly selenomethionine) supplementation in reducing antithyroperoxidase antibody levels and improve thyroid ultrasound features. In mild Graves’ orbitopathy, selenium supplementation has been associated with a decrease of the activity, as well as with quality of life improvement. Future research is necessary to clearly understand the selenium supplementation biologic effects while considering the basal selenium levels/biomarkers, selenoprotein gene polymorphisms that may be involved, underlying comorbidities and the major clinical outcomes.
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Affiliation(s)
- Liliana R Santos
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), 4200-135 Porto, Portugal.
- Serviço de Medicina 2B-Hospital de Santa Maria/Centro Hospitalar Lisboa Norte, 1649-035 Lisboa, Portugal.
- Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
| | - Celestino Neves
- Endocrinology Service, Hospital Center São João, 4200-319 Porto, Portugal.
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, 4200-135 Porto, Portugal.
| | - Miguel Melo
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), 4200-135 Porto, Portugal.
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, 4200-135 Porto, Portugal.
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal.
- Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal.
| | - Paula Soares
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), 4200-135 Porto, Portugal.
- Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
- Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, 4200-135 Porto, Portugal.
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96
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Zheng H, Wei J, Wang L, Wang Q, Zhao J, Chen S, Wei F. Effects of Selenium Supplementation on Graves' Disease: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2018; 2018:3763565. [PMID: 30356415 PMCID: PMC6178160 DOI: 10.1155/2018/3763565] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 08/07/2018] [Indexed: 01/09/2023]
Abstract
Low selenium status is associated with increased risk of Graves' disease (GD). While several trials have discussed the efficacy of selenium supplementation for thyroid function, in GD patients, the effectiveness of selenium intake as adjuvant therapy remains unclear. In this systematic review and meta-analysis, we aimed to determine the efficacy of selenium supplementation on thyroid function in GD patients. Two reviewers searched PubMed, Web of Science, the Cochrane Central Register of Controlled Trials, and four Chinese databases for studies published up to October 31, 2017. RCTs comparing the effect of selenium supplementation on thyroid hyperfunction in GD patients on antithyroid medication to placebo were included. Serum free thyroxine (FT4), free triiodothyronine (FT3), thyrotrophic hormone receptor antibody (TRAb), and thyroid-stimulating hormone (TSH) levels were assessed. Ten trials involving 796 patients were included. Random-effects meta-analyses in weighted mean difference (WMD) were performed for 3, 6, and 9 months of supplementation and compared to placebo administration. Selenium supplementation significantly decreased FT4 (WMD=-0.86 [confidence interval (CI)-1.20 to -0.53]; p=0.756; I2=0.0%) and FT3 (WMD=-0.34 [CI-0.66 to -0.02]; p=0.719; I2=0.0%) levels at 3 months, compared to placebo administration; these findings were consistent at 6 but not 9 months. TSH levels were more elevated in the group of patients taking selenium than in the control group at 3 and 6, but not 9 months. TRAb levels decreased at 6 but not 9 months. At 6 months, patients on selenium supplementation were more likely than controls to show improved thyroid function; however, the effect disappeared at 9 months. Whether these effects correlate with clinically relevant measures remains to be demonstrated.
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Affiliation(s)
- Huijuan Zheng
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 Beixiange Street, Xicheng District, Beijing, 100053, China
| | - Junping Wei
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 Beixiange Street, Xicheng District, Beijing, 100053, China
| | - Liansheng Wang
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 Beixiange Street, Xicheng District, Beijing, 100053, China
| | - Qiuhong Wang
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 Beixiange Street, Xicheng District, Beijing, 100053, China
| | - Jing Zhao
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 Beixiange Street, Xicheng District, Beijing, 100053, China
| | - Shuya Chen
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 Beixiange Street, Xicheng District, Beijing, 100053, China
| | - Fan Wei
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 Beixiange Street, Xicheng District, Beijing, 100053, China
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97
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Multiple nutritional factors and thyroid disease, with particular reference to autoimmune thyroid disease. Proc Nutr Soc 2018; 78:34-44. [DOI: 10.1017/s0029665118001192] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Hashimoto's thyroiditis (HT) and Graves’ disease (GD) are examples of autoimmune thyroid disease (AITD), the commonest autoimmune condition. Antibodies to thyroid peroxidase (TPO), the enzyme that catalyses thyroid-hormone production and antibodies to the receptor for the thyroid-stimulating hormone, are characteristic of HT and GD, respectively. It is presently accepted that genetic susceptibility, environmental factors, including nutritional factors and immune disorders contribute to the development of AITD. Aiming to investigate the effect of iodine, iron and selenium in the risk, pathogenesis and treatment of thyroid disease, PubMed and the Cochrane Library were searched for relevant publications to provide a narrative review.Iodine: chronic exposure to excess iodine intake induces autoimmune thyroiditis, partly because highly-iodinated thyroglobulin (Tg) is more immunogenic. The recent introduction of universal salt iodisation can have a similar, although transient, effect.Iron: iron deficiency impairs thyroid metabolism. TPO is a haem enzyme that becomes active only after binding haem. AITD patients are frequently iron-deficient since autoimmune gastritis, which reduces iron absorption and coeliac disease which causes iron loss, are frequent co-morbidities. In two-thirds of women with persistent symptoms of hypothyroidism despite appropriate levothyroxine therapy, restoration of serum ferritin above 100 µg/l ameliorated symptoms.Selenium: selenoproteins are essential to thyroid action. In particular, the glutathione peroxidases remove excessive hydrogen peroxide produced there for the iodination of Tg to form thyroid hormones. There is evidence from observational studies and randomised controlled trials that selenium, probably as selenoproteins, can reduce TPO-antibody concentration, hypothyroidism and postpartum thyroiditis. Appropriate status of iodine, iron and selenium is crucial to thyroid health.
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98
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Avery JC, Hoffmann PR. Selenium, Selenoproteins, and Immunity. Nutrients 2018; 10:E1203. [PMID: 30200430 PMCID: PMC6163284 DOI: 10.3390/nu10091203] [Citation(s) in RCA: 457] [Impact Index Per Article: 76.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 08/29/2018] [Accepted: 08/30/2018] [Indexed: 12/14/2022] Open
Abstract
Selenium is an essential micronutrient that plays a crucial role in development and a wide variety of physiological processes including effect immune responses. The immune system relies on adequate dietary selenium intake and this nutrient exerts its biological effects mostly through its incorporation into selenoproteins. The selenoproteome contains 25 members in humans that exhibit a wide variety of functions. The development of high-throughput omic approaches and novel bioinformatics tools has led to new insights regarding the effects of selenium and selenoproteins in human immuno-biology. Equally important are the innovative experimental systems that have emerged to interrogate molecular mechanisms underlying those effects. This review presents a summary of the current understanding of the role of selenium and selenoproteins in regulating immune cell functions and how dysregulation of these processes may lead to inflammation or immune-related diseases.
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Affiliation(s)
- Joseph C Avery
- Department of Cell and Molecular Biology, John A. Burns School of Medicine, University of Hawaii, 651 Ilalo Street, Honolulu, HI 96813, USA.
| | - Peter R Hoffmann
- Department of Cell and Molecular Biology, John A. Burns School of Medicine, University of Hawaii, 651 Ilalo Street, Honolulu, HI 96813, USA.
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99
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A case report of a novel, integrative approach to Hashimoto’s thyroiditis with unexpected results. ADVANCES IN INTEGRATIVE MEDICINE 2018. [DOI: 10.1016/j.aimed.2018.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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100
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Valea A, Georgescu CE. Selenoproteins in human body: focus on thyroid pathophysiology. Hormones (Athens) 2018; 17:183-196. [PMID: 29873029 DOI: 10.1007/s42000-018-0033-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 04/18/2018] [Indexed: 02/07/2023]
Abstract
Selenium (Se) has a multilevel, complex and dynamic effect on the human body as a major component of selenocysteine, incorporated into selenoproteins, which include the selenocysteine-containing enzymes iodothyronine deiodinases. At the thyroid level, these proteins play an essential role in antioxidant protection and hormone metabolism. This is a narrative review based on PubMed/Medline database research regarding thyroid physiology and conditions with Se and Se-protein interferences. In humans, Se-dependent enzyme functions are best expressed through optimal Se intake, although there is gap in our knowledge concerning the precise mechanisms underlying the interrelation. There is a good level of evidence linking low serum Se to autoimmune thyroid diseases and, to a lesser extent, differentiated thyroid cancer. However, when it comes to routine supplementation, the results are heterogeneous, except in the case of mild Graves' orbitopathy. Autoimmune hypothyroidism is associated with a state of higher oxidative stress, but not all studies found an improvement of thyroid function after Se was introduced as antioxidant support. Meanwhile, no routine supplementation is recommended. Low Se intake is correlated with an increased risk of developing antithyroid antibodies, its supplementation decreasing their titres; there is also a potential reduction in levothyroxine replacement dose required for hypothyroidism and/or the possibility that it prevents progression of subclinical hypothyroidism, although not all studies agree. In thyroid-associated orbitopathy, euthyroidism is more rapidly achieved if the micronutrient is added to traditional drugs, while controls appear to benefit from the microelement only if they are deficient; thus, a basal assay of Se appears advisable to better select patients who need substitution. Clearly, further Se status biomarkers are required. Future introduction of individual supplementation algorithms based on baseline micronutrient levels, underlying or at-risk clinical conditions, and perhaps selenoprotein gene polymorphisms is envisaged.
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Affiliation(s)
- Ana Valea
- Department of Endocrinology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
- Endocrinology Clinic, Clinical County Hospital, Cluj-Napoca, Romania.
- , Cluj-Napoca, Romania.
| | - Carmen Emanuela Georgescu
- Department of Endocrinology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Endocrinology Clinic, Clinical County Hospital, Cluj-Napoca, Romania
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