An alternative therapy for graves' disease: clinical effects and mechanisms of an herbal remedy

Emerging therapeutic role of Prunella vulgaris in thyroid disease

Thyroid disease is characterized by unusual levels of thyroid hormones, which results in either hyperthyroidism or hypothyroidism. The pathology of a particular type or stage of thyroid disease is very complicated, and always linked to a variety of biological functions. Although the mortality rate is not high, thyroid dysfunction could lead to metabolic and immunological disorders that can subsequently cause discomfort. To date, many drugs are suggested to have curative effects on thyroid disease, however, drug toxicity and long treatment periods encourage the search for more promising ones. Prunella vulgaris L. (Labiatae) is a popular herb that has shown great potential for improving human immunity and organ protection. It has been extensively used in the treatment of many diseases but its ability to treat specific diseases has not been fully reported. In this review, a literature search regarding herbs and herbal recipes for treating thyroid disease were carried out, organized, and summarized. In addition, this study conducted a literature search on the current situation and progress of P. vulgaris treatment for various diseases. Finally, this study discussed studies regarding P. vulgaris treatment of goiter, and the mechanism of treatment through the regulation of apoptosis. Accordingly, a combination therapy of herbs and Western medicine can provide significant therapeutic effects in the clinical treatment of thyroid disease. Furthermore, the association between P. vulgaris and various diseases suggests that P. vulgaris is rich in a variety of active substances that can fight oxidation and participate in the regulation of apoptosis, thus having a protective effect on the thyroid. Here, a comprehensive literature review regarding the application of herbs or herbal recipes in the treatment of thyroid disease was presented. It is concluded that there is strong evidence for further research regarding the use of P. vulgaris in the treatment of thyroid diseases.

Derivation and 97% Purification of Human Thyroid Cells From Dermal Fibroblasts

Background: The success in rescuing thyroid deficiency in mice using thyroid cells derived from embryonic stem (ES) cells, together with the discovery of human induced pluripotent stem cells (iPSCs) from somatic cells, has raised the possibility of patient-specific thyroid cell replacement. In this study we demonstrate that human thyroid follicular cells can be derived from human iPSCs and show the ability of highly purified and differentiated cells to secrete thyroid hormone. Research Design and Methods: Human iPSCs were derived from adult skin fibroblasts using RNA reprogramming and differentiated in vitro into thyroid follicular cells by exposure to activin A, ethacridine and TSH as we have previously described for human ES cells. The resulting thyroid cells were then highly purified using double antibody cell sorting. Results: The iPSCs derived from human dermal fibroblasts showed stem cell-like morphologic changes and expressed pluripotent stem cell markers as assessed using qPCR, immunofluorescence staining, and FACS analysis. These cells retained their pluripotential characteristics as shown by teratoma formation after murine transplantation. Definitive endoderm cells were induced with activin A and the transcription factor TAZ was significantly induced on ethacridine treatment and translocated to the nucleus. Thyroid transcription factors NKX2-1 and PAX8 were also highly expressed in activin A derived endoderm cells and further induced by ethacridine. Following terminal differentiation with TSH, there was enhanced thyroid follicle formation, high expression of the thyroid specific genes-TG, TPO, TSHR and NIS, and secretion of thyroid hormone (T4) in vitro. Furthermore, we were able to achieve a 97% purification of TSHR+/NIS+ expressing cells after differentiation using a single purification procedure. Conclusions: These findings demonstrate that mature adult dermal fibroblasts can be matured into human iPSCs which have the potential to form functional thyroid follicular cells. This lays the groundwork for future person-specific thyroid regenerative therapy.

Therapeutic Effect of Scutellaria baicalensis on L-Thyroxine-Induced Hyperthyroidism Rats

Background

This study was performed to evaluate the anti-hyperthyroidal effects and action mechanism of Scutellaria baicalensis Georgi (SB), a medicinal herb, on levothyroxine (LT4)-induced hyperthyroidal rats.

Methods

Male Wistar rats were divided into five groups, namely, euthyroidal normal group (Normal), hyperthyroidism control group (Control), hyperthyroidism plus PTU-treated group (PTU) as a positive control, hyperthyroidism plus 400 mg/kg SB-treated group (SB400), and hyperthyroidism plus 800 mg/kg SB-treated group (SB800). The rats in groups other than Normal were injected with LT4 for 2 weeks to induce hyperthyroidism and then were administrated each treatment for 2 weeks. Clinical symptoms and biomarkers related to hyperthyroidism were examined, and the gene expressions related to the regulation of thyroid hormone were determined.

Results

Compared with the Control group, pulse rate, serum T3, T4, triglyceride, thyroid follicle size, and the deiodinase 1 (Dio1) gene expression were significantly reduced in the SB and PTU groups. Serum TSH and the thyroxine-binding globulin (Tbg) gene expression were significantly increased in the SB and PTU groups.

Conclusions

These results suggest that SB might suppress T3, T4, and adrenergic activity by modulating Dio1 and Tbg expression, and therefore, SB could be an alternative therapy for hyperthyroidism.

EFFECTIVENESS OF ANETHUM GRAVEOLENS L. ON ANTIOXIDANT STATUS, THYROID FUNCTION AND HISTOPATHOLOGY

CONTEXT

Anethum graveolens L. is used in the treatment of numerous diseases. But there is limited data about the Anethum graveolens efficiency in thyroid tissue.

OBJECTIVE

The aim of this study is to assess the functional and histopathological changes in thyroid tissues from rats treated with Anethum graveolens L. extract.

DESIGN

This is an experimental animal study and duration of the study was 30 days.

SUBJECTS AND METHODS

Twenty-eight female Wistar Albino rats were divided into four equal groups. A gavage of Anethum graveolens L. extract at 0, 50, 150 and 300 mg/kg/day doses were given to the rats with 1 mL 0.9% NaCl, respectively, for 30 days. Blood was taken at day 0, 15 and 30. fT3, fT4, TSH values and antioxidant efficiency were observed. Also the thyroidectomy tissue was assessed histopathologically.

RESULTS

There is no difference observed in the fT3, fT4 and TSH values of groups 1, 2 and 3 at day 1, 15 and 30 (p>0.05); however, in group 4, TSH value decreased on days 15 and 30 when compared to day 1 and the other groups (p<0.05). Also the hypertrophy and thyroid follicular cell hyperplasia were significantly increased in group 4 (p<0.05). There is no difference in antioxidant efficiency in any of the groups (p>0.05).

CONCLUSION

Anethum graveolens L. extract is effective on both the function and the histology of thyroid tissue but it has no effect on antioxidant status.

A methimazole resistant patient with Graves' disease (GD): A case report of mid-term management with herbal decoctions mainly composed of Anemarrhena Bunge

Graves' disease (GD) is the most common cause of hyperthyroidism. Anti-thyroid drugs, including methimazole, are the most commonly selected treatment option for this condition. But for decades, no additional drug option has been added. Anemarrhena Bunge has been used in many herbal decoctions for patients who had hyperthyroidism-like symptoms, such as sweating, heat intolerance, and anxiety. In this case study, a patient with GD who had once achieved therapeutic goals with methimazole but then re-developed hyperthyroidism was treated with only herbal decoctions, and achieved euthyroidism, normalization of T3, T4 levels for 13 months and maintenance of thyroid stimulating hormone (TSH) levels for 8 months and TSH binding inhibitory immunoglobulins (TBII)-negative status for 13 months (TSH and TBII level before treatment: 0.01 μIU/mL, 10.94 IU/L; TSH level normalization after 14 months from the initiation of the treatment: 0.75 μIU/mL, TBII level normalization after 9 months from the initiation of the treatment: 0.8 IU/L). The patient did not report any adverse effects related to this treatment. A herbal decoction with Anemarrhena Bunge might be effective in patients who are resistant to methimazole treatments, a finding which needs further investigation in future.