Medical Applications of Molecular Biotechnologies in the Context of Hashimoto's Thyroiditis

Hashimoto's thyroiditis (HT) is a gender autoimmune disease that is manifested by chronic inflammation of the thyroid. Clinical trial studies (CTSs) use molecular biotechnologies (MB) to approach HT appearance. The aims of this study were to analyze the applications of MB in CTSs carried out in HT populations (HT-CTSs). Further, to evaluate the role of MB in the context of the hygiene hypothesis (HH). From 75 HT-CTSs found at clinicaltrials.gov web place, forty-five were considered for this investigation. Finally, six HT-CTSs were reported as molecular HT-CTSs (mHT-CTSs) because these were planning to utilize MB. Two of mHT-CTSs were programmed on the French population to isolate DNA viral sequences. Blood, urine, and thyroid tissue biospecimens were analyzed to pick out the parvo and polyoma viruses. Two mHT-CTSs carried out in China aimed to identify oral and fecal microbiotas by measuring PCR sequencing of the 16S rRNA gene. Two mHT-CTSs were programmed in the USA and Greece, respectively, for interception of DNA polymorphisms to associate with genetic susceptibility to HT. In conclusion, MB are mainly employed in HT-CTSs for infective pathogenesis and genetic fingerprinting of HT. Furthermore, MB do not provide evidence of HH; however, they are useful for providing direct evidence of the presence of viruses.

TNF-α May Exert Different Antitumor Effects in Response to Radioactive Iodine Therapy in Papillary Thyroid Cancer with/without Autoimmune Thyroiditis

Simple Summary

Recent evidence shows that autoimmune thyroiditis (AIT) may impair the uptake of radioiodine (¹³¹I), altering the success of attempted remnant ablation in papillary thyroid cancer (PTC), but the cause is not clear. Finding the mechanisms that govern immune cells during the ¹³¹I therapy of PTC with concomitant AIT (PTC + AIT) could provide a rationale for these reports. Our study was conducted on female patients admitted for ¹³¹I therapy. In the PTC group, ¹³¹I therapy modulates the production of cytokines in situ, increasing the antitumor immune response accordingly. On the contrary, in the presence of chronic inflammation due to AIT, ¹³¹I therapy amplifies innate immunity, leading to a weaker development of adaptive, specific immunity.

Abstract

Autoimmune thyroiditis (AIT) may impair radioiodine (¹³¹I) uptake in papillary thyroid cancer (PTC). Finding the mechanisms that govern immune cells during ¹³¹I therapy of PTC with concomitant AIT (PTC + AIT) could provide a rationale. Our study aimed to evaluate the effects of ¹³¹I on anti-thyroglobulin antibodies (TgAb), matrix metalloproteinase-9 (MMP-9) and its tissue inhibitor TIMP-1 and tumor necrosis factor-α (TNF-α) and its receptors TNFR1 and TNFR2, in PTC and PTC + AIT patients. Peripheral blood was collected from 56 female patients with PTC and 32 with PTC + AIT before and 4 days after ¹³¹I (3.7 GBq). The serum levels of TgAb, MMP-9, TIMP-1, TNF-α, TNFR1 and TNFR2 were measured by ELISA. The mean radioactivity of blood samples collected after ¹³¹I intake was higher in the PTC + AIT group than in PTC (p < 0.001). In the PTC + AIT group, TNF-α/TNFR1 and TNF-α/TNFR2 ratios decreased by 0.38-fold and 0.32-fold after ¹³¹I and were positively correlated with the MMP-9/TIMP-1 ratio (r = 0.48, p = 0.005, and r = 0.46, p = 0.007). In the PTC group, TNF-α/TNFR1 and TNF-α/TNFR2 ratios increased by 3.17-fold and 3.33-fold and were negatively correlated with the MMP-9/TIMP-1 ratio (r = −0.62, p < 0.001 and r = −0.58, p < 0.001). Our results demonstrate that TNF-α may exert different antitumor effects in response to ¹³¹I therapy depending on the patient’s immune profile.

Neonatal Dyshormonogenetic Goiter with Hypothyroidism Associated with Novel Mutations in Thyroglobulin and SLC26A4 Gene

Congenital goiter is an uncommon cause of neck swelling and it can be associated with hypothyroidism. We discuss a case of primary hypothyroidism with goiter presenting at birth. Ultrasound showed the enlargement of the gland and thyroid function tests detected marked hypothyroidism. Genetic analysis via next generation sequencing (NGS) was performed finding two mutations associated with thyroid dyshormonogenesis: c.7813 C > T, homozygous in the exon 45 of the thyroglobulin gene (TG) and c.1682 G > A heterozygous in exon 15 of the SLC26A4 gene (pendrin). Sanger sequencing of parents' DNA samples revealed that the first mutation (c.7813 C > T) was inherited from both of them, while the second one (c.1682 G > A) was inherited from the mother. Hormone replacement therapy was started, following which a gradual decrease in the size of the goiter was seen with the normalization of hormonal levels. Normal infant growth status and neurological development were recorded during follow-up. Neonatal dyshormonogenetic goiter with hypothyroidism may represent an unusual cause of neonatal neck mass. Early identification and hormone replacement therapy are crucial for a better neurodevelopmental outcome. Genetic analysis is mandatory in order to reach a specific diagnosis and to elucidate new patterns of thyroid disorder.

Analyses of the Relation between BPPV and Thyroid Diseases: A Nested Case-Control Study

BACKGROUND

This study investigated relationship between multiple thyroid disorders and benign paroxysmal positional vertigo (BPPV), adjusting for levothyroxine medication.

METHODS

The Korean National Health Insurance Service-Health Screening Cohort data from 2002 to 2015 were used. A total of 19,071 patients with BPPV were matched with 76,284 participants of a control group in a ratio of 1:4 for age, sex, income, and region of residence. The previous histories of thyroid disorders such as goiter, hypothyroidism, thyroiditis, hyperthyroidism, and autoimmune thyroiditis were investigated in both the BPPV and control groups. The odds ratios (ORs) for BPPV in thyroid diseases were calculated using conditional logistic regression analyses.

RESULTS

The histories of goiter (5.5% vs. 4.1%), hypothyroidism (4.7% vs. 3.7%), thyroiditis (2.1% vs. 1.6%), and hyperthyroidism (3.1% vs. 2.5%) were higher in the BPPV group than in the control group (all p < 0.001). Goiter, hypothyroidism, thyroiditis, and hyperthyroidism were associated with BPPV (adjusted OR = 1.28 (95% CI = 1.17-1.39) for goiter, 1.23 (95% CI = 1.10-1.37) for hypothyroidism, 1.13 (95% CI = 1.02-1.26) for hyperthyroidism, each p < 0.05).

CONCLUSIONS

BPPV was associated with thyroid disorders such as goiter, hypothyroidism, thyroiditis, and hyperthyroidism.