Biochemical Significance of miR-155 and miR-375 as Diagnostic Biomarkers and Their Correlation with the NF-κβ/TNF-α Axis in Breast Cancer

Serum microRNAs (miRs) have recently been proposed as potential cancer biomarkers for early detection. Thyroid hormones play a crucial role in human health, and their alterations are linked to a range of diseases, such as breast cancer. The relationship between NF-κβ, TNF-α, and non-coding RNAs is an urgent need for clinical trials. This study aimed to investigate serum expression folds of miR-155 and miR-375 and their correlations with NF-κβ and TNF-α in breast cancer patients. The current study was conducted on 183 unrelated female participants. Serum levels of free T3 and T4, as well as expression folds of miR-155 and miR-375, were significantly higher in patients with fibroadenoma and breast cancer, despite TSH being significantly lower. Additionally, the signaling of TNF-alpha and NF-κβ were found to be significantly upregulated in the serum of patients with breast cancer. Up-regulation of miR-155 and miR-375 expression may be diagnostic biomarkers of breast cancer, pointing to the role of NF-κβ and TNF-α expression in miR-155 and miR-375 expression as therapeutic targets of breast cancer in the future.

Acute Thyroid Profile Changes During External Beam Irradiation of Neck

Thyroid gland is irradiated to a considerable dose in conventional radiotherapy of head neck cancer and significant proportion of patients later develop hypothyroidism. This study is an effort to shed light on acute changes in thyroid function after irradiation those are less clearly defined. Values were recorded before radiation treatment, after 4 week of irradiation, after completion of treatment, 1 month after completion of treatment and after 4 months of completion of treatment. A repeated measures ANOVA with a Greenhouse-Geisser correction determined that mean T3, T4 and TSH levels differed statistically significantly between time points. Post hoc test using the Bonferroni correction revealed statistical significance difference in values of T3, T4 and TSH done at specific intervals. External irradiation in cancer therapeutic doses affects thyroid function and sets at a new point with increased TSH, but in reference ranges, to maintain required thyroxin level.

Thyroid profile and LDH Isoenzymes as prognostic biomarkers for diabetic and/or obese subjects

BACKGROUND

This study aimed to evaluate the levels of thyroid hormones and lactate dehydrogenase (LDH) isoenzymes in obese and/or diabetic patients.

SUBJECTS AND METHODS

Forty male subjects categorized into four equal groups; group 1: Non obese control subjects, group 2: Subjects suffering from type 2 diabetes mellitus (T2DM), group 3: Obese subjects (BMI ≥ 30 kg/m2) and group 4: Subjects thatwere obese and had type 2 diabetes mellitus (T2DM). Liver, kidney, lipid, thyroid hormones, total LDH and LDH isoenzymes levels were determined.

RESULTS

There was a significant increase of TSH level (p<0.001) in diabetic group as compared with control group and a highly significant increase of TSH was obtained in obese and obese diabetic groups versus control and diabetic patients. LDH 2 was also highly significantly decreased in obese and obese diabetic groups versus diabetic patients. Percentage of LDH 4 was significantly decreased in both diabetic and obese groups and not significantly changed in obese diabetic patients as compared with the control group. LDH 5 percentage showed very highly significant decrease in diabetic, obese and highly significant decrease in obese diabetic groups when compared with control subjects while it was not significantly changed in obese and obese diabetic groups as compared with diabetic patients.

CONCLUSION

LDH isozymes can be used as valuable diagnostic markers for metabolic syndrome. This may help to explore the metabolic changes associated with obesity and diabetes complication and following up the complication of these abnormalities.

Is nitric oxide level affected in postmenopausal women with hypothyroidism?

AIM

To analyze serum levels of nitric oxide (NO), an indicator of cardiovascular health, in post-menopausal females with and without hypothyroidism.

METHODS

NO was analyzed colorimetrically in 30 newly diagnosed hypothyroid postmenopausal females and 30 postmenopausal females with normal thyroid profile. Results were compared and subjected to appropriate statistical analysis.

RESULTS

The levels of serum NO were found to be significantly decreased in postmenopausal females with hypothyroidism as compared to the levels in those with normal thyroid profile (P value < 0.05). A negative correlation of NO was observed with thyroid stimulating hormone whereas a positive correlation of NO was observed with free T3 (FT3), free T4 (FT4), T3 and T4 though it was statistically significant only for FT4 among postmenopausal females with hypothyroidism.

CONCLUSION

Postmenopausal hypothyroid females may be at a risk of compromised cardiovascular health as indicated by low NO levels. Regular monitoring and risk assessment is essential for timely intervention.

THYROID DYSFUNCTION AND INFERTILITY TREATMENT

Objective

To find out the relationship of thyroid hormone profile of females with outcomes after intra cytoplasmic sperm injection (ICSI).

Method

It was a cross sectional study conducted in Islamabad Clinic Serving Infertile Couple from June 2013 till August 2015. T3 (triiodo thyronine), T4 (thyroxine) and TSH (thyroid stimulating hormone) of 168 consented females was estimated after they underwent the first step of treatment protocol (ovarian down regulation) for ICSI. Pregnant group had ß hCG result more than 25 IU/mL while the rest were included in the non-pregnant group. Both groups were compared by using independent sample t-test. Pearson correlation coefficient was used to associate T3 and T4 with other pregnancy variables with their significance.

Results

Non pregnant women had significantly higher mean values for T3 and T4 as compared to pregnant women (p <0.05, p<0.01). Difference in mean TSH value between non-pregnant and pregnant women was not significant p=0.08. It was found that T4 gave significant negative association with grading of embryo-I, blastocysts formed, thickness of endometrium and number of gestational sacs.

Conclusion

Disturbance in thyroid profile with raised T4 levels leads to alteration in endometrial thickness and quality of embryos required for implantation and hence conception.

Antithyroid Peroxidase Antibodies in Women with Polycystic Ovary Syndrome

OBJECTIVE

To find the prevalence of thyroid autoimmunity in PCOS women of reproductive age group.

METHODS

Study design: Observational study was done at ESIMC and PGIMSR K.K. Nagar March 2013-Feb 2014. Ninety cases of women with PCOS based on Rotterdam's criteria and an equal number of age-matched controls (women without PCOS) were included in the study. Thyroid profile, antithyroid peroxidase titre, serum progesterone, testosterone and fasting blood sugar were estimated using standardised techniques.

RESULTS

Menstrual irregularity (oligomenorrhoea and amenorrhoea) was the most common abnormality found in patients with PCOS compared with non-PCOS (p < 0.0001). Hyperandrogenism was the second most common manifestation present in PCOS of our study group. Hirsutism was the striking hyperandrogenic feature that was present in study group. PCOS patients had higher BMI compared to controls (p < 0.0001). The prevalence of thyroid dysfunction was not significantly different in both the groups (p < 0.80). Anti-TPO titre was higher in PCOS patients (25.8 ± 2.9 IU/ml) compared to the controls (14.5 ± 2.3 IU/ml) (p < 0.009).

CONCLUSION

The present study shows that PCOS was associated with increased anti-TPO titres, thus emphasising the importance of screening all PCOS patients for anti-TPO along with routine thyroid profile.

Two-step thyroid screening strategy in the critical patient

BACKGROUND

Thyroid function biochemical tests are known for their usefulness in prognosis of long-term critical patients, although current data are controversial regarding the clinical benefit of both free triiodothyronine and thyroxine as prognostic thyroid markers during the first 48h after Intensive Care Unit (ICU) admission.

METHODS

The aim of this study was to evaluate the usefulness of two strategies for thyroid function assessment in the first 48h after admission at the ICU. The usefulness of a two-step biochemical thyroid strategy (initial isolated TSH determination, followed by subsequent fT4 and fT3) was compared with a complete one-step biochemical profile (TSH+fT4+fT3).

RESULTS

No significant differences were found between the rates of thyroid dysfunction detection when using both strategies (2.8% vs. 2.4%; p=0.71). Using the two-step strategy and a 2.5μUI/mL cut-off value for TSH, sensitivity and negative predictive value were 100%. Among patients with an altered fT3 only, mortality was 14% if TSH≤2.5μUI/mL, whereas it was 7% if TSH>2.5μUI/mL (p=0.008).

CONCLUSIONS

For patients with critical illness, the early two-step thyroid screening strategy (starting with an isolated TSH determination between 24 and 48h after admission) led to a saving of 50% in fT4 and fT3 tests, with a false-negative rate of 1.3%. This represents an improved diagnostic approach, hence avoiding the performance of unnecessary complementary biochemical measurements.