Expression of Cytokines and Cytokine Receptors-Genes in Patients with Different Forms of Thyroid Pathology in Ukrainian Population

Multiple susceptibility genes can be involved in the development of Hashimoto’s thyroiditis. Some of these genes are implicated in other autoimmune diseases, while others are specific to thyroid autoimmune response. 153 patients with thyroid pathology were enrolled in the study (152 women and 1 man, the average age was 46,02±14,3). They were divided into 3 groups: 16 patients with postoperative hypothyroidism; 65 patients with hypothyroidism resulting from autoimmune thyroiditis, and 72 patients with both AIT and elevated serum an anti-thyroglobulin and anti-thyroid peroxidase antibodies. We used a pathway-specific real-time Polymerase chain reaction array to identify and verify cytokines and receptor pathway-associated gene expression in peripheral white blood cells in randomly selected 12 individuals from each group. In the patients with postoperative hypothyroidism and those with hypothyroidism resulting from autoimmune thyroiditis, the expression of Chemokine (C-X3-C motif) receptor 1, Chemokine (C-X-C motif) receptor 4, Interleukin 6, and Interleukin 6 receptor significantly decreased, while the expression of IL6ST and IL10RA increased. In contrast, mRNA levels of Chemokine (C-X3-C motif) receptor 1, Chemokine (C-X-C motif) receptor 4, Interleukin 6, and Interleukin 6 receptor increased in the autoimmune thyroiditis patients with elevated serum anti-thyroglobulin and anti-thyroid peroxidase antibodies, while the expression of Interleukin 6 signal transducer and Interleukin 10 receptor, alpha decreased in this group of patients. The patients with hypothyroidism resulting from autoimmune thyroiditis and patients with elevated serum anti-thyroglobulin and anti-thyroid peroxidase antibodies had significantly lowered expression of Interleukin 10, while the expression of Interleukin 1, beta and Interleukin 1 receptor, type I was elevated. autoimmune thyroiditis and hypothyroidism affect the mRNA-level expression of cytokines and cytokine receptor genes in a gene-specific manner, and these changes to gene expression can be among the triggers of autoimmune inflammation progression in the thyroid gland. Transcriptional activity of cytokines, inducer, and receptor genes in the peripheral white blood cells can be used as an important minimally invasive prognostic marker of the autoimmune thyroid disease severity.

Thyroid Peroxidase Antibodies as a Marker of Iodine Status in Healthy Euthyroid Women in First Trimester of Pregnancy Visiting a Tertiary Care Hospital in Raipur, India

BACKGROUND The importance of adequate iodine status in pregnancy is undoubted as its deficiency is associated with adverse pregnancy outcomes for the mother as well as the foetus and neonate. Although median urine iodine concentration can assess iodine status of the population but not at an individual level. The purpose of this study was to assess the nutritional status of iodine and identify its effects on thyroid function during the first trimester of pregnancy. METHODS The study was carried out on 341 euthyroid healthy pregnant women using urine iodine concentration and other parameters of thyroid panel at a tertiary care hospital. RESULTS Median (interquartile range) urine iodine concentration and thyroid stimulating hormone (TSH) were 227.37 (161.7, 343.86) μg / L and 1.8 (1.1, 2.7) mIU / L respectively and Mean ± SD of free thyroxine and thyroid peroxidase antibodies were 14.53 ± 2.02 pmol / L and 38.23 ± 9.29 kIU / L respectively. Only thyroid peroxidase antibodies showed significant difference across groups with different iodine status. A positive correlation of urine iodine concentration (UIC) with thyroid peroxidase antibodies was observed (r = 0.137, P = 0.011). Multiple regression analysis revealed that thyroid peroxidase antibodies can serve as an independent predictor of iodine status in the presence of normal levels of TSH and FT4 (t - 3.063, CI; 0.880, 4.038, P = 0.002). CONCLUSIONS Thyroid peroxidase antibodies progressed positively with increase in urine iodine concentration indicating its role as a marker of iodine nutritional status and for early identification of women who can develop autoimmune thyroiditis resulting in hypothyroidism even prior to elevation of thyroid stimulating hormone levels. KEY WORDS Anti-TPO Ab, Free Thyroxine, Thyroid Stimulating Hormone, Urine Iodine Concentration

Comparison of the Frequency of Raised Level of Anti-Thyroid Peroxidase Antibody in the Patients of Hypothyroidism and the Euthyroids

The goal of this study was to compare the frequency of raised level of anti-thyroid peroxidase antibody in patients of hypothyroidism and the euthyroids. This case-control study was carried out at the department of Pathology, Quaid e Azam Medical College/Bahawal Victoria Hospital, Bahawalpur, from October 1, 2018 to Setember 30, 2019 and the subjects were selected by the non-probabilty consecutive sampling technique. The frequency of raised level of anti-thyroid peroxidase antibody in patients of hypothyroidism and the euthyroids was compared. In the present study, the mean age of the patients with cases of hypothyroidism was 32 ± 10 years, and the mean age of controls was 32 ± 10 years. Raised anti-thyroid peroxidase antibodies were found in 20 (28.99%) cases and 5 (7.25%) controls. After applying a Chi-squared test, a statistically significant (P = .00) difference in the level of anti-thyroid peroxidase antibodies between the cases and controls was detected. The presence of raised anti-thyroid peroxidase antibodies was also significantly associated with age and female gender. In conclusion the early screening of the anti-thyroid peroxidase antibodies specially in women above 30-years would notably affect the outcome of the disease with congruent disease management.he euthyroids was compared. In the present study, the mean age of the patients with cases of hypothyroidism was 32 ± 10 years, and the mean age of controls was 32 ± 10 years. Raised anti-thyroid peroxidase antibodies were found in 20 (28.99%) cases and 5 (7.25%) controls. After applying a Chi-squared test, a statistically significant (P = .00) difference in the level of anti-thyroid peroxidase antibodies between the cases and controls was detected. The presence of raised anti-thyroid peroxidase antibodies was also significantly associated with age and female gender. In conclusion the early screening of the anti-thyroid peroxidase antibodies specially in women above 30-years would notably affect the outcome of the disease with congruent disease management.

Association of thyroid antibodies status on the outcomes of pregnant women with hypothyroidism (maternal hypothyroidism on pregnancy outcomes, MHPO-4)

Background Autoimmunity increases with age and is often commonly evaluated in women of the reproductive age group. Prevalence of thyroid antibodies is common even in euthyroid pregnant women. We aim to compare the association of thyroid antibody status on the maternal and neonatal outcomes in pregnant women with hypothyroidism. Methods We conducted a cross-sectional retrospective study on 718 cases in the Aga Khan University Hospital. Information was collected on pregnant women who have been diagnosed with hypothyroidism before conception or during their antenatal period. Laboratory data were recorded for thyroid peroxidase antibodies, anti-thyroglobulin antibodies, and thyroid-stimulating hormone levels. Maternal and neonatal outcomes were also noted from medical file records. Data analysis was performed on Statistical Package for the Social Sciences version 20.0. Results Overall, 146 out 718 cases were included for final analysis. Thyroid peroxidase antibodies were positive in 66.4% and anti-thyroglobulin was positive in 52.1% cases, whereas 43.8% of cases had both antibodies positive. Pre-gestational diabetes was significantly associated with thyroid autoimmunity. There was a 73% less chance of gestational hypertension for thyroid autoimmune groups. Gestational diabetes and maternal (chronic) hypertension were found to have an independent effect on postpartum hemorrhage. Hypertensive disorders in pregnancy were found to have an independent risk for premature birth. Conclusion Our study reports a 74.7% prevalence of positive thyroid antibodies in hypothyroid pregnant women, with higher association with pre-gestational diabetes. Gestational hypertension was least likely to occur in thyroid autoimmune groups. None of the outcomes were independently associated with worse outcomes.