The study involved 147 women aged 31-47 with newly diagnosed AIT and hypothyroidism in the dynamics of replacement therapy with levothyroxine (before and after 6 months). The control group consisted of 63 conditionally healthy women, examined once at the beginning of the study. In peripheral blood serum, the concentrations of TNF-α, IL-1β, IL-4, IL-6, IL-8, IL-10, IL-17A, RANKL, OPG, TSH and TPOAb were determined. It was found that the initially increased values (p<0,001) of IL-1β and IL-6 remained in patients after substitu- tion therapy at higher levels than in the control group (p<0,001). The tendency to an increase in the levels of IL-10 (p=0,056) and IL-17A (p=0,067) revealed at the beginning of therapy was leveled out (p>0,05) by the end of the ob- servation. TNF-α values did not significantly differ from those of the control group both at baseline and after 6 months (p=0,166 and p=0,184, respectively). The concentrations of IL-4 (p=0,376 and p=0,179, respectively), IL-8 (p=0,102 and p=0,116, respectively) and OPG (p=0,988 and p=0,661, respectively) remained at the level of the results of healthy women before and after treatment. RANKL concentrations before treatment were elevated (p=0,029), having lost their significant significance after therapy (p=0,096). The initially decreased values of the OPG/RANKL index (p=0,017) also did not differ on repeated examination from the indicators of the control group (p=0,253). After 6 months of taking levo- thyroxine in women with AIT, a significant (p<0,001) decrease in initially elevated TSH levels to the values characteris- tic of the control group was recorded against the background of a significant (p<0,001) increase in the concentrations of initially elevated autoimmune antibodies (p<0,001). When examining women with AIT and confirmed hypothyroidism, it was found that replacement therapy with levothyroxine for 6 months did not significantly affect the production of most of the studied cytokines against the back- ground of a decrease in the initially increased TSH values to the values of the control group and a significant increase in the initially increased TPOAb.
autoimmune thyroiditis, hypothyroidism, cytokines, thyroid stimulating hormone, thyroid peroxidase antibody.
1. Gryaznova M. A., Hamnueva L. Yu. Osobennosti citokinovoy regulyacii pri autoimmunnoy patologii schitovidnoy zhelezy. Zhurnal nauchnyh statey «Zdorov'e i obrazovanie v XXI veke». 2017;19(7): 33-39.
2. Wiersinga W. M. Hashimoto’s Thyroiditis. In: Vitti P., Heged's L. (eds) Thyroid Diseases. Endocrinology. Springer, Cham. 2018:205-247. doi:10.1007/978-3-319-45013-1_7
3. Malaty W. Primary hypothyroidism. 2017. https://bestpractice.bmj.com/topics/en-us/535/ pdf/535.pdf. Accessed 4 Jan 2017.
4. Carly A., Laurberg P., Knudsen N., Perrild H., Ovesen L., Rasmussen L.B., Jorgensen T., Pedersen I.B. Thyroid peroxidase and thyroglobulin auto- antibodies in patients with newly diagnosed overt hypothyroidism. Autoimmunity. 2006;39(6):497- 503. doi: 10.1080/08916930600907913
5. Santaguida M. G., Gatto I., Mangino G., Virili C., Stramazzo .I, Fallahi P., Antonelli A., Segni M., Romeo G., Centanni M.. BREG cells in Hashimoto’s thyroiditis isolated or associated to further organ-specific autoimmune diseases. Clin Immunol. 2017;184:42-47. doi: 10.1016/j. clim.2017.04.012
6. Ramos-Levn A. M., Marazuela M. Pathogenesis of thyroid autoimmune disease: the role of cellular mechanisms. Endocrinol Nutr. 2016;63(8):421-429.
7. Autoimmunity from bench to bedside. Anaya J. M., Shoenfeld Y., Rojas-Villarraga A., Levy R. A., Cervera R. Bogota: El Rosario University Press. School of de Medicine and Health Sciences, CREA; 2013.
8. Ates I., Arikan M. F., Altay M., Yilmaz F. M., Yilmaz N., Berker D., Guler S. The effect of oxidative stress on the progression of Hashimoto’s thyroiditis. Arch Physiol Biochem. 2018; 124(4):351-356. doi:10.1080/13813455.2017.140 8660
9. Frchlich E., Wahl R. Thyroid autoimmunity: role of anti-thyroid antibodies in thyroid and extra- thyroidal diseases. Front. Immunol. 2017;8:521. doi:10.3389/fimmu.2017.00521
10. Wang C., Mu Z., Chen Y., Liu J., Ma J., Liu C., Hou Z. Study on Th17/Treg Cells and Cytokines in Hashimoto’s Thyroiditis with Different Iodine Nutrition Status. Science Journal of Public Health. 2021;9(1):12-22. doi:10.11648/j.sjph.20210901.12
11. Boldyreva Yu. V., Lebedev I. A., Kruchinin E. V., Alekberov R. I., Tarasov D. O, Tyapkin A. V., Kozlov M. V., Ahmet'yanov M. A., Lukashenok A. V., Mokin E. A., Fidomatova Z.Sh. Edinyy podhod k vedeniyu pacientov s autoimmunnym tireoiditom. Kardiologiya. 2019; 07(175): 110-113. doi: 10.25694/URMJ.2019.07.25
12. Lee S.A., Stetten N.E., Anton S.D. Patient perspectives on the treatment for Hashimoto’s thyroiditis: a qualitative analysis. Health Prim Car. 2018;2(4):1-5. doi: 10.15761/HPC.1000141
13. Ernst F.R., Barr P., Elmor R., Sandulli W., Thevathasan L., Sterman A.B., Goldenberg J., Vora K. The Economic Impact of Levothyroxine Dose Adjustments: the CONTROL HE Study. Clin Drug Investig. 2017;37(1):71-83. doi: 10.1007/s40261- 016-0462-3
14. Okosieme O., Gilbert J., Abraham P., Boelaert K., Dayan C., Gurnell M., Leese G., McCabe C., Perros P., Smith V., Williams G., Vanderpump M. Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee. Clin Endocrinol (Oxf). 2016; 84(6): 799-808. doi: 10.1111/cen.12824
15. Jonklaas J., Bianco A.C., Bauer A.J., Burman K.D., Cappola A.R., Celi F.S., Cooper D.S., Kim B. W., Peeters R. P., Rosenthal M. S., Sawka A. M. American Thyroid Association Task Force on Thyroid Hormone Replacement. Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement. Thyroid. 2014;24(12):1670- 1751. doi:10.1089/thy.2014.0028
16. Zdor V.V. Vzaimosvyaz' gormonal'noy i citokinovoy regulyacii pri autoimmunnom tireoidite. Klinicheskaya i eksperimental'naya tireoidologiya. 2017;13(2):45-56. doi: 10.14341/ ket2017245-56
17. Tayde P. S., Bhagwat N. M., Sharma P., Sharma B., Dalwadi P. P., Sonawane A., Subramanyam A., Chadha M., Varthakavi P. K. Hypothyroidism and Depression: Are Cytokines the Link? Indian J Endocrinol Metab. 2017;21(6):886- 892. doi: 10.4103/ijem.IJEM_265_17
18. Marchiori R. C., Pereira L. A., Naujorks A. A., Rovaris D. L., Meinerz D. F., Duarte M. M., Rocha J. B. Improvement of blood inflammatory marker levels in patients with hypothyroidism under levothyroxine treatment. BMC Endocr Disord. 2015;15:32. doi: 10.1186/s12902-015-0032-3
19. Botelho I. M. B., Moura Neto A., Silva C. A., Tambascia M. A., Alegre S. M., Zantut-Wittmann D. E. Vitamin D in Hashimoto’s thyroiditis and its relationship with thyroid function and inflammatory status. Endocrine J. 2018;65:1029-1037. doi: 10.1507/endocrj.EJ18-0166
20. Rapacki E., Lauritzen J. B., Madsen C. M., Jshrgensen H. L., Norring-Agerskov D. Thyroid- stimulating hormone (TSH) is associated with 30- day mortality in hip fracture patients. Eur J Trauma Emerg Surg. 2019: 1-7. doi: 10.1007/s00068-019- 01260-9
21. Kachouei A., Rezvanian H., Amini M., Aminorroaya A., Moradi E. The Effect of Levothyroxine and Selenium versus Levothyroxine Alone on Reducing the Level of Anti-thyroid Peroxidase Antibody in Autoimmune Hypothyroid Patients. Adv Biomed Res. 2018; 7: 1. doi: 10.4103/2277-9175.223735
22. Liu J., Chen Z., Liu M., Jia Y., Yao Z., Wang G. Levothyroxine Replacement Alleviates Thyroid Destruction in Hypothyroid Patients With Autoimmune Thyroiditis: Evidence From a Thyroid MRI Study. Front Endocrinol (Lausanne). 2019; 10: 138. doi: 10.3389/fendo.2019.00138
