Selenium Supplementation in the Treatment of Hashimoto's Thyroiditis: A Systematic Review and a Meta-analysis

Toulis, Konstantinos; Anastasilakis, Athanasios D.; Tzellos, Thrasivoulos; Goulis, Dimitrios G.; Kouvelas, Dimitrios

doi:10.1089/thy.2009.0351

Cited by 161 publications

(109 citation statements)

References 37 publications

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“…Clinical studies have demonstrated that in patients with HT, Se supplementation reduced thyroid peroxidase autoantibody titers significantly as compared with the control subjects receiving placebo (250). Since Se levels affect both the thyroid gland and the immune system, it has been difficult to determine the contribution of each to the observed effects with HT.…”

Section: G Autoimmunitymentioning

confidence: 99%

The Role of Selenium in Inflammation and Immunity: From Molecular Mechanisms to Therapeutic Opportunities

Huang

Rose

Hoffmann

2012

Antioxidants & Redox Signaling

655

475

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Dietary selenium (]Se), mainly through its incorporation into selenoproteins, plays an important role in inflammation and immunity. Adequate levels of Se are important for initiating immunity, but they are also involved in regulating excessive immune responses and chronic inflammation. Evidence has emerged regarding roles for individual selenoproteins in regulating inflammation and immunity, and this has provided important insight into mechanisms by which Se influences these processes. Se deficiency has long been recognized to negatively impact immune cells during activation, differentiation, and proliferation. This is related to increased oxidative stress, but additional functions such as protein folding and calcium flux may also be impaired in immune cells under Se deficient conditions. Supplementing diets with above-adequate levels of Se can also impinge on immune cell function, with some types of inflammation and immunity particularly affected and sexually dimorphic effects of Se levels in some cases. In this comprehensivearticle, the roles of Se and individual selenoproteins in regulating immune cell signaling and function are discussed. Particular emphasis is given to how Se and selenoproteins are linked to redox signaling, oxidative burst, calcium flux, and the subsequent effector functions of immune cells. Data obtained from cell culture and animal models are reviewed and compared with those involving human physiology and pathophysiology, including the effects of Se levels on inflammatory or immune-related diseases including anti-viral immunity, autoimmunity, sepsis, allergic asthma, and chronic inflammatory disorders. Finally, the benefits and potential adverse effects of intervention with Se supplementation for various inflammatory or immune disorders are discussed. Antioxid. Redox Signal. 16, 705-743.

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Section: G Autoimmunitymentioning

confidence: 99%

The Role of Selenium in Inflammation and Immunity: From Molecular Mechanisms to Therapeutic Opportunities

Huang

Rose

Hoffmann

2012

Antioxidants & Redox Signaling

655

475

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“…In particular treatment of GD is not satisfactory, anti-thyroid medications such as Methimazole are associated with serious side effects including liver dysfunction and agranulocytosis (32,33); thyroidectomy is associated with potential surgical risks; and radioactive iodine was shown to worsen or trigger de novo Graves ophthalmopathy (34). Treatment of HT is relatively straightforward, but up to 15% of HT patients remain symptomatic even after thyroid functions are normalized (35)(36)(37). Therefore, better treatment modalities to reverse the autoimmune response targeting the thyroid are needed.…”

Section: Discussionmentioning

confidence: 99%

Identifying a Small Molecule Blocking Antigen Presentation in Autoimmune Thyroiditis

Menconi

Osman

et al. 2016

Journal of Biological Chemistry

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We previously showed that an HLA-DR variant containing arginine at position 74 of the DR␤1 chain (DR␤1-Arg74) is the specific HLA class II variant conferring risk for autoimmune thyroid diseases (AITD). We also identified 5 thyroglobulin (Tg) peptides that bound to DR␤1-Arg74. We hypothesized that blocking the binding of these peptides to DR␤1-Arg74 could block the continuous T-cell activation in thyroiditis needed to maintain the autoimmune response to the thyroid. The aim of the current study was to identify small molecules that can block T-cell activation by Tg peptides presented within DR␤1-Arg74 pockets. We screened a large and diverse library of compounds and identified one compound, cepharanthine that was able to block peptide binding to DR␤1-Arg74. We then showed that Tg.2098 is the dominant peptide when inducing experimental autoimmune thyroiditis (EAT) in NOD mice expressing human DR␤1-Arg74. Furthermore, cepharanthine blocked T-cell activation by thyroglobulin peptides, in particular Tg.2098 in mice that were induced with EAT. For the first time we identified a small molecule that can block Tg peptide binding and presentation to T-cells in autoimmune thyroiditis. If confirmed cepharanthine could potentially have a role in treating human AITD. Autoimmune thyroid diseases (AITD),2 Graves disease (GD), and Hashimoto thyroiditis (HT), are among the most common autoimmune disorders, afflicting up to 5% of the United States population (1). They are characterized by infiltration of the thyroid by lymphocytes reactive to thyroid antigens and production of thyroid-specific antibodies (2). Complex interaction of genetic susceptibility factors, environmental triggers, and epigenetic alterations leads to the breakdown of tolerance, resulting in AITD (3-5). Currently, there is no satisfactory therapy except for hormone replacement therapy in HT or thyroid suppression or ablation in GD (6 -10). To develop new therapies for AITD a better understanding of their etiology is needed. We have been studying the etiology of AITD using a reverse-genetics approach, i.e. dissecting the mechanisms causing disease through unbiased genetic screening studies. These studies led to the identification of a specific HLA-DR pocket sequence that is strongly associated with AITD (11). The presence of arginine at position 74 of the DR␤ chain renders the individual highly susceptible to AITD, whereas glutamine at position 74 is protective (12). These data were confirmed by other groups (13). The presence of DR␤1-Arg74 (from here on we refer to the HLA-DR3 containing arginine at position 74 as HLA-DR␤1-Arg74) results in a more positively charged P4 pocket. With this structural change in the pocket, the selectivity and binding of pathogenic peptides is affected, conferring higher risk for disease (12).Besides the HLA genes, two thyroid-specific genes, the thyroglobulin (Tg) and thyrotropin receptor (TSHR) genes also contribute to the etiology of AITD (2). Thyroglobulin is the most abundant thyroidal protein (14), and it is the precursor to ...

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“…Son zamanlarda selenyum tedavisinin HT fizyolojisindeki ve tiroid bezi üzerinde etkili enzimlerin yapısındaki rolü araştırılmıştır (39). Tiroid glandını oksidatif stresten koruyan glutatyon peroksidaz, tiroid hormon sentezinde rol alan tiroid peroksidaz, T3 sentezinde rol alan iyodotironin deiyodinaz enzimleri selenoproteinlerdir.…”

Section: Tablo 2 Hashimoto Tiroiditinde Ayırıcı Tanıunclassified

Çocuk Ve Adolesanlarda Hashi̇moto Ti̇roi̇di̇ti̇ / Hashimoto Thyroiditis in Children and Adolescents

Binay¹,

Şimşek²

2016

Osmangazi̇ Journal of Medicine

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ÖZET: Hashimoto tiroiditi (HT) çocukluk yaş grubunda hipotiroidinin en sık sebebi olup guatr ya da atrofik tiroidit olarak karşımıza çıkabilir. Çeşitli hücre ve antikor aracılı immün sürece ve lenfositik infiltrasyona bağlı gelişen tiroid foliküllerinin harabiyeti ile karakterizedir. Etiyolojik olarak genetik yatkınlığı olan bireylerde çevresel faktörlerin etkisiyle ortaya çıktığı düşünülmektedir. HT tanısı serumda tiroid antijenlerine karşı gelişen (özellikle peroksidaz ve tiroglobulin) antikorların gösterilmesine dayanır. Ancak HT'li hastaların % 10-15'inde antikorlar negatif saptanabilir. Hastalar nonspesifik semptomlara sahip olup rutin tiroid fonksiyon testleri ile tanı alabilirler. HT değişken klinik prezentasyona sahiptir ve hastalar hipertiroid, hipotiroid veya ötiroid olabilir. Hipotiroidizm ile birlikte sık görülen semptomlar; halsizlik, soğuk intoleransı, konstipasyon, cilt kuruluğu, boy kısalığı ve kilo almadır. Klinik bulgular hipotiroidizmin derecesine bağlı olarak değişebilir. HT'de alopesi, vitiligo, çölyak hastalığı, addison hastalığı, tip 1 diyabet ve poliglandüler sendromlar gibi diğer otoimmün hastalıklar eşlik edebilir. HT tedavisinde klinik ve biyokimyasal olarak ötiroidiyi sağlamak amacıyla tiroid hormon replasmanı (levotiroksin) yapılmaktadır.. ANAHTAR KELIMELER: Hashimoto tiroiditi; adolesan; hipotiroidi; otoimmünite HASHIMOTO THYROIDITIS IN CHILDREN AND ADOLESCENTSABSTRACT: Hashimoto thyroiditis (HT) is the most common cause of hypothyroidism in pediatric age group resulting in either goiter or thyroid atrophy. It is characterized by the destruction of thyroid follicles by various cell-and antibody-mediated immune processes and lymphocytic infiltration. The etiology of HT is thought to be a combination of genetic susceptibility and environmental factors. The diagnosis of HT relies on the demostration of circulating antibodies to thyroid antigens mainly thyroperoxidase and thyroglobulin. However, 10-15 % of patients with HT may be antibody negative. Patients may have subclinical nonspecific symptoms, diagnosed based on routine screening of thyroid function. HT has a highly variable clinical presentation; patients may either be hyperthyroid, hypothyroid or euthyroid. Common presenting symptoms of hypothyroidism are fatigue, cold intolerance, constipation, dry skin, short stature and weight gain. Clinical findings may vary according to the extend of the hypothyroidism. HT is associated with other autoimmune diseases such as alopecia, vitiligo, coeliac disease, addison disease, type 1 diabetes and polyglandular syndrome. The treatment of HT is thyroid hormone replacement (levothyroxine) to restore a clinically and biochemically euthyroid state.

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Selenium Supplementation in the Treatment of Hashimoto's Thyroiditis: A Systematic Review and a Meta-analysis

Cited by 161 publications

References 37 publications

The Role of Selenium in Inflammation and Immunity: From Molecular Mechanisms to Therapeutic Opportunities

The Role of Selenium in Inflammation and Immunity: From Molecular Mechanisms to Therapeutic Opportunities

Identifying a Small Molecule Blocking Antigen Presentation in Autoimmune Thyroiditis

Çocuk Ve Adolesanlarda Hashi̇moto Ti̇roi̇di̇ti̇ / Hashimoto Thyroiditis in Children and Adolescents

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