Antithyroid Drugs Inhibit Radioiodine-Induced Increases in Thyroid Autoantibodies in Hyperthyroid Graves' Disease

Nakazato, Naoki; Yoshida, Katsumi; Mori, Keiichiro; Kiso, Yoshinori; Sayama, Noriyo; Tani, Junichi; Nakagawa, Yasuaki; Ito, Sadayoshi

doi:10.1089/thy.1999.9.775

Cited by 19 publications

(8 citation statements)

References 25 publications

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“…Simultaneous thyrostatic medication increases the possibility of treatment failure by more than 5 times [38]. The therapy with anti-thyroid drugs immediately after radioiodine is equally associated with reduced cure rate [21,39]. We suggest that the routine use of thionamides following radioiodine has little justification as also suggested by others [40].…”

Section: Ideal Choice Of Pre-treatment With Anti-thyroid Drugs If Anymentioning

confidence: 70%

Low failure rate of fixed administered activity of 400 MBq 131I with pre-treatment with carbimazole for thyrotoxicosis: the Gateshead Protocol

Razvi¹,

Basu²,

McIntyre³

et al. 2004

Nuclear Medicine Communications

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Section: Ideal Choice Of Pre-treatment With Anti-thyroid Drugs If Anymentioning

confidence: 70%

Low failure rate of fixed administered activity of 400 MBq 131I with pre-treatment with carbimazole for thyrotoxicosis: the Gateshead Protocol

Razvi¹,

Basu²,

McIntyre³

et al. 2004

Nuclear Medicine Communications

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“…In 1988, Velkeniers et al (14) reported that treatment failure occurred almost five times more often if ATDs were resumed after 131 I therapy of hyperthyroidism. Subsequently, the findings of other studies (15 -17) supported the view that the use of ATDs in the period after 131 I treatment reduced the cure rate from the therapy, in some cases associated with a blunted 131 I-induced increase in the titres of thyroid autoantibodies (17). However, all those studies (14-17) suffered from the drawbacks unavoidable in retrospective designs.…”

Section: Discussionmentioning

confidence: 85%

Resumption of methimazole after 131I therapy of hyperthyroid diseases: effect on thyroid function and volume evaluated by a randomized clinical trial

Bonnema

Bennedbæk

Gram³

et al. 2003

European Journal of Endocrinology

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Objective: Retrospective studies have indicated that anti-thyroid drugs (ATD) might possess a radioprotective effect, leading to a higher rate of recurrence of hyperthyroidism after iodine-131 ( 131 I) therapy. Design: A randomized clinical trial was performed to clarify whether resumption of methimazole after 131 I influences the final outcome of this treatment. Methods: We assigned 149 patients with Graves' disease or a toxic nodular goitre to groups either to resume (þATD) or not to resume (2ATD) methimazole 7 days after 131 I. Before 131I therapy, all patients were rendered euthyroid by methimazole, which was discontinued 4 days before the 131 I therapy. Results: During the follow-up period of 12 months, 13 patients developed hypothyroidism, 42 were euthyroid, and 18 had recurrence of hyperthyroidism in the þATD group; the respective numbers in the 2ATD group were 16, 42 and 18 (P ¼ 0.88). At 3 weeks after 131 I therapy, the serum free-thyroxine index was slightly decreased (by 5.7%; 95% confidence interval (CI) 215.5 to 5.4%) in the þ ATD group, in contrast to an increase of 35.9% (95% CI 18.8 to 55.5%) in the 2ATD group (P , 0.001 between groups). In the subgroup that remained euthyroid during follow-up, thyroid volume reduction, assessed by ultrasonography, was smaller in the þATD group [38.7% (95% CI 33.3to 44.1%)] than in the 2ATD group [48.6% (95% CI: 41.5 -55.6%)] (P , 0.05). Conclusion:No radioprotective effect could be demonstrated, with regard to final thyroid function, for the resumpton of methimazole 7 days after 131 I therapy. Although resumption of methimazole slightly reduced the magnitude of shrinkage of the goitre obtained by 131 I, the prevention of a temporary thyrotoxicosis in the early period after radiation favours this regimen.

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“…Recent research showed that methimazole moderately inhibited the synthesis of immunoglobulins including TSAb (14)(15)(16)(17)(18)(19)(20). In this study, we treated GO and GD patients with methimazole and examined the effect of the drug on the T cell subgroups, the populations of Th1 and Th2 cells, and the Th1/Th2 cell ratio in these patients.…”

Section: Discussionmentioning

confidence: 96%

CD4+ T cells and the Th1/Th2 imbalance are implicated in the pathogenesis of Graves' ophthalmopathy

Xia

Zhou²,

Liang³

et al. 2006

Int J Mol Med

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Abstract. Graves' ophthalmopathy (GO) is considered to be an organ-specific autoimmune disease. However, the pathogenesis of GO is incompletely understood at the present time.To clarify the immunological differences between newly diagnosed GO and Graves' disease (GD) without ophthalmopathy or healthy controls (HC), we examined T-cell profile and the Th1/Th2 profile cell balance in GO (n=20), GD (n=20) and HC (n=20) using flow cytometry. We also assessed the influence of methimazole on the immunocyte profiles in patients with GO and GD and analyzed the relationship of the immunologic changes with CAS, FT3, FT4, TRAb, TMA and TGA among the three investigated groups. We report in this study that: 1) The percentage of CD4 + T cells and the ratio of CD4 + /CD8 + cells were higher, but the population of CD8 + T cells was lower in both GO and GD than those of HC (P<0.05); 2) The percentage of CD8 -/IFNÁ + T cells (Th1) and the ratio of CD8 -/IFNÁ + to CD8 -/IL-4 + T cells (Th1/Th2) in GO were considerably higher as compared to those in GD and HC (P<0.05). On the contrary, the population of Th1 cells, as well as the ratio of Th1/Th2 cells, was lower in GD than that of GO and HC (P<0.05); 3) There were no significant differences in T-cell profile and the Th1/Th2 cell balance in either GO or GD patients before and after methimazole treatment; 4) There was a positive correlation of Th1 cell percentage and the Th1/Th2 cell ratio with the clinical activity score (CAS) in GO (P<0.05), whereas CAS in GO had no correlation with the T-cell profile, the percentage of Th2 cells, and TRAb (P>0.05); 5) T-cell subset and the ratio of Th1/Th2 cells did not correlate significantly with FT3, FT4, TRAb, TMA, or TGA in GO and GD (P>0.05). Finally, 6) there were no statistical differences in TRAb, TMA, and TGA between early GO and GD without ophthalmopathy (P>0.05). Collectively, these results indicate that the balance of Th1/Th2 in GO shifts to Th1 dominance and that the cellular immune responses mediated by the Th1-type CD4 + cells might play a dominant role in the pathogenesis of GO, and thus suggest that the Th1 cell percentage and the ratio of Th1/Th2 cell subsets may be potentially utilized as clinical parameters for disease activity, for monitoring the effectiveness of immunosuppressive treatment, or for developing immunospecific forms of therapy for Graves' ophthalmopathy.

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Antithyroid Drugs Inhibit Radioiodine-Induced Increases in Thyroid Autoantibodies in Hyperthyroid Graves' Disease

Cited by 19 publications

References 25 publications

Low failure rate of fixed administered activity of 400 MBq 131I with pre-treatment with carbimazole for thyrotoxicosis: the Gateshead Protocol

Low failure rate of fixed administered activity of 400 MBq 131I with pre-treatment with carbimazole for thyrotoxicosis: the Gateshead Protocol

Resumption of methimazole after 131I therapy of hyperthyroid diseases: effect on thyroid function and volume evaluated by a randomized clinical trial

CD4+ T cells and the Th1/Th2 imbalance are implicated in the pathogenesis of Graves' ophthalmopathy

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