The clinical and physiological spectrum of interferon-alpha induced thyroiditis: Toward a new classification

Abstract

Interferon-alpha (IFN␣) is a major treatment modality for several malignant and nonmalignant diseases, especially hepatitis C. Prospective studies have shown that up to 15% of patients with hepatitis C receiving IFN␣ develop clinical thyroid disease, and up to 40% were reported to develop thyroid antibodies. Some of these complications may result in discontinuation of interferon therapy. Thus, interferon induced thyroiditis (IIT) is a major clinical problem for patients receiving interferon therapy. IIT can be classified as autoimmune type and non-autoimmune type. I nterferons were discovered in the 1950Јs and were immediately recognized for their ability to render cells resistant to virus infection. 1 Interferons have been classified into two major groups, type I interferons and type II interferons, based on their capacity to bind to common receptor types. Type I interferons bind to a type I interferon receptor and include interferon-␣, interferon-␤, interferon-, and interferon-. 2 Type II interferons bind to a distinct type II receptor and include interferon-␥. 2 In addition to their antiviral properties, interferons have immunomodulatory, antiangiogenic, antiproliferative and antitumor activity, and act as important regulators of growth and differentiation. 3 Interferons work by directly binding to either type I or type II receptors. The cytoplasmic domains of the transmembrane glycoproteins are associated with members of the JAK family of kinases. They activate various signaling pathways, including the JAK-STAT pathway, the Crk-pathway, the IRS signaling pathway, and the MAP kinase pathway, which leads to signal transduction and subsequent activation or repression of specific genes. 3,4 More than twenty interferon-induced proteins have been identified. 5 Interferon-alpha (IFN␣) was the first cytokine to be reproduced by recombinant DNA technology and has emerged as a major therapeutic modality for several malignant and nonmalignant diseases. Among the diseases treated by IFN␣ are melanoma, renal cell carcinoma, hairy cell leukemia, Kaposi's sarcoma, and hepatitis B and C. 5 However, the most common prescription for IFN␣

The Effectiveness of Nursing Intervention Program on Emotional Distress, Self-Efficacy, and Liver Enzymes Among Hepatitis C Virus Patients Undergoing Antiviral Treatment Therapy (Sovaldi Medication)

“…The finding of the present study revealed that there was no significant difference regarding the patient's complain from weakness and fatigue between pre and post intervention program; this could be due to patients' believe that fatigue was a sign of disease Enzymes Among Hepatitis C Virus Patients Undergoing Antiviral Treatment Therapy (Sovaldi Medication) progression which as a result contribute to patients' beliefs that weakness and fatigue were uncontrollable and this supported by [32], who stated that; "the cognitive-behavioral theory posits that patients' beliefs about the illness and fatigue and their coping behaviors, rather than objective disease measures, determine the experience and the consequences of fatigue. When patients are aware of having a chronic illness, they interpret sensations (including fatigue) in the context of their knowledge and beliefs about the illness.…”

Hypothyroidism related to tyrosine kinase inhibitors: an emerging toxic effect of targeted therapy

“…[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] some small molecule tyrosine kinase inhibitors (tKis) have been shown to cause hypothyroidism related symptoms to a variable extent, which can reduce a patient's quality of life. we review the available data for tKi related thyroid dysfunction and the hypothesized patho physiological mechanisms of this toxicity.…”

“…interleukin 2 and interferons (iFns) could induce functional thyroid damage in patients affected by melanoma or renal cell carcinoma (rCC), by causing thy roiditis. [12][13][14][15][16] increased levels of thyroid auto antibodies 14,15 or hypothyroidism without autoantibodies 16,17 have been associ ated with improved outcome in patients with competing interests The authors declared no competing interests. reviews (Flt3), colony stimulating factor 1 receptor (CsF1r), ret, Kit, and platelet derived growth factor receptor.…”

Prevalence of thyroid disorders and the correlation of thyroid profile with liver enzymes, serum activin-A and follistatin during the treatment of patients with chronic hepatitis C genotype 1 and 4

“…However, patients with destructive thyroiditis were also reported to have inhibitory TSHR-Abs [32]. The most prevalent Tabs in our study were TSHR-Abs and the lowest were TPO-Abs.…”