The Effect of Thionamide to TRH, TSH, IL-4, T-REG, and Anti-TPO in Graves’ Disease

Abstract

The most common cause of hyperthyroidism is Graves' disease. TRH and TSH are hormonal factors that modulate and control thyroid function in Graves' disease. In the immunological aspect, Graves' disease is played by the role of T-reg, IL-4, and anti-TPO. Graves' disease treatment goal is to inhibit thyroid hormone secretion by administering thionamide. The evaluation of this treatment is its hormonal and immunological aspects. To describe the effect of thionamide on serum TRH, TSH, IL-4, T-reg, and anti-TPO levels in Graves' disease. This study is a clinical trial study in 25 study participants. All study participants were given thionamide, namely PTU 300mg for three months and blood samples were taken for laboratory tests. Serum TRH, TSH, IL-4, T-reg FOXP3, and anti-TPO levels were examined by ELISA. The mean levels at the beginning and after three months of therapy are: serum TRH 92.589pg/mL and 115.944pg/mL; serum TSH 0.041mU/L and 0.223mU/L; serum IL-4 19.759pg/mL and 23.040pg/mL; T-reg FOXP3 gene polymorphism 0.621ng/mL and 0.518 ng/mL; serum anti-TPO 2697.539pg/mL and 2604.710pg/mL. Increased levels of serum TRH and TSH levels were statistically significant. The change in serum IL-4, T-reg FOXP3 gene polymorphism, and anti-TPO levels were not statistically significant. The administration of thionamide in Graves' disease for three months will significantly decrease Wayne index and serum FT4 levels, increase serum TRH and TSH levels.

The Profile of Thyrotropin-Releasing Hormone, T-Regulator, and Interleukin-4 of Untreated Graves’ Disease in Indonesia

“…The TRH effect is initiated by binding of peptides with G protein-coupled receptor (GPCR) on the thyrotropic plasma membrane. TRH secretion is influenced by thyroid hormones through a negative feedback mechanism in the hypothalamic-pituitary-thyroid axis [5,6].…”

“…Measuring anti-TPO can be used as a predictive marker in diagnosing patients with autoimmune thyroid disorders. [6][7][8][9].…”

The Role of Interleukin-4 Gene Promoter Polymorphisms in Graves’ Disease

“…These genes control immune responses such as major histocompatibility complex genes, T cell receptor genes, and antibody genes and genes that encode autoantigen targets in autoimmune thyroid disease. Recent studies have found that promoter gene polymorphisms are associated with Graves' disease [6][7][8][9][10][11].…”

CORRELATION BETWEEN POLYMORPHISMS OF FOXP3 T-Regulatory PROMOTOR GENE WITH TGF-β IN PATIENTS WITH GRAVES’ DISEASE

“…The incidence of Graves' disease worldwide is estimated as much as 0.4% of cases per year and is more experienced by women in the ratio of 5:1 [2,3]. In Indonesia, 0.4% of Indonesia's population aged 15 years or older has hyperthyroidism [4,5].…”