Особенности Естественного И Адаптивного Иммунитета В Патогенезе Аутоиммунных Заболеваний Щитовидной Железы. Cпособы Иммунокоррекции (Часть 1)

Rakov²,

Ковзун³

et al. 2021

Act Sci wom hea

Vitamin due to the presence of the receptor (VDR), which is found in almost all nuclear cells is an important regulator in the pathogenesis of many diseases. The question of the causal relationship between vitamin D deficiency and Graves 'disease and the importance of this vitamin for thyroid function in the treatment of Graves' disease deserves special attention. The aim of the study was to investigate the level of 25-(OH) D in the body in Graves' disease and its relationship with thyroid function. We examined 143 patients who were first diagnosed with moderate Graves' disease (GD). All patients studied by us, residents of Ukraine, 67% of them live in Kyiv, 19% in Kyiv region, 14% in other regions of Ukraine. The average age of the subjects was 43.8 ± 0.95, among whom were men 22.4%, women -77.6%. The analysis of immune parameters and thyroid function depending on the age of patients, the content of vitamin D in the serum, and its quartile distribution before treatment. Subsequently, all patients were divided into two groups depending on the therapy. The first group included 73 subjects, whose average age was 44.69 ± 1.39, patients in this group received tyrosol at a dose of 5 -10 mg per day. The second group consisted of 70 patients. whose average age was 42.93 ± 1.29, they took tyrosol at a dose of 5-10 mg per day and vitamin D preparations -2000 MO/day. In patients with Graves' disease. the highest content of 25-(OH) D in serum was observed in the age group of 19-30 years -59.1 nmol/l and a low level of antibodies to the TSH receptor -9.0 mUi/l. A significant decrease in the immune index was observed only in the 3 rd and 4 th quartiles, when the content of 25-(OH) D in the serum reached 47.5 nmol/l and above, i.e. approached a moderate deficit. At a slight increase to 34 nmol/l, such changes were insignificant. After 3 months of treatment, the level of AbrTSH in the serum during treatment with vitamin D was twice lower than when treated with tyrosol alone. After 6 months, compared with the treatment with tyrosol, the effect of treatment was 2 times better. In contrast to TPOAbs in Graves' disease without treatment with vitamin D, where it did not differ depending on the level of 25 (OH) D, in the second group after 6 months of treatment there was a significant decrease in this indicator (p = 0.009). Compared to tyrosol treatment alone, there was a significant increase in TSH levels and a decrease in thyroid volume after 6 months. Data on the dependence of thyroid function on the level of 25 (OH) D were indicative. In each of the quartiles, the level of TSH after treatment with vitamin D was 4-5 times higher than in the group of patients treated only with tyrosol. Convincing data on the positive effect of vitamin D on autoimmune parameters, thyroid function and the need for its inclusion in the treatment of Graves' disease.

Section: Introductionmentioning

confidence: 99%

Relationship Between Vitamin D and Autoimmune Condition and Thyroid Function with Newly Onset Grave’s Disease

Rakov²,

Ковзун³

et al. 2021

Act Sci wom hea

“…Among them are autoimmune thyroiditis and Graves' disease. Various links of acquired and innate immunity, cellular and humoral components are involved in the pathogenesis of these diseases [4,5]. The main antigens for autoimmune reactions are thyroglobulin, thyroxine peroxidase and thyroid stimulating hormone receptor.…”

Section: Introductionmentioning

confidence: 99%

A rare case of transformation of autoimmune thyroiditis into Grave’s disease after COVID-19 disease

J Clin Images Med Case Rep

Rakov²

2021

Autoimmune Thyroiditis (AIT) and Graves’ disease are autoimmune diseases with the opposite state of thyroid function: hypothyroidism and thyrotoxicosis. Typically, thyrotoxicosis can progress to thyroiditis and eventually hypothyroidism. The transformation of autoimmune thyroiditis into Graves’ disease is a very rare event. SARS-CoV-2 viral infection shares autoimmune mechanisms with common diseases of the thyroid gland and may be the cause of their diseases. We have described a case of Graves’ disease after suffering Covid-19 in a patient with autoimmune thyroiditis and hypothyroidism.

Епідеміологія Автоімунного Тиреоїдиту

Mìžnarodnij endokrinologìčnij žurnal

Тоvkay²,

Rakov³

et al. 2021

A review of the literature on the epidemiology of autoimmune thyroiditis (AT) is presented. This review examines the etiological factors of autoimmune thyroid damage. In case of damage to thyroid cells, the formation of antibodies and lymphoid infiltration of the gland is of great importance. It is noted that genetic factors precede the occurrence of pathological changes. Loss of immune tolerance to thyroid autoantigens such as thyroid peroxidase (TPO), thyroglobulin underlies the development of AT. The role of oxidative stress and reactive oxygen species is important in the pathogenesis of the disease. It is shown that at the beginning, AT is asymptomatic and the formation of TPO and thyroglobulin antibodies precedes the onset of the disease and may indicate latent AT. The prevalence of latent AT varies from country to country and ranges from 2 to 20 %, and among women it was 4–6 times higher than among men. Subsequently, latent AT progresses to subclinical and overt thyroiditis with hypothyroidism. The incidence of manifest AT in various countries is from 27 to 273 per 100,000 population. Often, the disease began in childhood and adolescence. The frequency of pathology, including latent subclinical and manifest AT, in this cohort of the population according to different authors is from 0.3 to 9.6 %. Pregnancy was also accompanied by the presence of TPO antibodies but with reduced aggression of cellular elements and antibodies to the thyroid gland. The postpartum period was characterized by exacerbation of the disease. In Ukraine, the incidence of AT is 43.1 per 100,000, the prevalence is almost 10 times higher — 421.2 per 100,000. It is concluded that AT is the most common organ-specific autoimmune disease.