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3 . 2022

Chemiluminescent activity of neutrophils in patients with Graves’ disease after 2-week withdrawal of thiamazole

Abstract

Graves’ hyperthyroidism stimulates enhanced synthesis of reactive oxygen species (ROS) by phagocytic cells. The immunomodulatory effect of thionamide therapy has a short-term effect, which is realized at the onset of Graves’ hyperthyroidism, is associated with the drug-induced euthyroidism achievement, and a gradual thyrostatic dose reduction to a supportive one creates an immunogenic potential for functional activity of pro-inflammatory cells and disease relapse.

The aim of the study was to investigate chemiluminescent activity of neutrophils and thyroid status in patients with Graves’ disease after 2-week withdrawal of thiamazole.

Material and methods. Inclusion criteria: women aged 18 to 55 years with a diagnosis of Graves’ disease. All patients were prescribed radioactive iodine therapy with preliminary conservative treatment with thiamazole and beta-blockers until the symptoms of thyrotoxicosis were eliminated. The patients were prepared for radioactive iodine (RAI) according to the standard protocol, which includes thiamazole withdrawal two weeks before taking a solution of RAI. Chemiluminescence was used to assess the level of ROS synthesis in peripheral blood neutrophils. The time to reach the maximum (Tmax), the maximum luminescence intensity (Imax), and the area under the curve (S) were determined.

Results and discussion. After 2 weeks of thiamazole withdrawal in preparation for RAI, 16 (33.33%) patients retained drug-induced euthyroidism, 17 (35.41%) had isolated T3 toxicosis, 15 (31.25%) patients developed manifest hyperthyroidism. Regardless of the thyroid status in patients compared with the control, an increase in total synthesis (S) with a decrease in intensity (Imax) for all chemiluminescence reactions was revealed.

Conclusion. Persistent changes in the kinetics of ROS formation for short-term thiamazole withdrawal should be taken into account not only for planning treatment with RAI and the thyrostatic discontinuation, but also in developing and optimizing methods of causal treatment of the disease.

Keywords:Graves’ disease; isolated T3-toxicosis; antithyroid drugs; thiamazole; radionuclide therapy, chemiluminescence; oxidative stress; reactive oxygen species

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Dudina M.A., Fomina D.V., Dogadin S.A., Savchenko A.A., Gvozdev I.I. Chemiluminescent activity of neutrophils in patients with Graves’ disease after 2-week withdrawal of thiamazole. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2022; 11 (3): 7–14. DOI: https://doi.org/10.33029/2304-9529-2022-11-3-7-14 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
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