PLACE OF SELENIUM IN THE TREATMENT OF THYROID DISEASES
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1 VII, 2013, 2 27, PLACE OF SELENIUM IN THE TREATMENT OF THYROID DISEASES D. Gavrailova Faculty of Public Health, Medical University So a : (Se).,. Se, - (, )., Se., Se -. :,,, :,, Summary: The essential trace mineral, selenium (Se), is of fundamental importance to human health. Many of its physiologic roles may be ascribable to its presence within selenoproteins, known for their antioxidant properties. Several studies have investigated the potential positive effects of Se supplementation in thyroid diseases, characterized by increased levels of hydrogen peroxide and free radicals (autoimmune chronic thyroiditis, Graves disease). These studies have supplied evidences indicating that Se supplementation, maximizing the antioxidant enzymes activity, may reduce the thyroid in ammatory status. Then, it may be assumed that Se could have therapeutic role in autoimmune thyroid disease. Key words: selenium, selenoenzymes, thyroid, autoimmun thyroid diseases Address for coerrespondence: D. Gavrailova, Faculty of Public Health, Medical University So a, -, [41]. (Se) -,, -. -, - [37] [7], - (GPx), (TrxR) - (DIO), - [24]. (GPx) (TrxR) - - [5, 7]. - (DIO), -
2 28 ( 4 ) ( 3 ), , ( 3 ) - T 3 3,3`- [5, 33, 43]. (TSH,, ), [4, 20], - [9]. Se -,, - [9, 20]. - (H 2 ),, - - [14]., - H 2.,, - - 1, T 4 3 [21]. - GPx, DIO - [20, 21]. [5, 10] -, -, - H 2. ( ) - -, -, - [6, 34]. - (TPOAb, -TPO) / (TG-Ab). - Se, -. - TPOAb -. Duntas., - TPOAb 46% (P < ) 3-55,5% (P < 0.05) 6- L- L- [11]. - Mazokopakis. [30] , 200 microg Se L TPO 6 (5,6% 3-9,9% 6- ) 21% TPOAb ( < ). -, Se 6 - -TPO, - - Se 6, 8% - -TPO, - 4.8% ( < ). - O. Turker. [44], 9 L- (200/100 g/ ) -. L- TSH 2 MIU/l., 200 g/ L- 3 (N = 48), TPOAb % ( TPOAb 803 IU/ml 572 IU/ml P < 0.001), (N = 20) L g/ % (P < 0.01),, g/ 30,3% (P < 0.01). TPOAb ( 38.1%, P < 0.01), 3-200
3 29 g/, 100 g/,,, -. -,, - -, 200 g/ (Na 2 SO 3 ) 3, - [18]., -, IU/ml. R. Gärtner [13] -, - - (TPOAb 1200 IU/ml). TPOAb. - Y. J. Tong. [42], - - TPOAb (> 600 IU/ml) - - TPOAb ( - 83,6, 95,6 92,9 UI/ml). G. Karanikas. [17] - TPOAb -, -. - GP TrxR, - [11].. Xue. [46] 2010., , , -. -, TNF-, IL-1, IL-6, - IL-2, - TNF-, -, -. R. Krysiak. Okopien ( - -, TPOAb) - -, TPOAb, - [23] % - TPOAb, 8% - [35, 39]., - (PPT), - [27]. -, -, -, -., [19].,, - - R. Négro. [33] - 2 TPO- : ( S 1 ) ( - S 0 ). TPOAb, -, 200 g/ (62,4% 43.9% P < 0.01). -, ,, S (28,6% 48,6% P < 0.01) (11.7% 20,3% P < 0.01), -,. J. H. Lazarus [28]
4 30, - PPT. D. Nacamulli. [31] (80 g) (Na 2 SeO 3 ) ( 4 TSH, - ). 30% (P = 0,0001) TPOAb 19% -, 6-.,, -, - ( - ) GPx, TrxR, ,,, - [12]. GRAVE - [2, 15]. GP [22] ( -, ) [2]. V. Bacic-Vrca. [3] - ( E, C, - 60 g/ ) GP, -, -,. - T. Wertenbruch [45], -., - - (> 120 microg/l) TSH, -. - Se. - ( ) (European Group on Graves Orbitopathy EUGOGO) 200 g/ - [29] % (P < 0.001), 61% - (P = 0.01) (P = 0.01) - 7% 26%,. - -, - H 2. - [38]. ( ),, - [40] -. [26] ,,
5 31 -,, [8]. -.,, [1]. L. Rasmussen. [36], -., - (P = 0,006), (P = 0.007) 10 mm (P = 0.087),.. Derumeaux. [8] [16]. - M. Kucharzewski. [25],, - - -, -.,,,, -., - Se,,. - : - - -, -, -, -, - L-, - - /., -, - [9, 32]. 1.,.,.,.. -., 11, 2006, 4, A b a l o v i c h, M. et al. Peripheral parameters of oxidative stress in Graves disease: the effects of methimazole and 131 iodine treatments. Clin. Endocrinol., 59, 2003, Baci V r c a, V. et al. Supplementation with antioxidants in the treatment of Graves disease: the effect on the extracellular antioxidative parameters. Acta Pharmaceutica, 54, 2004, B a t e s, J. M. et al. Effects of selenium de ciency on tissue selenium content, deiodinase activity, and thyroid hormone economy in the rat during development. Endocrinology, 141, 2000, B e c k e t t, G. J. et J. R. Arthur. Selenium and endocrine systems. J. Endocrinol., 184, 2005, Bianchi, G. P. et al. Health-related quality of life in patients with thyroid disorders. Qual. Life Res., 13, 2004, C a s t e l l a n o, S. et al. Diversity and functional plasticity of eukaryotic selenoproteins: identi cation and characterization of the Sel family. Proc. Natl. Acad. Sci USA, 102, 2005, D e r u m e a u x, H. et al. Association of selenium with thyroid volume and echostructure in 35- to 60-year-old French adults. Eur. J. Endocrinol., 148, 2003, D r u t e l, A., F. Archambeaud et Ph. Caron. Selenium and the Thyroid Gland. Clin. Endocrinol., 78, 2013, 2, Duntas, L. H. The role of selenium in thyroid autoimmunity and cancer. Thyroid, 16, 2006, D u n t a s, L. H., E. Mantzou et D. A. Koutras. Effects of a six month treatment with selenomethionine in patients with autoimmune thyroiditis. Eur. J. Endocrinol., 148, 2003, D u n t a s, L. H. Selenium and the Thyroid: A Close-Knit Connection. J. Clin. Endocrinol. Metab., 95, 2010, 12, G ä r t n e r, R. et al. Selenium supplementation in patients with autoimmune thyroiditis decreases thyroid peroxidase antibodies concentrations. J. Clin. Endocrinol. Metab., 87, 2002, 4, Goldhaber, S. B. Trace element risk assessment: essentiality vs. toxicity. Regul. Toxicol. Pharmacol., 38, 2003, G u e r r a, L. N. et al. Antioxidants and methimazole in the treatment of Graves disease: effect on urinary malondialdehyde levels. Clin. Chim. Acta, 352, 2005, Jellum, E. et al. The JANUS serum bank. Sci. Total Environ., , 1993, Karanikas, G. et al. Relation of anti-tpo autoantibody titre and T-lymphocyte cytokine production patterns in Hashimoto s thyroiditis. Clin. Endocrinol., 63, 2005, Karanikas, G. et al. No immunological bene t of selenium in consecutive patients with autoimmune thyroiditis. Thyroid, 18, 2008, K a r i t a, K. et al. Variation in plasma selenium levels as a result of the menstrual cycle and pregnancy in healthy Japanese women. Biol. Trace Elem. Res., 99, 2004, K ö h r l e, J. et al. Selenium, the thyroid, and the endocrine system. Endocr. Rev., 26, 2005, 7,
6 K ö h r l e, J. et R. Gärtner. Selenium and thyroid. Best Pract. Res. Clin. Endocrinol. Metab., 23, 2009, K o m o s i n s k a - V a s s e v, K. et al. Free radical activity and antioxidant defense mechanisms in patients with hyperthyroidism due to Graves disease during therapy. Clin. Chim. Acta, 300, 2000, Krysiak, R. et B. Okopien. The effect of levothyroxine and selenomethionine on lymphocyte and monocyte cytokine release in women with Hashimoto s thyroiditis. J. Clin. Endocrinol. Metab., 96, 2011, 7, Kryukov, G. V. et al. Characterization of mammalian selenoproteomes. Science, 300, 2003, K u c h a r z e w s k i, M. et al. Concentration of selenium in the whole blood and the thyroid tissue of patients with various thyroid diseases. Biol. Trace Elem. Res., 88, 2002, Laclaustra, M. et al. Serum selenium and serum lipids in US adults: National Health and Nutrition Examination Survey (NHANES) Atherosclerosis, 210, 2010, L a z a r u s, J. H., A. Parkes et L. Premawardhana. Postpartum thyroiditis. Autoimmunity, 35, 2002, L a z a r u s, J. H. Does selenium supplementation during and after pregnancy reduce postpartum thyroid dysfunction and autoimmunity? Nat. Clin. Pract. Endocrinol. Metab., 3, 2007, M a r c o c c i, C. et al. Selenium and the course of mild Graves orbitopathy. N. Engl. J. Med., 364, 2011, Mazokopakis, E. E. et al. Effects of 12 months treatment with L-selenomethionine on serum anti-tpo levels in patients with Hashimoto s thyroiditis. Thyroid, 17, 2007, 7, Nacamulli, D. et al. In uence of physiological dietary selenium supplementation on the natural course of autoimmune thyroiditis. Clin. Endocrinol., 73, 2010, Negro, R. Selenium and thyroid autoimmunity. Biologics, 2, 2008, 2, Negro, R. et al. The in uence of selenium supplementation on postpartum thyroid status in pregnant women with thyroid peroxidase autoantibodies. J. Clin. Endocrinol. Metab., 92, 2007, Ott, J. et al. Hashimoto s thyroiditis affects symptom load and quality of life unrelated to hypothyroidism: a prospective case control study in women undergoing thyroidectomy for bening goiter. Thyroid, 21, 2011, P o p p e, K. et D. Glinoer. Thyroid autoimmunity and hypothyroidism before and during pregnancy. Hum. Reprod. Update, 9, 2003, R a s m u s s e n, L. B. et al. Selenium status, thyroid volume, and multiple nodule formation in an area with mild iodine de - ciency. Eur. J. Endocrinol., 164, 2011, R a y m a n, M. P. The importance of selenium to human health. Lancet, 356, 2000, R o y, G. et G. Mugesh. Selenium analogues of antithyroid drugs recent developments. Chem. Biodivers., 5, 2008, 3, Stagnaro-Green, A. Postpartum thyroiditis. Best Pract. Res. Clin. Endocrinol. Metab., 18, 2004, Stranges, S. et al. Effects of long-term selenium supplementation on the incidence of type 2 diabetes: a randomized trial. Ann. Intern. Med., 147, 2007, T h o m s o n, C. D. Assessment of requirements for selenium and adequacy of selenium status: a review. Eur. J. Clin. Nutr., 58, 2004, To n g, Y. J. et al. An epidemiological study on the relationship between selenium and thyroid function in areas with different iodine intake. Zhonghua Yi Xue Za Zhi, 83, 2003, 23, Toulis, K. A. et al. Selenium supplementation in the treatment of Hashimoto s thyroiditis: a systematic review and a meta-analysis. Thyroid, 20, 2010, T u r k e r, O. et al. Selenium treatment in autoimmune thyroiditis: 9-month follow-up with variable doses. J. Endocrinol., 190, 2006, W e r t e n b r u c h, T. et al. Serum selenium levels in patients with remission and relapse of Graves disease. Med. Chem., 3, 2007, X u e, H. et al. Selenium upregulates CD4(+)CD25(+) regulatory T cells in iodine-induced autoimmune thyroiditis model of NOD.H-2(h4) mice. Endocr. J., 57, 2010,
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