Dataset Information

A 2018 European Thyroid Association Survey on the Use of Selenium Supplementation in Hashimoto's Thyroiditis.

ABSTRACT:

Objective

To investigate clinical practice regarding the use of selenium supplementation in patients with Hashimoto's thyroiditis (HT) among members of the European Thyroid Association (ETA).

Methods

ETA members were invited to participate in an online survey investigating the use of selenium supplementation across the spectrum of benign thyroid diseases. Of 872 invited members, 242 (28%) completed the survey. After exclusion of basic scientists and non-European members, survey data from 212 respondents were eligible for further analyses. Responses from 65 (31%) individuals who did not at all recommend selenium, or only considered its use in the setting of a clinical trial, were not included in the final analysis of survey data from 147 respondents.

Results

While only a minority of respondents (29 of 147, 20%) stated that the available evidence warrants the use of Se in patients with HT, a statistically significant majority (95 of 147; 65%, p < 0.001) used Se occasionally or routinely. Se was predominantly recommended for patients with HT not receiving LT4 (102 of 147; 69%) to reduce circulating thyroid autoantibody levels. Very few respondents routinely recommended Se to pregnant patients with HT.

Conclusions

A minority of responding ETA members stated that the available evidence warrants the use of Se in HT, but a majority recommended it to some extent, especially to patients not yet receiving LT4. This is questionable, and selenium is not recommended to patients with HT according to current ETA guidelines. Ongoing and future trials may lead to the reversal of current medical practice.

SUBMITTER: Winther KH

PROVIDER: S-EPMC7109430 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Publications

A 2018 European Thyroid Association Survey on the Use of Selenium Supplementation in Hashimoto's Thyroiditis.

Winther Kristian Hillert KH Papini Enrico E Attanasio Roberto R Negro Roberto R Hegedüs Laszlo L

European thyroid journal 20200114 2

<h4>Objective</h4>To investigate clinical practice regarding the use of selenium supplementation in patients with Hashimoto's thyroiditis (HT) among members of the European Thyroid Association (ETA).<h4>Methods</h4>ETA members were invited to participate in an online survey investigating the use of selenium supplementation across the spectrum of benign thyroid diseases. Of 872 invited members, 242 (28%) completed the survey. After exclusion of basic scientists and non-European members, survey da ...[more]

PMID: 32257959

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Project description:BACKGROUND: Hashimoto's thyroiditis (HT) has been found to coexist with differentiated thyroid cancer (DTC) in surgical specimens, but an association between the two conditions has been discounted by the medical literature. Therefore, we performed this study to determine any potential relationship between HT and the risk of developing DTC. METHODS: We collected data for thyrotropin (TSH), thyroxine (T4), thyroid peroxidase antibody (TPO-Ab) titers, surgical pathology, and weight-based levothyroxine (LT4) replacement dose for patients who were referred for thyroid surgery. Patients with HT at final pathology were studied further. To estimate thyroid function, patients with preoperative hypothyroid HT (Hypo-HT) were divided into three equal groups based on their LT4 replacement: LT4-Low (<0.90 ?g/kg), LT4-Mid (0.90-1.43 ?g/kg), and LT4-High (>1.43 ?g/kg). A group of preoperatively euthyroid (Euth-HT) patients but with HT by pathology was also studied. All subjects were also grouped based on their TPO-Ab titer in TPO-high (titer >1:1000) or TPO-low/negative (titer <1:1000 or undetectable) groups. The relationship of HT and DTC was studied extensively. RESULTS: Of 2811 subjects, 582 had HT on surgical pathology, 365 of whom were Euth-HT preoperatively. DTC was present in 47.9% of the Euth-HT, in 59.7% of LT4-Low, 29.8% of LT4-Mid, and 27.9% of LT4-High groups. The relative risk (RR) for DTC was significantly elevated for the Euth-HT and LT4-Low groups (p<0.001), but not for the LT4-Mid or LT4-High replacement dose groups. TPO-low/negative status conferred an increased RR in the Euth-HT and LT4-Low replacement dose groups (p<0.001 both), while TPO-high status decreased it in Euth-HT group (p<0.05) and made it nonsignificant in the LT4-Low group. CONCLUSIONS: HT pathology increases the risk for DTC only in euthyroid subjects and those with partially functional thyroid glands (LT4-Low) but not in fully hypothyroid HT (LT4-Mid and LT4-High). High TPO-Ab titers appear to protect against DTC in patients with HT.

Project description:PurposePrevious studies have suggested that SERPINA1 may promote a better prognosis in papillary thyroid carcinoma (PTC) along with Hashimoto's thyroiditis (HT). This study aims to further explore the role of the SERPINA1 gene in PTC and its relationship with HT using multiple databases.MethodsTranscriptomic data from The Cancer Genome Atlas (TCGA) were utilized to analyze differences in SERPINA1 expression between PTC patients with and without HT. The expression levels of SERPINA1 in tumor tissues and its association with tumor characteristics were assessed using the Wilcoxon test across both patient groups. The impact of SERPINA1 expression on immune cell infiltration in PTC was evaluated using the CIBERSORT tool. Single-cell transcriptomic data from the Gene Expression Omnibus (GEO) were further analyzed to identify SERPINA1-expressing subpopulations based on Thyroid Differentiation Score (TDS) and pseudotime analysis. Gene Set Variation Analysis (GSVA) was employed to characterize pathways associated with SERPINA1, inferring its potential functions. Finally, CellChat was used to investigate key ligand-receptor interactions between SERPINA1-positive subpopulations and other cell types.ResultsTCGA data analysis reveals that, compared to normal thyroid tissue, the transcriptional level of SERPINA1 is significantly elevated in PTC tissues. Moreover, the expression of SERPINA1 is closely linked to certain clinical pathological features of PTC and the infiltration of immune cells in the tumor microenvironment. Single-cell transcriptome analysis reveals that SERPINA1 is primarily expressed in thyrocytes and myeloid cells. In thyrocytes, SERPINA1 is associated with complement-related proteins (e.g., C3, CD55). In poorly differentiated thyrocytes, it is linked to protease inhibitors and epithelial-mesenchymal transition (EMT) pathways, while in moderately differentiated thyrocytes, it associates with apolipoproteins APOE and APOC1. In macrophages, SERPINA1 is highly expressed in HT-associated macrophages and unpolarized macrophages, correlating with inflammation and extracellular matrix regulation pathways. Cell-cell interaction analysis indicates that SERPINA1-positive cells interact with other cells in the tumor microenvironment through macrophage migration inhibitory factor (MIF) and fibronectin 1 (FN1).ConclusionCompared to normal thyroid tissue or cells, the expression level of SERPINA1 is elevated in PTC. In cancer cells, SERPINA1 may be associated with the complement system and complement regulator functions. In poorly differentiated thyrocytes, SERPINA1 may primarily function as a protease inhibitor and is closely related to FN1. In moderately differentiated thyrocytes, SERPINA1 is associated with apolipoproteins. In unpolarized macrophages, the function of SERPINA1 may be to act as a serine protease inhibitor, participating in the remodeling of the extracellular matrix. In macrophages within an HT environment, the elevated expression of SERPINA1 may serve as a protective mechanism to limit inflammation. In the tumor microenvironment coexisting with HT, SERPINA1 outside the tumor cells may enter the tumor cells through lipid metabolism pathways. The potential role of SERPINA1 in PTC progression is complex, and the findings of this study require further validation.

Dataset Information

A 2018 European Thyroid Association Survey on the Use of Selenium Supplementation in Hashimoto's Thyroiditis.

Objective

Methods

Results

Conclusions

Publications

A 2018 European Thyroid Association Survey on the Use of Selenium Supplementation in Hashimoto's Thyroiditis.

Similar Datasets

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