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Abstract
Radioiodine therapy (RIT) has been effectively used for a long time in medical practice for the treatment of hyperthyroidism in patients with diffuse toxic goiter (DTG, Graves’ disease). However, despite the long clinical experience of using radioiodine, there is a number of unclear and controversial questions regarding the side effects and long-term consequences of RIT, including its effect on the immune system, which is known to be very sensitive to ionizing radiation. Cytokines are key factors regulating hematopoiesis, immune response and inflammation. The aim of the work was to study the effect of RIT on the production of pro-inflammatory interleukin‑1β (IL‑1β) and anti-inflammatory interleukin‑10 (IL‑10) in patients with DTG. Material and methods. The levels of IL‑1β and
IL‑10 were determined in 21 patients (16 women and 5 men) with DTG aged 22-67 years (mean value — 44.9±2.6 years) and in 14 donors (control group) of the corresponding age and gender. The activity of radioactive iodine ranged from 400 MBq to 800 MBq (mean value — 549±20.0 MBq). IL‑1β and IL‑10 were studied by the enzyme immunoassay in dynamics: before iodine‑131 intake and in 6 days, 1 and 6 months after RIT. Results. It was found that before RIT in patients with DTG, the content of IL‑1β was 12.46±2.34 pg/mL, which is 2.8 times higher than the control value (p<0.001), and the level of IL‑10 exceeded the donor values by 2 times (24.81±3.46 pg/mL versus 11.80±0.77 pg/mL; p<0.01). After RIT the production of both cytokines increases. The maximum content of IL‑1β was found one month after RIT (35.56±4.28 pg/mL), while the concentration of IL‑10 was the highest on day 6 (43.87±5.82 pg/mL). The levels of IL‑1β and IL‑10 return to baseline values in 6 months after RAI therapy, but remain significantly higher than the control values. Conclusions. In patients with DTG, the levels of pro-inflammatory (IL‑1β) and anti-inflammatory (IL‑10) cytokines in the blood are significantly higher than in healthy donors. RIT increased IL‑1β and
IL‑10 levels. In our opinion, this is due to inflammation caused by the destruction of the thyroid tissue. The difference in the time peaks of IL‑1β and IL‑10 secretion after RIT may indicate the deregulatory balance of pro-and anti-inflammatory factors.
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