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C Pelosini,
M Maffei,
G Ceccarini,
M Marchi,
A Marsili,
G Galli,
G Scartabelli,
A Tamberi,
F Latrofa,
P Fierabracci, P Vitti,
A Pinchera,
F Santini
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ABSTRACT: Background: GPR7, the endogenous coupled receptor for neuropeptide B and neuropeptide W, is expressed in several regions of the Central Nervous System (CNS), which are involved in the regulation of feeding behaviour. GPR7 affects the regulation of energy balance through a mechanism independent of leptin and melanocortin pathways. Aim: Aim of this study was to investigate whether GPR7 gene mutations can be detected in human subjects and, in that event, if they are differently distributed among lean and obese subjects. Subjects and Methods: The coding region of GPR7 were sequenced in 150 obese patients and 100 normal-weight unrelated controls. Functional studies of the allelic variants were performed. Results: One genetic GPR7 variant was found (Tyr135Phe - rs33977775) in obese subjects (13,3%) and lean control (25%). Functional studies did not reveal significant differences between the wild type and the Tyr135Phe allelic variants in their NPW mediated capacity to inhibit forskolin-induced cAMP production. Conclusions: Screening of GPR7 gene mutations among lean and obese subjects revealed a Tyr135Phe allelic variant that was fairly common in the study population. As indicated by in vitro and in silico studies, this variant is unlikely to cause a functional derangement of the receptor.
Journal of endocrinological investigation 04/2013; · 1.57 Impact Factor
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F Aghini Lombardi,
E Fiore,
M Tonacchera,
L Antonangeli,
T Rago,
M Frigeri,
A M Provenzale,
L Montanelli,
L Grasso,
A Pinchera, P Vitti
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ABSTRACT: Context: Iodine deficiency disorders are a major public health problem, and programs have been implemented to improve iodine nutrition. Objective: The objective of the study was to verify the effects of voluntary iodine prophylaxis in a small rural community (Pescopagano, Italy). Design: The design of the study was the evaluation of the prevalence of thyroid disorders 15 years after a previous survey conducted before iodine prophylaxis. Setting: The setting for this study was a general community survey. Participants: One thousand one hundred forty-eight residents were examined in 2010 and 1411 in 1995. Results: In 2010, 757 of 1148 subjects (65.9%) routinely used iodized salt, urinary iodine excretion being significantly higher than in 1955 (median 98.0 μg/L, vs 55.0 μg/L, P < .0001). The prevalence of goiter was lower in 2010 than in 1995 (25.8% vs 46.1%, P < .0001), mainly due to the reduction of diffuse goiter (10.3% vs 34.0%, P < .0001). In 2010 vs 1995, thyroid autonomy in subjects younger than 45 years old (3 of 579, 0.5% vs 25 of 1010, 2.5% P = .004) and nonautoimmune hyperthyroidism in subjects older than 45 years old (8 of 569, 1.4% vs 18 of 401, 4.5%, P = .03) were less frequent. The prevalence of hypothyroidism was higher in 2010 vs 1995 (5.0% vs 2.8%, P = .005), mainly because of an increased frequency of subclinical hypothyroidism in subjects younger than 15 years old (7 of 83, 8.4% vs 0 of 419, 0.0%, P < .0001). Accordingly, serum thyroid autoantibodies (19.5% vs 12.6%; P < .0001) and Hashimoto's thyroiditis (14.5% vs 3.5%; P < .0001) were more frequent in 2010 than in 1995. Conclusions: In the present work, the role of voluntary iodine prophylaxis was assessed in a small rural community relatively segregated, in which genetic and other environmental factors have not substantially changed between the 2 surveys. Iodine intake strongly affected the pattern of thyroid diseases, but the benefits of correcting iodine deficiency (decreased prevalence of goiter and thyroid autonomy in younger subjects and reduced frequency of nonautoimmune hyperthyroidism in older subjects) far outweighs the risk of development of thyroid autoimmunity and mild hypothyroidism in youngsters.
The Journal of clinical endocrinology and metabolism 03/2013; 98(3):1031-9. · 6.50 Impact Factor
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P Agretti,
M Segni,
G De Marco,
E Ferrarini,
C Di Cosmo,
A Corrias,
G Weber,
D Larizza,
V Calcaterra,
Mr Pelizzo,
G Cesaretti, P Vitti,
M Tonacchera
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ABSTRACT: Toxic thyroid adenomas or functioning nodules are rare in children and adolescents, representing less than 3% of all causes of hyperthyroidism (1). Somatic gain-of-function mutations of the TSHr gene (accession number NM_00369) have been identified as a cause of toxic thyroid adenomas and functioning nodules of toxic multinodular goitre in the adult (2). In patients with of toxic thyroid adenomas coming from an area of iodine deficiency activating somatic mutations in the TSHr gene have been detected in up to 80%, and in the Gsα gene up to 25%, suggesting that these genetic anomalies may play a role in the pathogenesis of functioning nodules in adults. In contrast, the incidence of gain-of-function somatic mutations of the TSHr or Gsα genes in rare toxic thyroid adenoma in the paediatric population is poorly understood (3). In this study we searched for somatic mutations of TSHr and Gsα genes in a group of 9 children affected by toxic thyroid adenomas or functioning nodules that had undergone surgery. © 2013 Blackwell Publishing Ltd.
Clinical Endocrinology 01/2013; · 3.17 Impact Factor
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ABSTRACT: Background Iodine deficiency (ID) still now represents one of the major worldwide health problems. ID is the result of insufficient dietary iodine intake. Iodine is an essential micronutrient but scarcely presents in nature. The main strategy for the correction of iodine deficiency is the fortification of table salt with iodide/iodine but Italy is far from reaching an iodized salt use higher 90% of population. Also because of the evidence for the risk on blood pressure, it is recommended to decrease the daily salt intake to less than 5g/d. An opportunity to increase the iodine intake is the possibility to introduce iodine fortification in the industrial processing foods. Aim The aim was to evaluate the effectiveness of a diet containing iodized foods enriched during industry processing with protected iodized salt (Presal®). Subjects and Methods The evaluation of increasing of iodine intake was assessed by measuring the urinary iodine excretion (UIE) in 30 healthy volunteers who added to own alimentary habits a basket of iodine enriched foodstuffs. Results Median UIE at baseline was 105 mcg/L, 156 mcg/L during the enriched diet and 90.5 mcg/L a week after withdrawal of enriched diet. Conclusions Stable iodized salt (Presal®) represent a good way to introduce iodine with the normal diet without increasing the normal consumption of salt for the healthy problems related to the blood pressure. The availability of stable iodized salt (Presal®) allows the preservation of iodine after cooking.
Journal of endocrinological investigation 11/2012; · 1.57 Impact Factor
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ABSTRACT: Thyroglobulin autoantibodies (TgAb) can develop in patients with subacute thyroiditis (SAT).
Comparison of the epitope pattern of TgAb of patients with SAT, Hashimoto's thyroiditis (HT) [autoimmune thyroid disease (AITD)] and non-toxic multinodular goiter (NTMG) (non-AITD).
Serum TgAb from 10 patients with SAT, 45 with HT, and 19 with NTMG were evaluated. Serum TgAb binding to Tg was inhibited by 4 recombinant human TgAb-Fab, recognizing Tg epitope regions A, B, C, and D. The ability of single TgAb-Fab to inhibit the binding of serum TgAb to Tg was evaluated in enzymelinked immunosorbent assay.
Levels of inhibition were different for all TgAb-Fab in the 3 groups of patients. Inhibition by region A TgAb-Fab in SAT [50.5 (30.3-62.5)%] (median and 25th to 75th percentiles) was similar to HT [49.0 (38.0-69.5)%] and significantly higher than in NTMG [25.0 (14.0-37.0)%]; by region B TgAb-Fab in SAT [0.0 (0.0-12.5)%] was significantly lower than in HT [28.0 (9.5-48.0)%] and similar to NTMG [9.0 (4.8-20.5)%]; by region C TgAb-Fab in SAT [9.5 (0.0-25.8)%] were similar to HT [23.0 (9.5-41)%] and NTMG [6.5 (1.7-21.5)%]; and by region D TgAb-Fab in SAT [0.0 (0.0-8.0)%] were lower than in HT [12.0 (1.0-28.5)%] and similar to NTMG [1.0 (0.0-5.0)%].
The epitope pattern of TgAb of SAT is restricted to the A region that is immunodominant in AITD and non-AITD. In the majority of patients with SAT, the autoimmune phenomena represent a non-specific and transient response to the release of thyroid antigens, rather than the expression of thyroid autoimmunity.
Journal of endocrinological investigation 09/2012; 35(8):712-4. · 1.57 Impact Factor
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V Belardi,
E Fiore,
E Giustarini,
I Muller,
S Sabatini,
V Rosellini,
E Seregni,
R Agresti,
C Marcocci, P Vitti,
C Giani
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ABSTRACT: Background: an increased frequency of primary hyperparathyroidism (PHP) has been reported in patients with treated breast cancer (BC). PHP has been found in about 7% of BC patients after surgery and radio-, chemio- or hormonal therapy. The aim of this work was evaluate the frequency of PHP in untreated BC patients. Subjects and Methods: we evaluated 186 women with BC and 233 women with thyroid cancer (TC, n=122) or benign thyroid diseases (BTD, n=111). In all patients serum calcium, albumin, PTH and 25-OHvitD were measured before any treatment. Results: Serum calcium concentrations were significantly higher in BC than in TC and BTD groups (median values 9.5 mg/dl, 9.3 mg/dl and 9.3 mg/dl, respectively), but, according to a logistic regression model, calcium was not significantly different between the 3 groups when age was taken into account. In all patients, serum calcium was in the normal range, indicating that no case of overt PHP was present. Five patients (1 in BC, 2 in TC and 2 in BDT groups) had serum calcium close to the upper limit of normal range, high PTH and low 25-OHvitD, indicating a possible PHP with hypercalcemia masked by concomitant 25-OHvitD deficiency. Conclusions: in untreated BC group, no patient had overt PHP and 1/186 (0.5%) presented a possible PHP masked by 25-OHvitD deficiency, a PHP frequency much lower than that observed in treated BC patients. These data suggest that the treatments of BC may be responsible for the increased frequency of PHP reported in previous studies.
Journal of endocrinological investigation 08/2012; · 1.57 Impact Factor
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M Giannetti,
P Piaggi,
G Ceccarini,
S Mazzeo,
G Querci,
P Fierabracci,
G Salvetti,
G Galli,
I Ricco,
S Martinelli,
C Di Salvo,
M Anselmino,
A Landi, P Vitti,
A Pinchera,
F Santini
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ABSTRACT: Nonalcoholic fatty liver disease is a common finding in obese subjects. Increasing evidence has been provided suggesting that it represents the hepatic component of the metabolic syndrome.
Aim of this longitudinal study was to evaluate the relationships between several anthropometric measures, including the hepatic left lobe volume (HLLV), and various indicators of the metabolic syndrome in a cohort of severely obese women before and after laparoscopic adjustable gastric banding (LAGB).
Seventy-five obese women (mean age 45 ± 10 years and body mass index (BMI) 42.5 ± 4.8 kg m(-2)) underwent LAGB and completed an average (± s.d.) post-surgical follow-up of 24 ± 6 months. Determination of HLLV, subcutaneous and intra-abdominal fat (IAF) was based on ultrasound. The principal component statistical analysis applied to pre-operative measurements, highlighted HLLV as a parameter that clustered with serum insulin, IAF, serum glucose and uric acid, along with triglycerides (TGs), alkaline phosphatase and high-density lipoprotein cholesterol. After LAGB, the average reduction of BMI was 23%, 12% for subcutaneous fat (SCF), 42% for HLLV and 40% for visceral fat. Among body weight, BMI, SCF, IAF and HLLV, reduction of the latter was an independent predictor of reduction of serum transaminases and γ-Glutamyltransferase, glucose, insulin and TGs.
In severely obese women: (i) HLLV is a sensitive indicator of ectopic fat deposition, clustering with parameters defining the metabolic syndrome; (ii) weight loss achieved by LAGB is associated with a reduction of liver volume as estimated by HLLV; (iii) among various anthropometric parameters measured, reduction of HLLV that follows LAGB represents the best single predictor of improvement of various cardiometabolic risk factors.
International journal of obesity (2005) 12/2011; 36(3):336-41. · 4.34 Impact Factor
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M Tonacchera,
P Agretti,
T Rago,
G De Marco,
F Niccolai,
A Molinaro,
M Scutari,
A Candelieri,
D Conforti,
R Musmanno,
G Di Coscio,
F Basolo,
P Iacconi,
P Miccoli,
A Pinchera, P Vitti
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ABSTRACT: Fine needle aspiration (FNA) with cytologic evaluation is the most reliable tool for malignancy prediction in thyroid nodules, but cytologic diagnosis remains undetermined for 20% of nodules.
We investigated the diagnostic potential of a set of 6 marker genes to distinguish benign and malignant thyroid nodules.
The prospective study included 153 thyroid samples obtained by FNA of thyroid nodules from 151 patients (56 benign, 43 malignant, and 54 nodules with undetermined cytology). Gene expression was evaluated by quantitative realtime PCR and statistical analysis of data was performed. All samples were analyzed for V600E BRAF mutation.
A decrease in TTF3 and HGD1 expression was observed in malignant nodules with respect to benign ones, while an increase in PLAB expression was demonstrated in these nodules. The decision model was valid for 88 of 99 cases of benign and malignant nodules, with a total of 11 false positive or negative predictions. The obtained malignant/benign phenotype prediction was also valid for 37 of 54 cases of nodules with undetermined cytology with a total of 8 false positive and 9 false negative predictions. V600E BRAF gene mutation was demonstrated in 19/43 malignant nodules, in 0/56 benign nodules, and in 1/54 undetermined nodules.
The expression profiles of genes (TFF3, HGD1, and PLAB) allowed a good prediction for the differentiation of benign thyroid lesions and thyroid cancer starting from cells of FNA; however, this assay showed limitations when applied to discriminate thyroid nodules with undetermined cytology.
Journal of endocrinological investigation 10/2011; 35(8):754-9. · 1.57 Impact Factor
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Annales d Endocrinologie 04/2011; 72(2):162-3. · 0.74 Impact Factor
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A Dimida,
E Ferrarini,
P Agretti,
G De Marco,
L Grasso,
M Martinelli,
I Longo,
D Giulietti,
A Ricci,
M Galimberti,
B Siervo,
G Licitra,
F Francia,
A Pinchera, P Vitti,
M Tonacchera
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ABSTRACT: Electric and magnetic fields (EMF) might be involved in human disease and numerous research and scientific reviews have been conducted to address this question. In particular thyroid structural and functional alterations caused by various forms of non-ionizing radiation have been described.
The aim of this study was to analyze the possible effects of EMF on thyroid, in particular we analyzed the effects caused by a GSM (Global System for Mobile Communications) signal (900 MHz) on cultured thyroid cells (FRTL- 5).
The experimental setup was designed in order to expose samples to a radiofrequency wave in well-controlled conditions. We used the FRTL-5 cell line, an epithelial monoclonal continuous cell line derived from Fisher rat thyroid tissue growing as monolayer, expressing the TSH receptor and the sodium-iodide symporter (NIS). FRTL-5 were subsequently irradiate for 24, 48, and 96 h with EMF (800-900 MHz, power-frequency of mobile communication systems) and iodide uptake and cAMP production were measured.
The irradiation of cells with EMF at 900 Mhz for 24, 48, and 96 h did not influence the level of cAMP production and was not able to modify iodide accumulation in FRTL- 5 cells with respect to basal conditions.
In conclusion, EMF do not seem to be able to interfere with the biochemical properties of FRTL-5 cells in vitro.
Journal of endocrinological investigation 03/2011; 34(3):185-9. · 1.57 Impact Factor
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R Negro,
P Beck-Peccoz,
L Chiovato,
P Garofalo,
R Guglielmi,
E Papini,
M Tonacchera,
F Vermiglio, P Vitti,
M Zini,
A Pinchera
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ABSTRACT: Hyperthyroidism in pregnancy is an uncommon disease, involving less than 1% of pregnancies. The recognition of hyperthyroidism may be elusive as some sign and symptoms may be attributed to the state of pregnancy itself. Furthermore, the diagnosis of hyperthyroidism is sometimes challenging and treatment must take into account not only the mother but also the fetus' health. A carefully tailored treatment is necessary to avoid or reduce the risks of complications associated with uncontrolled disease which are represented by spontaneous abortion, congenital abnormalities, preeclampsia, preterm birth, low birth weight, placental abruption, neonatal thyroid dysfunction, and perinatal mortality. The Italian Thyroid Association (AIT) and Italian Association of Clinical Endocrinologists (AME) constituted an ad hoc committee that developed clinical practice recommendations for diagnosis and treatment of hyperthyroidism in pregnancy. The review and recommendations have been based on a comprehensive analysis of the current literature and from the consensus of experts.
Journal of endocrinological investigation 03/2011; 34(3):225-31. · 1.57 Impact Factor
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ABSTRACT: Thyroid gland is highly dependent on dietary intake of iodine for normal function, so it is particularly subjected to "endocrine disruptor" action. The human sodium/iodide symporter (hNIS) is an integral plasma membrane glycoprotein mediating the active transport of iodide into thyroid follicular cells, a crucial step for thyroid hormone biosynthesis. Beyond to perchlorate and thyocianate ions a few other inhibitors of iodide uptake have been described.
The aim of this study was to investigate if 10 substances usually used as drugs in clinical practice were able to inhibit NIS-mediated iodide uptake in vitro.
A CHO cell line stably expressing hNIS was used to test any inhibition of NIS-mediated iodide uptake exerted by drugs. Perchlorate and thyocianate ions were used as positive controls.
None of the analyzed substances was able to significantly inhibit iodide uptake in our system. As we expected, perchlorate and thyocianate ions were able to inhibit iodide uptake in a dose-dependent manner.
In conclusion, we carried out an in vitro assay to evaluate the potential inhibitory effect of common drugs on NISmediated iodide uptake by using CHO-hNIS cells. None of the analyzed substances was able to inhibit iodide uptake; only perchlorate and thyocianate were able to inhibit iodide uptake in a dose-dependent manner.
Journal of endocrinological investigation 03/2011; 34(3):170-4. · 1.57 Impact Factor
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ABSTRACT: Indeterminate and nondiagnostic patterns represent the main limitation of fine-needle aspiration (FNA) cytology of thyroid nodules, clinical and echographic features being poorly predictive of malignancy. The newly developed real-time ultrasound elastography (USE) has been previously applied to differentiate malignant from benign lesions. The aim of this study was to get further insights into the role of USE in the presurgical diagnosis of nodules with indeterminate or nondiagnostic cytology.
The study included 176 patients who had one (n=138) or multiple (n=38) nodules with indeterminate or nondiagnostic cytology on FNA, for whom histology was available after thyroidectomy. A total of 195 nodules (142 indeterminate, 53 nondiagnostic) were submitted to USE, and elasticity was scored as 1 (high), 2 (intermediate), or 3 (low).
In indeterminate lesions, the score 1, describing high elasticity, was strongly predictive of benignity, being found in 102 of 111 benign nodules and in only one of 31 carcinomas (P<0.0001). By combining the scores 2 and 3, USE had a sensitivity of 96.8% and a specificity of 91.8%. In nodules with nondiagnostic cytology, score 1 was found in 39 of 45 benign nodules and in only one of eight carcinomas (P<0.0001). By combining the scores 2 and 3, USE had a sensitivity of 87.5% and a specificity of 86.7%.
USE may represent an important tool for the diagnosis of thyroid cancer in nodules with indeterminate or nondiagnostic cytology and may prove useful in selecting patients who are candidates for surgery.
The Journal of clinical endocrinology and metabolism 12/2010; 95(12):5274-80. · 6.50 Impact Factor
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C Romei,
B Cosci,
G Renzini,
V Bottici,
E Molinaro,
L Agate,
P Passannanti,
D Viola,
A Biagini,
F Basolo,
C Ugolini,
G Materazzi,
A Pinchera, P Vitti,
R Elisei
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ABSTRACT: This study was aimed to demonstrate the clinical benefits of rearranged during transfection (RET) genetic screening in patients with apparently sporadic medullary thyroid cancer (MTC) not only to identify the hereditary nature of the disease in the index case but also to discover family members harbouring the same germline mutations (i.e. gene carriers) who are unaware of their condition.
RET genetic screening allowed the identification of germline RET mutations in apparently sporadic MTC resulting in their re-classification as hereditary forms.
RET genetic screening was performed in 729 apparently sporadic MTC patients by direct sequencing RET exons 5, 8, 10, 11 and 13-16. Clinical and biochemical evaluation of gene carriers was also performed.
We discovered an unsuspected germline RET mutation in 47 of 729 (6·5%) apparently sporadic MTC who were re-classified as hereditary. We found 60 of 146 (41·1%) gene carriers, 35 of whom had biochemical or clinical evidence of MTC. Thirty gene carriers underwent total thyroidectomy and 27 of 30 (90%) were persistently cured after a mean follow-up of 6·0 years. As a further result of RET genetic screening, we observed a significantly higher prevalence of familial medullary thyroid cancer (FMTC) in our series with respect to the largest series of the International RET Consortium (P = 0·0002).
RET genetic screening of patients with apparently sporadic MTC represents a major tool for the preclinical diagnosis and early treatment of unsuspected affected family members and allows the identification of a relevant percentage of hidden FMTC.
Clinical Endocrinology 11/2010; 74(2):241-7. · 3.17 Impact Factor
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ABSTRACT: American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules are systematically developed statements to assist health care professionals in medical decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied. These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes in this area are expected, periodic revisions are inevitable. We encourage medical professionals to use this information in conjunction with their best clinical judgment. Any decision by practitioners to apply these guidelines must be made in light of local resources and individual patient circumstances.
Journal of endocrinological investigation 05/2010; 33(5):287-91. · 1.57 Impact Factor
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T Rago,
E Fiore,
M Scutari,
F Santini,
G Di Coscio,
R Romani,
P Piaggi,
C Ugolini,
F Basolo,
P Miccoli,
A Pinchera, P Vitti
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ABSTRACT: To evaluate the risk of papillary thyroid carcinoma (PTC) at fine-needle aspiration (FNA) cytology in 34 120 patients.
False positive and false negative rates of FNA cytology were 1.2 and 1.8% in comparison with the histology in 3406 nodules from 3004 patients who underwent surgery. PTC (901 cases) was more frequent in solitary nodule (SN; 446/13 549, 3.3%) than in multinodular goiter (MNG; 411/19 923, 2%, chi(2)=48.8; P<0.0001), and in males (209/6382, 3.3%) than in females (648/26 945, 2.40%, chi(2)=15.58; P<0.0001). PTC prevalence in Graves' disease (GD; 13/286, 4.5%) and Hashimoto's thyroiditis (HT; 31/508, 6.1%) was higher than in SN, this difference being significant in HT (chi(2)=8.7; P=0.003), but not in GD (chi(2)=1.6; P=0.2). Using the multiple logistic regression analysis, independent risk predictors of PTC were determined, which were younger age (odds ratio (OR)=0.97, confidence interval (CI) 0.964-0.974; P<0.0001), male gender (OR=1.44, CI 1.231-1.683; P<0.0001), and SN versus MNG (OR=0.63, CI 0.547-0.717; P<0.0001). The individual risk predictivity was highly improved by including serum TSH in the prediction model, which was measured at FNA in 11 919 patients.
A cytology suspicious or indicative of PTC was associated with younger age, male gender, and solitary versus multiple nodularity. These clinical parameters, together with serum TSH, may allow formulation of an algorithm that could be usefully applied to predict the risk of PTC in individual patients when cytology does not give a diagnostic result.
European Journal of Endocrinology 04/2010; 162(4):763-70. · 3.42 Impact Factor
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ABSTRACT: Vitiligo is an acquired depigmenting disorder characterized by the loss of melanocytes from the epidermis with the development of white patches in various distribution. The pathogenesis of vitiligo is still unknown, but the association with autoimmune disorders and organ specific autoantibodies, supports the hypothesis of an autoimmune pathogenesis.
The aim of the present study was to investigate if autoantibodies present in sera of patients affected by vitiligo may be able to interfere with the activity of the αMSH on the melanocortin 1 receptor (MC1R). MATERIALS/ SUBJECTS AND METHODS: IgG from the sera of 41 patients with vitiligo associated or not with thyroid autoimmune diseases or other autoimmune pathologies were incubated with HBL20 cells (human malignant melanocytes expressing the MC1R) in the presence of a sub-maximal dose of αMSH. A normal IgG range was determined by using IgG extracted from 30 control sera of normal subjects.
None of the IgG from vitiligo patients was able to inhibit αMSH-stimulated cAMP production in HBL20 cells.
Autoantibodies against MC1R are rare or absent in sera of vitiligo patients.
Journal of endocrinological investigation 03/2010; 33(11):784-8. · 1.57 Impact Factor
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E Fiore,
T Rago,
M A Provenzale,
M Scutari,
C Ugolini,
F Basolo,
G Di Coscio,
P Miccoli,
L Grasso,
A Pinchera, P Vitti
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ABSTRACT: The risk of papillary thyroid cancer (PTC) is related to serum TSH, and the development of thyroid autonomy by reducing TSH levels decreases the frequency of PTC in patients with nodular goiter. Our aim was to investigate the effect of L-thyroxine (LT(4)) on the frequency of PTC diagnosed by cytology in a large series of patients with nodular goiter untreated (n=20 055) or treated with L-T(4) (n=7859). L-T(4)-treated patients with respect to untreated patients presented significantly lower serum TSH (median, interquartile range: 0.30 muU/ml, 0.08-0.62 microU/ml versus 0.70 muU/ml, 0.38-1.14 muU/ml; P<0.0001) and prevalence of PTC (3.2 vs 5.1%; P<0.0001). The frequency of PTC was closely related to serum TSH, with it being lowest in patients with TSH below the normal range (<0.4 muU/ml; 189/10 059, 1.9%) and highest in patients with TSH above the normal range (>3.4 muU/ml; 21/127, 16.5%), also showing a progressive increase from the lower to the upper quartile of normal range. A significantly higher proportion of L-T(4)-treated patients (6650/7859, 84.6%) had serum TSH below the median (0.90 muU/ml) with respect to untreated patients (12,599/20,055, 62.8%; chi(2) P value <0.0001), with it being included in the range of TSH associated with a lower frequency of PTC. The relationship between serum TSH and frequency of PTC was unrelated to the type of nodularity (solitary versus multinodular) and was not age dependent. In conclusion, patients with nodular goiter, treatment with L-T(4) is responsible for the reduction of serum TSH and is associated with a decreased frequency of PTC.
Endocrine Related Cancer 01/2010; 17(1):231-9. · 4.36 Impact Factor
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ABSTRACT: A firm or hard consistency is associated with an increased risk of malignancy in thyroid nodules. Ultrasound (US) elastosonography is a new powerful diagnostic technique that assesses hardness as indicator of malignancy that was recently applied in the diagnostic approach of nodular thyroid disease. The basic principle of elastosonography is that tissue compression produces strain (displacement), that is less in hard than in soft tissues and is scored measuring the degree of distortion of US beam under the application of an external force, during the examination. The US elastogram is displayed over the B-mode image in a colour scale that corresponds to tissue elasticity. The US elastosonography performed on selected series of patients has displayed a sensitivity of 97%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 98%. The predictivity of US elastographic measurement was independent from the nodule size, high sensitivity and specificity being observed also in nodules <1 cm. These data were also confirmed by other authors in smaller cytological series. Available data suggest that predictivity of US elastosonography is maintained in indeterminate lesions. Conventional US maintains a pivotal importance to define which nodules are suitable for elastographic characterization. Indeed, nodules in which US reveals the presence of calcified shell and cystic nodules have to be excluded from the US elastographic evaluation. Another limitation is that the nodule to be examined must be clearly distinguishable from other nodules present in the thyroid. Thus, multinodular goiters with coalescent nodules are not suitable for this analysis. US elastosonography seems to have a great potential as a new tool for the diagnosis of thyroid cancer, especially in nodules with indeterminate cytology.
The quarterly journal of nuclear medicine and molecular imaging: official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of... 10/2009; 53(5):455-64.
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E Fiore,
T Rago,
M Scutari,
C Ugolini,
A Proietti,
G Di Coscio,
M A Provenzale,
P Berti,
L Grasso,
S Mariotti,
A Pinchera, P Vitti
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ABSTRACT: We evaluated the association between thyroid autoimmunity and thyroid cancer in a retrospective series of unselected thyroid nodules submitted to fine-needle aspiration (FNA) cytology.
Anti-thyroid antibodies (TAb) were measured in patients with multinodular goiter (MNG) and single/isolated thyroid nodule (S/I) submitted to FNA. Thyroid lymphocytic infiltration (LI) on histology was studied in a subgroup of patients submitted to thyroidectomy; 13,021 patients were included: on cytology 622 had papillary thyroid cancer (c- PTC) and 12,399 benign thyroid nodular diseases (c-BTN). LI was evaluated in histological samples of 688 patients: 304 with PTC (h-PTC) and 384 with BTN (h-BTN).
TAb prevalence was not different in c-BTN and c-PTC (38.7% vs 35.6%). TAb were more frequent in c-BTN than c-PTC in females with MNG (40.1% vs 32.5%, p=0.02), and in c-PTC than in c-BTN in males with S/I (31.2% vs 20.4%, p=0.02) and, although not significantly, in females younger than 30 yr (35.1% vs 30.7%). The frequency and severity of LI was significantly higher in h-PTC than h-BTN, both in MNG (82.5% vs 45.0%, p<0.001) and S/I (85.6% vs 71.0%, p<0.001), but a higher number of patients with h-PTC had negative circulating TAb, despite the presence of moderate/severe LI.
TAb are weakly associated to PTC in males and young females, while they are more frequent in older females with BTN. The frequency and severity of LI is significantly higher in PTC than in BTN, but in cancer patients TAb are frequently negative, despite the evidence of histological thyroiditis. These data suggest that different kinds of immune response may be involved in PTC and BTN.
Journal of endocrinological investigation 04/2009; 32(4):344-51. · 1.57 Impact Factor
