The effect of levothyroxine and selenomethionine on lymphocyte and monocyte cytokine release in women with Hashimoto's thyroiditis.

Abstract

CONTEXT:

No previous study determined monocyte- and lymphocyte-suppressing effects of levothyroxine and selenomethionine and assessed whether their coadministration is superior to treatment with only one of these drugs.

OBJECTIVE:

Our objective was to compare the effect of levothyroxine and selenomethionine on monocyte and lymphocyte cytokine release and systemic inflammation in patients with Hashimoto's thyroiditis.

DESIGN, SETTING, PARTICIPANTS, AND INTERVENTION:

We conducted a randomized clinical trial involving a group of 170 ambulatory euthyroid women with recently diagnosed and previously untreated Hashimoto's thyroiditis and 41 matched healthy subjects. Participants were randomized in a double-blind fashion to receive a 6-month treatment with levothyroxine, selenomethionine, levothyroxine plus selenomethionine, or placebo. One hundred sixty-five patients completed the study.

MAIN OUTCOME MEASURES:

Monocyte and lymphocyte release of proinflammatory cytokines and plasma levels of C-reactive protein (CRP) were assessed.

RESULTS:

Compared with the control subjects, monocytes and lymphocytes of Hashimoto's thyroiditis patients released greater amounts of all cytokines studied. Levothyroxine reduced monocyte release of TNF-α, IL-1β, IL-6, and monocyte chemoattractant protein-1, whereas selenomethionine inhibited lymphocyte release of IL-2, interferon-γ, and TNF-α, which was accompanied by a reduction in plasma CRP levels. The decrease in cytokine release and in plasma CRP levels was strongest when both drugs were given together.

CONCLUSIONS:

Despite affecting different types of inflammatory cells, levothyroxine and selenomethionine exhibit a similar systemic antiinflammatory effect in euthyroid females with Hashimoto's thyroiditis. This action, which correlates with a reduction in thyroid peroxidase antibody titers, may be associated with clinical benefits in the prevention and management of Hashimoto's thyroiditis, particularly in subjects receiving both agents.

• Authors: Robert Krysiak, Boguslaw Okopien
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 96 Issue 7 Pg. 2206-15 (Jul 2011) ISSN: 1945-7197 [Electronic] United States
• PMID: 21508145 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Cytokines
• C-Reactive Protein
• Selenomethionine
• Thyroxine

Topics

• Adolescent
• Adult
• C-Reactive Protein (metabolism)
• Cytokines (blood)
• Female
• Hashimoto Disease (blood, drug therapy)
• Humans
• Lymphocytes (drug effects, metabolism)
• Middle Aged
• Monocytes (drug effects, metabolism)
• Selenomethionine (pharmacology, therapeutic use)
• Thyroxine (pharmacology, therapeutic use)