Introduction. Autoimmune thyroiditis is one of the most important problems of modern endocrinology, with inadequately studied etiological and pathogenic mechanisms of development. It is characterized by the lack of objective and reliable diagnostic methods, effective treatment methods, uncertain therapy or indications for the choice of treatment methods.
The aim of the study. Determination of markers for prediction of clinical course and choice of surgery’ volume in patients with nodular goiter and autoimmune thyroiditis, taking into account the oxidative, autoimmune and apoptotic processes.
Material and methods. A total of 95 patients who were operated for a nodular endemic goiter on the background of autoimmune thyroiditis were examined. The status of pro- and antioxidant systems, the activity of proinflammatory cytokines, hormonal function of thyroid gland, the level of antibodies to thyroperoxidase, thyroglobulin antibodies and ultrasound structural changes in the thyroid gland have been evaluated in all patients, before and after surgery.
Results. In patients with nodular endemic goiter and autoimmune thyroiditis, in the remote period after surgical treatment, there is a significant increase in the peroxide oxidation index and a decrease in the activity of antioxidant defense systems, against the suppression of apoptotic processes and the activation of pro-inflammatory cytokines. These processes lead to functional failure, hyperplasia and the progression of structural thyroid abnormalities, with progression of the functional incapacity of the thyroid gland and inadequate long-term outcome of treatment.
Conclusions. The study allowed to clarify the indications and contraindications of different methods of treatment in patients with NGAIT, taking into account the parameters of severity of peroxide oxidation processes, the activity of apoptosis and functional capacity of the gland.
Keywords: nodular endemic goiter, autoimmune thyroiditis, apoptosis, cytokines, peroxidation, surgery volume.
NGAIT – nodular goiter with autoimmune thyroiditis; TG – thyroidgland; AOS – antioxidant systems; MA – malonic aldehyde; OMP – oxidative modification of proteins; CP – ceruloplasmin; GP – glutathione peroxidase; CT – catalase; TPOAB – thyroperoxidase antibodies, TGAB – thyroglobulin antibodies.
Michael I. SHEREMET
Surgery Department No1 of Bukovinian State Medical University, Ukraine
Address: Holovna str., 191, 58018 Chernovtsy,Ukraine
Email: email@example.com; phone 0956064607