Lewinski Andrzej, Brona Anna, Lewandowski Krzysztof C, Jedrzejuk Diana, Bohdanowicz-Pawlak Anna, Skowronska-Jozwiak Elżbieta, Bienkiewicz Małgorzata, Milewicz Andrzej
Department of Endocrinology & Metabolic Diseases, Medical University of Lodz, Polish Mother's Memorial Hospital - Research Institute, Rzgowska 281/289, 93-338 Lodz, Poland.
Thyroid Res. 2013 Aug 6;6(1):9. doi: 10.1186/1756-6614-6-9.
In order to assess safety of radioactive iodine administration in the treatment of thyrotoxicosis, we measured concentrations of matrix metalloproteinase-2 (MMP-2), its main inhibitor - TIMP-2 (tissue inhibitor of MMP-2), matrix metalloproteinase-9 (MMP-9), its main inhibitor - TIMP-1, adiponectin, as well as pro-inflammatory and procancerogenic thrombospondin-1 (TSP-1).
The study involved 23 patients treated with radioiodine for thyrotoxicosis. Serum concentrations of TSH, free T4, free T3, MMP-2, MMP-9, TIMP-1, TIMP-2, total adiponectin and TSP-1 were measured by immunoassays just before radioiodine administration (visit 1), and subsequently, after 7 days (visit 2), 3 months (visit 3), 6 to 8 months (visit 4) and 15-18 months after radioiodine administration (visit 5).
There were no acute changes in serum concentrations of MMP-2, MMP-9, TIMP-1, TIMP-2, adiponectin and TSP-1 (visit 1 vs. 2). Subsequently, there was an increase in MMP-2 (from 393±106 ng/ml to 774±424 ng/ml), TIMP-1 (from 177±76 ng/ml to 296±118 ng/ml), and adiponectin (from 16442±9490 ng/ml to 23518±9840 ng/ml), visit 1 to 5, respectively (p < 0.01). Further analysis revealed no significant change in MMP-2/TIMP-2 ratio, but there was a significant decrease in MMP-9/TIMP-1 ratio (p < 0.05), suggestive of possible decrease in free MMP-9 concentrations.
Our data reveal a significant and sustained increase in serum adiponectin, as well as possible decrease of free MMP-9 concentration after radioiodine administration. In contrast, there was no significant change of TSP-1. This might indicate overall safety of radioiodine treatment of thyrotoxicosis in terms of the risks of subsequent cardiovascular and neoplastic disease.
为了评估放射性碘治疗甲状腺毒症的安全性，我们测量了基质金属蛋白酶-2（MMP-2）、其主要抑制剂——组织金属蛋白酶抑制因子-2（TIMP-2）、基质金属蛋白酶-9（MMP-9）、其主要抑制剂——组织金属蛋白酶抑制因子-1（TIMP-1）、脂联素以及促炎和致癌的血小板反应蛋白-1（TSP-1）的浓度。
本研究纳入了23例接受放射性碘治疗甲状腺毒症的患者。在放射性碘给药前（第1次就诊），以及随后在放射性碘给药后7天（第2次就诊）、3个月（第3次就诊）、6至8个月（第4次就诊）和15至18个月（第5次就诊）时，通过免疫测定法测量血清促甲状腺激素（TSH）、游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）、MMP-2、MMP-9、TIMP-1、TIMP-2、总脂联素和TSP-1的浓度。
MMP-2、MMP-9、TIMP-1、TIMP-2、脂联素和TSP-1的血清浓度在放射性碘给药后无急性变化（第1次就诊与第2次就诊相比）。随后，MMP-2（从393±106 ng/ml增至774±424 ng/ml）、TIMP-1（从177±76 ng/ml增至296±118 ng/ml）和脂联素（从16442±9490 ng/ml增至23518±9840 ng/ml）分别在第1次就诊至第5次就诊时升高（p<0.01）。进一步分析显示，MMP-2/TIMP-2比值无显著变化，但MMP-9/TIMP-1比值显著降低（p<0.05），提示游离MMP-9浓度可能降低。
我们的数据显示，放射性碘给药后血清脂联素显著且持续升高，游离MMP-9浓度可能降低。相比之下，TSP-1无显著变化。这可能表明放射性碘治疗甲状腺毒症在后续心血管疾病和肿瘤疾病风险方面总体是安全的。
