Falaschi P, D'Urso R, Proietti A, Martocchia A, Pastore R, Angelucci L
Chair of Medical Therapy, 2nd University of Naples, Italy.
Life Sci. 1997;60(1):43-50. doi: 10.1016/s0024-3205(96)00587-5.
Recent studies pointed out the development of autoimmune thyroid diseases during interferon (IFN) therapy, mainly in patients with positive thyroid autoantibodies (MsAb and TgAb) before treatment. The effects of recombinant human IFN alpha (rhIFNalpha) on thyroid function and thyroid autoantibodies were studied in 12 patients with chronic active hepatitis associated with virus B or C, selected on the basis of negative results for MsAb and TgAb. No significant variation in T3, T4 and TSH levels was observed either after the first administration of rhIFN alpha (3 million IU i.m.) or after three months of therapy (3 million IU i.m. 3 times a week). TSH response to TRH was in the normal range either before or after the therapy. The absence of MsAb and TgAb was confirmed in all the patients at the end of the treatment. These results indicate that no patient developed thyroid disorder during IFN therapy. Nevertheless, since positive MsAb and TgAb have been considered as a risk factor for thyroid diseases, in patients selected for IFN therapy they should be carefully assessed for autoantibodies before undergoing IFN treatment.
近期研究指出,在干扰素(IFN)治疗期间会出现自身免疫性甲状腺疾病,主要发生在治疗前甲状腺自身抗体(MsAb和TgAb)呈阳性的患者中。在12例乙型或丙型病毒相关慢性活动性肝炎患者中研究了重组人干扰素α(rhIFNα)对甲状腺功能和甲状腺自身抗体的影响,这些患者是基于MsAb和TgAb检测结果为阴性而入选的。首次注射rhIFNα(300万国际单位,肌肉注射)后或治疗三个月后(300万国际单位,每周肌肉注射3次),未观察到T3、T4和TSH水平有显著变化。治疗前后TSH对TRH的反应均在正常范围内。治疗结束时所有患者的MsAb和TgAb均为阴性。这些结果表明,在IFN治疗期间没有患者发生甲状腺疾病。然而,由于MsAb和TgAb阳性被认为是甲状腺疾病的危险因素,对于入选接受IFN治疗的患者,在进行IFN治疗前应仔细评估其自身抗体情况。