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Emilio Fiore1, Francesco Latrofa1, Paolo Vitti1

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Summary

Excess iodine can trigger autoimmune thyroid disease (AITD) by altering thyroglobulin (Tg). This autoimmunity is linked to papillary thyroid carcinoma (PTC) risk, influenced by thyroid-stimulating hormone (TSH) levels.

Keywords:
Hashimoto's thyroiditisIodinePapillary thyroid cancerThyroid autoimmunity

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Area of Science:

  • Endocrinology
  • Immunology
  • Oncology

Background:

  • Iodine intake influences thyroid disease expression and can induce autoimmune thyroid disease (AITD).
  • Thyroglobulin (Tg) is a key target in iodine-induced autoimmunity, potentially due to post-translational modifications.
  • The association between AITD and papillary thyroid carcinoma (PTC) is an area of ongoing research.

Purpose of the Study:

  • To review the roles of iodine in AITD development and the relationship between AITD and PTC.
  • To elucidate the mechanisms underlying iodine-induced autoimmunity and its link to PTC.
  • To investigate the influence of thyroid function and TSH levels on PTC risk in the context of AITD.

Main Methods:

  • Review of existing literature on iodine, AITD, and PTC.
  • Analysis of thyroglobulin (Tg) epitope recognition patterns by anti-Tg antibodies (TgAb) in different thyroid conditions.
  • Examination of the correlation between serum TSH levels and PTC risk.

Main Results:

  • Unmasking of cryptic epitopes on iodinated Tg contributes to iodine-induced AITD in humans.
  • TgAb recognition patterns differ between AITD and non-AITD (including PTC), with AITD showing restricted epitopic binding.
  • Elevated serum TSH levels, rather than thyroiditis itself, significantly increase PTC risk, particularly in Hashimoto's thyroiditis.

Conclusions:

  • Iodine exposure can precipitate AITD through specific alterations in Tg.
  • Distinct immunological mechanisms differentiate AITD from immune responses in PTC.
  • Thyroid-stimulating hormone (TSH) levels play a critical role in the pathogenesis of PTC associated with autoimmune thyroid conditions.