Recreational Exercise and Inflammatory Patterns in Hashimoto's Thyroiditis: Observations from a Cross-Sectional...

Area of Science:

• Endocrinology
• Immunology
• Exercise Physiology

Background:

• Hashimoto's thyroiditis (HT) is an autoimmune disease characterized by chronic inflammation of the thyroid gland.
• Systemic inflammation plays a crucial role in the pathogenesis and progression of HT.
• The influence of recreational exercise (RE) on inflammatory profiles in HT patients with varying disease severity remains incompletely understood.

Purpose of the Study:

• To investigate the association between recreational exercise (RE) and systemic inflammation in individuals with Hashimoto's thyroiditis (HT).
• To analyze how RE affects inflammatory protein profiles across different HT disease severity groups: euthyroid, levothyroxine (LT4)-treated, and hypothyroid.
• To identify potential benefits of RE on inflammation and disease management in HT.

Main Methods:

• Cross-sectional observational study involving 403 participants from the Croatian Biobank of Patients with HT (CRO-HT).
• Included 173 controls and 230 HT patients categorized by thyroid status (euthyroid, LT4-treated, hypothyroid).
• Measured serum levels of 92 inflammatory proteins using Olink® Target 96 Inflammation panel; assessed exercise status via questionnaires.

Main Results:

• RE was associated with distinct inflammatory protein changes depending on thyroid status.
• In controls, RE correlated with reduced MMP-10 and FGF-5 (cardiovascular/muscle benefits).
• In euthyroid HT, RE linked to decreased CXCL9 and TRAIL (reduced type 1 inflammation/vascular risk).
• LT4-treated patients showed RE-associated increases in IL-15RA and IL-24 (improved muscle metabolism/anti-inflammatory effects).
• Hypothyroid patients had RE-associated reductions in CCL20 and increases in HGF, with mixed effects on bone/immune regulation (TRANCE, TWEAK).
• Notably, RE was linked to reduced CXCL9 and CCL20, proteins previously associated with HT risk.

Conclusions:

• Recreational exercise is associated with distinct alterations in systemic inflammatory profiles across different Hashimoto's thyroiditis disease severity groups.
• The most favorable inflammatory responses to RE were observed in levothyroxine (LT4)-treated patients, suggesting a potential synergistic effect with hormone therapy.
• These findings highlight the potential role of tailored exercise interventions in managing systemic inflammation in HT.