REVIEW   

Minerva Endocrinologica 2020 December;45(4):326-44

DOI: 10.23736/S0391-1977.20.03268-X

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Oxidative stress as a key feature of autoimmune thyroiditis: an update

Rosaria M. RUGGERI ^{1, 2} ✉, Alfredo CAMPENNÌ ³, Giuseppe GIUFFRIDA ^{1, 2}, Marco CASCIARO ⁴, Maria C. BARBALACE ⁵, Silvana HRELIA ⁵, Francesco TRIMARCHI ⁶, Salvatore CANNAVÒ ^{2, 7}, Sebastiano GANGEMI ⁴

¹ Department of Clinical and Experimental Medicine, Gaetano Martino University Hospital, University of Messina, Messina, Italy; ² Unit of Endocrinology, University Hospital of Messina, Messina, Italy; ³ Department of Biomedical Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy; ⁴ Unit of Allergology and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy; ⁵ Department of Life Quality Studies, University of Bologna, Bologna, Italy; ⁶ Peloritana dei Pericolanti Academy, University of Messina, Messina, Italy; ⁷ Department of Human Pathology DETEV, University of Messina, Messina, Italy

INTRODUCTION: Oxidative stress has been proposed as one of the factors concurring in the pathophysiology of autoimmune thyroid diseases. Reactive oxygen species are the main expression of oxidative stress in biological systems, and their production can overcome antioxidant defenses ultimately leading to cell damage, apoptosis, and death. The present review was aimed at describing the state of the art of the relationships between oxidative stress and autoimmune thyroiditis. The most used biomarkers of oxidative stress and their correlation with thyroid function are reported.
EVIDENCE ACQUISITION: We conducted a search of the literature in the English language starting from 2000, using the following search terms: “Hashimoto thyroiditis,” ”autoimmune thyroiditis,” “hypothyroidism,” “hyperthyroidism,” “oxidative stress,” “oxidants,” “antioxidant,” “advanced glycation end products.” Both clinical studies and animal models were evaluated.
EVIDENCE SYNTHESIS: Data form clinical studies clearly indicate that the balance between oxidants and antioxidants is shifted towards the oxidative side in patients with autoimmune thyroiditis, suggesting that oxidative stress may be a key event in the pathophysiology of the disease, irrespective of thyroid function. Studies in animal models, such as the NOD.H2h4 mouse, confirm that thyroidal accumulation of ROS plays a role in the initiation and progression of autoimmune thyroiditis.
CONCLUSIONS: Oxidant/antioxidant imbalance represent a key feature of thyroid autoimmunity. Oxidative stress parameters could be used as biochemical markers of chronic inflammation, to better predict the disease evolution along its natural history. Dietary habits and antioxidant supplements may provide protection from autoimmunity, opening new perspectives in the development of more tailored therapies.

KEY WORDS: Hashimoto disease; Oxidative stress; Antioxidants; Autoimmunity