New approaches to postoperative treatment of patients with nodular goiter and autoimmune thyroiditis

Main Article Content

М.І. Sheremet


Background. Oxidative stress is a multifactorial process involving numerous metabolic pathways in the cell. Thyroid hormones play a significant role in reactive oxygen species production due to their ability to accelerate the basal metabolism and to change respiratory rate in mitochondria. On the other hand, thyroid hormones also differ from the cell antioxidant mechanisms in different ways, thus, creating a multivariate situation whose outcome is difficult to predict. The purpose of this study was to research the activity of oxidant and antioxidant defense in the blood and in the thyroid tissue of patients with nodular goiter against the background of autoimmune thyroiditis (AIT) and their changes due to the use of alpha-lipoic acid in preoperative preparation and in the postoperative period. Materials and methods. The activity of oxidant and antioxidant defense in the blood and in the thyroid tissue was studied in 80 patients with nodular goiter and AIT in the pre- and postoperative periods. Results. The study showed that in patients with nodular goiter and AIT, there is an activation of peroxidation and an increase in the functional ability of the antioxidant defense elements in the blood and in the thyroid tissue. Conclusions. It has been found that inclusion of alpha-lipoic acid in the integrated treatment of such patients contributes to a decrease in the activity of peroxidation, activation of antioxidant defense systems and more rapid restoration of the thyroid function.

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How to Cite
Sheremet М. “New Approaches to Postoperative Treatment of Patients With Nodular Goiter and Autoimmune Thyroiditis”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 13, no. 8, Dec. 2017, pp. 551-6, doi:10.22141/2224-0721.13.8.2017.119269.
Clinical Thyroidology


Tsyganenko OS, Voroschuk RS. Immunomorfological reaction in the thyroid tissue in patients with autoimmune thyroiditis in combination with nodular goiter. In: Nicholas Anestiadi Tenth Congress of the Association of Surgeons of Moldova. 2007 October; Chisinau. Arta Medica. 2007;4(25):51-52. (in Russian).

Sheremet MI, Sydorchuk LP, Shidlovskyi VO, Bedenyuk AD. Research of prognostic markers of proliferation and apoptosis in patients with nodular goiters combined with autoimmune thyroiditis. Archives of the Balkan Medical Union. 2016 Dec;51(4):488-491.

Oliynyk VA. Chronic lymphocytic thyroiditis (Hashimoto's thyroiditis): the current state of the problem. Endokrynologia. 2006;1:71-79. (in Ukrainian). Vlasenko MV. Autoimmune thyroiditis in adolescents. In: Karachentseva IuI, Kazakova AV, Kravchun NA, Il'ina IM, editors. 100 izbrannykh lektsii po endokrinologii [100 selected lectures on endocrinology]. Kharkiv; 2009. 372-378 p. (in Russian).

Ai J, Leonhardt JM, Heymann WR. Autoimmune thyroid diseases: Etiology, pathogenesis, and dermatologic manifestations. J Am Acad Dermatol. 2003 May;48(5):641-59; quiz 660-2. doi: 10.1067/mjd.2003.257.

Sheremet МІ, Sydorchuk LP, Shidlovskyi VО, et al. New prognostistic markers of nodular forms of goiter combined with autoimmune thyroiditis. Journal of Education, Health and Sport. 2017;7(3):475-482. doi: 10.5281/zenodo.399322.

Andreyev AYu, Kushnareva YuE, Starkov AA. Mitochondrial metabolism of reactive oxygen species. Biochemistry (Moscow). 2005;70(2);200-214. (in Russian).

Pankiv IV. Efficiency of alpha lipoic acid therapy at diabetic foot syndrome. Mezhdunarodnyi Endokrinologicheskii Zhurnal. 2014;3(59):45-51. (in Ukrainian).

Myshunina TM, Kalinichenko OV, Tron'ko MD. Mechanism of apoptosis in the thyroid cells under thyroid pathology. Fiziolohichnyĭ zhurnal. 2009;55(6):90-102. (in Ukrainian).

Myshunina TM, Kalinichenko OV, Tron'ko MD. Mitochondrial and postmitochondrial mechanisms of apoptosis in a thyroid gland with signs of lymphoid infiltration or chronic thyroiditis. Endocrinologia. 2009;14(1):48-56. (in Ukrainian).

Nedosekova YuV, Urasova OI, Kravets YeB, Chaikovsky AV. The role of apoptosis in development of autoimmune thyroid diseases. Bulletin of Siberian Medicine. 2009;8(1):64-70. (in Russian).

Nekrasova TA, Shcherbatyuk TG, Davydenko DV, Ledentsova OV, Strongin LG. Peculiarities of lipid and protein peroxidation in autoimmune thyroiditis with and without mild thyroid dysfunction. Klinicheskaia I eksperimentalnaia tiroidologia. 2011;7(4):38-43. (in Russian).

Erdamar H, Demirci H, Yaman H, et al.The effect of hypothyroidism, hyperthyroidism, and their treatment on parameters of oxidative stress and antioxidant status. Clin Chem Lab Med. 2008;46(7):1004-10. doi: 10.1515/CCLM.2008.183.

Shen HM, Yang CF, Ding WX, Liu J, Ong CN. Superoxide radical-initiated apoptotic signaling pathway in selenite-treated HepG (2) cell: mitochondria serve as main target. Free Radic Biol Med. 2001 Jan 1;30(1):9-21. doi: 10.1016/S0891-5849(00)00421-4.

Novitsky VV, Ryazantseva NV, Chasovskyh NYu, et al. Modulation of apoptosis of mononuclear cells under conditions of oxidative stress. Bulletin of Experimental Biology and Medicine.2008;145(3):251-254. (in Russian).

Hancock JT, Desikan R, Neill SJ. Role of reactive oxygen species in cell signaling pathways. Biochem Soc Trans. 2001 May;29(Pt 2):345-50. PMID: 11356180.

Soti C, Csermely P. Protein stress and stress proteins: implications in aging and disease. J Biosci. 2007 Apr;32(3):511-5. PMID: 17536170.