Abstract: A szelen nelkulozhetetlen nyomelem, amely antioxidans hatasa reven lenyeges az immun- es az endokrin rendszer műkodeseben. A pajzsmirigy hormonszintezise soran kepződő szabad gyokoknek szerepuk lehet a thyreoidea autoimmun betegsegeiben. A vizsgalat celja az volt, hogy meghatarozzak, a szelenkezeles hat-e a pajzsmirigy-peroxidaz, a tireoglobulin elleni antitestek szintjere es az antioxidans statusra. Modszer:
Szazharmincket autoimmun thyreoiditises betegben kettős vakmodszerrel teszteltek a szelen hatasait. Mindket csoportban alkalmaztak L-tiroxin-szubsztitucios kezelest, igy a TSH-szint az elettani tartomanyban maradt. A kezelt csoportba 70 beteg (68 nő, atlageletkor 41,4 ± 9,5 ev), a placebocsoportba 62 beteg (61 nő, atlageletkor 42,7 ± 8,3 ev) tartozott. A TSH, az fT4, az fT3 es az antitestek mereset kemilumineszcens technikaval vegeztek. A teljes antioxidans-kapacitast Randox kittel, a szerumszelenszintet atomabszorpcios modszerrel hataroztak meg. A kezeles soran a vizsgalt betegek 2 × 100 µg L-szelen-metionin tablettat kaptak. A betegek klinikai es laboratoriumi vizsgalatat haromhavonta vegeztek egy even at. Eredmenyek:
A szelenszint a betegek szerumaban lenyegesen alacsonyabb volt, mint az egeszseges kontrollokban. Az fT3/fT4 arany magasabb volt a szelennel kezeltekben, mint a placebocsoportban. A szelen hatasara az autoantitestek (főleg a pajzsmirigy-peroxidazenzim elleni antitestek) titere szignifikansan csokkent a megfigyelesi idő vegere. Inverz osszefuggest talaltak az antioxidans status es a pajzsmirigy-peroxidazenzim elleni antitestek titere kozott. A pajzsmirigy terfogata a kezelt betegekben nem csokkent jelentősen. Mellekhatast a kezeles soran nem tapasztaltak. Kovetkeztetes:
A szelenkezeles autoantitest-kepzest gatlo hatasa miatt alkalmas az autoimmun thyreoiditises betegek kezelesere.
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Selenium as an essential trace element is capable of exerting complex effects on the endocrine and immune system by its antioxidant capacity. The role of selenium is important because the level of free oxygen radicals is elevated in the physiological thyroid hormone synthesis. The aim of study
was to determine whether selenium therapy can influence the level of antithyroid peroxidase and antithyroglobulin antibodies or whether there is a correlation between antioxidant capacity and the titer of autoantibodies. Method:
132 patient with autoimmune thyroiditis were investigated in a prospective, blind and placebo-controlled study. L-thyroxine substitution therapy was made in both groups and the level of TSH remained in the normal range. The selenium-treated group (n = 70 patients, 68 female, mean age 41,4 ± 9,5 year) was compared with the placebo-treated group (n = 62 patients, 61 female, mean age 42,7 ± 8,3 year). Selenium therapy was continued by L-seleno-methionine (per os 2 × 100 µg/day) for one year. Determination of TSH, fT4, fT3 and autoantibodies was carried out by chemiluminescence method. Total antioxidant capacity was determined by Randox kit, the level of selenium in the sera by atomic absorption technique was measured. In the follow-up study, patients were controlled every third month and at the end of a one-year observation period. Results:
The level of selenium in the untreated patients was significantly lower than in treated patients and controls. The fT3/fT4 ration proved to be higher in patients after selenium therapy. The titer of antithyroid antibodies (mostly the antithyroid peroxidase) significantly decreased at the end of the study. An inverse correlation was found between antioxidant capacity and the level of antithyroid peroxidase antibodies. The volume of thyroid gland slightly diminished in treated patients. Side effects were not observed. Conclusions:
Selenium completed with L-thyroxine is a suitable therapy for patients with autoimmune thyroiditis.