During the last four decades, there have been considerable advances in the efficacy and precision of serum thyroid function testing. The development of the third generation assays for the measurement of serum thyroid stimulating hormone (TSH, thyrotropin) and the log-linear relationship with free thyroxine (T4) established TSH as the hallmark of thyroid function testing. While it is widely accepted that TSH outside of the normal range is consistent with thyroid dysfunction, a vast multitude of additional factors must be considered before an accurate clinical diagnosis can be made. This is especially important during pregnancy, when the thyroid is under considerable additional pregnancy-related demands requiring significant maternal physiological changes. This paper examines serum TSH measurement in pregnancy and some associated potential confounding factors.

Offie P. Soldin

Sarah H. Chung

Christine Colie

The Use of TSH in Determining Thyroid Disease: How Does It Impact the Practice of Medicine in Pregnancy?

Autoantibodies to thyroglobulin and thyroid peroxidase are common in the euthyroid population and are considered secondary responses and indicative of thyroid inflammation. By contrast, autoantibodies to the TSH receptor are unique to patients with Graves' disease and to some patients with Hashimoto's thyroiditis. Both types of thyroid antibodies are useful clinical markers of autoimmune thyroid disease and are profoundly influenced by the immune suppression of pregnancy and the resulting loss of such suppression in the postpartum period. Here, we review these three types of thyroid antibodies and their antigens and how they relate to pregnancy itself, obstetric and neonatal outcomes, and the postpartum.

Francis S. Balucan

Syed A. Morshed

Terry F. Davies

Thyroid Autoantibodies in Pregnancy: Their Role, Regulation and Clinical Relevance

Peripheral nerve regeneration is a unique process in which cellular rather than tissue response is involved. Depending on the extent and proximity of the lesion and the age and type of the neuronal soma, the cell body may either initiate a reparative response or may die. Microsurgical intervention may alter the prognosis after a peripheral nerve injury but to a certain extent. By altering the biochemical microenvironment of the neuron, we can increase the proportion of neurons that survive the injury and initiate the reparative response. 
Thyroid hormone critically regulates tissue growth and differentiation and plays a
crucial role during organ development. Furthermore, recent research has provided
new insight into thyroid hormone cellular action. Thyroid hormone regulates stress
response intracellular signaling and targets molecules important for cytoskeletal
stability and cell integrity. Changes in thyroid hormone signaling occur in nerve and
other tissues, with important physiological consequences. The interest in thyroid
hormone in the context of nerve regeneration has recently been revived.

Ioannis D. Papakostas

George A. Macheras

Thyroid Hormones and Peripheral Nerve Regeneration

Aim. We aimed to analyze the diagnostic criteria proposed by the Bethesda System for Reporting Thyroid Cytopathology for follicular lesions of undetermined significance (FLUS), the risk of cancer and diagnostic improvement with use of immunocytochemistry. Methods. For each FLUS diagnosis, we analyzed the cytological criteria (9 Bethesda criteria), secondary fine-needle aspiration (FNA) results, surgical procedures, contribution of immunocytochemistry with the antibodies cytokeratin 19 (CK19) and monoclonal anti-human mesothelial cell (HBME1). Results. Among patients with 2,210 thyroid FNAs, 244 lesions (337 nodules) were classified as FLUS (11&#x25; of all thyroid FNAs). The 3 criteria most often applied were cytological atypia suggesting papillary carcinoma (36&#x25;), microfollicular architecture but sparse cellularity (23.1&#x25;), cytological atypia (21.5&#x25;). With secondary FNA, 48.8&#x25; of nodules were reclassified as benign. For about half of all cases (41.4&#x25; for the first FNA, 57.6&#x25; for the second FNA), immunocytochemistry helped establishing a diagnosis favoring malignant or benign. No benign immunocytochemistry results were associated with a malignant lesion. In all, 22.5&#x25; of the 39 removed nodules were malignant. Conclusion. The FLUS category is supported by well-described criteria. The risk of malignancy in our series was 22.5&#x25;. Because we had no false-negative immunocytochemistry results, immunocytochemistry could be helpful in FLUS management.

J. Ratour

M. Polivka

H. Dahan

L. Hamzi

R. Kania

M. L. Dumuis

R. Cohen

M. Laloi-Michelin

B. Cochand-Priollet

Diagnosis of Follicular Lesions of Undetermined Significance in Fine-Needle Aspirations of Thyroid Nodules

Although thyroid hormone is one of the most potent stimulators of growth and metabolic rate, the potential to use thyroid hormone to treat cutaneous pathology has never been subject to rigorous investigation. A number of investigators have demonstrated intriguing therapeutic potential for topical thyroid hormone. Topical T3 has accelerated wound healing and hair growth in rodents. Topical T4 has been used to treat xerosis in humans. It is clear that the use of thyroid hormone to treat cutaneous pathology may be of large consequence and merits further study. This is a review of the literature regarding thyroid hormone action on skin along with skin manifestations of thyroid disease. The paper is intended to provide a context for recent findings of direct thyroid hormone action on cutaneous cells in vitro and in vivo which may portend the use of thyroid hormone to promote wound healing.

Joshua D. Safer

Thyroid Hormone and Wound Healing

Heart failure represents the final common outcome in cardiovascular diseases. Despite significant therapeutic advances, morbidity and mortality of heart failure remain unacceptably high. Heart failure is preceded and sustained by a process of structural remodeling of the entire cardiac tissue architecture. Prevention or limitation of cardiac remodeling in the early stages of the process is a crucial step in order to ameliorate patient prognosis. Acquisition of novel pathophysiological mechanisms of cardiac remodeling is therefore required to develop more efficacious therapeutic strategies. Among all neuroendocrine systems, thyroid hormone seems to play a major homeostatic role in cardiovascular system. In these years, accumulating evidence shows that the &#x201c;low triiodothyronine&#x201d; syndrome is a strong prognostic, independent predictor of death in patients affected by both acute and chronic heart disease. In experimental models of cardiac hypertrophy or myocardial infarction, alterations in the thyroid hormone signaling, concerning cardiac mitochondrion, cardiac interstitium, and vasculature, have been suggested to be related to heart dysfunction. The aim of this brief paper is to highlight new developments in understanding the cardioprotective role of thyroid hormone in reverting regulatory networks involved in adverse cardiac remodeling. Furthermore, new recent advances on the role of specific miRNAs in thyroid hormone regulation at mitochondrion and interstitial level are also discussed.

G. Nicolini

L. Pitto

C. Kusmic

S. Balzan

L. Sabatino

G. Iervasi

F. Forini

New Insights into Mechanisms of Cardioprotection Mediated by Thyroid Hormones

Although the role of thyroid hormone during embryonic development has long been recognized, its role later in adult life remains largely unknown. However, several lines of evidence show that thyroid hormone is crucial to the response to stress and to poststress recovery and repair.  Along this line, TH administration in almost every tissue resulted in tissue repair after various injuries including ischemia, chemical insults, induction of inflammation, or exposure to radiation. This novel action may be of therapeutic relevance, and thyroid hormone may constitute a paradigm for pharmacologic-induced tissue repair/regeneration.

Iordanis Mourouzis

Efstathia Politi

Constantinos Pantos

Thyroid Hormone and Tissue Repair: New Tricks for an Old Hormone?

Introduction. The aim of this study was to evaluate the serum levels of resistin and insulin-like growth factor-1 (IGF-1) and and also the potential relationship between thyroid function and levels of resistin and IGF-1 in hypothyroid and hyperthyroid patients. 
Methods. Fifteen cases of hypothyroid (HT), 16 of subclinically hypothyroid (SCHT), 15 of hyperthyroid (HrT), 15 of subclinically hyperthyroid (SCHrT), and 17 healthy individuals have been included in the study. Serum resistin levels were measured using enzyme-linked immunosorbent assay and IGF-1 and thyroid stimulating hormone (TSH) levels by chemiluminescence method. 
Results. Resistin levels in total HT group were significantly higher than in controls (12.66&#x2009;&#xb1;&#x2009;6.04 and 8.45&#x2009;&#xb1;&#x2009;2.90&#x2009;ng/mL, resp.). In SCHrT subgroup resistin levels were significantly higher than those of controls (14.88&#x2009;&#xb1;&#x2009;7.73 and 8.45&#x2009;&#xb1;&#x2009;2.90&#x2009;ng/mL, resp.). IGF-1 levels were significantly lower in total HT than in total HrT and control groups (117.22&#x2009;&#xb1;&#x2009;52.03, 155.17&#x2009;&#xb1;&#x2009;51.67, and 184.00&#x2009;&#xb1;&#x2009;49.73&#x2009;ng/mL, resp.). Furthermore IGF-1 levels in HT subgroup were significantly lower compared to controls (123.70&#x2009;&#xb1;&#x2009;44.03 and 184&#x2009;&#xb1;&#x2009;49.73&#x2009;ng/mL, resp.). In SCHT subgroup IGF-1 levels were significantly lower than those of control and SCHrT groups (111.11&#x2009;&#xb1;&#x2009;59.35, 184.00&#x2009;&#xb1;&#x2009;49.73, and 166.60&#x2009;&#xb1;&#x2009;47.87&#x2009;ng/mL, resp.). There were significant correlations between IGF-1 and TSH in HT subgroup and between resistin and TSH in total HrT group. Conclusion. It was concluded that increased resistin levels are directly related to thyroid dysfunction, and GH/IGF-1 axis is influenced in clinically or subclinically hypothyroidism patients.

Ceren Eke Koyuncu

Sembol Turkmen Yildirmak

Mustafa Temizel

Tevfik Ozpacaci

Pinar Gunel

Mustafa Cakmak

Y&#xfc;ksel G&#xfc;len Ozbanazi

Serum Resistin and Insulin-Like Growth Factor-1 Levels in Patients with Hypothyroidism and Hyperthyroidism

Introduction. Thyroidectomy creates a potential risk for all parathyroid glands and the recurrent laryngeal nerve (RLN). The identification and dissection of the RLN is the gold standard for preserving its function. In some cases, it may be quite difficult to identify the nerve localization. In such elusive locations, we aimed to identify RLNs using peroperative injection of a blue dye into the inferior thyroid artery. Materials and Methods. This study included 10 selected patients whose RLN identification had been difficult peroperatively during the period from April 2008 to June 2009. When the RLNs became elusive in location, the branches of the inferior thyroid artery (ITA) on the capsule of the thyroid lobe were isolated, and then 0.5&#x2009;mL isosulphan blue dye was injected into the artery. Results. RLN was carefully dissected in the tracheoesophageal groove. RLN was clearly visualized, in all patients. All RLNs were identified along their course in the dyed surrounding tissue. No RLN palsy was encountered. Conclusion. The injection of blue dye into the ITA branches can be used as an alternate method in case of difficulty in identification of RLNs.

Gulcin Hepgul

Meltem Kucukyilmaz

Oguz Koc

Yigit Duzkoylu

Yavuz Selim Sari

Yesim Erbil

The Identification of Recurrent Laryngeal Nerve by Injection of Blue Dye into the Inferior Thyroid Artery in Elusive Locations

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Journal of Thyroid Research publishes articles on the molecular and cellular biology, immunology, biochemistry, physiology and pathology of thyroid diseases, with a specific focus on thyroid cancer.

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Journal of Thyroid Research&nbsp;maintains an Editorial Board of practicing researchers from around the world, to ensure manuscripts are handled by editors who are experts in the field of study.

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Journal of Thyroid Research - Table of contents 2013

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Journal of Thyroid Research publishes articles on the molecular and cellular biology, immunology, biochemistry, physiology and pathology of thyroid diseases, with a specific focus on thyroid cancer.

Journal of Thyroid Research