Novel therapies for thyroid autoimmune diseases: An update. Issue 1 (January 2020)

• Record Type: Journal Article
• Authors: Ferrari, Silvia Martina; Fallahi, Poupak; Elia, Giusy; Ragusa, Francesca; Camastra, Stefania; Paparo, Sabrina Rosaria; Giusti, Claudia; Gonnella, Debora; Ruffilli, Ilaria; Shoenfeld, Yehuda; Antonelli, Alessandro
• Is Part Of: Best practice & research. Volume 34:Issue 1(2020)
• Publication Date: 2020-01
• Subjects: autoimmune thyroid disorders -- corticosteroids -- rituximab -- teprotumumab -- tocilizumab -- antigen-specific immunotherapy; Endocrine glands -- Diseases -- Periodicals; Metabolism -- Disorders -- Periodicals; Endocrinology -- Periodicals; Metabolism -- Periodicals; 616.4
• DOI: 10.1016/j.beem.2019.101366
• Languages: English
• ISSNs: 1521-690X

Abstract

Abstract : A Th1 immune-preponderance has been shown in the immunopathogenesis of autoimmune thyroiditis (AT), Graves' disease (GD) and Graves' Ophthalmopathy (GO), in which the Th1-chemokines (CXCL9, CXCL10, CXCL11), and their (C-X-C)R3 receptor, have a crucial role. Methimazole, and corticosteroids have been shown to modulate these chemokines; several efforts have been done to modulate the autoimmune reaction with other drugs, i.e. PPAR-γ, or -α ligands, or antibodies, or small molecules directed against CXCL10, or CXCR3. Antigen-specific therapy for GD, by inducing T cell tolerance through an immunization with TSH-R peptides, has been published. Drugs targeting cytokines [anti-TNFα (Etanercept), and anti-IL-6 (Tocilizumab)], and RTX (a chimeric monoclonal antibody vs . CD20) have been used in GO, with promising results. Teprotumumab (a human monoclonal anti-IGF-1R blocking antibody) has been investigated in a trial, showing it was very effective in GO patients. Still, more studies are needed for new therapies targeting autoimmune thyroid disorders.