NEW THERAPIES FOR THE TREATMENT OF THYROID AUTOIMMUNE DISEASES
- Silvia Martina Ferrari, Italy
Abstract
Background and Aims
Interferon (IFN)-γ, IFN-γ-dependent chemokines (CXCL9, CXCL10, CXCL11) and the CXCR3 receptor have a crucial role in the pathogenesis of autoimmune thyroid diseases (AITD), in which the predominance of a Th1 immune related response has been reported. Both methimazole, and corticosteroids, have been shown to modulate the Th1-dependent chemokines.
Methods
We have searched on Pubmed about novel therapeutic targets in AITD.
Results
The new knowledge about the immunopathogenesis of AITD leads to the study of new drugs able to modulate the autoimmune reaction, such as peroxisome proliferator-activated receptor (PPAR)-γ or -α ligands, or antibodies, or small molecules directed against CXCL10, or CXCR3. Drugs targeting cytokines [anti-Tumor necrosis factor (TNF)-α (Etanercept), anti-IL-6 (Tocilizumab)], and rituximab (a chimeric monoclonal antibody vs. CD20) have shown promising results in Graves’ Ophthalmopathy (GO). Also an antigen-specific therapy for Graves’ disease (GD), by inducing T cell tolerance through an immunization with TSH-R peptides, has been published. Teprotumumab (a human monoclonal anti-IGF-1R blocking antibody) has been investigated in a multicenter, double-masked, randomized, placebo-controlled trial, showing its effectiveness in GO patients.
Conclusions
More studies are needed to identify new therapies for the treatment of autoimmune thyroid disorders.