Thyroid hormone withdrawal leads to permanent DNA modifications that are not seen in patients treated with rhTSH.
ID
Bron
Verkorte titel
Aandoening
Patients with differentiated thyroid cancer
Ondersteuning
Onderzoeksproduct en/of interventie
Uitkomstmaten
Primaire uitkomstmaten
Epigenetic DNA modifications
Achtergrond van het onderzoek
Introduction
Hypothyroidism is one of the most common endocrine disorders. Despite adequate restoration of euthyroidism with LT4, a substantial part of patients (~10-15%) display significant impairment of psychological well-being compared to matched controls. The same holds true for patients who have been treated for differentiated thyroid cancer (DTC). We speculate that the decreased QoL in DTC patients is due to the episode of hypothyroidism, induced by thyroid hormone withdrawal. Epigenetic modifications of the DNA of patients with a history of hypothyroidism are likely to affect thyroid hormone signaling for the rest of their lifes.
Objective
To study if thyroid hormone withdrawal leads to permanent DNA modifications that are not seen in patients treated with recombinant human (rh)TSH.
Study Design
Within our Academic Center for Thyroid Diseases, we are prospectively collecting repeated DNA and serum of patients treated with DTC before, during and after treatment with radioactive iodine, either augmented via thyroid hormone withdrawal or rhTSH. We will study if DNA methylation is affected by thyroid hormone withdrawal in genomic DNA of these patients, and if these changes persist after LT4 supplementation. Patients treated with rhTSH will be used as a control, since these patients undergo the same surgery and treatment with radioactive iodine, but do not become hypothyroid
Study Population
Patients, aged 18-80 years, treated with DTC before, during and after treatment with radioactive iodine, either augmented via thyroid hormone withdrawal or rhTSH.
Primary Endpoint
Epigenetic DNA modifications (does thyroid hormone withdrawal result in epigenetic modifications, and if so, do these epigenetic modifications persist after restoring euthyroidism?).
Anticipated Result
Thyroid hormone withdrawal leads to permanent epigenetic DNA modifications that are not
seen in patients treated with rhTSH.
Doel van het onderzoek
Thyroid hormone withdrawal leads to permanent DNA modifications that are not seen in
patients treated with rhTSH.
Onderzoeksopzet
3
Publiek
Wetenschappelijk
Belangrijkste voorwaarden om deel te mogen nemen (Inclusiecriteria)
1. Have the capacity to understand and willingness to sign an informed consent form
2. Planned for total thyroidectomy because of differentiated thyroid cancer
3. Aged 18-80 years
Belangrijkste redenen om niet deel te kunnen nemen (Exclusiecriteria)
1. Alcohol abuse
2. Other malignancy
3. Clinically relevant active systemic disease (such as autoimmune or infectious diseases)
4. Pregnancy
5. Use drugs interfering with thyroid hormone metabolism (e.g. antiepileptic drugs, amiodarone,
and lithium)
6. Other primary thyroid disease
Opzet
Deelname
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