Novel therapies for thyroid autoimmune diseases: An update

Silvia Martina Ferrari, Poupak Fallahi, Giusy Elia, Francesca Ragusa, Stefania Camastra, Sabrina Rosaria Paparo, Claudia Giusti, Debora Gonnella, Ilaria Ruffilli, Yehuda Shoenfeld, Alessandro Antonelli

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish
Article number101366
JournalBest Practice and Research in Clinical Endocrinology and Metabolism
Volume34
Issue number1
DOIs
StatePublished - Jan 2020

Keywords

  • antigen-specific immunotherapy
  • autoimmune thyroid disorders
  • corticosteroids
  • rituximab
  • teprotumumab
  • tocilizumab

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