Novel Therapies for Thyroid Autoimmune Diseases: an update

Publication date: Available online 28 November 2019Source: Best Practice & Research Clinical Endocrinology & MetabolismAuthor(s): Silvia Martina Ferrari, Poupak Fallahi, Giusy Elia, Francesca Ragusa, Stefania Camastra, Sabrina Rosaria Paparo, Claudia Giusti, Debora Gonnella, Ilaria Ruffilli, Yehuda Shoenfeld, Alessandro AntonelliAbstractA 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.
Source: Best Practice and Research Clinical Endocrinology and Metabolism - Category: Endocrinology Source Type: research