Zeinab Amirkhani, Mehrosadat Alavi, Mehdi Kalani, Ali Alavianmehr, Shirin Farjadian
Journal: Iranian journal of immunology : IJI 2022;19(1):7
PMID: 35293348
Thyroid cancer is the most prevalent endocrine malignancy. Thyroid cancers are classified into differentiated (papillary and follicular) and undifferentiated (anaplastic and medullary) carcinoma. Inflammation, recently considered as one of the hallmarks of cancer, plays an important role in the development and progression of thyroid cancers. The aim of this study was to investigate the possible prophylactic or therapeutic immunomodulatory effects of omega-3 in patients with differentiated carcinoma (DTC) before or after radioactive iodine (RAI) ablation. This study is a randomised controlled study. Patients were allocated into two groups based on RAI dosage: high-dose and intermediate-dose. Then patients in each group were randomly distributed into three subgroups: (1) RAI ablation only, (2) treated with omega-3 for 30 days before RAI ablation, and (3) treated with omega-3 for 30 days after RAI ablation. Results show that Omega-3 had better anti-inflammatory effects when it was used therapeutically after RAI ablation in DTC patients than when it was used prophylactically before RAI ablation. Authors conclude that future analyses could focus on intracellular cytokine production by different T cell subsets in peripheral blood, tumour-infiltrating T cells, tumour-draining lymph nodes, and tumour cells in patients with DTC who receive a combination of RAI and omega-3.
BACKGROUND
Thyroid cancer and radioactive iodine (RAI) ablation for postsurgical management may lead to uncontrolled inflammation.
OBJECTIVE
This study was intended to assess the prophylactic and therapeutic immunomodulatory effects of omega-3 fatty acids in patients with differentiated thyroid cancer (DTC).
METHODS
A total of 85 patients with DTC were allocated into two groups based on RAI dosage after thyroidectomy. Patients in each group were randomly distributed into three subgroups: G1 with RAI ablation only, G2 treated with omega-3 for 30 days before RAI ablation, and G3 treated with omega-3 for 30 days after RAI ablation. Fifteen healthy individuals were included as controls. Serum cytokine levels including IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-13, IL-17A, IL-17F, IL-21, IL-22, TNF-α and IFN-γ were determined by cytometric bead assay.
RESULTS
IL-4, IL-6, IL-21 and IL-22 levels in patients with DTC were higher than in the healthy controls. Regardless of RAI dosage, IL-6 showed an increasing trend after RAI ablation. IL-4, IL-22, and IL-17A remained at considerably higher levels than in the healthy controls after RAI ablation. Within-group comparisons showed a significant reduction in Th1+Th17/Th2+Th22 ratio in G2 patients 1 week after RAI ablation. Between-group comparisons showed increased IL-10 levels in G3 compared with G1 patients one week after high-dose RAI ablation. In G3, Th1+Th17/Th2+Th22 and Th1+Th17/Th2+Th9+Th22 ratios were remarkably lesser than in G2 patients 1 month after intermediate-dose RAI ablation.
CONCLUSION
Our results showed better anti-inflammatory effects of omega-3 when it was used therapeutically after RAI ablation in patients with DTC than when it was used prophylactically before RAI.
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