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Reviews in Endocrine and Metabolic Disorders

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27-10-2023 | Thyroiditis

Clinical and molecular impact of concurrent thyroid autoimmune disease and thyroid cancer: From the bench to bedside

Authors: Victor Alexandre dos Santos Valsecchi, Felipe Rodrigues Betoni, Laura Sterian Ward, Lucas Leite Cunha

Published in: Reviews in Endocrine and Metabolic Disorders | Issue 1/2024

Abstract

The recent incorporation of immune checkpoint inhibitors targeting the PD-1 (programmed cell death receptor 1) and CTLA-4 (cytotoxic T lymphocyte antigen 4) pathways into the therapeutic armamentarium of cancer has increased the need to understand the correlation between the immune system, autoimmunity, and malignant neoplasms. Both autoimmune thyroid diseases and thyroid cancer are common clinical conditions. The molecular pathology of autoimmune thyroid diseases is characterized by the important impact of the PD-1/PD-L1 axis, an important inhibitory pathway involved in the regulation of T-cell responses. Insufficient inhibitory pathways may prone the thyroid tissue to a self-destructive immune response that leads to hypothyroidism. On the other hand, the PD-1/PD-L1 axis and other co-inhibitory pathways are the cornerstones of the immune escape mechanisms in thyroid cancer, which is a mechanism through which the immune response fails to recognize and eradicate thyroid tumor cells. This common mechanism raises the idea that thyroid autoimmunity and thyroid cancer may be opposite sides of the same coin, meaning that both conditions share similar molecular signatures. When associated with thyroid autoimmunity, thyroid cancer may have a less aggressive presentation, even though the molecular explanation of this clinical consequence is unclear. More studies are warranted to elucidate the molecular link between thyroid autoimmune disease and thyroid cancer. The prognostic impact that thyroid autoimmune disease, especially chronic lymphocytic thyroiditis, may exert on thyroid cancer raises important insights that can help physicians to better individualize the management of patients with thyroid cancer.

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Title: Clinical and molecular impact of concurrent thyroid autoimmune disease and thyroid cancer: From the bench to bedside
Authors: Victor Alexandre dos Santos Valsecchi
Felipe Rodrigues Betoni
Laura Sterian Ward
Lucas Leite Cunha
Publication date: 27-10-2023
Publisher: Springer US
Keywords: Thyroiditis
Thyroid Disease
Thyroid Disease
Hashimoto Thyroiditis
Thyroid Cancer
Thyroid Cancer
Thyroid Cancer
Published in: Reviews in Endocrine and Metabolic Disorders / Issue 1/2024
Print ISSN: 1389-9155
Electronic ISSN: 1573-2606
DOI: https://doi.org/10.1007/s11154-023-09846-w

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