Lymphocyte function following radioiodine therapy in patients with thyroid carcinoma

 

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Summary

Aim: Since the nuclear disaster in Fukushima has raised great concern about the danger of radioactivity, we here addressed the question if the therapeutic use of iodine 131, the most frequently applied radionuclide, was harmful to immune function in patients. It was our aim to define for the first time in a clinical setting how radioiodine therapy alters anti-microbial immune responses. Patients, methods: In 21 patients with thyroid carcinoma anti-microbial lymphocyte responses were assessed by lymphocyte transformation test and ELISpot – measuring lymphocyte proliferation and on a single cell level production of pro- and anti-inflammatory cytokines (interferon-γ and interleukin- 10) – prior to therapy, at day 1 and day 7 post therapy. Results: Proliferative lymphocyte responses and interferon-γ production after in vitro stimulation with microbial antigens were significantly (p < 0.05) increased at day 1 vs. pre therapy, and returned to pre therapy levels at day 7. On the contrary, at day 1 interleukin-10 production was significantly (p < 0.05) reduced. Thus, we observed a short-term increase in pro-inflammatory immune responses. However, T lymphocyte responses were in the range of healthy controls at all three time points. Conclusion: Thyroid carcinoma patients receiving radioiodine therapy do not display any sign of immunosuppression.

Zusammenfassung

Nachdem die nukleare Katastrophe in Fukushima zu großer Besorgnis wegen der Gefahren radioaktiver Strahlung geführt hat, stellten wir die Frage, ob die Therapie mit Iod-131, dem am häufigsten verwendeten Radionuklid, die Immunfunktion von Patienten beeinträchtigt. Es war unser Ziel, erstmals in einer klinischen Studie zu definieren, wie die Radioiodtherapie die Immunabwehr gegenüber Mikroorganismen beeinflusst. Patienten, Methoden: Bei 21 Patienten mit Schilddrüsenkarzinom wurde die Immunabwehr gegenüber Mikroorganismen mit dem Lymphozyten- Transformationstest und dem ELISpot – die entweder die Lymphozytenproliferation oder auf Einzelzell-Niveau die Bildung pround anti-inflammatorischer Zytokine (Interferon- γ und Interleukin-10) messen – vor der Therapie, an Tag 1 und Tag 7 nach der Therapie untersucht. Ergebnisse: Die Lymphozytenproliferation und die Interferon-γ-Produktion nach Stimulation mit mikrobiellen Antigenen waren an Tag 1 vs. vor Therapie signifikant (p < 0,05) höher. Die Reaktionen kehrten an Tag 7 auf das Ausgangsniveau zurück. Die Produktion von Interleukin-10 dagegen war an Tag 7 signifikant (p < 0,05) reduziert. Wir beobachteten also kurzzeitig einen Anstieg proinflammatorischer Immunantworten. Allerdings waren die Reaktionen der T-Lymphozyten zu allen drei Zeitpunkten im Normbereich. Schlussfolgerung: Bei Patienten mit Schilddrüsen karzinom, die eine Radioiodtherapie erhalten, findet sich kein Hinweis auf eine Immun suppression.

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