Peculiarities of treatment of patients with comorbid pathology: chronic pancreatitis and hypothyroidism, taking into account SEPP1 gene polymorphism (RS7579)
DOI:
https://doi.org/10.15587/2519-4798.2023.295472Keywords:
chronic pancreatitis, hypothyroidism, SEPP1(rs 7579) gene polymorphism, sodium selenite drugAbstract
Optimization of therapeutic regimens during the treatment of the polymorbid course of chronic pancreatitis combined with hypothyroidism is an important task of modern science.
Aim: to treat patients with comorbid pathology: chronic pancreatitis and hypothyroidism, taking into account the polymorphism of the SEPP1 gene (RS7579)
Materials and methods. During the research, we examined 128 people. Patients were divided into 3 groups. The first group included 48 patients with chronic pancreatitis, the second - 50 patients with chronic pancreatitis in combination with hypothyroidism, and the third - 30 practically healthy people.
Results. Symptoms of maldigestion decreased in 72 % of the examined patients. Signs of nutritional deficiency have significantly decreased, and general well-being has improved. Multicomponent therapy also affected mood, sleep, and reduced irritability and symptoms of depression and anxiety disorders. A multisystemic polysyndromic approach to treatment led to improvements in both pancreatic and thyroid function. The effectiveness of the treatment strategy for patients with chronic pancreatitis was dependent on individual characteristics, such as the severity of chronic pancreatitis, the presence of primary hypothyroidism, the degree of selenium deficiency and concomitant symptoms, taking into account polymorphic variants of the SEPP1 (rs7579) gene. Selenoid deficiency decreased, especially in the group with a combination of chronic pancreatitis and hypothyroidism. The improvement in thyroid hormone activity included a 40.46 % decrease in blood TSH and a 2.5-fold increase in free T4.
Conclusions. The program of complex therapy led to the normalization of the condition of patients with the G-allele genotype of the SEPP1 gene (rs7579), as evidenced by significant improvements in most of the analyzed indicators. The concentration of fecal elastase 1 and blood selenoprotein P significantly increased, and the level of serum pancreatic α-amylase significantly decreased in carriers of the AA genotype. Under the influence of therapy, there were also changes in the hormonal activity of the thyroid gland, a decrease in the concentration of total metabolites of NO, and an improvement in the health indicators of the cardiovascular system. However, for patients with the AA genotype of the SEPP1 (rs7579) gene, continuation of therapy remains important to achieve an optimal condition, in particular, to manage cholesterol levels and other cardiovascular risk factors
References
- Beyer, G., Habtezion, A., Werner, J., Lerch, M. M., Mayerle, J. (2020). Chronic pancreatitis. The Lancet, 396 (10249), 499–512. doi: https://doi.org/10.1016/s0140-6736(20)31318-0
- Löhr, J. M., Dominguez‐Munoz, E., Rosendahl, J., Besselink, M., Mayerle, J., Lerch, M. M. et al. (2017). United European Gastroenterology evidence‐based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU). United European Gastroenterology Journal, 5 (2), 153–199. doi: https://doi.org/10.1177/2050640616684695
- Xu, Y.-W., Li, R., Xu, S.-C. (2020). Hypothyroidism with elevated pancreatic amylase and lipase without clinical symptoms: A case report. World Journal of Clinical Cases, 8 (15), 3299–3304. doi: https://doi.org/10.12998/wjcc.v8.i15.3299
- Kyriacou, A., McLaughlin, J., Syed, A. A. (2015). Thyroid disorders and gastrointestinal and liver dysfunction: A state of the art review. European Journal of Internal Medicine, 26 (8), 563–571. doi: https://doi.org/10.1016/j.ejim.2015.07.017
- Stuss, M., Michalska-Kasiczak, M., Sewerynek, E. (2017). The role of selenium in thyroid gland pathophysiology. Endokrynologia Polska, 68 (4), 440–465. doi: https://doi.org/10.5603/ep.2017.0051
- Kravchenko, V. I., Grossman, A. B., Rakov, O. V., Kovzun, O. I., Pankiv, V. I,, Simurov, O. V. (2021). Selenium supply and thyroid condition in Graves’ disease in the region of iodine deficiency. Problemi Endokrinnoi Patologii, 75 (1), 26–33. doi: https://doi.org/10.21856/j-pep.2021.1.04
- Hill, K. E., Zhou, J., McMahan, W. J., Motley, A. K., Atkins, J. F., Gesteland, R. F., Burk, R. F. (2003). Deletion of Selenoprotein P Alters Distribution of Selenium in the Mouse. Journal of Biological Chemistry, 278 (16), 13640–13646. doi: https://doi.org/10.1074/jbc.m300755200
- Saito, Y. (2021). Selenium Transport Mechanism via Selenoprotein P – Its Physiological Role and Related Diseases. Frontiers in Nutrition, 8. doi: https://doi.org/10.3389/fnut.2021.685517
- Bosschaerts, T., Guilliams, M., Noel, W., Hérin, M., Burk, R. F., Hill, K. E. et al. (2008). Alternatively Activated Myeloid Cells Limit Pathogenicity Associated with African Trypanosomiasis through the IL-10 Inducible Gene Selenoprotein P. The Journal of Immunology, 180 (9), 6168–6175. doi: https://doi.org/10.4049/jimmunol.180.9.6168
- Brown, K., Arthur, J. (2001). Selenium, selenoproteins and human health: a review. Public Health Nutrition, 4 (2b), 593–599. doi: https://doi.org/10.1079/phn2001143
- Mao, J., Vanderlelie, J. J., Perkins, A. V., Redman, C. W., Ahmadi, K. R., Rayman, M. P. (2016). Genetic polymorphisms that affect selenium status and response to selenium supplementation in United Kingdom pregnant women. The American Journal of Clinical Nutrition, 103 (1), 100–106. doi: https://doi.org/10.3945/ajcn.115.114231
- Moriguchi Watanabe, L., Bueno, A. C., de Lima, L. F., Ferraz-Bannitz, R., Dessordi, R., Guimarães, M. P. et al. (2021). Genetically determined variations of selenoprotein P are associated with antioxidant, muscular, and lipid biomarkers in response to Brazil nut consumption by patients using statins. British Journal of Nutrition, 127 (5), 679–686. doi: https://doi.org/10.1017/s000711452100146x
- Unifikovanyi klinichnyi protokol pervynnoi ta spetsializovanoi medychnoi dopomohy "Khronichnyi pankreatyt" (2023). MOZ: DP "Derzhavnyi ekspertnyi tsentr Ministerstva okhorony zdorovia Ukrainy". Available at: https://www.dec.gov.ua/wp-content/uploads/2023/07/1204_05072023_ukpmd.pdf
- Khronichnyi pankreatyt. Klinichna nastanova, zasnovana na dokazakh (2023). MOZ: DP "Derzhavnyi ekspertnyi tsentr Ministerstva okhorony zdorovia Ukrainy". Available at: https://www.dec.gov.ua/wp-content/uploads/2023/07/2023_kn_hronichnyj-pankreatyt.pdf
- Urgatz, B., Razvi, S. (2023). Subclinical hypothyroidism, outcomes and management guidelines: a narrative review and update of recent literature. Current Medical Research and Opinion, 39 (3), 351–365. doi: https://doi.org/10.1080/03007995.2023.2165811
- Durante, C., Hegedüs, L., Czarniecka, A., Paschke, R., Russ, G., Schmitt, F., Soares, P., Solymosi, T., Papini, E. (2023). 2023 European Thyroid Association Clinical Practice Guidelines for thyroid nodule management. European Thyroid Journal, 12 (5). doi: https://doi.org/10.1530/etj-23-0067
- Vrodzhenyi hipotyreoz. Klinichna nastanova, zasnovana na dokazakh (2023). MOZ: DP "Derzhavnyi ekspertnyi tsentr Ministerstva okhorony zdorovia Ukrainy". Available at: https://www.dec.gov.ua/wp-content/uploads/2023/07/2023_kn_vrodzhenyj-gipotyreoz.pdf
- Moshtaghi, A., Amini, G., Salehi, R., Kazemi, M., Behjati, M., Khosravi, S. (2019). Evaluation of SEPP1 and Selenoprotein S Gene Polymorphisms (RS7579 and RS34713741) in Relation to Colorectal Cancer Susceptibility in Subset of Iranian Population: A Case-control Study. Advanced Biomedical Research, 8 (1), 47. doi: https://doi.org/10.4103/abr.abr_249_18
- Mosallaei, M., Simonian, M., Ahangari, F., Miraghajani, M., Mortazavi, D., Salehi, A. R. et al. (2018). Single nucleotide polymorphism rs4648298 in miRNAs hsa-miR21 and hsa-miR590 binding site of COX gene is a strong colorectal cancer determinant. Journal of Gastrointestinal Oncology, 9 (3), 448–457. doi: https://doi.org/10.21037/jgo.2017.11.01
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Veronika Ratsa, Olexandr Fediv, Larisa Sydorchuk
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.