Tiroid Hastalıklarında Mikrobiyotanın Rolü

Yıl 2022, , 107 - 111, 31.08.2022

Zeynep Ercan Karakaya , Hayrettin Mutlu

https://doi.org/10.47769/izufbed.1144675

Öz

Bağırsak mikrobiyotası, konakçının sindirim ve immünolojik homeostazını sağlaması için gereklidir. Mikrobiyota homeostazı bozulduğunda ve disbiyoz meydana geldiğinde, epitel bariyerin bozulması başta immünolojik ve metabolik olmak üzere bağırsak ve sistemik bozukluklara yol açmaktadır. Bağırsak yolunun rolü, eksojen ve endojen iyodotironinler dahil olmak üzere besinlerin, ilaçların, hormonların, tiroid homeostazında yer alan mikro besinlerin metabolizmasında çok önemlidir. Yapılan çalışmalarda, bağırsak disbiyozu daha çok otoimmün tiroid hastalıklarında, tiroid karsinomunda tespit edilmiştir. Buna ek olarak, tiroid hastalıklarında bakteri çeşitliliği ve plazma tiroid parametreleri ile bakteri çeşitliliği arasında korelasyon gözlenmiştir. Buna rağmen tiroid homeostazı ile mikrobiyota bileşimi arasındaki bağlantı henüz netliğe kavuşmamıştır. Tiroid hastalıklarından muzdarip hastaları tedavi ederken, önerilecek probiyotik desteğinin, bağırsak bileşimine uygun yapılması konusunda ilgili klinik çalışmalara ihtiyaç olduğu görülmektedir.

Anahtar Kelimeler

Beslenme, Mikrobiyota, Tiroid hastalıkları, Probiyotik desteği

Role of Microbiota in Thyroid Diseases

Öz

The intestinal microbiota is essential for the host to ensure digestive and immunologic homeostasis. When microbiota homeostasis is impaired and dysbiosis occurs, the malfunction of epithelial barrier leads to intestinal and systemic disorders, chiefly immunologic and metabolic. The role of the intestinal tract is crucial in the metabolism of nutrients, drugs, and hormones, including exogenous and endogenous iodothyronines as well as micronutrients involved in thyroid homeostasis. In the studies, intestinal dysbiosis was detected mostly in autoimmune thyroid diseases and thyroid carcinoma. In addition, a correlation was observed between bacterial diversity and plasma thyroid parameters and bacterial diversity in thyroid diseases. However, the link between thyroid homeostasis and microbiota composition has not yet been clarified. When treating patients suffering from thyroid diseases, it is seen that there is a need for relevant clinical studies on making the probiotic supplement to be recommended in accordance with the intestinal composition.

Kaynakça

• Thursby, E., & Juge, N. (2017). Introduction to the human gut microbiota. Biochemical Journal, 474(11), 1823-1836.
• Totan, B., Yıldıran, H., & Ayyıldız, F. (2019). Bağırsak Mikrobiyatası Vücut Ağırlığını Etkiler Mi?. Selçuk Tıp Dergisi, 35(3), 210-216.
• Fröhlich, E., & Wahl, R. (2019). Microbiota and thyroid interaction in health and disease. Trends in Endocrinology & Metabolism, 30(8), 479-490.
• Zhang, Y. J., Li, S., Gan, R. Y., Zhou, T., Xu, D. P., & Li, H. B. (2015). Impacts of gut bacteria on human health and diseases. International journal of molecular sciences, 16(4), 7493-7519.
• Chang, C., & Lin, H. (2016). Dysbiosis in gastrointestinal disorders. Best practice & research Clinical gastroenterology, 30(1), 3-15.
• Wilmanski, T., Rappaport, N., Diener, C., Gibbons, S. M., & Price, N. D. (2021). From taxonomy to metabolic output: what factors define gut microbiome health?. Gut Microbes, 13(1), 1907270.
• Virili, C., & Centanni, M. (2015). Does microbiota composition affect thyroid homeostasis?. Endocrine, 49(3), 583-587.
• Selber-Hnatiw, S., Rukundo, B., Ahmadi, M., Akoubi, H., Al-Bizri, H., Aliu, A. F., ... & Gamberi, C. (2017). Human gut microbiota: toward an ecology of disease. Frontiers in microbiology, 8, 1265.
• Docimo, G., Cangiano, A., Romano, R. M., Pignatelli, M. F., Offi, C., Paglionico, V. A., ... & Pasquali, D. (2020). The human microbiota in endocrinology: implications for pathophysiology, treatment, and prognosis in thyroid diseases. Frontiers in Endocrinology, 869.
• Opazo, M. C., Coronado-Arrázola, I., Vallejos, O. P., Moreno-Reyes, R., Fardella, C., Mosso, L., Kalergis, A. M., Bueno, S. M., & Riedel, C. A. (2022). The impact of the micronutrient iodine in health and diseases. Critical reviews in food science and nutrition, 62(6), 1466–1479. https://doi.org/10.1080/10408398.2020.1843398
• Taylor, P. N., Albrecht, D., Scholz, A., Gutierrez-Buey, G., Lazarus, J. H., Dayan, C. M., & Okosieme, O. E. (2018). Global epidemiology of hyperthyroidism and hypothyroidism. Nature Reviews Endocrinology, 14(5), 301-316.
• Şahin, Z.B. (2020). Hashimoto tiroiditi ile tiroid nodül sitolojisi ve tiroid kanseri arasındaki ilişki. Gaziantep Üniversitesi Tıp Fakültesi İç Hastalıkları Anabilim Dalı Uzmanlık Tezi, Gaziantep, Türkiye, 64 s.
• Ersoy, M. (2016). Graves hastalığı aktivasyonuyla gelen hastalarda 25(OH) D düzeyleri ve inflamatuar belirteçler. Eskişehir Tıp Fakültesi İç Hastalıkları Anabilim Dalı Uzmanlık Tezi, Eskişehir, Türkiye, 107 s.
• Erdoğan, A. (2021). Papiller benzeri nükleer özellikler gösteren noninvaziv foliküler tiroid neoplazmı, klasik varyant papiller tiroid karsinomu ve foliküler varyant papiller tiroid karsinomunun sitoloji materyalinde ayrımında moleküler testlerin rolü. Gazi Üniversitesi Tıp Fakültesi Tıbbi Patoloji Anabilim Dalı Uzmanlık tezi, Ankara, Türkiye, 119 s.
• Fernández-García, V., González-Ramos, S., Martín-Sanz, P., Laparra, J. M., & Boscá, L. (2021). Beyond classic concepts in thyroid homeostasis: Immune system and microbiota. Molecular and Cellular Endocrinology, 533, 111333.
• Shen, H., Han, J., Li, Y., Lu, C., Zhou, J., Li, Y., & Su, X. (2019). Different host-specific responses in thyroid function and gut microbiota modulation between diet-induced obese and normal mice given the same dose of iodine. Applied microbiology and biotechnology, 103(8), 3537-3547.
• Knezevic, J., Starchl, C., Tmava Berisha, A., & Amrein, K. (2020). Thyroid-gut-axis: how does the microbiota influence thyroid function?. Nutrients, 12(6), 1769.
• Ferreira, R. L. U., Sena-Evangelista, K. C. M., De Azevedo, E. P., Pinheiro, F. I., Cobucci, R. N., & Pedrosa, L. F. C. (2021). Selenium in human health and gut microflora: bioavailability of selenocompounds and relationship with diseases. Frontiers in nutrition, 8, 292.
• Zhou, L., Li, X., Ahmed, A., Wu, D., Liu, L., Qiu, J., ... & Xin, Y. (2014). Gut microbe analysis between hyperthyroid and healthy individuals. Current microbiology, 69(5), 675-680.
• Zhao, F., Feng, J., Li, J., Zhao, L., Liu, Y., Chen, H., ... & Wei, Y. (2018). Alterations of the gut microbiota in Hashimoto's thyroiditis patients. Thyroid, 28(2), 175-186.
• Lin, B., Zhao, F., Liu, Y., Wu, X., Feng, J., Jin, X., Yan, W., Guo, X., Shi, S., Li, Z., Liu, L., Chen, H., Wang, H., Wang, S., Lu, Y., & Wei, Y. (2022). Randomized Clinical Trial: Probiotics Alleviated Oral-Gut Microbiota Dysbiosis and Thyroid Hormone Withdrawal-Related Complications in Thyroid Cancer Patients Before Radioiodine Therapy Following Thyroidectomy. Frontiers in endocrinology, 13, 834674. https://doi.org/10.3389/fendo.2022.834674
• Chang, S. C., Lin, S. F., Chen, S. T., Chang, P. Y., Yeh, Y. M., Lo, F. S., & Lu, J. J. (2021). Alterations of Gut Microbiota in Patients With Graves' Disease. Frontiers in cellular and infection microbiology, 11, 663131. https://doi.org/10.3389/fcimb.2021.663131
• Jiang, W., Yu, X., Kosik, R. O., Song, Y., Qiao, T., Tong, J., ... & Li, D. (2021). Gut Microbiota May Play a Significant Role in the Pathogenesis of Graves' Disease. Thyroid, 31(5), 810-820.
• Talebi, S., Karimifar, M., Heidari, Z., Mohammadi, H., & Askari, G. (2020). The effects of synbiotic supplementation on thyroid function and inflammation in hypothyroid patients: A randomized, double blind, placebo controlled trial. Complementary therapies in medicine, 48, 102234. https://doi.org/10.1016/j.ctim.2019.102234
• Gong, B., Wang, C., Meng, F., Wang, H., Song, B., Yang, Y., & Shan, Z. (2021). Association Between Gut Microbiota and Autoimmune Thyroid Disease: A Systematic Review and Meta-Analysis. Frontiers in endocrinology, 12, 774362. https://doi.org/10.3389/fendo.2021.774362
• Zhang, J., Zhang, F., Zhao, C., Xu, Q., Liang, C., Yang, Y., Wang, H., Shang, Y., Wang, Y., Mu, X., Zhu, D., Zhang, C., Yang, J., Yao, M., & Zhang, L. (2019). Dysbiosis of the gut microbiome is associated with thyroid cancer and thyroid nodules and correlated with clinical index of thyroid function. Endocrine, 64(3), 564–574. https://doi.org/10.1007/s12020-018-1831-x
• Yu, X., Jiang, W., Kosik, R. O., Song, Y., Luo, Q., Qiao, T., ... & Li, D. (2022). Gut microbiota changes and its potential relations with thyroid carcinoma. Journal of Advanced Research, 35, 61-70.