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New therapeutic horizons for Graves' hyperthyroidism.
Endocrine Reviews ( IF 20.3 ) Pub Date : 2020-08-26 , DOI: 10.1210/endrev/bnaa022
Laura C Lane 1, 2, 3 , Tim D Cheetham 1, 3 , Petros Perros 2 , Simon H S Pearce 1, 2
Affiliation  

Graves’ hyperthyroidism is characterised by the presence of autoantibodies that stimulate the thyroid stimulating hormone receptor (TSHR), resulting in uncontrolled secretion of excessive thyroid hormone. Conventional treatments including antithyroid medication, radioiodine or surgery have remained largely unchanged for the past 70 years and either lack efficacy for many patients, or result in lifelong thyroid hormone replacement therapy in the case of the latter two options. The demand for new therapeutic options combined with greater insight into basic immunobiology, has led to the emergence of novel approaches to treat Graves’ hyperthyroidism. The current therapies under investigation include biologics, small-molecules and peptide immunomodulation. There is a growing focus on TSHR-specific treatment modalities, which carry the advantage of eliciting a specific, targeted approach, with the aim of avoiding disruption of the functioning immune system. These therapies offer the new opportunity to supersede the inadequate treatments currently available for some Graves’ patients, with the hope of successful restoration of euthyroidism without the need for ongoing therapy. Several of these therapeutic options have the potential to translate into clinical practice in the near future. This review provides a comprehensive summary of the recent advances and various stages of development of the novel therapeutic approaches to treat Graves’ hyperthyroidism.

中文翻译:

格雷夫斯甲状腺功能亢进症的新治疗视野。

格雷夫斯的甲状腺功能亢进症的特征是存在刺激促甲状腺激素受体 (TSHR) 的自身抗体,导致甲状腺激素分泌过多而不受控制。在过去的 70 年中,包括抗甲状腺药物、放射性碘或手术在内的常规治疗基本保持不变,或者对许多患者缺乏疗效,或者在后两种选择的情况下导致终身甲状腺激素替代治疗。对新治疗方案的需求以及对基础免疫生物学的更深入了解,导致出现了治疗 Graves 甲状腺功能亢进症的新方法。目前正在研究的疗法包括生物制剂、小分子和肽免疫调节。人们越来越关注 TSHR 特定的治疗方式,它具有引发特定的、有针对性的方法的优势,目的是避免破坏功能性免疫系统。这些疗法提供了新的机会,可以取代目前某些 Graves 患者可用的不充分治疗,希望在无需持续治疗的情况下成功恢复甲状腺功能正常。其中一些治疗选择有可能在不久的将来转化为临床实践。本综述全面总结了治疗 Graves 甲状腺功能亢进症的新治疗方法的最新进展和各个发展阶段。这些疗法提供了新的机会,可以取代目前某些 Graves 患者可用的不充分治疗,希望在无需持续治疗的情况下成功恢复甲状腺功能正常。其中一些治疗选择有可能在不久的将来转化为临床实践。本综述全面总结了治疗 Graves 甲状腺功能亢进症的新治疗方法的最新进展和各个发展阶段。这些疗法提供了新的机会,可以取代目前某些 Graves 患者可用的不充分治疗,希望在无需持续治疗的情况下成功恢复甲状腺功能正常。其中一些治疗选择有可能在不久的将来转化为临床实践。本综述全面总结了治疗 Graves 甲状腺功能亢进症的新治疗方法的最新进展和各个发展阶段。
更新日期:2020-08-26
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