For the past 80 years, radioiodine (131I) has been used to ablate thyroid tissue not removed by surgery or to treat differentiated thyroid cancer that has metastasized to other parts of the body. However, the Na+/I- symporter (NIS), which mediates active iodide uptake into thyroid follicular cells, is also expressed in several non-thyroidal tissues. This NIS expression permits 131I accumulation and radiation damage in these non-target tissues, which accounts for the adverse effects of radioiodine therapy. We will review the data regarding the expression, function, and regulation of NIS in non-thyroidal tissues and explain the seemingly paradoxical adverse effects induced by 131I, the self-limited gastrointestinal adverse effects in contrast to the permanent salivary dysfunction that is seen after 131I therapy. We propose that prospective studies are needed to uncover the time-course of pathological processes underlying development and progression or ultimate resolution of 131I-induced salivary ductal obstruction and nasolacrimal duct obstruction. Finally, preventive measures and early therapeutic interventions that can be applied potentially to eliminate or alleviate long-term radioiodine adverse effects will be discussed.

中文翻译：

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Na+/I- 同向转运体在非甲状腺组织中的表达、功能和调节以及对甲状腺癌治疗的影响。

在过去的 80 年中，放射性碘 (131I) 已被用于消融未通过手术切除的甲状腺组织或治疗已转移到身体其他部位的分化型甲状腺癌。然而，介导甲状腺滤泡细胞吸收活性碘的 Na+/I- 同向转运体 (NIS) 也在几种非甲状腺组织中表达。这种 NIS 表达允许 131I 在这些非靶组织中积累和辐射损伤，这说明了放射性碘治疗的不利影响。我们将回顾有关 NIS 在非甲状腺组织中的表达、功能和调节的数据，并解释 131I 诱导的看似矛盾的副作用，即自限性胃肠道副作用与 131I 后出现的永久性唾液功能障碍形成对比治疗。我们建议需要前瞻性研究来揭示 131I 诱导的唾液导管阻塞和鼻泪管阻塞的发展和进展或最终解决的病理过程的时间过程。最后，将讨论可用于消除或减轻长期放射性碘副作用的预防措施和早期治疗干预措施。