Introduction: The role of oxidative stress in pathogenesis and autoimmune diseases is well known. According to the function of the enzyme glutathione peroxidase via its antioxidant role in the body, the aim of this study was to investigate the level of salivary glutathione peroxidase in patients with Hashimoto's thyroiditis compared to a control group. Materials & Methods: In this case-control study, 30 patients with Hashimoto's thyroiditis and 30 healthy subjects were studied as a control group. The two studied groups were the same in terms of age and gender. Five ml of total unstimulated saliva of the subjects was collected under resting conditions in a quiet room between 10 a.m. and 12 noon (spitting method). The amount of glutathione peroxidase in the saliva samples of these subjects was measured using the ELISA method. The results were analyzed using Mann-Whitney and chi-square statistical tests at a significance level of 0.05. Results: The results showed that the mean age of the participants was 36.96±8.85 years. Totally, 71.7% of the participants were women with a mean age of 37.74±8.29 years and 28.3% were men with a mean age of 35±9.24 years. The level of salivary glutathione peroxidase was significantly lower in patients with Hashimoto's thyroiditis (13.26±13.55) than in the control group (24.95±18.06, P<0.002). Conclusion: The level of salivary glutathione peroxidase in patients with Hashimoto's thyroiditis was significantly reduced than normal. Foods rich in antioxidants, especially glutathione, are recommended. Keywords: Saliva, Glutathione Peroxidase, Hashimoto Disease, Thyroid

Background: Selenium , (Se) can be found in the molecular structure of selenoproteins,including thioredoxin reductase and glutathione peroxidase and also in Type , I and II deiodinases. Previous studies have shown that Se deficiency has been linked to autoimmune thyroid disease , (AITD). In the present study, we investigated the serum Se levels of patients with Graves’,disease , (GD), Hashimoto’, s thyroiditis , (HT), and euthyroid individuals as a control group. Materials and Methods: The present study was performed on patients with newly diagnosed AITD , (GD and HT). The control group was matched with the case group in terms of parameters such as age and sex. Free thyroxine, free triiodothyronine, thyroid‑, stimulating hormone, antithyroid peroxidase, antithyroglobulin, and serum Se levels were measured in all participants. These parameters were compared between groups. Results: Data from 132 , patients with HT, 120 , patients with GD, and 120 healthy euthyroid patients as a control group were analyzed. The Se level in patients with HT , (104. 36 , µ, g/l) and GD , (97. 68 , µ, g/l) was significantly lower than in the control group , (122. 63 , µ, g/l) , (P , < , 0. 001). The incidence of Se deficiency in patients with HT, GD, and in the control group was 15. 2%, 2. 5%, and 2. 5%, respectively , (P , < , 0. 001). In patients with GD, 34 , patients , (28. 33%) had Graves’,orbitopathy. Se levels in patients with orbitopathy were significantly lower than in patients without orbitopathy. Conclusion: The serum Se level was significantly lower in newly diagnosed patients with GD and HT than in the control group. Overall, Se deficiency can be considered a risk factor for AITDs.

Background: Hashimoto’ s thyroiditis (HT) is themostprevalentautoimmunedisease, andthere isnodefinitive treatment available for this disease. To find the appropriate therapeutic approach, it is necessary to determine the mechanism of this disease. To achieve this purpose, the frequency of CD4+ T cells was evaluated in patients with HT and compared with healthy individuals. Methods: Twenty-six female patients with HT, aged 20-45 years, enrolled in this study. Based on the level of thyroglobulin antibody (anti-TG) and anti-thyroid peroxidase antibody (anti-TPO) in serum of patients with HT, they were divided into two groups. The serum level of anti-TPO was above 100 IU/mL in the group 1 (n = 13), whereas the serum levels of both anti-TPO and anti-TG were above 100 IU/mL in the group 2 (n = 13). Eleven healthy women were considered control group, or group 3. Using flow cytometry, the frequency of T helper (Th)1, Th2, Th17, T regulatory type 1 (Tr1), and LT CD4+IL-4+IL-17+ cells and mean fluorescent intensity (MFI) of their related cytokines were evaluated. Results: The frequency of Th2 cells in the groups 1 (anti-TPO > 100) and 2 (anti-TPO > 100 and anti-TG > 100) were more than control group. Only the difference between groups 3 (healthy control) and 2 was significant (P = 0. 022). The frequency of LT CD4+IL-4+IL-17+ cells in the group 1 was significantlymorethan group 3 (P = 0. 027); However, the difference between group 2 and 3 was not significant (P = 0. 126). The expression of interferon-gamma (IFN-) in the group 2 (P = 0. 001) and group 1 (P = 0. 001) was significantly higher than group 3. The frequency of Th17, Th1, and Tr1 cells and MFI of IL-17 and IL-10 were not significantly different between the study groups. Conclusions: In the present study, no significant differences were observed in the frequency of Th17 and Tr1 cells and in MFI of IL-17 and IL-10 in comparison to healthy individuals. Therefore, trying to makea change in the population of these cells probably does not have a significant therapeutic effect. Since Th2 cells and the expression of IFN- increased inwomenwithHT, reducing the frequency of Th2 cells or the expression of IFN- may be effective in controlling the disease progression. It may be helpful for these patients to prevent the progression of the disease.

Autoimmunity represents the attack of the immune system of an organism against its own cells and tissues. Autoimmune diseases may affect one organ (Hashimoto thyroiditis) or can be systemic (chronic urticaria). Many factors are implicated in the pathogenesis of autoimmunity (white cells, cytokines, chemokines). Hashimoto thyroiditis has been associated with chronic urticaria in the last 3 decades in a number of clinical studies. Anti-thyroid antibodies have been documented in a proportion ranging from 10% to 30% in chronic urticaria patients in different countries from 3 continents. Two of the factors involved in the mechanism of autoimmunity are present both in the pathophysiology of Hashimoto thyroiditis and chronic urticaria. According to recent studies, IL6 is implicated in the pathogenesis of both diseases. TregsCD4+CD25+Foxp3+ cells have also been implicated in the pathological mechanisms of these 2 entities. This review offers an explanation of the clinical and statistical association between these two diseases from the pathophysiological point of view.

Background: The aim of the current trial was to investigate the effect of Vitamin D treatment on metabolic markers in people withVitamin D deficiency and thyroid autoimmunity. Materials and Methods: In this double‑blind, randomized, placebo‑controlledclinical trial, 65 Vitamin D deficient euthyroid or hypothyroid patients with positive TPO‑Ab were enrolled. They randomlyallocated into two groups to receive oral Vitamin D3 (50000 IU weekly) and placebo for 12 weeks. Serum concentration of calcium, phosphorus, albumin, C‑reactive protein, blood urea nitrogen, creatinine, glycated hemoglobin (HbA1c), insulin, fasting plasmaglucose (FPG), triglyceride (TG), total cholesterol, and high‑density lipoprotein were measured in both groups before and after thetrial. Homeostasis model assessment estimates of beta cell function (HOMA‑B) and HOMA‑insulin resistance (HOMA‑IR) werecalculated before and after trial in both groups.Results: Thirty‑three and thirty‑two participants were allocated to Vitamin D‑treatedand placebo‑treated groups, respectively. Mean (standard error) level of Vitamin D increased significantly in Vitamin D‑treatedgroup (45.53 [1.84] ng/mL vs.12.76 [0.74] ng/mL, P=0.001). The mean of HbA1c and insulin was increased significantly both inVitamin D‑treated and placebo‑treated groups (P<0.05). Other variables did not meet a significant change after trial (P=NS). Inbetween‑group comparison, there was not any significant difference between Vitamin D‑treated and placebo‑treated groups regardingmeasures of HOMA‑B, HOMA‑IR, FPG, HbA1c, and TG (P=NS).Conclusion: Our findings showed that weekly 50000 IU oralVitamin D3 for 12 weeks did not improve metabolic markers, IR, or insulin secretion in Vitamin D deficient patients with Hashimotothyroiditis.

Background: Struma ovarii (SO) is a rare phenomenon. In addition, it can be identified from the histological assessment and may show the characteristics of Hashimoto’ s thyroiditis in rare cases. In several cases, malignant stroma ovarii is found to produce hyperthyroidism while very few cases are reported with Hashimoto’ s thyroiditis. The present study reported SO co-incident with Hashimoto’ s thyroiditis. It should be mentioned that accurate monitoring of any signs of hypothyroidism is highly important after the surgery. Case Report: A 21-year-old patient with oligomenorrhea, hypogastric pain for the last year, dyspareunia and dysmenorrhea with a right adnexal cystic focus, and a bright echogenic focus referred to Al-Zahra hospital, Rasht. Histopathologic examination was compatible with the diagnosis of mature cystic teratoma containing SO co-incident with Hashimoto’ s thyroiditis while the patient was in a good general appearance 2 days after the surgery. Regarding the subclinical hypothyroidism and due to her willingness to conceive, the clinician administered levothyroxine and thus the patient was in a stable state within 6 months. Conclusion: In general, it is recommended to consider SO in women with ovarian mass and impaired thyroid function.