Comparing the effects of propylthiouracil and methimazole treatments on serum oxidative stres indicators (tas, tos) and on osteopontine, an inflammatory marker, in graves' disease

Graves' disease is an autoimmune disease that indicate itself with goiter, hyperthyroidism, and Graves' ophthalmopathy. TSH receptors in Graves' patients are considered as antigene and there is an antibody production against these receptors. In its medical treatment, methimazole and propylthiouracil are used. Osteopontine is an inflammatory protein, that is believed to have an important role in the pathogenesis of autoimmune diseases. Studies showed that in various autoimmune diseases, expression of osteopontin, increased in plasma and in the affected tissue. It is indicated that, it is also high in Graves' disease. Propylthiouracil and methimazole, used for the treatment of Graves' disease, contribute to prolonged remission with their direct effects on the immune system. In our study, we aim to evaluate the effect of propylthiouracil and methimazole treatment on serum osteopontin and oxidative stress in Graves' disease. In our study, 60 newly diagnosed Graves' patients who had come to our clinic and 30 healthy subjects as the control group were studied. Serum samples are taken from all patients with Graves disease and healthy control group in order to measure the level of serum osteopontine, total antioxidant status (TAS) and total oxidative stres (TOS) and these samples stored at -80°C. Then, for the treatment of Graves'disease, in 30 patients propylthiouracil therapy and in 30 patient methimazole therapy started randomly. After providing euthyroid, serum samples were obtained again and stored at -80°C. TAS, TOS, and osteopontine levels were studied in serum samples of the patients. Oxidative stress index (OSI) was determined by ratio of serum TOS levels to TAS levels. Groups were similar in terms of age and gender. Osteopontine levels of Graves' patients were significantly higher than the control group (p = 0.014). After antithyroid therapy, osteopontin levels were significantly decreased compared to baseline (p = 0.002). In the group that took propylthiouracil therapy, there was a significant reduction in TOS and OSİ levels (respectively p = 0.008 and p = 0.001) and there was a significant increase in TAS levels (p = 0.001) In the group that took methimazole, there was a reduction in TAS, TOS, and OSI levels, but it was statistically not significant. We believe that, antithyroid drug therapy in Graves' disease has a therapeutic effect on oxidative stress and on osteopontin, an inflammatory marker, and these effects are more explicit in propylthiouracil compared to methimazole. It is suggested that, having more reduction in the levels of oxidative stres and osteopontine, propylthiouracil may be more effective in inducing remission in Graves' disease.