title: Airway function and markers of airway inflammation in patients with treated hypothyroidism.
abstract: BACKGROUND
  There is increasing evidence of an association between organ specific autoimmune diseases, particularly autoimmune thyroid disease and respiratory morbidity. A study was undertaken to determine whether patients with autoimmune thyroid disease have objective evidence of airway inflammation and dysfunction.
  
  
  METHODS
  Twenty six non-smoking women with treated hypothyroidism and 19 non-smoking controls completed a symptom questionnaire and underwent full lung function tests, capsaicin cough reflex sensitivity measurement, methacholine challenge test, and sputum induction over two visits.
  
  
  RESULTS
  Symptoms of cough (p = 0.01), dyspnoea (p = 0.01), sputum production (p = 0.004), and wheeze (p = 0.04) were reported more commonly in patients than controls. Patients with hypothyroidism had heightened cough reflex sensitivity compared with controls (geometric mean concentration of capsaicin causing five coughs: 40 v 108 mmol/l; mean difference 1.4 doubling doses; 95% confidence interval of difference 0.4 to 2.5; p = 0.008) and a significantly higher proportion of patients had airway hyperresponsiveness (methacholine provocative concentration (PC(20)) <8 mg/ml: 38% v 0%; p = 0.016). Patients with hypothyroidism also had a significantly higher induced sputum total neutrophil cell count (p = 0.01), total lymphocyte count (p = 0.02), and sputum supernatant interleukin-8 concentrations (p = 0.048).
  
  
  CONCLUSIONS
  Patients with treated hypothyroidism report more respiratory symptoms and have objective evidence of airway dysfunction and inflammation.
authors.affiliation: Institute for Lung Health, Department of Respiratory Medicine, Glenfield Hospital, Leicester LE3 9QP, UK. sb134@le.ac.uk
authors.forename: S S
authors.initials: SS
authors.lastname: Birring
authors.forename: R B
authors.initials: RB
authors.lastname: Patel
authors.forename: D
authors.initials: D
authors.lastname: Parker
authors.forename: S
authors.initials: S
authors.lastname: McKenna
authors.forename: B
authors.initials: B
authors.lastname: Hargadon
authors.forename: W R
authors.initials: WR
authors.lastname: Monteiro
authors.forename: J F
authors.initials: JF
authors.lastname: Falconer Smith
authors.forename: I D
authors.initials: ID
authors.lastname: Pavord
mesh_terms: D015415:Biomarkers / Q000032:analysis; D001991:Bronchitis / Q000473:pathology / Q000503:physiopathology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007037:Hypothyroidism / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D007958:Leukocyte Count; D008875:Middle Aged; D009504:Neutrophils; D013183:Sputum / Q000166:cytology; D018709:Statistics, Nonparametric; D014797:Vital Capacity / Q000502:physiology
chemical_list: D015415:Biomarkers
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