title: Thyroid nodules and thyroid autoimmunity in the context of environmental pollution.
abstract: Evidence suggests that in most industrialized countries autoimmune disorders, including chronic lymphocytic thyroiditis, are increasing. This increase parallels the one regarding differentiated thyroid cancer, the increment of which is mainly due to the papillary histotype. A number of studies have pointed to an association between chronic lymphocytic thyroiditis and differentiated thyroid cancer. The upward trend of these two thyroid diseases is sustained by certain environmental factors, such as polluting substances acting as endocrine disrupting chemicals. Herein we will review the experimental and clinical literature that highlights the effects of environmental and occupational exposure to polluting chemicals in the development of autoimmune thyroid disease or differentiated thyroid cancer. Stakeholders, starting from policymarkers, should become more sensitive to the consequences for the thyroid resulting from exposure to EDC. Indeed, the economic burden resulting from such consequences has not been quantified thus far.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Policlinico G. Martino, Padiglione H, 4 piano, via Consolare Valeria, 98125, Messina, Italy. s.benvenga@live.it.|Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina School of Medicine, Messina, Italy. s.benvenga@live.it.|Interdepartmental Program of Molecular and Clinical Endocrinology, and Women's Endocrine Health, University Hospital Policlinico G. Martino, Messina, Italy. s.benvenga@live.it.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Benvenga
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Antonelli
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Policlinico G. Martino, Padiglione H, 4 piano, via Consolare Valeria, 98125, Messina, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Vita
mesh_terms: D015551:Autoimmunity / Q000187:drug effects*; D004785:Environmental Pollutants / Q000633:toxicity*; D004787:Environmental Pollution; D006801:Humans; D013961:Thyroid Gland / Q000187:drug effects*; D013964:Thyroid Neoplasms / Q000139:chemically induced; D016606:Thyroid Nodule / Q000139:chemically induced*
chemical_list: D004785:Environmental Pollutants
keywords: Autoimmune thyroid diseases; Pollution; Thyroid; Thyroid cancer
references.citation: Am J Physiol Endocrinol Metab. 2008 Feb;294(2):E456-62
references.pmid: 18073318
references.citation: Int J Environ Res Public Health. 2013 Dec 16;10(12):7207-28
references.pmid: 24351742
references.citation: J Clin Endocrinol Metab. 2014 Mar;99(3):923-31
references.pmid: 24423323
references.citation: Ann Endocrinol (Paris). 2010 Dec;71(6):525-34
references.pmid: 20817147
references.citation: Thyroid. 2002 Jul;12(7):613-7
references.pmid: 12193307
references.citation: J Occup Environ Med. 1998 Dec;40(12):1072-82
references.pmid: 9871884
references.citation: BMC Cancer. 2012 Dec 21;12:610
references.pmid: 23256514
references.citation: Chemosphere. 2006 Jan;62(4):559-64
references.pmid: 16095667
references.citation: Hormones (Athens). 2010 Apr-Jun;9(2):109-17
references.pmid: 20687394
references.citation: Zhonghua Nei Ke Za Zhi. 2008 Mar;47(3):189-92
references.pmid: 18785499
references.citation: J Endocrinol Invest. 2002 May;25(5):447-54
references.pmid: 12035942
references.citation: Endocrine. 2016 Apr;52(1):120-9
references.pmid: 26306774
references.citation: Exp Toxicol Pathol. 2013 Nov;65(7-8):989-94
references.pmid: 23557935
references.citation: Occup Environ Med. 1994 Aug;51(8):536-40
references.pmid: 7951778
references.citation: Environ Sci Pollut Res Int. 2014 Oct;21(19):11361-9
references.pmid: 24878560
references.citation: Environ Res. 2010 Jan;110(1):112-7
references.pmid: 19913221
references.citation: Zhonghua Yu Fang Yi Xue Za Zhi. 2013 Feb;47(2):109-12
references.pmid: 23719099
references.citation: Gig Sanit. 2014 May-Jun;(3):52-6
references.pmid: 25306702
references.citation: Environ Sci Technol. 2015 Jun 16;49(12):7448-55
references.pmid: 25988605
references.citation: J Endocrinol Invest. 2005 Mar;28(3):209-13
references.pmid: 15952403
references.citation: Arq Bras Endocrinol Metabol. 2014 Aug;58(6):640-5
references.pmid: 25211447
references.citation: J Inorg Biochem. 2011 Nov;105(11):1464-8
references.pmid: 22099156
references.citation: J Appl Toxicol. 2015 Sep;35(9):992-8
references.pmid: 25644787
references.citation: J Clin Endocrinol Metab. 2006 Nov;91(11):4295-301
references.pmid: 16868053
references.citation: Thyroid. 2013 Feb;23(2):142-50
references.pmid: 23151083
references.citation: Gut. 1998 Feb;42(2):170-4
references.pmid: 9536939
references.citation: Ann Saudi Med. 1995 Jul;15(4):363-6
references.pmid: 17590608
references.citation: Pediatr Diabetes. 2006 Apr;7(2):81-7
references.pmid: 16629713
references.citation: Autoimmunity. 2015;48(7):494-501
references.pmid: 25915572
references.citation: Int J Endocrinol. 2015;2015:952729
references.pmid: 26064115
references.citation: Zhonghua Yu Fang Yi Xue Za Zhi. 2015 Feb;49(2):142-6
references.pmid: 26081399
references.citation: Nat Clin Pract Endocrinol Metab. 2008 Aug;4(8):454-60
references.pmid: 18607401
references.citation: Thyroid. 2013 Sep;23(9):1180-1
references.pmid: 23607293
references.citation: Am J Epidemiol. 1993 Oct 1;138(7):482-91
references.pmid: 8213752
references.citation: Thyroid. 1998 Sep;8(9):827-56
references.pmid: 9777756
references.citation: Environ Health Perspect. 2002 Oct;110 Suppl 5:877-81
references.pmid: 12426151
references.citation: Mol Cell Endocrinol. 2012 May 22;355(2):240-8
references.pmid: 21939731
references.citation: Endocr J. 2014;61(12):1181-90
references.pmid: 25242258
references.citation: Gen Comp Endocrinol. 2014 Sep 15;206:155-65
references.pmid: 25101840
references.citation: Environ Health. 2006 Dec 06;5:32
references.pmid: 17147831
references.citation: Lancet. 2003 Feb 8;361(9356):501-11
references.pmid: 12583960
references.citation: Clin Endocrinol (Oxf). 1994 Apr;40(4):529-35
references.pmid: 8187321
references.citation: N Engl J Med. 1980 Jan 3;302(1):31-3
references.pmid: 6243165
references.citation: Nitric Oxide. 2015 May 1;47:65-76
references.pmid: 25889269
references.citation: J Occup Environ Med. 1999 Apr;41(4):248-60
references.pmid: 10224590
references.citation: East Afr Med J. 2007 Mar;84(3):117-20
references.pmid: 17600980
references.citation: Orv Hetil. 2011 Oct 16;152(42):1692-7
references.pmid: 21979222
references.citation: Sci Total Environ. 2014 Jan 1;466-467:706-15
references.pmid: 23973536
references.citation: J Occup Environ Med. 2001 Jul;43(7):630-4
references.pmid: 11464394
references.citation: PLoS One. 2014 Mar 21;9(3):e92465
references.pmid: 24658602
references.citation: Acta Endocrinol (Copenh). 1990 Mar;122(3):391-5
references.pmid: 2109446
references.citation: Thyroid. 2008 Apr;18(4):429-41
references.pmid: 18399767
references.citation: J Endocrinol Invest. 2002 May;25(5):414-9
references.pmid: 12035936
references.citation: Otolaryngol Head Neck Surg. 2013 Mar;148(3):396-402
references.pmid: 23300224
references.citation: Am J Epidemiol. 2010 Feb 15;171(4):455-64
references.pmid: 20061368
references.citation: J Clin Endocrinol Metab. 2002 Feb;87(2):489-99
references.pmid: 11836274
references.citation: PLoS One. 2013;8(3):e55450
references.pmid: 23526929
references.citation: J Clin Endocrinol Metab. 1994 Nov;79(5):1404-9
references.pmid: 7962336
references.citation: J Clin Endocrinol Metab. 2006 Dec;91(12):5076-82
references.pmid: 16968790
references.citation: Epidemiology. 2014 Mar;25(2):255-64
references.pmid: 24407430
references.citation: J Endocrinol Invest. 2003 Aug;26(8):703-9
references.pmid: 14669822
references.citation: Environ Sci Pollut Res Int. 2015 Feb;22(3):2287-94
references.pmid: 25182428
references.citation: J Clin Endocrinol Metab. 2012 Apr;97(4):1134-45
references.pmid: 22278420
references.citation: J Clin Endocrinol Metab. 1999 May;84(5):1762
references.pmid: 10323417
references.citation: Thyroid. 2008 Oct;18(10):1065-9
references.pmid: 18816178
references.citation: Endocr J. 2015;62(8):711-7
references.pmid: 25994040
references.citation: Environ Res. 2013 Nov;127:7-15
references.pmid: 24183346
references.citation: Mediators Inflamm. 2015;2015:621072
references.pmid: 25861163
references.citation: Thyroid Res. 2014 Dec 05;7(1):11
references.pmid: 25506398
references.citation: Thyroid. 2016 Jan;26(1):1-133
references.pmid: 26462967
references.citation: J Toxicol Sci. 2015 Jun;40(3):309-19
references.pmid: 25972192
references.citation: Endocr Rev. 2009 Jun;30(4):293-342
references.pmid: 19502515
references.citation: Niger Med J. 2014 May;55(3):246-9
references.pmid: 25013258
references.citation: Ann Ist Super Sanita. 2014;50(2):186-91
references.pmid: 24968919
references.citation: East Afr Med J. 1996 Oct;73(10):694-6
references.pmid: 8997854
references.citation: Environ Sci Pollut Res Int. 2015 Oct;22(19):14589-99
references.pmid: 25138556
references.citation: Environ Res. 2013 Oct;126:51-9
references.pmid: 24053974
references.citation: J Rheumatol. 2001 May;28(5):962-7
references.pmid: 11361223
references.citation: Thyroid. 2006 Dec;16(12):1259-64
references.pmid: 17199436
references.citation: Clinics (Sao Paulo). 2006 Aug;61(4):307-12
references.pmid: 16924321
references.citation: Int J Environ Res Public Health. 2015 May 29;12(6):6098-114
references.pmid: 26035660
references.citation: Thyroid. 2003 Feb;13(2):129-32
references.pmid: 12699586
references.citation: Int J Clin Exp Med. 2015 Apr 15;8(4):6420-6
references.pmid: 26131268
references.citation: Environ Health Perspect. 2002 Dec;110(12 ):1169-73
references.pmid: 12460794
references.citation: Environ Res. 2012 Aug;117:68-74
references.pmid: 22776325
references.citation: Trop Geogr Med. 1993;45(3):126-8
references.pmid: 8362454
references.citation: Environ Res. 2015 Apr;138:298-305
references.pmid: 25749125
references.citation: G Ital Med Lav Ergon. 2012 Jul-Sep;34(3 Suppl):280-2
references.pmid: 23405642
references.citation: J Clin Endocrinol Metab. 2015 Apr;100(4):1278-88
references.pmid: 25742518
references.citation: Thyroid. 2008 Mar;18(3):353-62
references.pmid: 18298316
references.citation: Endocr Relat Cancer. 2014 Oct;21(5):T235-54
references.pmid: 24948559
references.citation: Thyroid. 2003 Jul;13(7):631-6
references.pmid: 12964967
references.citation: J Med Case Rep. 2009 Jul 16;3:6905
references.pmid: 19830129
references.citation: Environ Health Perspect. 2010 May;118(5):686-92
references.pmid: 20089479
references.citation: Eur J Endocrinol. 1998 Oct;139(4):402-9
references.pmid: 9820616
references.citation: Lancet. 2009 Jun 13;373(9680):2027-33
references.pmid: 19481249
references.citation: Int Arch Occup Environ Health. 1997;70(2):101-6
references.pmid: 9253638
references.citation: Environ Health Perspect. 2007 Aug;115(8):1197-203
references.pmid: 17687447
references.citation: Endocr Relat Cancer. 2009 Dec;16(4):1251-60
references.pmid: 19528244
references.citation: Toxicol Sci. 2014 Feb;137(2):311-23
references.pmid: 24189131
references.citation: Br J Dermatol. 2014 Oct;171(4):786-98
references.pmid: 25059078
references.citation: Quant Imaging Med Surg. 2014 Aug;4(4):232-8
references.pmid: 25202658
references.citation: J Clin Endocrinol Metab. 2015 Apr;100(4):1245-55
references.pmid: 25742516
references.citation: Mult Scler Int. 2013;2013:182516
references.pmid: 24324888
references.citation: Neuroepidemiology. 2000 Mar-Apr;19(2):67-75
references.pmid: 10686531
references.citation: Thyroid. 2007 Sep;17(9):811-7
references.pmid: 17956155
references.citation: Int J Immunogenet. 2015 Jun;42(3):190-4
references.pmid: 25817800
references.citation: Inflamm Allergy Drug Targets. 2009 Dec;8(5):359-63
references.pmid: 20025583
references.citation: Curr Opin Endocrinol Diabetes Obes. 2011 Oct;18(5):315-20
references.pmid: 21825977
references.citation: Thyroid. 2015 Jul;25(7):716-59
references.pmid: 25900731
references.citation: Nihon Eiseigaku Zasshi. 1999 Oct;54(3):526-33
references.pmid: 10555441
references.citation: PLoS One. 2015 May 18;10(5):e0126989
references.pmid: 25992849
references.citation: Environ Res. 2009 Jan;109(1):86-92
references.pmid: 18995849
references.citation: Indian J Med Res. 2014 Dec;140(6):729-35
references.pmid: 25758571
references.citation: J Appl Toxicol. 2000 Nov-Dec;20(6):483-9
references.pmid: 11180271
references.citation: Toxicology. 2012 Dec 8;302(1):68-76
references.pmid: 22889935
references.citation: Aquat Toxicol. 2013 Jan 15;126:207-13
references.pmid: 23220413
references.citation: Chemosphere. 2007 Aug;69(1):118-27
references.pmid: 17537484
references.citation: Inhal Toxicol. 2012 Aug;24(9):589-98
references.pmid: 22861002
references.citation: Gen Comp Endocrinol. 2015 Aug 1;219:64-73
references.pmid: 25585150
references.citation: J Occup Environ Med. 2010 Jun;52(6):653-60
references.pmid: 20523234
references.citation: Hormones (Athens). 2013 Jan-Mar;12(1):46-57
references.pmid: 23624131
references.citation: Ann Ig. 2014 Mar-Apr;26(2):167-75
references.pmid: 24763449
references.citation: Curr Opin Endocrinol Diabetes Obes. 2007 Oct;14(5):398-409
references.pmid: 17940471
references.citation: Eur J Endocrinol. 2015 Apr;172(4):383-9
references.pmid: 25599710
references.citation: Toxicol Appl Pharmacol. 2005 Sep 1;207(2 Suppl):282-92
references.pmid: 16023690
references.citation: Environ Health Perspect. 2013 Feb;121(2):181-6
references.pmid: 23164649
references.citation: J Clin Endocrinol Metab. 2015 Apr;100(4):1267-77
references.pmid: 25742517
references.citation: J Occup Environ Med. 2015 Oct;57(10):e101-13
references.pmid: 26461871
references.citation: Med Tr Prom Ekol. 2012;(5):41-8
references.pmid: 22855999
references.citation: Thyroid. 2003 Oct;13(10):995-6; author reply 996
references.pmid: 14611712
references.citation: Occup Med (Lond). 2004 Sep;54(6):435
references.pmid: 15358844
references.citation: Diabetes Care. 2000 Mar;23(3):414-6
references.pmid: 10868874
references.citation: Environ Int. 2015 Oct;83:171-5
references.pmid: 26142926
references.citation: Am J Epidemiol. 2014 Sep 1;180(5):490-8
references.pmid: 25096280
references.citation: Cytopathology. 2003 Jun;14(3):126-30
references.pmid: 12828721
references.citation: J Biochem Mol Toxicol. 2005;19(3):175
references.pmid: 15977190
references.citation: J Cancer Res Clin Oncol. 2014 Jun;140(6):1021-6
references.pmid: 24619663
references.citation: Thyroid. 2005 Sep;15(9):963-75
references.pmid: 16187904
references.citation: Clin Endocrinol (Oxf). 2002 Jun;56(6):787-91
references.pmid: 12072049
references.citation: Neurol India. 2014 Mar-Apr;62(2):218-9
references.pmid: 24823748
references.citation: J Endocrinol Invest. 1991 Feb;14 (2):115-21
references.pmid: 1648115
references.citation: Biomed Khim. 2014 Nov-Dec;60(6):655-60
references.pmid: 25552505
references.citation: Isr Med Assoc J. 2011 Feb;13(2):121-7
references.pmid: 21443044
references.citation: Arch Environ Contam Toxicol. 2015 Aug;69(2):181-90
references.pmid: 25700983
references.citation: Rev Epidemiol Sante Publique. 2010 Oct;58(5):359-67
references.pmid: 20980113
references.citation: Best Pract Res Clin Endocrinol Metab. 2010 Feb;24(1):133-41
references.pmid: 20172477
references.citation: Int J Mol Sci. 2014 Nov 25;15(12):21674-86
references.pmid: 25429429
references.citation: Thyroid. 2004 Apr;14(4):295-300
references.pmid: 15142363
references.citation: Sci Total Environ. 2012 Oct 1;435-436:66-73
references.pmid: 22846765
references.citation: Eur J Endocrinol. 2014 Feb 04;170(3):367-73
references.pmid: 24322183
references.citation: J Clin Endocrinol Metab. 2015 May;100(5):1870-8
references.pmid: 25710564
references.citation: Horm Metab Res. 2008 May;40(5):323-8
references.pmid: 18491251
references.citation: Eur J Endocrinol. 1999 Jun;140(6):505-11
references.pmid: 10366406
references.citation: Aquat Toxicol. 2015 Mar;160:188-96
references.pmid: 25646720