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Radioiodine Therapy Induces Dose-Dependent In Vivo Oxidation Injury: Evidence by Increased Isoprostane 8-Epi-PGF₂

¹ Department of Angiology, University of Vienna, Vienna, Austria
² Clinical Division of Oncology, Department of Internal Medicine I, University of Vienna, Vienna, Austria
³ Institute of Nuclear Medicine, University of Perugia, Perugia, Italy
⁴ Department of Nuclear Medicine, University of Vienna, Vienna, Austria
⁵ Wilhelm Auerswald Atherosclerosis Research Group (ASF) Vienna, Vienna, Austria

¹³¹I is the treatment of choice for differentiated thyroid cancer and hyperthyroidism. A relationship between low-density lipoprotein oxidation and radioiodine therapy-related side effects, consequently inducing increased formation of 8-epi-prostaglandin F₂ (PGF₂) in situ, has recently been reported by several investigators. Isoprostanes, among them 8-epi-PGF₂, have been associated with increased oxidation injury due to various pathologic conditions in vivo. The aim of this study was to investigate the possible induction of oxidative stress as a consequence of ¹³¹I therapy. Methods: 8-epi-PGF₂ was examined in plasma, serum, and urine in 42 patients undergoing radioiodine treatment of hyperthyroidism or thyroid cancer. The 8-epi-PGF₂ levels were analyzed daily for 1 wk and thereafter at different points up to 12 wk after treatment. Results: The isoprostane levels showed an increase after application of radioiodine in all investigated compartments. The effect was significantly higher and longer lasting after higher-activity therapy (2,960 or 7,400 MBq) than after lower-activity therapy (185 or 740 MBq). Conclusion: These findings document a significant, dose-dependent in vivo oxidation injury as a consequence of therapeutic radioiodine application to the salivary gland.

Key Words: radioiodine therapy • oxidation injury • isoprostanes • 8-epi-prostaglandin F₂

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