IL18 is a Prospective Target Affecting Radioiodine Therapy Sensitivity and Prognosis in Differentiated Thyroid Carcinoma

Abstract

Background: Differentiated Thyroid Carcinoma (DTC) presents diverse patient outcomes, highlighting the need to identify reliable prognostic biomarkers. This study focuses on the role of interleukins, particularly interleukin18 (IL18), in predicting survival rates and treatment responses among DTC patients. Methods: We conducted a comprehensive analysis of the association between various pyroptosis-related genes (IL18, IL1A, IL6, Granzyme A (GZMA), and Neutrophil elastase (ELANE)) and overall survival in DTC. The study employed univariate and multivariate Cox models to assess the prognostic value of these cytokines. Additionally, a nomogram model was created, integrating clinical characteristics to improve the precision of predicting patient outcomes. IL18 expression levels in DTC tissues compared to normal tissues were examined, along with their association with patient survival and response to radioactive iodine (RAI) therapy. Results: IL18 emerged as a significant protective factor associated with better survival outcomes, exhibiting higher expression levels in DTC tissues compared to normal tissues. However, its expression was notably lower in RAI-refractory or high-risk groups. This study also identified axitinib as a potential therapeutic agent for high-risk DTC cases, supported by drug prediction analysis. Furthermore, immune cell analysis linked high IL18 expression with an abundance of specific T cells, indicating its involvement in regulating the immune response and influencing the effectiveness of RAI treatment. Conclusions: IL18 holds promise as a prognostic biomarker in DTC, offering valuable insights into patient survival and potential treatment pathways. This study emphasizes the importance of combining molecular and clinical data to improve prognostic models and therapeutic strategies, highlighting the need for further research into the mechanisms of action of IL18 in DTC.