血管性痴呆合并甲状腺功能减退发生率的研究

目的 探讨血管性痴呆患者合并甲状腺功能减退的几率是否较其他人群升高。方法 选取2014年12月~2016年12月我院收治的100例血管性痴呆患者为VD组,同时收集100例年龄匹配智力正常人群作为对照组,对两组人群进行甲状腺功能检测,比较两组FT3、FT4、TSH检测结果以及甲状腺功能减退发生率。结果 VD组中甲状腺功能减退发生率为21.00%,高于对照组的6.00%,差异具有统计学意义（P＜0.05）。VD组FT3和FT4水平分别为（2.85±0.55）nmol/L和（8.81±4.72）nmol/L,低于对照组的（5.31±1.25）nmol/L和（18.15±4.58）nmol/L,TSH水平为（8.14±4.43）μIU/ml,高于对照组的（2.54±1.76）μIU/ml,差异具有统计学意义（P＜0.05）。结论 血管性痴呆合并甲状腺功能减退的发生率高于正常人群。     

促甲状腺激素生物素-链亲和素TRFIA定量检测法的建立

用Eu3＋标记链亲和素（SA）,分别用两株识别人促甲状腺素（human thyroid stimulating hormone,hTSH）的单克隆抗体包被96微孔板并生物素化,建立了高灵敏的hTSH生物素-链亲和素（BAS）时间分辨荧光免疫分析（TRFIA）检测法。本法的灵敏度为0.02mIU/L;批内CV为2.7%~3.5%,批间CV为3.2%~3.8%;平均回收率为100.26%;与电化学发光免疫分析技术（ECLIA）比对,相关系数达0.9544,线性方程为Y=1.3133X-32.297;与ECLIA临床测定值也呈明显相关;正常值范围为0.33~3.09mIU/L。本文建立的hTSH-BAS-TRFIA具有灵敏度高,特异性强,稳定性好,测定范围宽,检测时间短和非放射性等优点,具有良好的应用价值。     

Lower proportion of CD19+IL-10+ and CD19+CD24+CD27+ but not CD1d+CD5+CD19+CD24+CD27+ IL-10+ B cells in children with autoimmune thyroid diseases

Abstract

Introduction: As it is generally known, regulatory B cells (Bregs) control inflammation and autoimmunity. The significance of Bregs in the population of children with autoimmune thyroid diseases (AITD) still offers plenty of potential to explore. The aim of this study was to estimate the expression of Bregs (phenotype CD19⁺CD24⁺CD27⁺IL-10⁺, CD19⁺IL-10⁺, CD1d⁺CD5⁺CD19⁺IL-10⁺ and CD1d⁺CD5⁺CD19⁺CD24⁺CD27⁺) in a paediatric cohort with AITD and in health controls.

Materials and methods: A total of 100 blood samples were obtained from 53 paediatric patients with Graves’ disease (GD) (N?=?12 newly diagnosed, mean age 12.5?±?3.5 and N?=?17 during methimazole therapy, mean age 12.7?±?4.4), Hashimoto’s thyroiditis (HT) (N?=?10 newly diagnosed, mean age 13.3?±?2.9 and N?=?10 during L-thyroxine therapy, mean age 13.7?±?3.4) and compared with healthy controls (C) (N?=?15, mean age 13.1?±?3.1). The expressions of the immune cell populations were analysed by four-color flow cytometry using a FASC Canto II cytometer (BD Biosciences).

Results: There was a decreasing tendency in the number of lymphocytes B producing IL-10 (B10) cells among all B lymphocytes and more widely, also among all lymphocytes, in each study group, as compared to C. We reported a reduction in IL-10 production in Bregs with the expression of CD19⁺CD24⁺CD27⁺IL-10 and CD1d⁺CD5⁺CD19⁺IL-10⁺ in both untreated and treated AITD.

Conclusions: Our data demonstrate that the reduction in the number of Bregs with CD19⁺CD24⁺CD27⁺IL-10⁺ and CD19⁺IL-10⁺ expression could be responsible for breaking immune tolerance and for AITD development in children.     

Mutations of thyrotropin receptor gene

 Thyrotropin is the primary pituitary hor- mone which stimulates the growth and differentiation of thyroid cells. TSH binds a specific receptor present in the plasma membrane of thyroid cells and signals the G protein transducers, which activate different effec- tors, mainly adenyl cyclase and phospholipase C. The TSH receptor belongs to a broad class of receptors known as seven-loop receptors because they contain a long stretch of amino acids which cross the plasma membrane seven times. Mutations in the TSH receptor gene have been found in hyperfunctioning thyroid adenomas. These mutations are: (a) somatic (present only in the tumor), (b) dominant (only one copy of the gene is affected), and (c) lead to the constitutive activation of the cAMP signaling cascade. Most mutations which have been identified occur in the intracellular loop III and in the transmembrane domain VI. Germline mutations in the same regions of the receptor have been found in congenital nonautoimmune hyperthyroidism. In addition, germ line mutations have been described in the extracellular domain of the receptor leading to increased TSH levels. The clinical implications of these findings are discussed. Received: 15 January 1996 / Accepted: 8 March 1996     

Prevalence and clinical relevance of thyroid stimulating hormone receptor‐blocking antibodies in autoimmune thyroid disease

The prevalence and clinical relevance of thyroid stimulating hormone (TSH) receptor (TSHR) blocking antibodies (TBAb) in patients with autoimmune thyroid disease (AITD) was investigated. Serum TBAb were measured with a reporter gene bioassay using Chinese hamster ovary cells. Blocking activity was defined as percentage inhibition of luciferase expression relative to induction with bovine TSH alone (cut‐off 40% inhibition). All samples were measured for TSHR stimulatory antibody (TSAb) and TSHR binding inhibiting immunoglobulins (TBII). A total of 1079 unselected, consecutive patients with AITD and 302 healthy controls were included. All unselected controls were negative for TBAb and TSAb. In contrast, the prevalence of TBAb‐positive patients with Hashimoto's thyroiditis and Graves' disease was 67 of 722 (9·3%) and 15 of 357 (4·2%). Of the 82 TBAb‐positive patients, thirty‐nine (48%), 33 (40%) and 10 (12%) were hypothyroid, euthyroid and hyperthyroid, respectively. Ten patients were both TBAb‐ and TSAb‐positive (four hypothyroid, two euthyroid and four hyperthyroid). Thyroid‐associated orbitopathy was present in four of 82 (4·9%) TBAb‐positive patients, with dual TSHR antibody positivity being observed in three. TBAb correlated positively with TBII (r = 0·67, P < 0·001) and negatively with TSAb (r = –0·86, P < 0·05). The percentage of TBII‐positive patients was higher the higher the level of inhibition in the TBAb assay. Of the TBAb‐positive samples with  > 70% inhibition, 87% were TBII‐positive. Functional TSHR antibodies impact thyroid status. TBAb determination is helpful in the evaluation and management of patients with AITD. The TBAb assay is a relevant and important tool to identify potentially reversible hypothyroidism.     

甲状腺功能检测在心脑血管疾病中的应用和分析

目的探讨甲状腺功能检测在心脑血管疾病中的应用价值。方法采用回顾性分析的方法,分析我院收治的心肌梗死、心力衰竭及脑血栓患者FT3、FT4、TSH情况。结果心肌梗死、心力衰竭及脑血栓患者FT3、FT4均明显低于对照组,脑血栓患者TSH明显高于对照组,P〈0.05,差异均有统计学意义。结论心脑血管疾病发生时,甲状腺功能检测可以作为观察病情和预后较好的预警指标,具有较高的临床参考价值。     

甲状腺重量及血清TSH浓度对小剂量131Ⅰ治疗甲亢疗效的影响

目的:评价甲状腺重量及血清TSH浓度对小剂量131Ⅰ治疗甲状腺功能亢进症(甲亢)疗效的影响.方法:患者治疗前均行甲状腺SPECT扫描并检测血清FT3、FT4、TSH浓度;131I治疗的剂量为常规剂量的1/2～2/3.结果:①治疗前一次给药组TSH浓度为0.10±0.34mμ·L-1,重复给药组为0.04±0.10mμ·L-1,两者差异有显著性(P＜0.05);②治疗前甲状腺的重量一次给药组为51.22±26.09g,重复给药组87.34±63.69g,两者差异有显著性(P＜0.0001).结论:小剂量131Ⅰ治疗甲亢的疗效良好,多数患者能一次治愈,但对于大甲状腺患者或血清TSH浓度很低者则需多次治疗.     

Maternal photoperiodic programming enlightens the internal regulation of thyroid‐hormone deiodinases in tanycytes

Seasonal rhythms in physiology are widespread among mammals living in temperate zones. These rhythms rely on the external photoperiodic signal being entrained to the seasons, although they persist under constant conditions, revealing their endogenous origin. Internal long‐term timing (circannual cycles) can be revealed in the laboratory as photoperiodic history‐dependent responses, comprising the ability to respond differently to similar photoperiodic cues based on prior photoperiodic experience. In juveniles, history‐dependence relies on the photoperiod transmitted by the mother to the fetus in utero, a phenomenon known as “maternal photoperiodic programming” (MPP). The response to photoperiod in mammals involves the nocturnal pineal hormone melatonin, which regulates a neuroendocrine network including thyrotrophin in the pars tuberalis and deiodinases in tanycytes, resulting in changes in thyroid hormone in the mediobasal hypothalamus. This review addresses MPP and discusses the latest findings on its impact on the thyrotrophin/deiodinase network. Finally, commonalities between MPP and other instances of endogenous seasonal timing are considered, and a unifying scheme is suggested in which timing arises from a long‐term communication between the pars tuberalis and the hypothalamus and resultant spontaneous changes in local thyroid hormone status, independently of the pineal melatonin signal.