碘对自身免疫性甲状腺疾病外周血单个核细胞HLA-DR表达的影响

目的 :探讨碘在自身免疫性甲状腺疾病 (AITD)发病中的作用及机制。方法 :选择具有遗传倾向疾病Graves病一级亲属的外周血单个核细胞 (PBMNC) ,采用细胞培养和免疫印迹技术 ,检测 Na I对 PBMNC HL A - DR表达的影响。结果 :Graves病一级亲属 :PBMNC HL A- DR表达量随培养液 Na I浓度增加而递增 ;而对正常无遗传倾向者 PBMNC HL A- DR表达量无影响。结论 :过多的碘可以上调有遗传倾向者 PBMNC HL A- DR表达。     

Genetic susceptibility to autoimmune thyroid diseases in a Chinese Han population: Role of vitamin D receptor gene polymorphisms

Purpose

Previous studies have found that some immune-related genes were associated with autoimmune thyroid diseases (AITDs). A couple of studies have explored the association between vitamin D (1,25-dihydroxyvitamin D3) receptor (VDR) gene polymorphisms and susceptibility to AITDs in different populations and found conflicting results. This case-control study was designed to evaluate the role of polymorphisms of VDR gene in the predisposition of AITDs in a Chinese Han population.

Methods

A total of 417 patients with Graves’ disease (GD), 250 patients with Hashimoto's thyroiditis (HT) and 301 healthy subjects were enrolled. The Matrix Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometer (MALDI-TOF-MS) Platform was applied to detect four SNPs (rs1544410, rs2228570, rs731236 and rs7975232) in the VDR gene.

Results

In the rs7975232 allele A frequency showed a significant increase in GD patients (30.34% vs. 25.42% in controls; P = 0.041, OR = 1.278, 95%CI = 1.010–1.617). However, no relationship was found between clinical phenotypes and the four SNPs.

Conclusions

This result suggests that the VDR gene may be one susceptibility gene which contributes to the risk of GD.     

Association of Interleukin-1B and Interleukin-4 Gene Variants with Autoimmune Thyroid Diseases in Tunisian Population

Autoimmune thyroid diseases (AITD) including Graves’ disease (GD) and Hashimoto’s thyroiditis (HT) are complex genetic diseases. Cytokines IL-1B and IL-4 play a role in the pathogenesis of AITD. This study was conducted on Tunisian patients with GD or HT to investigate the association of IL-1B and IL-4 gene polymorphisms with the risk and the prognosis of AITD. A total of 358 healthy controls and 341 patients with AITDs (249 HT and 92 GD) were genotyped for IL-1B+3953C/T and IL-4 intron 3 VNTR polymorphisms. A significant association was found between IL-1B+3953C/T polymorphism and GD or HT, both in the dominant and additive models. The IL-1B+3953T allele was associated with GD (p = 0.0003, OR = 1.93, CI = 1.34-2.78) and HT (p = 0.009, OR = 1.43, CI = 1.09-1.88). The IL-4 VNTR polymorphism was associated only with HT risk both in additive (p = 0.03, OR = 0.31, CI = 0.11-0.86) and recessive (p = 0.03, OR = 3.04, CI = 1.13-8.17) models. No significant association was found between IL-1B+3953C/T polymorphism and change in the serum concentrations of TSH and FT4 in GD and HT patients. In HT patients, the IL-1B+3953T allele (p = 0.009, OR = 0.42, CI = 0.22-0.83) and the IL-1B+3953T/T genotype (p = 0.03, OR = 0.21, CI = 0.04-1.07) were more frequent in the absence than in the presence of an anti-TPO antibody. The proportion of HT patients with the P1P2 genotype of the IL-4 gene was significantly higher in the absence than in the presence of the anti-TPO antibody (p = 0.04, OR = 0.39, CI = 0.17-0.89). These preliminary results suggest that IL-1B and IL-4 gene polymorphisms may be associated with GD and HT susceptibility and may represent prognostic factors for predicting the severity of HT.     

Systemic lupus erythematosus and thyroid disease – Experience in a single medical center in Taiwan

BackgroundTo investigate the association of systemic lupus erythematosus (SLE) with thyroid diseases in a medical center in central Taiwan.MethodsThis is a retrospective cohort of 2796 SLE patients in a tertiary referral medical center from 2000 to 2013. We screened SLE by catastrophic illness registration from national insurance bureau; and thyroid diseases by ICD 9 codes, then confirmed by thyroid function test, auto-antibody, medical and/or surgical intervention. We compared the rate of hyperthyroidism, hypothyroidism and autoimmune thyroid disease (AITD) in SLE patients and the 11,184 match controls. We calculated the rate of these thyroid diseases and positive antibodies to thyroglobulin (ATGAb), thyroid peroxidase (TPOAb) in SLE patients grouped by the presence of overlap syndrome and anti-dsDNA antibody. We also compared the association of thyroid diseases to severe SLE conditions, including renal, central nervous system (CNS) involvement, and thrombocytopenia.ResultsCompared to the matched controls, the cumulative incidence of thyroid disease, including hyperthyroidism, hypothyroidism and AITD, were all higher in SLE patients (p < 0.0001). The average age of SLE patients with thyroid diseases patients were older than those without thyroid diseases (p = 0.002). Those had euthyroid AITD were younger than other patients with thyroid diseases (p = 0.02). Up to 30.3% SLE patients had overlap syndrome and had higher relative risk of thyroid diseases than those without overlap syndrome, in terms of hypothyroidism and AITD, but not hyperthyroidism. SLE patients with thyroid diseases also carry higher risk for severe complications such as renal involvement (p = 0.024) central nervous system involvement (p < 0.0001).ConclusionSLE patients had significantly higher rate of hyperthyroidism, hypothyroidism, and AITD than the matched control. Among lupus patients, the risks of thyroid diseases are even higher in the presence of overlap syndrome. SLE patients with thyroid diseases had higher risk of renal and CNS involvement.     

AITD甲状腺细胞Fas、FasL的单抗免疫组化测定

测定凋亡相关蛋白Fas、FasL在自身免疫性甲状腺疾病(AITD)病人甲状腺细胞中的表达,以研究细胞凋亡在AITD发病中的作用.本研究采用甲状腺粗针穿刺取甲状腺组织,然后用单克隆抗体免疫组织化学法和图像分析检测甲状腺细胞中Fas、FasL的表达,于电镜下观察结果.Graves病(GD)组Fas、FasL染色强度显著低于对照组(P＜0.01).桥本氏甲状腺炎(HT)组两者染色强度显著高于对照组(P＜0.01).这说明Fas、FasL这两种凋亡相关蛋白在HT病人甲状腺细胞中表达显著增强,而在GD病人中表达较少,进一步证实了细胞凋亡在AITD发病机制中具有重要作用.     

运用ROC曲线方法评价TRAb、TPO-Ab和TGA在Graves'病和HT鉴别诊断中的意义

目的:应用临床诊断性能(ROC)曲线方法评价TSH受体抗体(TRAb)、甲状腺过氧化物酶抗体(TPO-Ab)和甲状腺球蛋白抗体(TGA)在Graves'病(格雷夫斯病)和桥本甲状腺炎鉴别诊断中的意义.方法:以甲状腺细针穿刺细胞学检查结果作为诊断金标准,以采用化学发光法测定63例自身免疫性甲状腺病患者血清的TRAb、TP...     

丙硫氧嘧啶联合氟羟强的松龙治疗自身免疫性甲状腺疾病伴甲亢70例临床研究

目的探讨丙硫氧嘧啶联合氟羟强的松龙在治疗自身免疫性甲状腺疾病（AITD）伴甲亢患者的临床疗效。方法将2010年5月～2012年8月收集的70例AITD伴甲亢患者随机分为两组：丙硫氧嘧啶治疗组和丙硫氧嘧啶联合氟羟强的松龙治疗组。每组35例。在治疗过程中,同时监测两组患者的血清促甲状腺激素（TSH）、血清游离甲状腺素（FT4）、血清游离三碘甲状腺原氨酸（FT3）、血清甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体（TGAb）的变化水平,并分析其治疗效果。结果丙硫氧嘧啶治疗组治疗后FT4下降明显（P〈0．05）,TSH的水平略有上升,TPOAb和TGAb与治疗前相比差异无显著性（P〉0．05）;丙硫氧嘧啶联合氟羟强的松龙治疗组治疗后FT3、FT4、TPOAb和TGAb较治疗前有下降明显,差异有统计学意义（P〈0．05）,TSH较治疗前有显著性上升（P〈0．05）。结论丙硫氧嘧啶与氟羟强的松龙联合用药可以有效降低自身免疫性甲状腺疾病伴有甲亢患者血清中FT3、FT4、TPOAb和TGAb的水平,抑制病情的进一步发展,促进甲状腺功能的恢复。     

应用血液测定实验室诊断自身免疫性甲状腺疾病

目的探讨甲状腺球蛋白抗体(TG-Ab)、甲状腺过氧化物酶抗体(TPO-Ab)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)对自身免疫性甲状腺疾病(AITD)的临床应用价值。方法采用化学发光免疫分析法定量检测153例自身免疫性甲状腺疾病患者、74例非自身免疫性甲状腺疾病患者和71例健康对照组血清中的TG-Ab、TPO-Ab、FT3、FT4。结果不同自身免疫性甲状腺疾病患者之间和自身免疫性甲状腺疾病患者与非自身免疫性甲状腺疾病患者及正常健康人群之间其TG-Ab、TPO-Ab、FT3、FT4水平差异有统计学意义。AITD组TG-Ab和TPO-Ab水平与非AITD组、健康对照组比较差异有统计学意义(P<0.01),桥本甲状腺炎组TG-Ab和TPO-Ab水平与Graves病组比较差异有统计学意义(P<0.01),桥本甲亢组和Graves病组FT3、FT4水平差异无统计学意义(P>0.05),而TPO-Ab、TG-Ab差异有统计学意义(P<0.01)。结论 TG-Ab、TPO-Ab、FT3、FT4四项指标对AITD的诊断及鉴别诊断有重要临床意义。     

自身免疫性甲状腺疾病患者血清雌二醇泌乳素检测的临床意义

目的:探讨自身免疫性甲状腺疾病(AITD)患者外周血清雌二醇与泌乳素的变化特点及临床意义。方法:采用放射免疫法检测60例AITD患者和20例正常人外周血血清雌二醇和泌乳素的含量。结果:AITD患者血清雌二醇含量高于正常对照(P<0.05),原发性甲亢组与甲低组比较差异无显著性(P>0.05)。血清泌乳素在甲减组明显高于对照组而在甲亢组则与对照比较差异无显著性,甲亢组与甲减组无明显区别。血清雌二醇与泌乳素在AITD患者呈显著性相关(r=0.523,P<0.05)此外,血清雌二醇泌乳素与患者sTSH、TGAb、TMAb之间无显著相关性(r依次为0.208,0.154,0.212)。结论:AITD患者体内存在雌二醇与泌乳素的异常表达,由此加重免疫功能的紊乱,在AITD的发生发展中发挥重要作用。     

同种动物间TSH抗独特型抗体制备及和AITD关系

根据自身免疫性甲状腺疾病（Ａｕｔｏｉｍｍｕｎｏｔｈｙｒｏｉｄｄｉｓｅａｓｅ，ＡＩＴＤ）发病机制新学说：独特型－抗独特型免疫网络学说，用兔抗人ＴＳＨ抗体在同种家兔中制备了ＴＳＨ抗独特型抗体（ＴＳＨＡｂ＿２），并从免疫学、生物学功能方面进行了鉴定，同时用豚鼠脂肪中ＴＳＨ受体纯化了ＴＳＨＡｂ＿２并检测了兔血清Ｔ＿４、ＴｍＡｂ的值，发现免疫后两者均明显升高（Ｐ＜０．０１）．本实验支持ＡＩＴＤ中独特型－抗独特型免疫网络学说。