摘要
目的分析Graves病(GD)合并甲状腺过氧化物酶抗体(TPOAb)阳性患者的辅助性T淋巴细胞17(Th17)、调节性T淋巴细胞(Treg)及相关细胞因子变化并探讨其临床意义。方法选取初发GD患者160例,根据TPOAb滴度将其分为TPOAb阴性组(32例)、TPOAb轻度升高组(68例)、TPOAb中度升高组(40例)和TPOAb重度升高组(26例),另选取同期健康体检者20例作为对照组。采用化学发光法检测游离甲腺三碘原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、促甲状腺素受体抗体(TRAb)和TPOAb水平;采用流式细胞仪测定Th17和Treg表达,计算Th17/Treg比值;采用酶联免疫吸附试验检测白细胞介素(IL)-17和转化生长因子(TGF)-β水平,计算IL-17/TGF-β比值;比较各组上述指标并进行分析。结果4组GD患者的FT3、FT4、TRAb、TPOAb、Th17、Th17/Treg比值、IL-17及IL-17/TGF-β比值均明显高于对照组,而TSH、Treg和TGF-β明显低于对照组(P<0.05)。TPOAb重度升高组患者FT4、TRAb、Th17、Th17/Treg比值、IL-17及IL-17/TGF-β比值明显高于其他3组GD患者(P<0.05)。TPOAb中度升高组患者Th17、Th17/Treg比值、IL-17及IL-17/TGF-β比值明显高于TPOAb阴性组和TPOAb轻度升高组(P<0.05)。结论TPOAb中、重度升高GD患者的Th17/Treg免疫失衡较严重,可能参与了TPOAb的产生。
Objective To analyze the changes of helper T lymphocyte 17(Th17),regulatory T lymphocyte(Treg)and related cytokines of Graves disease(GD)patients with thyroid peroxidase antibody(TPOAb)positive,and to explore the clinical significance.Methods A total of 160 patients with newly diagnosed GD were selected.According to the TPOAb titer,GD patients were divided into TPOAb-negative group(32 cases),TPOAb-slightly elevated group(68 cases),TPOAb-moderately elevated group(140 cases)and TPOAb-severely increased group(20 cases),and 20 healthy subjects in the same period were selected as the control group.The levels of free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH),thyrotropin receptor antibody(TRAb)and TPOAb were detected by chemiluminescence.Expressions of Th17 and Treg were measured by flow cytometry,and Th17/Treg ratio was calculated.Levels of interleukin(IL)-17 and transforming growth factor(TGF)-βwere detected by enzyme-linked immunosorbent assay,and IL-17/TGF-βratio was calculated.Indexes above were compared and analyzed.Results FT3,FT4,TRAb,TPOAb,Th17,Th17/Treg ratio,IL-17 level and IL-17/TGF-βratio of the 4 groups GD patients were significantly higher than those in control group,while TSH,Treg and TGF-β were significantly lower than those of control group(P<0.05).FT4,TRAb,Th17,Th17/Treg ratio,IL-17 and IL-17/TGF-βratio of patients in TPOAb-severely increased group were significantly higher than those in other 3 groups of GD patients(P<0.05).Th17,Th17/Treg ratio,IL-17 and IL-17/TGF-β ratio of patients in TPOAb-moderately elevated group were significantly higher than those in TPOAb-negative group and TPOAb-slightly elevated group(P<0.05).Conclusion Th17/Treg immune imbalance is serious in GD patients with moderately and severely elevated TPOAb,which maybe involved in the generation of TPOAb.
作者
尚恒
马金刚
魏红丽
杨华
范斌
路林峰
Shang Heng;Ma Jingang;Wei Hongli;Yang Hua;Fan Bin;Lu Linfeng(Department of Endocrinology,Cangzhou People's Hospital,Cangzhou 061000,China)
出处
《临床内科杂志》
CAS
2020年第4期276-279,共4页
Journal of Clinical Internal Medicine
基金
沧州市科技计划项目(172302048)。
