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Objective:To investigate the clinicopathological features and prognosis of medullary thyroid carcinoma (MTC) co-existent with Hashimoto's thyroiditis (HT).Methods:Seven cases of MTC co-existent with HT were collected from Fujian Cancer Hospital between Jan 2007 and May 2021. Its clinicopathological features were analyzed.Results:All patients were adult female with a median age of 49 years, and 6 of them were unilateral MTC. The tumor diameter ranged from 0.4 to 7.0 cm. The thyroid tissue surrounding the tumor showed HT. The follow-up time was 16 to 152 months, with a median time of 61 months, 5 patients (tumor diameter <1 cm) were biochemically cured, 1 patient (tumor diameter >1 cm) was anatomically cured. The another patient died due to tumor progression 30 months after surgery, the tumor cells in which were highly atypia and more mitoses (5~8/10HPF) necrosis and vascular invasion were also observed.Conclusion:MTC with HT are mostly sporadic cases, and most of them have a fair prognosis.
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Objective:To explore the mechanism of modified Xiaoyao Powder on inflammatory response of rats with syndrome of stagnation of liver qi and spleen deficiency of experimental autoimmune thyroiditis (EAT) from the perspective of differentiation of microrna 326 (miR326) regulating Th17 cell.Methods:48 rats were randomly divided into normal group (12 rats) and model group (36 rats) respectively and they were immunized twice a week with high iodine water combined with subcutaneous injection of thyroglobulin. From the fifth to eighth weeks, 36 rats were immunized once a week. From the fifth week, the model group with liver depression and spleen deficiency syndrome of Traditional Chinese Medicine was reproduced with chronic restraint stress, excessive fatigue and eating incoherence methods. The modelrats were randomly divided into model group, Xiaoyao Powder group and Jinshuibao group. Rats in Xiaoyao Powder group were gavaged with 13.63 g/(kg·d) Xiaoyao Powder modified granule suspension, and rats in Jinshuibao group were gavaged with 477 mg/(kg·d) Jinshuibao suspension, twice a day, for 8 weeks.The levels of serum FT3, FT4, TSH, TGAb and TPOAb were detected by ELISA; the expression of miR326, IL-17 mRNA, IL-4 mRNA and IFN-γ mRNA were detected by PCR. The expression of Ets-1 protein in thyroid tissue was detected by Wes method, and the proportion of CD4 + IFNγ + T cells, CD4 + IL-4 + T cells and CD4 + IL-17 + T cells were detected by flow cytometry, HE staining was used to detect the pathological manifestations of thyroid tissue in each group. Results:Compared with the model group, the serum TSH [(3 328.88±724.45) pg/ml vs. (1 900.25±203.91) pg/ml] in Xiaoyao Powder group increased ( P<0.01), TGAb [(63.60±9.01) IU/ml vs. (96.19±10.74) IU/ml] and TPOAb [(6.84±1.45) IU/ml vs. (11.62±2.06) IU/ml] decreased ( P<0.01), and the expression of miR326 (3.57±0.57 vs. 7.63±0.90),IL-17 mRNA (6.71±0.97 vs. 13.02±1.18) significantly decreased ( P<0.01), the expression of Ets-1 (0.71±0.40 vs. 0.39±0.02) significantly increased ( P<0.01), the ratio of CD4 +IFN-γ + T cell [(13.10±2.23)% vs. (20.7±2.07)%], CD4 +IL-17 + T cell ratio [(18.90±1.31)% vs. (25.1±1.03)%] significantly decreased ( P<0.01), and thyroid histopathology changed significantly. Conclusion:Modified Xiaoyao Powder could regulate the expression of target protein Ets-1 upward, inhibit the differentiation of Th17 cells and further reduce the expression of IL-17 mRNA by regulating the expression of mir-326 downward in the thyroid tissue of EAT rats, so as to improve the inflammatory response of rats with liver depression and spleen deficiency.
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Objective: To observe the anti-inflammatory effect, as well as the effect on the expression of microtubule-associated protein light chain 3B (LC3B) and Beclin-1 of herbal cake-partitioned moxibustion in rats with experimental autoimmune thyroiditis (EAT). Methods: Female Sprague-Dawley rats were randomly divided into a normal group and a modeling group. The EAT rat model was prepared by a combination of antigen immunization plus iodine agent induction. After the model was prepared, rats in the modeling group were randomly and equally divided into a model group and a herbal cake-partitioned moxibustion group. In the herbal cake-partitioned moxibustion group, moxibustion was alternately applied to two groups of points [Dazhui (GV14)-Mingmen (GV4) and Tiantu (CV22)-Guanyuan (CV4)], and the treatment continued for 30 d. Rats in the normal and model groups were only fixed identically without intervention. Histopathological manifestations of thyroid glands were observed by hematoxylin-eosin staining; the concentrations of thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TGAb), interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were detected by enzyme-linked immunosorbent assay; real-time fluorescence quantitative polymerase chain reaction and immunohistochemistry were used to detect the mRNA and protein expression of autophagy-related factors LC3B and Beclin-1 in thyroid tissue. Results: There were massive follicular destruction, lymphocytic infiltration, and interstitial fibrous tissue hyperplasia of the thyroid glands in the model group. Some follicles of the thyroid glands were destroyed with few lymphocyte infiltrations and fibrous tissue hyperplasia in the moxibustion group. Compared with the normal group, the concentrations of serum TPOAb, TGAb, IL-1β, IL-6, and TNF-α were increased in the model rats (P<0.05); the mRNA and protein expression levels of LC3B and Beclin-1 in thyroid tissue were reduced in the model group (P<0.05). Compared with the model group, the concentrations of serum TPOAb, TGAb, IL-1β, IL-6, and TNF-α were reduced in the herbal cake-partitioned moxibustion group (P<0.05); the mRNA and protein expression levels of LC3B and Beclin-1 in thyroid tissue were increased in the herbal cake-partitioned moxibustion group (P<0.05). The mRNA and protein expression of LC3B and Beclin-1 in thyroid tissue was negatively correlated with the serum levels of TPOAb and TGAb.Conclusion: Herbal cake-partitioned moxibustion reduces the inflammatory response in the thyroid glands of EAT rats and lowers the levels of serum TPOAb and TGAb. This may be related to the regulation of mRNA and protein expression of the autophagy-associated factors LC3B and Beclin-1 in rat thyroid tissue.
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Objective:To investigate the effect of Zuojin Pill on the expression of hypoxia inducible factor-1α (HIF-1α) and apoptosis of thyroid cells in rats with autoimmune thyroiditis (AIT). Methods:Ninetysix rats were divided into control group, model group, standarlized protocol and low, medium and high dose Zuojin Pill groups. Except the control group, the rats in other groups were produced as AIT model. After successful modeling, rats in low-, medium-, and high-dose groups were intragastrically administered with 0.63, 1.26, and 2.52 g/kg Zuojin Pill respectively, standarlized protocol was given 6.25 mg/kg Tripterygium wilfordii polyglycoside, and the control group and model group were given the same amount of normal saline. The levels of tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) were detected by enzyme-linked immunosorbent assay (ELISA); the activity of SOD and the content of MDA in thyroid tissue were detected by kit; the pathological changes of thyroid tissue were observed by HE staining; the apoptosis of thyroid cells was detected by TUNEL; the expression of HIF-1α, B-cell lymphoma-2 (Bcl-2), Bcl-2-related X protein (Bax) and Cleaved caspase-3 in thyroid tissues was detected by Western blot. Results:Compared with the model group, the content of TNF-α, TPOAb and TGAb in serum of rats in the low, medium and high dose Zuojin Pill groups significantly decreased, the content of IL-10 in serum significantly increased ( P<0.05). The SOD activity significantly increased, and the MDA content significantly decreased in the low, medium and high dose Zuojin Pill groups ( P<0.05). The apoptosis rate significantly decreased in the low, medium and high dose Zuojin Pill groups ( P<0.05). The expression of HIF-1α (0.48 ± 0.05, 0.63 ± 0.06, 0.86 ± 0.06 vs. 0.33 ± 0.03), Bcl-2 (0.48 ± 0.04, 0.59 ± 0.05, 0.68 ± 0.04 vs. 0.37 ± 0.04) significantly increased, the expression of Bax (0.67 ± 0.05, 0.53 ± 0.05, 0.40 ± 0.05 vs. 0.80 ± 0.06), Cleaved caspase-3 (0.64 ± 0.06, 0.51 ± 0.03, 0.36 ± 0.03 vs. 0.77 ± 0.05) significantly decreased in the low, medium and high dose Zuojin Pill groups ( P<0.05). Conclusion:Zuojin Pill could enhance the expression of HIF-1α, regulate the secretion of inflammatory factors, reduce the level of oxidative stress and thyroid autoantibody, and inhibit the apoptosis of thyroid cells.
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Objective@#To evaluate the clinical value of the superior thyroid artery peak systolic velocity (STA-PSV) for the differential diagnosis of autoimmune thyrotoxicosis.@*Methods@#A total of 301 patients with newly diagnosed thyrotoxicosis and without any anti-thyroid drug intervention were collected from the Department of Endocrinology and Metabolism, Peking University People′s Hospital from Jan. 2015 to Oct. 2018. Among them, 241 patients were with Graves′ disease (GD) and 60 patients were with autoimmune thyroiditis (AIT). STA-PSV, thyroid function and thyrotropin receptor antibody (TRAb) were determined. A multiple linear regression was used to identify factors associated with STA-PSV. A receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the discriminating ability of STA-PSV to GD.@*Results@#STA-PSV leves in GD group were significantly higher than those in AIT group [61.00 (41.00, 86.50) cm/s vs. 34.50 (25.25, 46.00) cm/s, P<0.001]. The ROC curve analysis showed that the AUC was 0.790 (95%CI 0.734-0.845), and 49.5cm/s was the optimal cutoff point for the diagnosis of GD, in which the sensitivity was 64.3% and the specificity was 83.3%. In all patients with thyrotoxicosis, multiple linear regression analyses showed free thyroxine (FT4) (β=0.371, 95%CI 0.005-0.010, P<0.001) and TRAb (β=0.138, 95%CI 0.001-0.014, P=0.035) were positively associated with STA-PSV.@*Conclusions@#The STA-PSV is positively associated with FT4 and TRAb levels, and it is a helpful marker in differential diagnosis between GD and AIT.
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Introduction: vitiligo is a multifactorial acquired depigmenting disorder, characterized by a spontaneous loss of functional melanocytes from the epidermis. Vitiligo and Hashimoto's thyroiditis (HT) often occur in association and seem to be characterized by an autoimmune process. The vitiligo associated with HT suggests genetic homologies between them. Objective: to identify protein sequence homology between melanocyte protein (Pmel) and thyroid peroxidase (TPO), using bioinformatics tools, to propose an initial mechanism which could explain the production of cross-reacting autoantibodies to melanocyte and TPO. Methods: we performed a comparison between Pmel and TPO amino acids (AA) sequences, available on the National Center for Biotechnology Information (NCBI) database by BLAST (Basic Local Alignment Search Tool) in order to find local homology regions between the AA sequences. Results: the homology sequence between the Pmel and TPO ranged from 21.0 % (19 identical residues out of 90 AA in the sequence) to 55.0% (6 identical residues out of 11 AA in the sequence). The identical alignments presented relatively high E values due to presence of short alignment. Conclusion: bioinformatics data suggest a possible pathological link between Pmel and TPO. Sequence homology between Pmel and TPO may present a molecular mimicry suggesting the possibility of antigen crossover between Pmel and TPO that might represent an immunological basis for vitiligo associated with HT.
Introdução: o vitiligo é uma doença de despimentação adquirida multifatorial, caracterizada por uma perda espontânea de melanócitos funcionais da epiderme. Vitiligo e tiroidite de Hashimoto (TH) ocorrem frequentemente em associação e parecem ser caracterizados por um processo autoimune. O vitiligo associado à TH sugere homologias genéticas entre eles. Objetivo: identificar homologia das sequências de proteína entre a proteína do melanócito (Pmel) e peroxidase da tiróide (TPO), usando ferramentas de bioinformática, para propor um mecanismo inicial que poderia explicar a produção de autoanticorpos de reação cruzada entre o melanócito e a TPO. Metodologia: foi realizada uma comparação entre a sequência de aminoácidos (AA) da Pmel e da TPO, disponível no banco de dados Basic Local Alignment Search Tool (BLAST) do National Center for Biotechnology Information (NCBI), a fim de encontrar regiões de homologia locais entre as sequências de AA. Resultados: a sequência de homologia entre a Pmel e a TPO variou de 21,0% (19 resíduos idênticos na sequência de cada 90 AA na sequência) a 55,0% (6 resíduos idênticos na sequência de 11 AA). Os alinhamentos idênticos apresentaram valores relativamente altos (E) devido à presença de alinhamentos curtos. Conclusão: os dados de Bioinformática sugerem uma possível ligação patológica entre Pmel e a TPO. A sequência de homologia entre Pmel e a TPO pode apresentar um mimetismo molecular sugerindo a possibilidade de cruzamento entre antígeno da Pmel e da TPO que pode representar uma base imunológica para a associação entre o vitiligo e a TH.
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Humans , Vitiligo , Amino Acid Sequence , Sequence Homology, Amino Acid , Computational Biology , Hashimoto Disease , Comparative Study , Peroxidase , DatabaseABSTRACT
ABSTRACT Objective The aim of this study was to describe the relationship between thyroid volume and age, gender, anthropometric characteristics, and echogenicity in oldest-old subjects in an iodine-sufficient area. Subjects and methods The study included 81 independent elderly individuals aged ≥ 80 years (65 [80.2%] women). We determined these individuals' anthropometric characteristics, body mass index (BMI), and lean body mass, as well as thyroid volume and echogenicity by ultrasonography. Results We observed that octogenarians and nonagenarians had different profiles of thyroid echogenicity. The volume of the thyroid was smaller in nonagenarians than octogenarians (p = 0.012, r = 0.176), and subjects aged 80-89 years had more often hypoechoic glands than those aged ≥ 90 years (p = 0.01 versus 0.602). Conclusion The identification of ultrasonographic differences in oldest-old individuals will contribute to establishing preclinical markers, such as echogenicity, to identify individuals at risk of developing autoimmune thyroid disease. Future prospective studies should identify if 80-89-year-old individuals with hypoechoic glands progress to hypothyroidism, and if the absence of changes in echogenicity (i.e. a normal thyroid parenchyma) would have a positive impact on longevity among nonagenarians.
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Humans , Male , Female , Aged, 80 and over , Thyroid Gland/anatomy & histology , Thyroid Gland/diagnostic imaging , Ultrasonography/methods , Organ Size , Reference Values , Thyroid Diseases/pathology , Thyroid Diseases/diagnostic imaging , Thyrotropin/blood , Sex Factors , Anthropometry , Cross-Sectional Studies , Analysis of Variance , Age Factors , Statistics, NonparametricABSTRACT
Autoimmune thyroid disease (AITD) is an archetypal organ-specific autoimmune disorder that is characterized by the production of thyroid autoantibodies and lymphocytic infiltration into the thyroid.Excessive iodine can increase the incidence of AITD.During trapping,oxidation and organification of excessive iodine in thyroid cells,excessive reactive oxygen species (ROS) were generated,which induces apoptosis of thyroid cells,accelerates thyroglobulin autoantigen presentation,promotes lymphocytes infiltration and cytokine expression.Excessive iodine is an environmental risk factor which promotes the people with stealth autoimmune thyroid disease to get sick.In this article,we discussed the relationship between excessive iodine and AITD and its mechanism.
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Objective To explore the mechanism of Xiaoying decoction on experimental autoimmune thyroiditis (EAT) rats in view of regulatory T cells and Th17 cells.Methods SD rats were divided into five groups,normal control group,model control group,tripterygium glycoside group,Xiaoying decoction low and high dose groups.Except for normal control group,the other groups were established the model of EAT.Rats in the Xiaoying decoction low,and high dose groups were given Xiaoying decoction of 17.24 and 68.95 g·kg-1;rats in the tripterygium glycoside group were given tripterygium glycoside 6.25 mg·kg-1.The serum free triiodothyronine(FT3),free thyrocyte(FT4) and thyroglobulin antibody were detected by RIA method.Thyrocyte morphology was observed under optical microscope.The expression levels of Foxp3 mRNA and IL-17 mRNA were detected by real-time PCR.The changes of Treg cells and Th17 cells were analyzed by flow cytometry.Results Compared with the normal control group,FT3,FT4 and TgAb were increased in the model control group (P ＜0.01,P ＜0.01,P ＜0.05).Compared with the model control group,FT3,FT4 and TgAb were decreased in tripterygium glycoside group and Xiaoying decoction high dose group (P ＜ 0.05).The infiltration score in the normal control group,model control group,tripterygium glycoside group,Xiaoying decoction low and high dose groups were 0,4,4,3.5,2.Compared with model control group,the infiltration was improved (P ＜0.01).Foxp3 mRNA expression was decreased while IL-17 mRNA increased in the model control group as compared with the normal control group(P ＜ 0.01).In contrast,the expression of Foxp3 mRNA was increased and IL-17 mRNA expression was decreased in Xiaoying decoction low and high dose groups,tripterygium glycoside group as compared with the model control group (P ＜0.05).Compared with the normal control group,rats in the model control group had fewer Treg cells and more Th17 cells (P ＜0.01).Compared with the model control group,the percentage of Treg cells was elevated and Th17 cells was reduced in tripterygium glycoside group and Xiaoying decoction high dose groups (P ＜ 0.01).Conclusion The therapeutic mechanism of Xiaoying decoction on EAT rats may be related to changing the percentage of regulatory T cells and Th17 cells with up-regulating the expression of Foxp3 mRNA and down-regulating the expression of IL17mRNA.
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Inflammatory pseudotumor is a benign disease entity, which is histologically composed of inflammatory cells and fibrotic stroma. It is mainly found in the respiratory tract, but it has also been reported in the liver, central nervous system, soft tissues, urological system, and gastrointestinal tract. It is extremely rare in the spleen and there have been no cases of splenic inflammatory pseudotumor associated with autoimmune thyroiditis in Korea. The pathogenesis or etiology is unknown, but hypotheses include infection, autoimmunity, and parenchymal necrosis with hemorrhage. Because inflammatory pseudotumor may mimic malignant tumors on radiologic findings, pathologic confirmation is necessary to distinguish it from lymphoproliferative disorders of the spleen and other malignant tumors. We report a case of inflammatory pseudotumor of the spleen associated with autoimmune thyroiditis in a patient who complained of periumbilical pain.
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Humans , Autoimmunity , Central Nervous System , Gastrointestinal Tract , Granuloma, Plasma Cell , Hemorrhage , Korea , Liver , Lymphoproliferative Disorders , Necrosis , Respiratory System , Spleen , Thyroiditis, AutoimmuneABSTRACT
Objective To observe the effect ofJiuwei-Sanjie capsuls combined with levothyroxine sodium on IL-17 and IL-23 expression in the patients with Hashimoto’s thyroiditis (HT). Methods A total of 76 HT patients were randomly divided into the control group (n=38) and observation group (n=38). The control group was treated with Levothyroxine Sodium, and the observation group was treated with Levothyroxine Sodium andJiuwei-Sanjie capsuls. The expression of FT3, FT4, TSH, TGAb, and TPOAb were detected by chemiluminescent immunoassay. The expression of IL-17 and IL-23 were detected by ELISA analysis. The clinical effect were compared.ResultsThe clinical effect was 94.7% (36/38) in observation group, which was better than that of 81.6% (31/38) in control group (χ2=2.316,P=0.042) . After treatment, the expression of IL-17 (22.32 ± 4.25 ng/mlvs. 31.55 ± 6.84 ng/ml,t=2.416) and IL-23 (14.72 ± 3.42 ng/mlvs. 23.27 ± 5.26 ng/ml, t=2.512) in observation group was lower than that in control group (P expression in patients with Hashimoto's thyroiditis, and improve thyroid function.
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Objective To investigate the correlation between thyroid antibody level and carotid atherosclerotic plaque in patients with acute ischemic stroke.Methods Consecutive patients with acute ischemic stroke were enrolled retrospectively.They were divided into a non-plaque group and a plaque group according to the findings of carotid artery color-Doppler ultrasonography.The plaque group was redivided into a stable plaque subgroup and a non-stable plaque subgroup.Chemiluminescence method was used to measure the serum thyroperoxidase antibodies (TPOAb) and thyroglobulin antibodies (TGAb) levels and they were compared.Results A total of 383 patients were enrolled in the study,including 116 (30.3％) did not have plaque and 267 (69.7％) had plaque,68 of them had unstable plaque,and 199 had stable plaque.The level of TGAb in the plaque group was significantly higher than that in the non-plaque group (Z =-4.826,P ＜0.001).Multivariate logistic regression analysis showed that the level of TGAb might be an independent risk factors for carotid plaque (odds ratio 1.007,95％ confidence interval 1.001-1.012;P =0.016).The serum level of TPOAb in the stable plaque group was significantly higher than that in the unstable plaque group (Z =-2.114,P=0.035),but multivariate logistic regression analysis showed that it was not the independent risk factor for unstable plaque (odds ratio 1.001,95％ confidence interval 0.996-1.006;P =0.786).Conclusions The level of serum thyroid antibodies increased in patients with acute ischemic stroke,especially the increased level of TGAb might be associated with the occurrence and development of carotid atherosclerotic plaque,however,it was not associated with the plaque stability.
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Thyroid peroxidase antibody (TPOAb) play an important role in the diagnosis of autoimmune thyroid disease.Chemiluminescence immunoassay (CLIA) is a new method been strongly recommended in recent years.The definition of positive value of TPOAb is inconsistent.The definition of TPOAb positive value is important for exploring the development of autoimmune thyroid disease.TPOAb is significantly increased in Hashimoto's disease and the titer is associated with the degree of infiltration and destruction of thyroid follicular.It is essential to monitor TPOAb in postpartum thyroiditis and early pregnancy.The positive of TPOAb is closely related to the adverse pregnancy outcomes caused by various risk factors.Graves disease combined with Hashimoto's must to be considered.
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Objective To establish experimental autoimmune thyroiditis (EAT) rat model induced by bovine thyroglobulin (bTg) and to observe the effect of iodine on IP-10 in rat serum and IP-10 mRNA expression in rat thyroid tissue.Methods One hundred and thirty-five four-week old female Lewis rats were divided into normal control (NC,20 rats) group;TG group,25 rats;H Ⅰ group,20 rats;H Ⅰ + TG group,25 rats;H Ⅱ group,20 rats and H Ⅱ + TG group,25 rats according to a random number table.The water iodine concentration was 25.7 μg/L given to rats of HⅠ and H I + TG groups,and 423.3 μg/L of H Ⅱ and H Ⅱ + TG groups.Rats of NC and TG groups drank distilled water.Rats of TG,H Ⅰ + TG,H Ⅱ + TG groups were immunized with 0.1 ml bTg (8 g/L) in IFA.All rats were killed at the end of 15 weeks.Urinary iodine was determined by As3+-Ce4+ catalytic spectrophotometry (WS/T 107-2006).Pathological changes in thyroid tissue were observed by light microscope.Serum IP-10 was determined by enzyme-linked immunosorbent assay (ELISA),and IP-10 mRNA expression in thyroid was detected by real-time PCR.Results The differences of urinary iodine between groups were statistically significant (x2 =106.4,P ＜ 0.05).Compared with NC group (456.45 μg/L) urinary iodine in other groups increased significantly (TG,H Ⅰ,H Ⅰ + TG,HⅡ,HⅡ + TG:800.08,18 633.20,13 869.08,87 889.97,61 661.51 μg/L,all P ＜ 0.05).The pathological changes of rats in each group aggravated following increased iodine intake,NC group had normal thyroid structure;thyroid of TG group had a small amount of lymphocytes;thyroid of H Ⅰ group showed irregular follicular,part of the follicular was destroyed;a large number of lymphocytes infiltrated between follicular of H Ⅱ group;in H Ⅱ + TG group,the follicular was destroyed severely,diffuse inflammatory cell infiltration.The difference of serum IP-10 between groups no were statistically significant (F =1.462,P ＞ 0.05).The expression of IP-10 mRNA of H Ⅰ + TG (2.80 ± 1.73) rats thyroid was higher than that in NC (1.65 ± 1.62) and H Ⅰ (1.07 ± 1.00) groups,H Ⅱ (0.64 ± 0.64),H Ⅱ + TG (0.80 ± 0.49) were lower than H Ⅰ + TG group (all P ＜ 0.05).Conclusions Excessive iodine intake could have increased inflammatory cells in EAT rat and rats have showed more serious pathologic changes.These phenomena may be ralated with changed expression of IP-10 mRNA in EAT rat thyroid.
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Objective To estimate the prevalence of thyroid dysfunction and thyroid autoantibodies in adults with alopecia areata (AA), and to analyze the relationship between alopecia areata (AA) and thyroid autoimmunity in adults.Methods A predesigned questionnaire was used to collect data on demographic information, medical history,and family history of AA in first-degree relatives from patients with AA.Thyroid function was evaluated, and anti-thyroid peroxidase antibody (TPO-Ab) was screened in all the patieuts.Statistical analysis was carried out by the chi-square test and Fisher's exact test.Results Totally, 209 patients with AA were enrolled.Of these patients, 6.7％ were complicated by thyroid diseases, 20.6％ were positive for TPO-Ab.Compared with the patients without TPO-Ab, those with TPO-Ab showed a significant increase in the proportion of patients with early-onset (＜ 18 years) AA (x2 =5.589, P =0.025),prevalence rate of alopecia totalis/alopecia universalis (x2 =9.990, P=0.006) and thyroid diseases (x2 =12.279, P =0.002), and incidence rate of AA in first-degree relatives (x2 =14.426, P =0.001).Conclusions The positive rate of TPO-Ab is increased in patients with AA.It is recommended to evaluate thyroid function and to screen for thyroid autoantibodies in patients with AA despite of the absence of clinical manifestations of thyroid diseases.
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CONTEXT AND OBJECTIVE: Celiac disease is an autoimmune disorder with an average prevalence of 1% in Europe and the United States. Because of strong European ancestry in southern Brazil, this study aimed to evaluate the seroprevalence of celiac disease among autoimmune thyroiditis patients. DESIGN AND SETTING: Cross-sectional study in a public university hospital. METHODS: This cross-sectional prevalence study included autoimmune thyroiditis patients who were tested for anti-endomysial and anti-transglutaminase antibodies between August 2010 and July 2011. RESULTS: Fifty-three patients with autoimmune thyroiditis were included; 92.5% were women, with mean age of 49.0 ± 13.5 years. Five patients (9.3%) were serologically positive for celiac disease: three of them (5.6%) were reactive for anti-endomysial antibodies and two (3.7%) for anti-transglutaminase. None of them exhibited anemia and one presented diarrhea. Endoscopy was performed on two patients: one with normal histology and the other with lymphocytic infiltrate and villous atrophy. CONCLUSION: The prevalence of celiac disease among patients with autoimmune thyroid disease was 9.3%; one patient complained of diarrhea and none presented anemia. Among at-risk populations, like autoimmune thyroiditis patients, the presence of diarrhea or anemia should not be used as a criterion for indicating celiac disease investigation. This must be done for all autoimmune thyroiditis patients because of its high prevalence. .
CONTEXTO E OBJETIVO: A doença celíaca é uma doença autoimune, com prevalência média de 1% na Europa e nos Estados Unidos. Em função da forte ascendência europeia no sul do Brasil, este estudo objetiva relatar a soroprevalência de doença celíaca em indivíduos com tireoidite autoimune. TIPO DE ESTUDO E LOCAL: Estudo transversal em um hospital público universitário. MÉTODOS: Este estudo transversal de prevalência incluiu pacientes com tireoidite autoimune que foram submetidos a testes de anticorpos antiendomísio e antitransglutaminase entre agosto de 2010 e julho de 2011. RESULTADOS: Foram incluídos 53 pacientes com tireoidite autoimune, 92,5% mulheres, com idade média de 49,0 ± 13,5 anos. Cinco (9,3%) pacientes apresentaram sorologia positiva para doença celíaca, sendo três (5,6%) com anticorpo antiendomísio positivo e dois (3,7%) com antitransglutaminase positivo. Nenhum paciente apresentou anemia e um apresentou diarreia. Apenas dois pacientes realizaram endoscopia: um com histologia normal e outro apresentou infiltrado linfocitário e atrofia vilositária. CONCLUSÕES: A prevalência de doença celíaca entre pacientes com doença autoimune da tireoide foi de 9,3%; um paciente queixou-se de diarreia e ninguém apresentou anemia. Em populações de risco, como é o caso de pacientes com tireoidite autoimune, a presença de diarreia ou anemia não devem ser utilizados como critério para indicar investigação de doença celíaca, que deve ser feita em todos os indivíduos com tireoidite autoimune devido a sua alta prevalência. .
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Celiac Disease/epidemiology , Duodenum/pathology , Thyroiditis, Autoimmune/epidemiology , Autoantibodies/analysis , Biopsy , Brazil/epidemiology , Celiac Disease/complications , Celiac Disease/pathology , Cross-Sectional Studies , Hospitals, Public , Hospitals, University , Prevalence , Seroepidemiologic Studies , Thyroiditis, Autoimmune/complications , Thyrotropin/blood , Transglutaminases/immunologyABSTRACT
Objective To detect the level of CD4+ T cell-derived leptin(LP) in peripheral blood mononuclear cells(PBMC) from the patients with Hashimoto′s thyroiditis(HT) and to investigate its role in the occurrence and development of HT .Methods The peripheral blood samples in the patients with HT and the healthy controls were collected and separated for obtaining PBMC .The CD4+ T cells magnetic beads was adopted to separate CD4+ T cells for culturing in vitro .The LP level in supernatant was detected by ELISA .The relative expression amount of the orphan nuclear receptor RORγt was detected by real-time quantitative PCR (qRT-PCR) method .Results The LP level of CD4+ T cell culture liquid in the HT patients was markedly higher than that in the healthy control group ,difference was statistically significant (P<0 .05) .Furthermore ,the LP level in CD4+ T cell culture liquid was posi-tively related with the relative expression amount of RORγt in HT patients .Conclusion The CD4+ T cell-induced leptin level is in-creased in HT patients ,which is closely related with the occurrence and development of HT .
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Objective To evaluate the incidence of autoimmune thyroid disease (AITD) in systemic lupus erythematosus (SLE) and examine the correlation between AITD and SLE activity.Methods The study group included 220 SLE patients with the screening of thyroid function (FT3,FT4,TSH) and antithyroid autoantibodies (TgAb,TPOAb) were hospitalized into Affiliated Hospital,Jining Medical College between July 2009 and October 2013.The control group included 160 healthy subjects.We compared the prevalence of AITD between SLE patients and normal controls and also the positive rate of anti-thyroid autoantibodies was observed.We also compared the positive rate of anti-thyroid autoantibodies between AITD in SLE and simple SLE group and also analyzed the correlation between two groups of patients and SLE activity (evaluated by the titer of anti-dsDNA,C3,C4,CH50,SLEDAI score).Results Among them,45 patients suffered from AITD (20.5％).There were hyperthyroidism (n =6,13.3％) and hypothyroidism (including subclinical hypothyroidism) (n =26,57.8％),Hashimoto' s thyroiditis (n =13,28.9％).And 74 SLE cases were positive for anti-thyroid autoantibodies.The prevalence of AITD and the positive rate of anti-thyroid autoantibodies in SLE patients (20.5％,33.6％) were higher than that in normal controls (3.13％,7.50％)(P ＜ 0.05).The positive rate of anti-thyroid autoantibodies of SLE with AITD patients (62.2％) was higher than that in simple SLE (21.5％).No significant differences existed in anti-dsDNA titre,C3,C4,CH50 and SLEDAI score between two groups (P ＞ 0.05).Conclusions The SLE patients have a great prevalence of AITD and a positive rate of anti-thyroid autoantibodies.Those with anti-thyroid autoantibodies have a higher incidence of AITD and it has nothing to do with SLE activity.It is essential to monitor thyroid function and thyroid autoantibodies during the follow-ups.
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OBJECTIVE To investigate the curative effect and mechanism of allo-bone marrow mes-enchymal stem cell(BM-MSC)infusion in the experimental autoimmune thyroiditis(EAT)mouse model. METHODS An EAT mouse model was established in C57BL/ 6 mice using porcine thyroglobulin(PTg) and Freund adjuvant,while BM-MSCs were injected into the EAT mice of BM-MSC treated group,3×105 per mouse on the 0,7th,14th and 21st day. On the 28th day,all the mice were sacrificed,and thyroid tissue was isolated,embedded in paraffin and stained with HE staining for histological examination. Serum was collected to assess the level of thyroglobulin antibodies( TgAb ) ,thyroid microsomal autoantibodies( TmAb),antithyroid peroxidase antibodies( TPOAb),3,5,3 ',5 '-tetraiodothyronine (TT4),3,5,3 '-triiodothyronine( TT3),interleukin-10( lL-10) and interferon-γ( lFN-γ ). RESULTS① Thyroid tissue in model group showed inflammatory response and infiltration. The level of TmAb, TgAb and TPOAb was significantly increased compared with normal control group,but the level of TT4 was decreased while there was no change in the level of TT3,suggesting that an EAT mouse model was established. ② The thyroid in model group and BM-MSC treated group showed inflammatory response and inflammatory cell infiltration,but the response in BM-MSC treated group was weaker than in model group. ③ Compared with model group,the level of TgAb,TmAb,TPOAb and lFN-γ was decreased obvi-ously(P﹤0.05),the level of TT4 and lL-10 was increased significantly(P﹤0.05),but the level of TT3 changed little in BM-MSC treated group. CONCLUSION BM-MSCs may partly restore the immunologi-cal homeostasis state. The mechanism may be related to its modulation of immune balance of Th1/ Th2.
ABSTRACT
We report the case of a 36-year-old woman who presented with headache, fever, and amenorrhea. Laboratory analysis revealed hypopituitarism and autoimmune thyroiditis, while a cerebrospinal fluid study suggested concurrent aseptic meningitis. A magnetic resonance image (MRI) scan revealed a 1.0x0.9 cm cystic mass enlarging the sella turcica. Surgical resection via an endoscopic transsphenoidal route was performed. The histological finding of the excised tissue revealed foamy histiocytes with vacuolated cytoplasm, supporting the diagnosis of xanthomatous hypophysitis. Although a residual soft lesion was observed on the MRI image postoperatively, the patient's headache and fever improved. Ten months after surgery, the patient complained of visual impairment and headache, and the residual mass had enlarged into the suprasellar area. High dose (500 mg intravenous) methylprednisolone was administered for 3 days. During the methylprednisolone pulse therapy, the patient's visual acuity and headache improved. A follow-up MRI taken after methylprednisolone therapy showed a marked mass reduction. Our case supports an autoimmune pathophysiology for xanthomatous hypophysitis and suggests that high dose glucocorticoid therapy as a treatment option.