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Xu YT, Zhang YM, Yang HX, Ye LF, Chen F, Lu X, Wang GC, Peng QL. Evaluation and validation of the prognostic value of anti-MDA5 IgG subclasses in dermatomyositis-associated interstitial lung disease. Rheumatology (Oxford) 2022; 62:397-406. [PMID: 35412602 DOI: 10.1093/rheumatology/keac229] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/24/2022] [Accepted: 03/24/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To investigate the association between the anti-melanoma differentiation associated gene 5 (MDA5) IgG subclasses and prognosis of patients with dermatomyositis (DM)-associated interstitial lung disease (ILD). METHODS This retrospective study included 122 anti-MDA5 positive DM-ILD patients admitted from October 2017 to October 2020 as training cohort, and additional 68 patients from August 2014 to September 2017 as validation cohort. The levels of anti-MDA5 total IgG and IgG subclasses were measured using in-house enzyme-linked immunosorbent assays, and analysed in association with the patient prognosis. RESULTS In the training cohort, the concentrations of anti-MDA5 IgG1 and IgG3 in non-survivors were significantly higher than in survivors (P < 0.05), whereas there were no significant differences in the IgG2 and IgG4 levels. Kaplan-Meier survival analysis revealed that the levels of anti-MDA5 total IgG, IgG1 and IgG3 were associated with mortality (P < 0.05). Multivariate analysis revealed anti-MDA5 IgG1 >13 U/ml and anti-MDA5 IgG3 >11 U/ml were independent risk factors for death of DM-ILD patients (P < 0.05). Anti-MDA5 IgG1 was confirmed as an independent risk factor in the validation cohort, while anti-MDA5 IgG3 was not. Anti-MDA5 IgG1 showed greater discriminable power for patient prognosis (Youden index 0.494) than anti-MDA5 total IgG, IgG3, or the combination of IgG1 and IgG3 (Youden index 0.356, 0.32 and 0.447, respectively). CONCLUSION Anti-MDA5 IgG1 and IgG3 are significantly associated with poor prognosis in DM-ILD patients, and anti-MDA5 IgG1 is more efficient as a prognostic biomarker in DM-ILD patients.
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Affiliation(s)
- Yue-Tong Xu
- Department of Rheumatology, Key Lab of Myositis, China-Japan Friendship Hospital.,Peking Union Medical College, Chinese Academy of Medical Sciences
| | - Ya-Mei Zhang
- Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hong-Xia Yang
- Department of Rheumatology, Key Lab of Myositis, China-Japan Friendship Hospital
| | - Li-Fang Ye
- Department of Rheumatology, Key Lab of Myositis, China-Japan Friendship Hospital.,Peking Union Medical College, Chinese Academy of Medical Sciences
| | - Fang Chen
- Department of Rheumatology, Key Lab of Myositis, China-Japan Friendship Hospital
| | - Xin Lu
- Department of Rheumatology, Key Lab of Myositis, China-Japan Friendship Hospital
| | - Guo-Chun Wang
- Department of Rheumatology, Key Lab of Myositis, China-Japan Friendship Hospital.,Peking Union Medical College, Chinese Academy of Medical Sciences
| | - Qing-Lin Peng
- Department of Rheumatology, Key Lab of Myositis, China-Japan Friendship Hospital.,Peking Union Medical College, Chinese Academy of Medical Sciences
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Kyriakos G, Patsouras A, Voutyritsa E, Gravvanis C, Papadimitriou E, Farmaki P, Quiles-Sánchez LV, Georgakopoulou VE, Damaskos C, Ríos-Vergara A, Marín-Martínez L, Diamantis E. The Role of TPOAb in Thyroid-Associated Orbitopathy: A Systematic Review. Ocul Immunol Inflamm 2022; 30:1740-1746. [PMID: 34214014 DOI: 10.1080/09273948.2021.1942498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Thyroid-associated orbitopathy (TAO) is one of the most common autoimmune inflammatory disorders of the orbit. The presence of anti-thyroid antibodies is believed to play a role in the pathogenesis and clinical status of the TAO patients. Herein, we review the usefulness of TPOAb as a biomarker for TAO. METHODS A systematic search in MEDLINE library was conducted. Results: Twenty studies were included. TPO is expressed in orbital tissues, and the polymorphism rs11675434 SNP has proven to be associated with clinically evident TAO. Studies in pediatric patients have shown a positive correlation between high TPOAb levels and TAO. In contrast, results in adults are inconsistent. Some studies imply a protective role of TPOAb, yet the majority did not find any association. Some authors have suggested an implication of TPOAb in the pathophysiology of TAO in TRAb-negative patients. CONCLUSIONS The role of TPOAb in TAO remains unclear and controversial.
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Affiliation(s)
- Georgios Kyriakos
- Sección de Endocrinología y Nutrición, Hospital General Universitario Santa Lucia, Cartagena, Spain
| | - Alexandros Patsouras
- Second Department of Internal Medicine, Tzanio General Hospital, Piraeus, Greece
| | - Errika Voutyritsa
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Gravvanis
- Unit of Endocrinology and Diabetes Center, Athens General Hospital ¨G. Gennimatas¨, Athens, Greece
| | - Eirini Papadimitriou
- Unit of Endocrinology and Diabetes Center, Athens General Hospital ¨G. Gennimatas¨, Athens, Greece
| | - Paraskevi Farmaki
- First Department of Pediatrics, Agia Sofia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Christos Damaskos
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonio Ríos-Vergara
- Sección de Endocrinología y Nutrición, Hospital General Universitario Santa Lucia, Cartagena, Spain
| | - Luis Marín-Martínez
- Sección de Endocrinología y Nutrición, Hospital General Universitario Santa Lucia, Cartagena, Spain
| | - Evangelos Diamantis
- Unit of Endocrinology and Diabetes Center, Athens General Hospital ¨G. Gennimatas¨, Athens, Greece
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3
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Hashimoto Encephalopathy—Still More Questions than Answers. Cells 2022; 11:cells11182873. [PMID: 36139446 PMCID: PMC9496753 DOI: 10.3390/cells11182873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/05/2022] [Accepted: 09/12/2022] [Indexed: 12/03/2022] Open
Abstract
The normal function of the nervous system is conditioned by the undisturbed function of the thyroid gland and its hormones. Comprehensive clinical manifestations, including neurological disorders in Hashimoto’s thyroiditis, have long been understood and, in recent years, attention has been paid to neurological symptoms in euthyroid patients. Hashimoto encephalopathy is a controversial and poorly understood disease entity and the pathogenesis of the condition remains unclear. We still derive our understanding of this condition from case reports, but on the basis of these, a clear clinical picture of this entity can be proposed. Based on a review of the recent literature, the authors present the current view on the subject, discuss controversies and questions that still remain unanswered, as well as ongoing research in this area and the results of our own work in patients with Hashimoto’s thyroiditis.
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4
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Deng Y, Wang J, Zou G, Liu Z, Xu J. The characteristics and clinical significance of elevated serum IgG4/IgG levels in patients with Graves' disease. Endocrine 2022; 75:829-836. [PMID: 34773561 DOI: 10.1007/s12020-021-02935-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/28/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE This study aims to further explore the clinical and laboratory characteristics of patients with GD with high serum IgG4 based on the IgG4/IgG ratio. METHODS This study is a prospective observational study. A total of 25 normal controls and 84 people newly diagnosed with GD were enrolled in this study. Taking the IgG4/IgG ratio of 8% as the cutoff value, the experimental groups were further divided into two subgroups: the high IgG4/IgG subgroup and the normal IgG4/IgG subgroup. We evaluated the differences in clinical characteristics and laboratory parameters between the groups. RESULTS The IgG4, IgG4/IgG, and IL-17 of the newly diagnosed GD group were significantly higher than those of the normal control group (P < 0.05). The differences in age, IL-1β, IL-17, and eosinophil count between the high IgG4/IgG subgroup and the normal IgG4/IgG subgroup were statistically significant (P < 0.05). After ATD treatment, some patients developed allergies; the high IgG4/IgG subgroup was significantly higher than the normal IgG4/IgG subgroup (χ2 = 4.424, P = 0.035). After 3 months of ATD treatment in patients with GD, the TRAb in the normal IgG4/IgG subgroup were significantly lower than before (P < 0.05), while the difference in the high IgG4/IgG subgroup was not statistically significant (P > 0.05). CONCLUSIONS A small portion of patients with GD harbored elevated serum IgG4/IgG levels. They are younger, have higher eosinophils, and are more prone to allergies; also, they have higher levels of cytokines IL-1β and IL-17 and their remission is not easily attained after treatment with ATD; this could be due to the instability of the Th17/Treg cell balance.
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Affiliation(s)
- Yuanyuan Deng
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, 330006, PR China
| | - Jiao Wang
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, 330006, PR China
| | - Guilin Zou
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, 330006, PR China
| | - Zelin Liu
- Department of Endocrinology and Metabolism, Fourth Affiliated Hospital of Nanchang University, Nanchang, PR China.
| | - Jixiong Xu
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, 330006, PR China.
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5
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Napodano C, Marino M, Stefanile A, Pocino K, Scatena R, Gulli F, Rapaccini GL, Delli Noci S, Capozio G, Rigante D, Basile U. Immunological Role of IgG Subclasses. Immunol Invest 2020; 50:427-444. [PMID: 32522062 DOI: 10.1080/08820139.2020.1775643] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The loss of tolerance to self-antigens is the unequivocal "red line" of autoimmunity: both development of autoreactive T and B cells and production of polyclonal autoantibodies represent seminal keys to the pathogenesis of protean autoimmune diseases. Most of these autoantibodies are immunoglobulins G (IgG), functionally distinguished in four subclasses named IgG1, IgG2, IgG3, and IgG4, due to structural differences in the hinge and heavy chain constant regions. Different studies analyzed serum levels of IgG subclasses in the course of different disorders, showing that they might have a pathogenic role by regulating interactions among immunoglobulins, Fc-gamma receptors, and complement. To date, the mechanisms promoting different IgG subclasses distribution during the natural history of most autoimmune diseases remain somewhat unclear. Evidence from the medical literature shows that the serum IgG profile is peculiar for many autoimmune diseases, suggesting that different subclasses could be specific for the underlying driving autoantigens. A better knowledge of IgG subsets may probably help to elucidate their pathological task, but also to define their relevance for diagnostic purposes, patients' personalized management, and prognosis assessment.
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Affiliation(s)
- Cecilia Napodano
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - MariaPaola Marino
- Institute of General Pathology, Dipartimento Di Medicina E Chirurgia Traslazionale, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Annunziata Stefanile
- Area Diagnostica di Laboratorio, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy
| | - Krizia Pocino
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Roberto Scatena
- Dipartimento Di Medicina Di Laboratorio, Ospedale Madre Giuseppina Vannini, Rome, Italy
| | - Francesca Gulli
- Dipartimento Di Medicina Di Laboratorio, Ospedale Madre Giuseppina Vannini, Rome, Italy
| | - Gian Lodovico Rapaccini
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefano Delli Noci
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Giovanna Capozio
- Department of Life Sciences and Public Health, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Donato Rigante
- Università Cattolica del Sacro Cuore, Rome, Italy.,Department of Life Sciences and Public Health, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Umberto Basile
- Area Diagnostica di Laboratorio, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
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6
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Aussy A, Fréret M, Gallay L, Bessis D, Vincent T, Jullien D, Drouot L, Jouen F, Joly P, Marie I, Meyer A, Sibilia J, Bader‐Meunier B, Hachulla E, Hamidou M, Huë S, Charuel J, Fabien N, Viailly P, Allenbach Y, Benveniste O, Cordel N, Boyer O. The IgG2 Isotype of Anti–Transcription Intermediary Factor 1γ Autoantibodies Is a Biomarker of Cancer and Mortality in Adult Dermatomyositis. Arthritis Rheumatol 2019; 71:1360-1370. [DOI: 10.1002/art.40895] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 03/14/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Audrey Aussy
- Normandy UniversityUniversity of RouenINSERM U1234Rouen University Hospital Rouen France
| | - Manuel Fréret
- Normandy UniversityUniversity of RouenINSERM U1234Rouen University Hospital Rouen France
| | | | - Didier Bessis
- St. Eloi Hospital and Montpellier University HospitalINSERM U1051 Montpellier France
| | - Thierry Vincent
- St. Eloi Hospital and Montpellier University Hospital Montpellier France
| | - Denis Jullien
- Lyon University and Édouard Herriot University Hospital Lyon France
| | - Laurent Drouot
- Normandy UniversityUniversity of RouenINSERM U1234Rouen University Hospital Rouen France
| | - Fabienne Jouen
- Normandy UniversityUniversity of RouenINSERM U1234Rouen University Hospital Rouen France
| | - Pascal Joly
- Normandy UniversityUniversity of RouenINSERM U1234Rouen University Hospital Rouen France
| | - Isabelle Marie
- Normandy UniversityUniversity of RouenINSERM U1234Rouen University Hospital Rouen France
| | - Alain Meyer
- Strasbourg University Hospital and Centre de Référence des Maladies Autoimmunes Rares Strasbourg France
| | - Jean Sibilia
- Strasbourg University Hospital and Centre de Référence des Maladies Autoimmunes Rares Strasbourg France
| | | | - Eric Hachulla
- European Reference Network on Connective Tissue and Musculoskeletal DiseasesUniversity of LilleHospital Claude Huriez Lille France
| | | | - Sophie Huë
- AP‐HPHenri Mondor Hospital Créteil France
| | | | | | | | - Yves Allenbach
- AP‐HPPitié‐Salpêtrière University HospitalCentre de Référence Maladies Neuro‐Musculaires, DHU i2B, INSERM UMRS 974 Paris France
| | - Olivier Benveniste
- AP‐HPPitié‐Salpêtrière University HospitalCentre de Référence Maladies Neuro‐Musculaires, DHU i2B, INSERM UMRS 974 Paris France
| | - Nadège Cordel
- Normandy UniversityUniversity of RouenINSERM U1234Rouen University Hospital, Rouen, France, and French West Indies University and Pointe‐à‐Pitre University Hospital Pointe‐à‐Pitre Guadeloupe France
| | - Olivier Boyer
- Normandy UniversityUniversity of RouenINSERM U1234Rouen University Hospital Rouen France
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7
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Zhao C, Gao Y, Yu N, Li T, Zhang Y, Zhang H, Lu G, Gao Y, Guo X. Unidirectional transport of IgG by neonatal Fc receptor in human thyrocytes varies across different IgG subclasses. Mol Cell Endocrinol 2018; 477:103-111. [PMID: 29908223 DOI: 10.1016/j.mce.2018.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/22/2018] [Accepted: 06/11/2018] [Indexed: 10/14/2022]
Abstract
Neonatal Fc receptor (FcRn) is down-regulated in Hashimoto's thyroiditis (HT) thyrocytes and mediates IgG endocytosis in thyrocytes. The serum distribution of IgG subclasses (of TgAb and TPOAb) differs between HT patients and normal individuals. We aimed to explore the direction and regulation of FcRn-mediated IgG transport in thyrocyte monolayers and the difference between various IgG subclass transport. IgG was transported by FcRn from the basolateral to apical side in the thyrocyte monolayers grown on Transwell filters and the transport was inhibited by IFN-γ and TNF-α. Stimulation by T3 and TSH down-regulated FcRn expression in thyrocytes. IgG1 was transported preferentially over IgG2 and IgG4, which might be related to the differences in FcRn-binding affinities as shown by SPR. FcRn mediates unidirectional IgG transport in thyrocytes in a tissue-specific manner. Down-regulation of FcRn is speculated to play a protective role in HT pathogenesis by mainly reducing IgG1 transport in thyrocytes.
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Affiliation(s)
- Chenxu Zhao
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, China
| | - Ying Gao
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, China
| | - Nan Yu
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, China
| | - Tiancheng Li
- Department of Otorhinolaryngology-Head and Neck Surgery, Peking University First Hospital, Beijing, 100034, China; Centre for Cancer Research, Massachusetts General Hospital, Boston, MA, 02129, USA
| | - Yang Zhang
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, China.
| | - Hong Zhang
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, China
| | - Guizhi Lu
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, China
| | - Yanming Gao
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, China
| | - Xiaohui Guo
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, China
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8
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Long-term plasma exchange as maintenance therapy for cerebellar-type Hashimoto’s encephalopathy, a case report. Transfus Apher Sci 2018; 57:418-420. [DOI: 10.1016/j.transci.2018.05.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 05/07/2018] [Accepted: 05/25/2018] [Indexed: 11/21/2022]
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9
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Engelhart S, Glynn RJ, Schur PH. Disease associations with isolated elevations of each of the four IgG subclasses. Semin Arthritis Rheum 2017; 47:276-280. [DOI: 10.1016/j.semarthrit.2017.03.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 02/27/2017] [Accepted: 03/29/2017] [Indexed: 01/11/2023]
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10
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Fröhlich E, Wahl R. Thyroid Autoimmunity: Role of Anti-thyroid Antibodies in Thyroid and Extra-Thyroidal Diseases. Front Immunol 2017; 8:521. [PMID: 28536577 PMCID: PMC5422478 DOI: 10.3389/fimmu.2017.00521] [Citation(s) in RCA: 222] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 04/19/2017] [Indexed: 12/17/2022] Open
Abstract
Autoimmune diseases have a high prevalence in the population, and autoimmune thyroid disease (AITD) is one of the most common representatives. Thyroid autoantibodies are not only frequently detected in patients with AITD but also in subjects without manifest thyroid dysfunction. The high prevalence raises questions regarding a potential role in extra-thyroidal diseases. This review summarizes the etiology and mechanism of AITD and addresses prevalence of antibodies against thyroid peroxidase, thyroid-stimulating hormone receptor (TSHR), and anti-thyroglobulin and their action outside the thyroid. The main issues limiting the reliability of the conclusions drawn here include problems with different specificities and sensitivities of the antibody detection assays employed, as well as potential confounding effects of altered thyroid hormone levels, and lack of prospective studies. In addition to the well-known effects of TSHR antibodies on fibroblasts in Graves' disease (GD), studies speculate on a role of anti-thyroid antibodies in cancer. All antibodies may have a tumor-promoting role in breast cancer carcinogenesis despite anti-thyroid peroxidase antibodies having a positive prognostic effect in patients with overt disease. Cross-reactivity with lactoperoxidase leading to induction of chronic inflammation might promote breast cancer, while anti-thyroid antibodies in manifest breast cancer might be an indication for a more active immune system. A better general health condition in older women with anti-thyroid peroxidase antibodies might support this hypothesis. The different actions of the anti-thyroid antibodies correspond to differences in cellular location of the antigens, titers of the circulating antibodies, duration of antibody exposure, and immunological mechanisms in GD and Hashimoto's thyroiditis.
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Affiliation(s)
- Eleonore Fröhlich
- Internal Medicine (Department of Endocrinology and Diabetology, Angiology, Nephrology and Clinical Chemistry), University of Tuebingen, Tuebingen, Germany
- Center for Medical Research, Medical University Graz, Graz, Austria
| | - Richard Wahl
- Internal Medicine (Department of Endocrinology and Diabetology, Angiology, Nephrology and Clinical Chemistry), University of Tuebingen, Tuebingen, Germany
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11
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Liu Y, Gong Y, Qu C, Zhang Y, You R, Yu N, Lu G, Huang Y, Zhang H, Gao Y, Gao Y, Guo X. CD32b expression is down-regulated on double-negative memory B cells in patients with Hashimoto's thyroiditis. Mol Cell Endocrinol 2017; 440:1-7. [PMID: 27832986 DOI: 10.1016/j.mce.2016.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 10/10/2016] [Accepted: 11/05/2016] [Indexed: 01/09/2023]
Abstract
Inhibitory CD32b receptors on B cells are critical for humoral immunity. The humoral response plays a role in the pathogenesis of Hashimoto's thyroiditis (HT). This study aimed to investigate B cell subset distribution and CD32b expression within these subsets in HT patients. B cell subset distribution and CD32b expression were analyzed in 60 HT patients and 21 healthy donors. Subset distribution and CD32b expression following stimulation with α-Ig and α-CD40 were also assessed. The percentage of double-negative (DN) memory cells was increased in the HT patients, while the expression level of CD32b on DN memory cells was decreased. Redistribution of B cell subsets was detected in response to stimulation with α-Ig. In addition, the expression level of CD32b was reduced following α-CD40 stimulation. These results suggest that abnormal B cell subset distribution and decreased CD32b expression on DN memory cells might be involved in the pathogenesis of HT.
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Affiliation(s)
- Yalei Liu
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, PR China.
| | - Yan Gong
- Department of Clinical Laboratory, Peking University First Hospital, Beijing, 100034, PR China.
| | - Chenxue Qu
- Department of Clinical Laboratory, Peking University First Hospital, Beijing, 100034, PR China.
| | - Yang Zhang
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, PR China.
| | - Ran You
- Department of Clinical Laboratory, Peking University First Hospital, Beijing, 100034, PR China.
| | - Nan Yu
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, PR China.
| | - Guizhi Lu
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, PR China.
| | - Youyuan Huang
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, PR China.
| | - Hong Zhang
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, PR China.
| | - Ying Gao
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, PR China.
| | - Yanming Gao
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, PR China.
| | - Xiaohui Guo
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, PR China.
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12
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Liu Y, You R, Yu N, Gong Y, Qu C, Zhang Y, Lu G, Huang Y, Zhang H, Gao Y, Gao Y, Guo X. Increased proportions of Tc17 cells and NK cells may be risk factors for disease progression in Hashimoto's thyroiditis. Int Immunopharmacol 2016; 40:332-338. [DOI: 10.1016/j.intimp.2016.09.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 09/15/2016] [Accepted: 09/19/2016] [Indexed: 10/21/2022]
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13
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Zaaber I, Mestiri S, Hammedi H, Marmouch H, Mahjoub S, Tensaout BBHJ, Said K. Association of Interleukin-1B and Interleukin-4 Gene Variants with Autoimmune Thyroid Diseases in Tunisian Population. Immunol Invest 2016; 45:284-97. [PMID: 27100882 DOI: 10.3109/08820139.2016.1153650] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
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.
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Affiliation(s)
- Ines Zaaber
- a Laboratory of Genetics, Biodiversity and Bioresource Valorization , Superior Institute of Biotechnology of Monastir, University of Monastir , Monastir , Tunisia
| | - Souhir Mestiri
- a Laboratory of Genetics, Biodiversity and Bioresource Valorization , Superior Institute of Biotechnology of Monastir, University of Monastir , Monastir , Tunisia
| | - Hounayda Hammedi
- a Laboratory of Genetics, Biodiversity and Bioresource Valorization , Superior Institute of Biotechnology of Monastir, University of Monastir , Monastir , Tunisia
| | - Hela Marmouch
- b Department of Internal Medicine-Endocrinology , Hospital Fattouma Bourguiba in Monastir , Monastir , Tunisia
| | - Silvia Mahjoub
- b Department of Internal Medicine-Endocrinology , Hospital Fattouma Bourguiba in Monastir , Monastir , Tunisia
| | - Besma Bel Hadj Jrad Tensaout
- a Laboratory of Genetics, Biodiversity and Bioresource Valorization , Superior Institute of Biotechnology of Monastir, University of Monastir , Monastir , Tunisia
| | - Khaled Said
- a Laboratory of Genetics, Biodiversity and Bioresource Valorization , Superior Institute of Biotechnology of Monastir, University of Monastir , Monastir , Tunisia
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14
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Lee IS, Lee JU, Lee KJ, Jang YS, Lee JM, Kim HS. Painful immunoglobulin G4-related thyroiditis treated by total thyroidectomy. Korean J Intern Med 2016; 31:399-402. [PMID: 26932403 PMCID: PMC4773714 DOI: 10.3904/kjim.2014.283] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 12/01/2014] [Accepted: 12/15/2014] [Indexed: 11/27/2022] Open
Affiliation(s)
- Ihn Suk Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Uee Lee
- Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kwan-Ju Lee
- Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yi Sun Jang
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong Min Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hye Soo Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Correspondence to Hye Soo Kim, M.D. Department of Internal Medicine, College of Medicine, Daejeon St. Mary’s Hospital, The Catholic University of Korea, 64 Daeheung-ro, Jung-gu, Daejeon 34943, Korea Tel: +82-42-220-9297 Fax: +82-42-220-7995 E-mail:
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15
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IgG anti-tTG responses in different autoimmune conditions differ in their epitope targets and subclass usage. Mol Immunol 2015; 67:369-76. [DOI: 10.1016/j.molimm.2015.06.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 06/18/2015] [Accepted: 06/24/2015] [Indexed: 02/07/2023]
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16
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Kaklamanos M, Thomas D, Pikazis D, Kaltsas G. Thyroid-specific changes following treatment with biological therapies in patients with rheumatic diseases. Endocrine 2015; 50:146-53. [PMID: 25690756 DOI: 10.1007/s12020-015-0551-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 02/07/2015] [Indexed: 12/18/2022]
Abstract
Biological anti-rheumatic agents (BAA) may induce autoimmune phenomena. Evidence on thyroid-specific effects of these agents is relatively limited. We studied prospectively, over 3 years, 36 rheumatic patients treated with BAA (18 Infliximab and 18 Rituximab) and no prior exposure to biological therapies (group-1), with respect to their thyroid function, thyroid antibody titers, and thyroid ultrasonographic parameters, such as left inferior thyroid artery peak systolic velocity (ITA PSV), left thyroid lobe vascularity index (TL VI), and echogenicity. Twenty-eight rheumatic patients treated with disease-modifying anti-rheumatic drugs and/or glucocorticoids (group-2), 21 rheumatic patients not receiving any treatment (group-3), and 49 healthy individuals (group-4) were used for comparison. Thyroid function and autoantibody titers were not significantly altered at any stage irrespectively of the administered BAA, previously unknown autoimmune thyroid disease (AITD) status, and/or concomitant treatment with glucocorticoids. Left ITA PSV was significantly increased in group-1 patients (mean ± SD start: 25.5 ± 14.1 cm/s vs. end: 29.8 ± 11.1 cm/s, p = 0.038 and p < 0.001, respectively). Six group-1, 7 group-2, and 3 group-3 patients developed reduced thyroid echogenicity during follow-up (start: p = 0.003 and end: p < 0.001). Left ITA PSV, left TL VI, and echogenicity changes were not related to alterations in thyroid volume, thyrotropin hormone levels, and/or underlying AITD. Infliximab and Rituximab do not cause any alterations in thyroid function and/or autoimmunity, even in patients with previously undiagnosed AITD. Elevated left ITA PSV and reduced thyroid echogenicity may be early features signaling progression to AITD in patients treated with BAA.
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Affiliation(s)
- Michail Kaklamanos
- Endocrine Unit, Department of Pathophysiology, National and Kapodistrian University of Athens, 75 Mikras Asias St, 11527, Athens, Greece,
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17
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Liu Y, Liu M, Zhang Y, Qu C, Lu G, Huang Y, Zhang H, Yu N, Yuan S, Gao Y, Gao Y, Guo X. The expression of Fcγ receptors in Hashimoto's thyroiditis. Cell Immunol 2015; 294:33-8. [PMID: 25670392 DOI: 10.1016/j.cellimm.2015.01.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 01/08/2015] [Accepted: 01/28/2015] [Indexed: 10/24/2022]
Abstract
The pathophysiological mechanism underlying Hashimoto's thyroiditis (HT) is still unclear. Thyroglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) are diagnostic hallmarks of HT. These IgG antibodies regulate the balance of immunologic tolerance and autoimmunity via Fcγ receptors (FcγRs). The aim of our study was to investigate the role of FcγRs in the pathogenesis of HT. The percentage of peripheral blood mononuclear cells (PBMCs) from HT patients bearing FcγRII was significantly lower than that seen in healthy donors, and the mean fluorescence intensity (MFI) value of FcγRII on PBMCs from HT patients was significantly higher. The percentage of PBMCs positive for FcγRIII also was significantly higher in HT patients, and the percentage of B cells bearing FcγRIIB in HT patients was significantly lower than that seen in healthy donors. Our study therefore provides evidence for FcγRs, especially FcγRIIB, being involved in the pathogenesis of HT.
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Affiliation(s)
- Yalei Liu
- Department of Endocrinology, Peking University First Hospital, Beijing 100034, PR China.
| | - Mingming Liu
- Institute of Microcirculation, Chinese Academy of Medical Science, Beijing 100005, PR China.
| | - Yang Zhang
- Department of Endocrinology, Peking University First Hospital, Beijing 100034, PR China.
| | - Chenxue Qu
- Department of Clinical Laboratory, Peking University First Hospital, Beijing 100034, PR China.
| | - Guizhi Lu
- Department of Endocrinology, Peking University First Hospital, Beijing 100034, PR China.
| | - Youyuan Huang
- Department of Endocrinology, Peking University First Hospital, Beijing 100034, PR China.
| | - Hong Zhang
- Department of Endocrinology, Peking University First Hospital, Beijing 100034, PR China.
| | - Nan Yu
- Department of Endocrinology, Peking University First Hospital, Beijing 100034, PR China.
| | - Shanshan Yuan
- Department of Endocrinology, Peking University First Hospital, Beijing 100034, PR China.
| | - Ying Gao
- Department of Endocrinology, Peking University First Hospital, Beijing 100034, PR China.
| | - Yanming Gao
- Department of Endocrinology, Peking University First Hospital, Beijing 100034, PR China.
| | - Xiaohui Guo
- Department of Endocrinology, Peking University First Hospital, Beijing 100034, PR China.
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18
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Takeshima K, Ariyasu H, Inaba H, Inagaki Y, Yamaoka H, Furukawa Y, Doi A, Furuta H, Nishi M, Akamizu T. Distribution of serum immunoglobulin G4 levels in Hashimoto's thyroiditis and clinical features of Hashimoto's thyroiditis with elevated serum immunoglobulin G4 levels. Endocr J 2015; 62:711-7. [PMID: 25994040 DOI: 10.1507/endocrj.ej15-0157] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Immunoglobulin G4-related disease (IgG4-RD) is characterized by elevated serum IgG4 levels, IgG4-positive plasmacytes, and lymphocyte infiltration into multiple organs. IgG4 thyroiditis is a subset of patients with Hashimoto's thyroiditis (HT) who exhibited histopathological features of IgG4-RD; its source of serum IgG4 is suggested to be the thyroid gland. Although a relationship between IgG4-RD and IgG4 thyroiditis has been reported, the meaning of serum IgG4 in HT is uncertain. In this report, we prospectively evaluated serum IgG4 levels and clinical features of patients with HT. A total of 149 patients with HT were prospectively recruited into this study. According to the comprehensive diagnostic criteria of IgG4-RD, patients were divided into two groups: elevated IgG4 (>135 mg/dL) and non-elevated IgG4 (≤135 mg/dL). Median serum IgG4 levels of HT patients were 32.0 mg/dL (interquartile range, 20.0-65.0), with a unimodal non-normal distribution. Six patients (4.0%) had elevated serum IgG4 levels above 135 mg/dL. The elevated IgG4 group was older and exhibited enlarged hypoechoic areas in the thyroid gland, as revealed by ultrasonography, relative to the non-elevated IgG4 group. Levothyroxine (L-T4) replacement doses and titers of anti-thyroid antibodies did not differ significantly between the two groups. Two out of six HT patients with elevated serum IgG4 levels had extra-thyroid organ involvement as seen in IgG4-RD. In conclusion, HT patients with elevated serum IgG4 levels shared clinical features with both IgG4-RD and IgG4 thyroiditis. Longer follow-up periods and histopathological assessments are needed to further understand the meaning of elevated serum IgG4 levels in HT.
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Affiliation(s)
- Ken Takeshima
- The 1st Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
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Li W, Fan G, Chen L, Zhang R, Zhang K, Sun Y, Lin G, Xie J, Wang L, Li J. A new type of natural bispecific antibody with potential protective effect in Hashimoto thyroiditis. J Clin Endocrinol Metab 2014; 99:E1602-9. [PMID: 24905062 DOI: 10.1210/jc.2013-4108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
CONTEXT As a new antibody concept, natural bispecific antibodies (nBsAbs) have been detected in long-term passive immunization and some diseases, but their potential immunomodulatory role remains unclear. Hashimoto thyroiditis (HT) appears to fulfill the condition for nBsAb production but has not yet been characterized. OBJECTIVE The objective of the study was to identify a new nBsAb against thyroid peroxidase (TPO) and thyroglobulin (Tg) in HT patients and to preliminarily explore its immunomodulatory role. DESIGN, SETTING, AND PATIENTS Serum samples were obtained from 136 HT patients, 92 diseased controls, and 99 healthy controls for anti-TPO/Tg nBsAb detection. The relationship between anti-TPO/Tg nBsAb and other clinical parameters was also analyzed. MAIN OUTCOME MEASURES The anti-TPO/Tg nBsAb was detected using a double-antigen sandwich ELISA. Higher nBsAb levels were found to be associated with decreased inflammation in HT patients. RESULTS The prevalence of anti-TPO/Tg nBsAb in HT was 44.9% (61 of 136), significantly higher than that of diseased controls (2.2%, 2 of 92) (P < .0001) and healthy controls (0%, 0 of 99) (P < .0001). HT patients who were nBsAb positive were prone to have significantly lower levels of serum C-reactive protein and TNF-α compared with the nBsAb-negative individuals (P < .05). The serum amyloid A and interferon-γ levels also showed a similar trend in the two groups. The IgG subclass of anti-TPO/Tg nBsAb was IgG4. Further analysis showed a negative correlation between anti-TPO/Tg nBsAb and serum total IgG4 (r = -0.697, P = .025) in IgG4 thyroiditis patients. CONCLUSIONS A new type of nBsAb against TPO and Tg in HT patients is identified. Our data also indicate a protective effect of anti-TPO/Tg nBsAb in the pathogenesis of HT and extend prior knowledge about nBsAb in diseases.
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Affiliation(s)
- Wenli Li
- National Center for Clinical Laboratories (W.L., G.F., L.C., R.Z., K.Z., Y.S., G.L., J.X., L.W., J.L.), Beijing Hospital, Beijing 100029, People's Republic of China; and Graduate School (W.L., G.F., L.C.), Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100005, People's Republic of China
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20
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Vasileiadis I, Boutzios G, Charitoudis G, Koukoulioti E, Karatzas T. Thyroglobulin antibodies could be a potential predictive marker for papillary thyroid carcinoma. Ann Surg Oncol 2014; 21:2725-32. [PMID: 24595799 DOI: 10.1245/s10434-014-3593-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Hashimoto thyroiditis (HT) is associated with an increased risk of developing papillary thyroid carcinoma (PTC). The relationship between thyroid autoimmunity and cancer remains controversial. The purpose of this study was to investigate whether the preoperative TgAb could be a potential predictor of PTC in patients with thyroid nodules and to assess whether there is an association of preoperative TgAb with lymph node metastases. METHODS This retrospective, nonrandomised study included 854 patients who underwent standard total thyroidectomy. Benign thyroid nodules were diagnosed in 447 patients, and 407 presented with malignant nodules. The examined parameters included the clinical characteristics, preoperative TSH and TgAb levels, and the histopathological characteristics of the tumour. RESULTS Tumour size >10 mm (p = 0.01), the presence of PTC (p < 0.001), elevated TSH levels (2.64 ± 1.28 μU/ml vs. 2.09 ± 0.98 μU/ml, p = 0.001), HT (p < 0.001), and lymph node metastasis (p = 0.005) were significantly associated with positive TgAb. Additionally, tumour size >10 mm (p < 0.001), preoperative TgAb positivity (p = 0.003), and elevated TSH levels (TSH > 3.4 μU/ml, p = 0.038) were independent risk factors for PTC based on the multivariate logistic regression analysis. CONCLUSIONS This study showed that TgAb positivity was an independent risk factor for PTC. A positive correlation between TgAb and PTC in patients with indeterminate nodules was existed. Additionally, a positive correlation existed between TgAb and lymph node metastases in patients with PTC. Prospective studies with a larger number of patients and long-term follow-up are needed clarify the potential role of positive serum TgAb in the prediction of PTC.
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Affiliation(s)
- Ioannis Vasileiadis
- Department of Otolaryngology/Head and Neck Surgery, Venizeleio - Pananeio General Hospital, Herakleion, Alexandroupolis, Greece,
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21
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Kawashima ST, Tagami T, Nakao K, Nanba K, Tamanaha T, Usui T, Naruse M, Minamiguchi S, Mori Y, Tsuji J, Tanaka I, Shimatsu A. Serum levels of IgG and IgG4 in Hashimoto thyroiditis. Endocrine 2014; 45:236-43. [PMID: 23695895 DOI: 10.1007/s12020-013-9988-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 05/13/2013] [Indexed: 12/24/2022]
Abstract
Although IgG4-related disease is characterized by extensive infiltration of IgG4-positive plasma cells and lymphocytes of various organs, the details of this systemic disease are still unclear. We screened serum total IgG levels in the patients with Hashimoto thyroiditis (HT) to illustrate the prevalence of IgG4-related thyroiditis in HT. Twenty-four of 94 patients with HT (25.5%) had elevated serum IgG levels and their serum IgG4 was measured. Five of the 24 cases had more than 135 mg/dL of IgG4, which is the serum criterion of IgG4-related disease. One was a female patient who was initially treated as Graves' disease and rapidly developed a firm goiter and hypothyroidism. The biopsy of her thyroid gland revealed that follicular cells were atrophic with squamous metaplasia, replaced with fibrosis, which was compatible with the fibrous variant of HT. Immunohistochemical examination revealed diffuse infiltration of IgG4-positive plasma cells, and the serum IgG4 level was 179 mg/dL. The levels of IgG and IgG4 were positively correlated with the titers of anti-thyroglobulin antibody or anti-thyroid peroxidase antibody. In conclusion, at least a small portion of patients with HT with high titers of anti-thyroid antibodies may overlap the IgG4-related thyroiditis.
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Affiliation(s)
- Sachiko-Tsukamoto Kawashima
- Division of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Mukaihata-cho 1-1, Fukakusa, Fushimi-ku, Kyoto, 612-8555, Japan
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22
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Zhang J, Zhao L, Gao Y, Liu M, Li T, Huang Y, Lu G, Gao Y, Guo X, Shi B. A classification of Hashimoto's thyroiditis based on immunohistochemistry for IgG4 and IgG. Thyroid 2014; 24:364-70. [PMID: 23992023 DOI: 10.1089/thy.2013.0211] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Hashimoto's thyroiditis (HT) is a common organ-specific autoimmune disease. Antithyroglobulin antibodies (TgAb) and antithyroperoxidase antibodies (TPOAb), predominantly of the immunoglobulin (Ig) G class, are hallmarks of HT. It has been reported that HT can be divided into IgG4 and non-IgG4 thyroiditis. The aim of our study was to investigate the meaning of this classification. METHODS Thyroid sections from 53 Hashimoto's patients with stored serum samples were collected to detect IgG4, IgG, α-smooth muscle actin, and transforming growth factor-β1 expression by immunohistochemical staining. The degree of fibrosis of thyroid parenchyma was qualitatively evaluated by Masson's trichrome. Serum total IgG, IgG4, TPOAb IgG, TgAb IgG, TPOAb IgG4, and TgAb IgG4 were detected by enzyme-linked immunosorbent assays (ELISAs). RESULTS Based on immunohistochemistry for IgG4 and IgG, 12 cases of IgG4-positive HT and 41 cases of IgG4-negative HT were identified in our study. The patients in the IgG4-positive HT group were significantly younger than those in the IgG4-negative HT group (p=0.023), and no significant differences were found in sex distribution, disease duration, and distribution of thyroid functional status between these two groups. The degree of fibrosis evaluated by Masson's trichrome and the immunohistochemical expression score of TGF-β1 in the IgG4-positive HT were significantly higher than those in the IgG4-negative HT (p<0.05). No significant differences were found in the levels of serum IgG4, total IgG, or IgG4/IgG ratio. However, TPOAb IgG4 and TgAb IgG4 levels and the ratios of TPOAb IgG4/TPOAb IgG, TgAb IgG4/TgAb IgG, TPOAb IgG4/IgG4, and TgAb IgG4/IgG4 were significantly higher in the IgG4-positive HT group than those in the IgG4-negative HT group respectively (p<0.05). CONCLUSIONS Our study indicates that HT can be divided into IgG4-positive and IgG4-negative HT, and this classification might have important clinical implications. The levels of IgG4 binding to specific thyroid antigens might be noninvasive markers to differentiate these two different immunophenotypes.
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Affiliation(s)
- Jing Zhang
- 1 Department of Endocrinology, Peking University First Hospital , Beijing, China
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23
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Stefanic M, Karner I. Thyroid peroxidase autoantibodies are associated with a lesser likelihood of late reversion to hyperthyroidism after successful non-ablative treatment of Graves' disease in Croatian patients. J Endocrinol Invest 2014; 37:71-7. [PMID: 24464453 DOI: 10.1007/s40618-013-0026-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 11/16/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Thyroid peroxidase autoantibodies (TPOAbs) are frequently observed in Graves' disease (GD) and tend to persist in patients even after successful treatment with antithyroid drugs. However, there is a lack of consistent data regarding the prognostic significance of TPOAbs during and after non-ablative treatment for Graves' hyperthyroidism. AIM To assess the prognostic value of TPOAbs on the long-term outcome of GD patients, who were in remission after the use of antithyroid drugs (block-and-replace regimen). SUBJECTS 100 remitters were retrospectively investigated for factors associated with the 5-year course of disease recurrence and compared to 60 age/sex-matched patients with intractable GD. RESULTS Mild hyperthyroidism, low baseline thyroid-stimulating antibodies levels, and small goiters were predictive of remission. Once attained, the remission was shorter in younger patients, patients with declining post-treatment TSH values, and negative baseline TPOAb levels. The 5-year cumulative incidence of relapse incrementally increased from 24 to 44 to 70 % across decreasing TPOAb tertiles (log-rank, p = 0.00056; the lower tertile representing TPOAb-negative cases). The age-of-onset (p = 0.034), and the baseline TPOAb value [upper tertile, hazard ratio (HR) 0.25; 95 % confidence interval, 0.11-0.59; p = 0.0014; middle tertile, HR 0.47 (0.24-0.9); p = 0.024; Cox regression] were inversely associated with late (>12 months) relapse rates in a level-dependent manner. In contrast, serum logTSH measured 6 months after drug discontinuation was inversely associated with hazard rates at all time points (p = 0.0005). CONCLUSION Baseline TPOAb positivity is an independent indicator of long-term remission in GD patients who have been successfully treated, but the mechanism of action and causal relations remain unknown.
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Affiliation(s)
- M Stefanic
- Clinical Institute of Nuclear Medicine and Radiation Protection, Osijek University Hospital, J. Huttlera 4, 31 000, Osijek, Croatia,
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24
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Kiseleva EP, Mikhailopulo KI, Novik GI, Szwajcer Dey E, Zdorovenko EL, Shashkov AS, Knirel YA. Isolation and structural identification of glycopolymers of Bifidobacterium bifidum BIM B-733D as putative players in pathogenesis of autoimmune thyroid diseases. Benef Microbes 2013; 4:375-391. [PMID: 24311320 DOI: 10.3920/bm2013.0015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2024]
Abstract
Bifidobacterium bifidum 791 (commercially available as B. bifidum BIM B-733D) cell-surface biopolymers (BPs) interact selectively with human serum thyroid peroxidase (TPO) and thyroglobulin (Tg) autoantibodies (anti TPO and anti Tg, respectively). BPanti-TPO and BPanti-Tg were isolated from the soluble fraction of B. bifidum BIM B-733D by affinity chromatography with anti-TPO or anti-Tg, respectively. Homogeneity of affinity eluates (AEanti-TPO and AEanti-Tg) was tested by size exclusion chromatography. For each AE, the elution profiles generated on the basis of absorbance at 280 nm do not conform to ELISA data for functional activity characteristic of BPs. Moreover, high functional activity was detected in chromatographic fractions that had significantly different molecular weights and no absorbance at 280 nm, which suggests a non-protein (carbohydrate) nature of BPanti-TPO and BPanti-Tg. The semi-preparative size exclusion chromatography of AEanti-TPO and AEanti-Tg with detection by refractometer gave 5,000-7,000 Da fractions containing substances that interact selectively with either anti TPO (BPanti-TPO) or anti-Tg (BPanti-Tg) according to ELISA data. Analysis by two-dimensional NMR spectroscopy including a 1H, 13C-heteronuclear single-quantum coherence experiment indicated that both substances are linear α-1,6-glucans. For the first time, an immunological similarity (molecular mimicry) of glycopolymers of B. bifidum BIM B-733D and human thyroid proteins, TPO and Tg, was shown. On the whole, our data point to a possible role of bifidobacteria in the pathogenesis of autoimmune thyroid diseases (ATD). The main requirements for triggering/acceleration or prevention/abrogation of ATD by bifidobacteria through molecular mimicry mechanism are hypothesised to be (1) genetic predisposition to ATD and (2) intestinal epithelium penetration by α-1,6-glucan.
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MESH Headings
- Antigens, Bacterial/chemistry
- Antigens, Bacterial/immunology
- Antigens, Bacterial/isolation & purification
- Antigens, Bacterial/metabolism
- Autoantibodies/metabolism
- Autoimmune Diseases/etiology
- Autoimmune Diseases/microbiology
- Bifidobacterium/chemistry
- Bifidobacterium/immunology
- Chromatography, Affinity
- Chromatography, Gel
- Humans
- Iodide Peroxidase/immunology
- Magnetic Resonance Spectroscopy
- Molecular Weight
- Polysaccharides, Bacterial/chemistry
- Polysaccharides, Bacterial/immunology
- Polysaccharides, Bacterial/isolation & purification
- Polysaccharides, Bacterial/metabolism
- Protein Binding
- Thyroglobulin/immunology
- Thyroid Diseases/etiology
- Thyroid Diseases/microbiology
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Affiliation(s)
- E P Kiseleva
- The Institute of Bioorganic Chemistry, National Academy of Sciences of Belaru, Acad. Kuprevicha 5/2, 220141 Minsk, Republic of Belarus
| | - K I Mikhailopulo
- The Institute of Bioorganic Chemistry, National Academy of Sciences of Belaru, Acad. Kuprevicha 5/2, 220141 Minsk, Republic of Belarus
| | - G I Novik
- The Institute of Microbiology, National Academy of Sciences of Belarus, Acad. Kuprevicha 5/2, 220141 Minsk, Republic of Belarus
| | - E Szwajcer Dey
- Division of Pure and Applied Biochemistry, Lund University, P.O. Box 124, 22100 Lund, Sweden
| | - E L Zdorovenko
- N.D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky prospekt 47, 119991 Moscow, Russia
| | - A S Shashkov
- N.D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky prospekt 47, 119991 Moscow, Russia
| | - Y A Knirel
- N.D. Zelinsky Institute of Organic Chemistry, Russian Academy of Sciences, Leninsky prospekt 47, 119991 Moscow, Russia
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26
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Shao C, Huo N, Zhao L, Gao Y, Fan X, Zheng Y, Wang L, Lu H, Xu X, Guo X. The presence of thyroid peroxidase antibody of IgG2 subclass is a risk factor for thyroid dysfunction in chronic hepatitis C patients. Eur J Endocrinol 2013; 168:717-22. [PMID: 23419250 DOI: 10.1530/eje-12-0775] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To investigate the prevalence of thyroid dysfunction (TD) and IgG subclasses of thyroid autoantibodies (TAs) and to determine the predictive factors of TD in chronic hepatitis C (CHC) patients. DESIGN Three hundred and twelve untreated hepatitis C virus-infected patients without a history of TD or treatment with thyroid hormones were enrolled in a cross-sectional study. Clinical and biological factors were statistically analyzed to determine the correlation between TD and this patient population. RESULTS The incidence of TD WAS 12.5% in CHC patients. Clinical hypothyroidism (5.8%) and subclinical hypothyroidism (3.8%) were more frequent than clinical hyperthyroidism (1.6%) and subclinical hyperthyroidism (1.3%). The percentage of TA-positive patients was significantly higher in people 60 years than in those 60 years (31.9 VS 18.6%; P=0.042). Positive thyroid peroxidase antibody (TPOAb) was more frequent, and alanine aminotransferase (ALT) levels were lower in patients who displayed TD (TPOAb: 62.1 vs 10.8%, P=0.000; ALT: 43.5 vs 51 IU/l, P=0.046). The positive percentage of TPOAb IgG2 subclass in the TD group was significantly higher than that of patients without TD (66.7 vs 16.7%, P=0.005). Multiple logistic regression analysis indicated that only TPOAb IgG2 subclass positivity was an independent risk factor for TD in CHC patients (odds ratio=8; 95% CI: 1.225-52.246; P=0.030). CONCLUSIONS TPOAb IgG2 subclass positivity is a risk factor for TD in CHC patients before antiviral treatment. IgG2 subclass of TPOAb might play an important role in the presence of TD in CHC patients.
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Affiliation(s)
- Cuiping Shao
- Departments of Infectious Diseases, Peking University First Hospital, Xicheng District, Beijing, People's Republic of China
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Zhang Y, Gao Y, Li M, Xie L, Huang Y, Gao Y, Guo X. Avidity of thyroglobulin antibody in sera from patients with Hashimoto's thyroiditis with different thyroid functional status. Clin Exp Immunol 2010; 161:65-70. [PMID: 20491790 DOI: 10.1111/j.1365-2249.2010.04155.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The mechanism of disease progression in Hashimoto's thyroiditis (HT) is still unclear. Thyroglobulin antibody (TgAb) is a diagnostic hallmark of HT. The aim of our study was to evaluate the avidity of TgAb in sera from HT patients with different thyroid functional status. Sera from 50 patients with newly diagnosed HT were collected and divided into three groups according to thyroid function: patients with hypothyroidism (H, n=18), subclinical hypothyroidism (sH, n=18) and euthyroidism (Eu, n=14). Titres and avidity of TgAb were determined by enzyme-linked immunosorbent assays (ELISAs). Avidity constant (aK) was determined as the reciprocal value of the thyroglobulin molar concentration in the liquid phase resulting in 50% inhibition of TgAb binding to thyroglobulin in solid-phase ELISAs. The titres and aK of TgAb were performed using log-transformation, and expressed as lgT and lgaK, respectively. Mean lgT of TgAb in sera was 4.19+/-0.60 in H, 3.77+/-0.63 in sH, and 3.29+/-0.64 in Eu, respectively. The median avidity of TgAb was 2.30x10(9) in H, 8.80x10(8) in sH, 2.00x10(7) in Eu, respectively. lgT and lgaK of TgAb were at significantly lower levels in Eu than in sH and H (P<0.05). Correlation was found between lgT and lgaK (r=0.594, P<0.05). lgaK was also related to TSH (r=0.308, P<0.05). Our study indicated that patients with high-avidity TgAb might be at high risk of developing subclinical, even to overt, hypothyroidism.
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Affiliation(s)
- Y Zhang
- Department of Endocrinology, University First Hospital, Beijing, China
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