Th1/Th2型细胞因子失衡与自身免疫性甲状腺疾病的关系研究

Relationship between the Th1/Th2 Cytokines Imbalance and Autoimmune Thyroid Diseases

目的分析血清Th1/Th2型细胞因子水平与抗甲状腺自身抗体的相关性,研究甲状腺Th1/Th2细胞免疫失衡与自身免疫性甲状腺疾病(AITD)的发病关系。方法选取21例Graves病(GD)患者、18例桥本甲状腺炎(HT)患者,17例非毒性结节性甲状腺肿(NTNG)患者,20例正常人作为对照进行研究。采用ELISA法检测各组人群血清Th1型细胞因子γ-干扰素(IFN-γ)、白介素2(IL-2)和Th2型细胞因子白介素4(IL-4)、白介素10(IL-10)的含量,并与血清促甲状腺激素受体抗体(TRAb)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)水平进行相关分析。结果GD患者血清IL-4和IL-10水平明显高于HT、NTNG和对照组(P<0.01);而HT患者血清IFN-γ和IL-2水平明显高于GD、NTNG和对照组(P<0.01),IL-4水平明显低于对照组(P<0.05);GD患者血清IL-4和IL-10含量与TRAb水平呈显著正相关(r=0.683,0.579;P<0.05);HT患者血清IFN-γ和IL-2水平与TGAb、TPOAb均呈显著正相关(IFN-γ:r=0.542,0.650;IL-2:r=0.517,0.602;P<0.05)。结论GD患者Th1/Th2细胞免疫平衡偏向以Th2细胞免疫占优势的免疫应答,而HT患者Th1/Th2细胞免疫平衡偏向以Th1细胞免疫占优势的免疫应答。

Objective To analyze the relationship between serum Th1/Th2 cytokines levels and autoantibodies against thyroid, and explore the role of Th1/Th2 cellular immunity imbalance in the pathogenesis of autoimmune thyroid diseases(AITD). Methods 21 patients with Graves'desease(GD), 18 cases with Hashimoto's thyroiditis(HT), 17 cases with non-toxic nodular goiter(NTNG) and 20 healthy subjects were enrolled in this study. The serum concentrations of their Th1 cytokines (IFN-γ,IL-2) and Th2 cytokines (IL-4,IL-10) were assayed by ELISA. The serum levels of their thyrotropin receptor antibodies(TRAb), thyroglobulin antibodies (TGAb) and thyroid peroxidase antibodies(TPOAb) were measured by routine methods. The relationship between the serum Th1, Th2 cytokines levels and serum TRAb, TGAb, TPOAb levels were analyzed. Results The serum levels of IL-4 and IL-10 in patients with GD were significantly higher than those in patients with HT,NTNG and healthy subjects(P<0.01), while the serum levels of INF-γ and IL-2 in patients with HT were significantly higher than those in patients with GD,NTNG and healthy subjects(P<0.01), and serum IL-4 level was significantly lower than that in healthy subject as well (P<0.05). In GD patients, the serum levels of both IL-4 and IL-10 were positively associated with serum TRAb titer, respectively(r=0.683, 0.579;P<0.05). In HT patients, the serum levels of both IFN-γ and IL-2 were positively associated with serum TGAb and TPOAb titers, respectively (IFN-γ:r=0.542, 0.650;IL-2:r=0.517,0.602;P<0.05). Conclusion The patients with GD or HT had a cellular immunity imbalance, a Th2 cell immune response was dominant in GD patients, whereas a Th1 cell immune response was dominant in HT patients.