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目的 探讨甲状腺中Th1/Th2 细胞失衡在自身免疫性甲状腺疾病 (AITD)发病中的作用。方法 选取 13例Graves病 (GD)患者、12例桥本甲状腺炎 (HT)患者 ,并以 8例非毒性结节性甲状腺肿患者作为对照进行研究。采用免疫组化染色方法检测这些患者甲状腺内单个核细胞 (ITMC)的γ 干扰素(IFN γ)和白介素 4(IL 4)细胞因子抗原表达 (分别代表Th1,Th2 分泌的细胞因子 ) ,并与外周血甲状腺刺激性抗体 (TSAb)、甲状腺球蛋白抗体 (TGAb)、甲状腺微粒体抗体 (TMAb)等免疫学指标进行相关分析。结果 ( 1)GD、HT患者ITMC的IL 4、IFN γ阳性表达明显高于对照组 (均P <0 .0 1) ;GD患者ITMC的IL 4阳性表达明显高于IFN γ阳性表达 ;而HT患者ITMC的IFN γ阳性表达则明显高于IL 4阳性表达(均P <0 .0 5 ) ;( 2 )GD患者ITMC的IL 4阳性表达与TSAb显著正相关 (r =0 .67,P <0 .0 1) ,ITMC的IFN γ阳性表达与TSAb无相关性 ;HT患者ITMC的IFN γ阳性表达与TGAb、TMAb均呈显著正相关(分别为r =0 .65 ,r =0 .5 9,均P <0 .0 5 ) ,但ITMC的IL 4阳性表达与TGAb、TMAb均无相关性。结论 GD患者Th1/Th2 细胞平衡失衡偏向以Th2 占优势的免疫应答 ,而HT患者Th1/Th2 平衡失衡偏向以Th1占优势的免疫应答。
Objective To investigate the role of Th1 / Th2 cell imbalance in the pathogenesis of autoimmune thyroid disease (AITD) in thyroid. Methods Thirteen patients with Graves’ disease (GD) and 12 patients with Hashimoto’s thyroiditis (HT) were enrolled. Eight patients with non-nodular goiter were selected as controls. Immunohistochemical staining was used to detect the expression of IFN-γ and IL-4 cytokines in the thyroid mononuclear cells (ITMCs) of these patients (representing the cytokines secreted by Th1 and Th2, respectively) (TSAb), thyroglobulin antibody (TGAb) and thyroid microsomal antibody (TMAb) were analyzed. Results (1) The positive expression of IL-4 and IFN-γ in ITMC of GD and HT patients was significantly higher than that of the control group (all P <0.01). The positive expression of IL-4 in ITMC of GD patients was significantly higher than that of IFN- The IFNγ expression of ITMC in patients was significantly higher than that in IL 4 (all P <0.05). (2) The positive expression of IL 4 in ITMC was positively correlated with TSAb in GD patients (r = 0.67, P < 0. 01). There was no correlation between IFNγ expression in ITMC and TSAb. The IFNγ expression in ITMC of HT patients was positively correlated with TGAb and TMAb (r = 0.65, r = 0.59 , All P <0.05), but IL-4 positive expression in ITMC had no correlation with TGAb and TMAb. Conclusions The imbalance of Th1 / Th2 cells in GD patients favors Th2-predominant immune response, whereas the imbalance of Th1 / Th2 in HT patients predisposes to Th1-predominant immune response.