Correlation of hormonal and cytokines regulation in case of autoimmune thyroiditis

Background. Studied immune aspects of the pathogenesis of autoimmune thyroiditis (AIT), which occupies the first place among human autoimmune pathologies. Treatment of the disease is based on thyroid hormones (TH) replacement therapy. TH are today considered to be super antigens in autoimmune inflammation of the thyroid gland.

Aims. On the basis of complex assessment of hormonal and immunological markers (TSH, TH, Treg, the Th1-, Th2-, Th17-marker cytokines) with a research of possible interrelations of their indicators at patients with various clinical options of a current of AIT initially and against the background of replacement therapy of TH to define differences in functional activity of various types of immunocompetent cages depending on weight of inflammatory process for forecasting of a further clinical current of AIT, optimization of protocols of therapy and timely correction of strategy of treatment.

Methods. In a prospective study, patients with AIT were evaluated for serum levels of cytokines and their receptors before initiating TH replacement therapy and on treatment by means of the ELISA modern methods with immuneсhemiluminescence and electroсhemiluminescence ways of detection.

Results. Patients suffering from AIT showed an excess production of Th1-, Th2-, Th17- and Tregs marker cytokines with a deficiency of TGF-β1, closely connected with autoimmune hypothyroidism severity. Under pressure of TH therapy the indices of most cytokines decreased or improved, with the exception of IL-6, IL-8, IL-2, IFN-g, TNF-α. The greatest variations from the normal range were recorded in the complicated hypothyroidism.

Conclusions. High serum TNF-α level in the onset of the disease is an important marker for the unfavourable AIT course and a predictor of hormone replacement therapy in case of its subclinical course. Safety indexes of functional thyroid epithelium are systemic levels of IL-8 and IL-22, their dynamic reduction in blood serum is an adverse factor, indicating a progressive loss of functionally active thyroid tissue and a possible increase of hypothyroidism in case of subclinical AIT course. If specific gravity and magnitudes of IL-1α, IL-6 and IFN-γ exceed manifold they can be considered to be predictors of AIT clinical course severity and autoimmune inflammation in the thyroid.

autoimmune thyroiditis, thyroid hormones, cytokines

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