In view of abundance of autoimmune diseases of thyroid gland, Graves’ Disease in particular, the role of immune regulation and the possibility of controlling it by estimating the function of regulatory T-limphocytes are important questions today. Available for practical estimation of T- and B-lymphocytes tolerance disorder in GBD are serum levels of Th1- and Th2- marker cytokines. Experimental thyrotoxicosis in Wistar rats showed significant increase in serum Il-1α, IFN-γ and Il-10 depending on the increase of thyroid hormones, as well as significant changes in correlation between pro- and anti-inflammatory cytokines with the shift towards Th1-marker cytokines in supernatant thyroid glands of the animals with thyrotoxicosis. Are found out also changes of proliferative activity thyrocytes with change of average diameter of follicles of a thyroid gland.

Cytokines and their receptors belong to a significant role in the initiation and the subsequent course and outcome of autoimmune thyroid disease. Interleukin-2 (IL-2), interleukin-4 (IL-4) and tumor necrosis factor-alpha (TNF-α)-cytokines, which have a multifaceted impact on the various stages of the immune response: the development of inflammatory response, cell proliferation, antibody and acute phase proteins synthesis. Pre-existing pattern of development of autoimmune thyroiditis (Hashimoto's thyroiditis) and Graves' disease (GD) as a state with two opposite positions of the predominant profile of Th1/Th2-lymphocyte activation. The study evaluated the cytokine production by Th1- and Th2-lymphocytes in patients with GD, assessment of lymphocyte receptor system and identified lymphocytes subpopulation in patients with BG, and the impact on the functional state of thyroid gland. It was shown that the immunoregulatory cytokines as Th1(IL2)- and Th2(IL-4)-helper lymphocytes are involved in the immune mechanism of BG. The level of IL-2, IL4, and TNF-α, and the number complementary lymphocyte receptors were not significantly changed in euthyroid or hyperthyroid GD patient. Nevertheless, there are strong correla! tions between production of immunoregulatory cytokines (IL-2, IL-4) with the functional state of the thyroid gland and increase of its volume in GD patient, what confirms the “functional synergies” of these cytokines in autoimmune inflammation in the GD.

Purpose: to analyze iodine sufficiency and to evaluate thyroid structural and functional status in Novosibirsk citizens for the 1995–2010 periods.Methods and materials. Thyroid structural and functional status, as well as iodine deficiency, were evaluated in Novosibirsk population of adults and adolescents within the international projects MONIСA (1994–1995) and HAPIEE (2004–2005) and cross-sectional populational screening of random representative sample of school students. Results. In 1994–1995 iodine deficiency (mainly minor or moderate) was revealed at 83% of adult Novosibirsk citizens at age 25–34. Median urinary iodine concentration was 47 μg/l. In adolescent population subclinical hypothyreosis was initially revealed in 1,5%. Another 1,5% of adolescents had initially diagnosed subclinical hyperthyreosis. In 2005 median urinary iodine concentration in adult (45–69 years old) was 107 μg/l. Among all urine samples median urinary iodine concentration of more than 100 μg/l (100–360 μg/l) was revealed in 54%, 13% had median urinary iodine concentration less than 50 μg/l. During the period 2009–2010 median urinary iodine concentration in adolescents (14–17 years old) was 93 μg/l. Among all urine samples median urinary iodine concentration of more than 100 μg/l (100–360 μg/l) was revealed in 39%, 7% had median urinary iodine concentration less than 50 μg/l. According to the above mentioned results mass iodine deficiency preventive actions lead to the increase of urinary iodine concentration in Siberian. However to the moment iodine deficiency in Novosibirsk is still exists. Persistent community oriented measures are necessary for the prevention of iodine deficiency.

The experience of the central performance of lymphadenectomy (TSLA) with primary thyroid cancer in 224 patients. All patients were divided into groups based on preoperative and intraoperative diagnosis of thyroid cancer and the vol- ume of operational benefits. Taking into account the frequency of metastasis to lymph nodes VI level TSLA should be performed in all patients with primary thyroid cancer regardless of the incidence of the primary tumor

The first time the assessment of an iodine status of St. Petersburg was carried out in 1999 by the staff of faculty therapy of Saint-Petersburg State Medical University named after academician I.P Pavlov. The median urinary iodine concentration was 105 mkg/l. In 2010 the iodine status of St. Petersburg was carried out again: the median urinary iodine concentration was significantly higher – 148 mkg/l. In this regard it was reasonable to carry out comparison of indicators of a iodine status St. Petersburg and the features of a course of a Grave’s disease before the beginning of actions for elimination of iodine deficiency (till 1999) and during active of iodine prophylaxis. There were 310 patients with a Grave’s disease, they were diagnosed during the period from 1970 to 2010. From 1980 to 2010 the number of remissions of a disease gradually decreased: till 1990 the number of remissions was 21.7% whereas from2006 to 2011 the remissions were noted at 3.9% of patients with a diffuse toxic goiter. The group of patients with disease recurrence was separately analysed. Till 1990 among the patients with recurrence of a disease developed in 207.00 ± 35.18 months, in the group of the diseased in 1990–1995 – in 73.00 ± 13.95 months, in the group among the diseased in 1996–2000 – in 22.86 ± 3.46 months, in the group 2001–2005 – in 28.59 ± 5.19 month, and in 2006–2011 – in 7.75 ± 1.21 months.The carried-out research showed that for the last 20 years the essential change of character of a course of a Grave’s disease noted. It is possible to suppose that the revealed features, most likely are connected with the change of a iodine status of the region.