Iwatani Y, Amino N, Kaneda T, Ichihara K, Tamaki H, Tachi J, Matsuzuka F, Fukata S, Kuma K, Miyai K
Department of Laboratory Medicine, Osaka University Medical School, Japan.
Clin Exp Immunol. 1989 Nov;78(2):196-200.
We examined the proportions of B lymphocytes bearing CD5 cell surface antigen (CD5+ B cells), which are capable of making autoantibodies, in peripheral blood from patients with various thyroid diseases. The level of CD5+ B cells was markedly increased (>9.0%) above the normal range (0.5-7.7%) in untreated, hyperthyroid patients with Graves' disease, although about 10% of the patients had no detectable serum thyroid-stimulating hormone (TSH) receptor antibody (TRAb). However, the levels of CD5+ B cells were normal in untreated patients with destructive thyrotoxicosis due to aggravation of Hashimoto's thyroiditis or subacute thyroiditis. In patients with stimulated hyperthyroid Graves' disease the levels of CD5+ B cells were correlated with those of thyroid hormones and TRAb, all significantly increased. However, once hyperthyroidism was controlled by anti-thyroid drugs, CD5+ B cells were decreased, followed in turn by reduction of TRAb. We conclude that the proportion of CD5+ B cells is useful as a therapeutic index and for diagnosis of Graves' disease and its differentiation from destruction-induced thyrotoxicosis.
我们检测了各类甲状腺疾病患者外周血中携带CD5细胞表面抗原的B淋巴细胞（CD5⁺ B细胞）的比例，这类细胞能够产生自身抗体。在未经治疗的Graves病甲亢患者中，CD5⁺ B细胞水平显著升高（>9.0%），高于正常范围（0.5 - 7.7%），尽管约10%的患者血清中未检测到促甲状腺激素（TSH）受体抗体（TRAb）。然而，因桥本甲状腺炎或亚急性甲状腺炎加重导致的破坏性甲状腺毒症未经治疗的患者中，CD5⁺ B细胞水平正常。在经刺激的Graves病甲亢患者中，CD5⁺ B细胞水平与甲状腺激素及TRAb水平相关，三者均显著升高。然而，一旦甲亢通过抗甲状腺药物得到控制，CD5⁺ B细胞减少，随后TRAb也随之降低。我们得出结论，CD5⁺ B细胞比例可作为Graves病的治疗指标及诊断依据，也有助于其与破坏性甲状腺毒症的鉴别诊断。
