Gisslinger H, Gilly B, Woloszczuk W, Mayr W R, Havelec L, Linkesch W, Weissel M
Department of Medicine II, University of Vienna, Austria.
Clin Exp Immunol. 1992 Dec;90(3):363-7. doi: 10.1111/j.1365-2249.1992.tb05852.x.
Forty-five patients with myeloproliferative or myelodysplastic syndromes, treated with recombinant interferon-alpha (rIFN-alpha) for a minimum of 1 up to 4 years, were examined for the occurrence of thyroid autoimmunity. During treatment, the rate of thyroid autoimmunity rose to more than 20%. The decrease in severity and frequency of thyroid autoimmunity after withdrawal of IFN shows that this is a potentially reversible side effect. The key determinant for the manifestation of this IFN-related autoimmune phenomenon seems to be a predisposition for autoimmunity, since patients with initially detectable thyroid antibodies are prone to exacerbations of thyroid autoimmunity. Concurrent with thyroid autoimmunity, hypothyroidism occurred but did not correlate with the levels of thyroid antibodies, although severe hypothyroidism in two patients was accompanied by increased levels of thyroid antibodies. This investigation shows that thyroid autoimmunity and consecutively hypothyroidism must be expected in certain patients treated with rIFN-alpha during long periods. Furthermore, it may be assumed that IFN-alpha does not induce the development of autoimmunity, but rather enhances the levels of pre-existent thyroid antibodies.
对45例接受重组α干扰素（rIFN-α）治疗至少1年至4年的骨髓增殖性或骨髓增生异常综合征患者进行了甲状腺自身免疫情况检查。治疗期间，甲状腺自身免疫发生率升至20%以上。停用干扰素后甲状腺自身免疫严重程度和发生率降低，表明这是一种潜在可逆的副作用。这种与干扰素相关的自身免疫现象表现的关键决定因素似乎是自身免疫易感性，因为最初可检测到甲状腺抗体的患者容易出现甲状腺自身免疫加重。与甲状腺自身免疫同时发生的是甲状腺功能减退，但与甲状腺抗体水平无关，尽管两名患者的严重甲状腺功能减退伴有甲状腺抗体水平升高。这项研究表明，长期接受rIFN-α治疗的某些患者一定会出现甲状腺自身免疫及随之而来的甲状腺功能减退。此外，可以推测α干扰素不会诱导自身免疫的发生，而是会提高已存在的甲状腺抗体水平。
