Mariotti S, Caturegli P, Barbesino G, Marinò M, Del Prete G F, Chiovato L, Tonacchera M, De Carli M, Pinchera A
Istituto di Endocrinologia, University of Pisa, Italy.
Clin Endocrinol (Oxf). 1992 Nov;37(5):415-22. doi: 10.1111/j.1365-2265.1992.tb02352.x.
The serum concentration of soluble interleukin-2 receptor (sIL-2R) is a marker of T-lymphocyte activation. Increased circulating sIL-2R has been reported in untreated Graves' disease. This finding has been interpreted as the consequence of the autoimmune activation, but recent data suggest that sIL-2R is directly correlated to thyroid state. The aim of this study was to elucidate the respective roles of autoimmunity and thyroid function in modulating serum sIL-2R.
sIL-2R was evaluated in 20 normal euthyroid subjects and in a large series of patients with autoimmune and non-autoimmune thyroid disorders in different functional state.
sIL-2R was assayed by a solid-phase monoclonal antibody assisted ELISA method.
Serum sIL-2R in normals was 461 +/- 186 U/ml (mean +/- SD). Increased sIL-2R was found in 61 hyperthyroid patients with Graves' disease (1610 +/- 962 U/ml, P < 0.0001) and in 23 with toxic adenoma (1121 +/- 598 U/ml, P < 0.0001). Restoration of euthyroidism lowered to normal sIL-2R in both groups. Serum sIL-2R was higher in euthyroid Graves' disease patients with active than in those with non-active ophthalmopathy. Decreased serum sIL-2R (228 +/- 93 U/ml, P < 0.0001) was found in 30 patients hypothyroid after total thyroidectomy. Highly variable circulating sIL-2R (range 100-1456 U/ml, mean +/- SD: 379 +/- 301 U/ml) was found in 49 patients with hypothyroid Hashimoto's thyroiditis (P = NS vs normals; P < 0.02 vs post-thyroidectomy hypothyroid patients). Treatment with L-thyroxine increased sIL-2R in all thyroidectomized and in the majority of Hashimoto's thyroiditis patients. In individual Hashimoto's thyroiditis patients (mostly with increased serum sIL-2R), L-thyroxine caused a decrease of circulating sIL-2R, sIL-2R was normal in 29 patients with euthyroid Hashimoto's thyroiditis. Both in Graves' disease and in Hashimoto's thyroiditis, no correlation was found between sIL-2R and anti-thyroglobulin, anti-thyroid peroxidase and anti-thyrotrophin-receptor autoantibodies. Highly significant positive correlation between serum thyroid hormones and sIL-2R was found in all study groups.
In thyroid disorders thyroid hormones are the main regulator of serum sIL-2R concentration. The contribution of autoimmune activation may be detected only in some patients with autoimmune hypothyroidism, while in Graves' disease the role of the immune system is masked by the hyperthyroid state.
血清可溶性白细胞介素-2受体（sIL-2R）浓度是T淋巴细胞活化的标志物。据报道，未经治疗的格雷夫斯病患者循环中的sIL-2R升高。这一发现被解释为自身免疫激活的结果，但最近的数据表明sIL-2R与甲状腺状态直接相关。本研究的目的是阐明自身免疫和甲状腺功能在调节血清sIL-2R中的各自作用。
对20名正常甲状腺功能正常的受试者以及大量处于不同功能状态的自身免疫性和非自身免疫性甲状腺疾病患者进行了sIL-2R评估。
采用固相单克隆抗体辅助ELISA法检测sIL-2R。
正常人群血清sIL-2R为461±186 U/ml（平均值±标准差）。61例格雷夫斯病甲亢患者（1610±962 U/ml，P<0.0001）和23例毒性腺瘤患者（1121±598 U/ml，P<0.0001）的sIL-2R升高。两组甲状腺功能恢复正常后，sIL-2R降至正常。有活动性眼病的格雷夫斯病甲状腺功能正常患者的血清sIL-2R高于无活动性眼病患者。30例全甲状腺切除术后甲状腺功能减退患者的血清sIL-2R降低（228±93 U/ml，P<0.0001）。49例桥本甲状腺炎甲状腺功能减退患者的循环sIL-2R高度可变（范围100 - 1456 U/ml，平均值±标准差：379±301 U/ml）（与正常人群相比P值无统计学意义；与甲状腺切除术后甲状腺功能减退患者相比P<0.02）。左甲状腺素治疗使所有甲状腺切除患者和大多数桥本甲状腺炎患者的sIL-2R升高。在个别桥本甲状腺炎患者（大多血清sIL-2R升高）中，左甲状腺素导致循环sIL-2R降低，29例桥本甲状腺炎甲状腺功能正常患者的sIL-2R正常。在格雷夫斯病和桥本甲状腺炎中，均未发现sIL-2R与抗甲状腺球蛋白、抗甲状腺过氧化物酶和抗促甲状腺素受体自身抗体之间存在相关性。在所有研究组中均发现血清甲状腺激素与sIL-2R之间存在高度显著的正相关。
在甲状腺疾病中，甲状腺激素是血清sIL-2R浓度的主要调节因子。自身免疫激活的作用可能仅在某些自身免疫性甲状腺功能减退患者中被检测到，而在格雷夫斯病中，免疫系统的作用被甲亢状态所掩盖。
