Potlukova E, Jiskra J, Limanova Z, Kralikova P, Smutek D, Mareckova H, Antosova M, Trendelenburg M
3rd Clinic of Medicine, General Teaching Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
Clin Exp Immunol. 2008 Jul;153(1):96-101. doi: 10.1111/j.1365-2249.2008.03670.x. Epub 2008 May 23.
Autoantibodies against complement C1q (anti-C1q) have been well described in patients with systemic lupus erythematosus, where they correlate with the occurrence of severe lupus nephritis. However, data on anti-C1q in organ-specific autoimmune diseases are scarce. In order to determine the prevalence of anti-C1q in patients with autoimmune thyroid disorders (AITD) and a possible association with thyroid function, we measured prospectively anti-C1q in 23 patients with Graves' disease (GD) and 52 patients with Hashimoto's thyroiditis (HT). Anti-C1q levels were correlated with parameters of thyroid function and autoantibodies against thyroperoxidase, thyroglobulin and thyroid stimulating hormone (TSH) receptor. Twenty-one patients with multi-nodular goitre and 72 normal blood donors served as controls. We found elevated concentrations of anti-C1q more frequently in patients with AITD than in controls: seven of 23 (30%) patients with GD and 11 of 52 (21%) patients with HT, compared with one of 21 (5%) patients with multi-nodular goitre and six of 72 (8%) normal controls. Anti-C1q levels did not correlate with thyroid autoantibodies. However, in GD absolute levels of anti-C1q correlated negatively with TSH and positively with free thyroxine (FT4) and triiodothyronine (FT3). In contrast, in HT, anti-C1q correlated positively with TSH levels. No correlation between TSH and thyroid autoantibodies was found. In conclusion, we found an increased prevalence of anti-C1q in patients with AITD and their levels correlated with the thyroid function in both GD and HT. This correlation seems to be independent of thyroid autoantibodies. Therefore, anti-C1q might point to a pathogenic mechanism involved in the development of AITD that is independent of classical thyroid autoantibodies.
针对补体C1q的自身抗体（抗C1q）在系统性红斑狼疮患者中已有充分描述，它们与严重狼疮性肾炎的发生相关。然而，关于器官特异性自身免疫性疾病中抗C1q的数据却很稀少。为了确定自身免疫性甲状腺疾病（AITD）患者中抗C1q的患病率以及与甲状腺功能的可能关联，我们前瞻性地检测了23例格雷夫斯病（GD）患者和52例桥本甲状腺炎（HT）患者的抗C1q水平。抗C1q水平与甲状腺功能参数以及抗甲状腺过氧化物酶、甲状腺球蛋白和促甲状腺激素（TSH）受体的自身抗体相关。21例多结节性甲状腺肿患者和72名正常献血者作为对照。我们发现，AITD患者中抗C1q浓度升高的情况比对照组更常见：23例GD患者中有7例（30%），52例HT患者中有11例（21%），相比之下，21例多结节性甲状腺肿患者中有1例（5%），72名正常对照中有6例（8%）。抗C1q水平与甲状腺自身抗体无关。然而，在GD中，抗C1q的绝对水平与TSH呈负相关，与游离甲状腺素（FT4）和三碘甲状腺原氨酸（FT3）呈正相关。相反，在HT中，抗C1q与TSH水平呈正相关。未发现TSH与甲状腺自身抗体之间存在相关性。总之，我们发现AITD患者中抗C1q的患病率增加，其水平在GD和HT中均与甲状腺功能相关。这种相关性似乎独立于甲状腺自身抗体。因此，抗C1q可能指向AITD发生过程中涉及的一种致病机制，该机制独立于经典的甲状腺自身抗体。
