Klatka Maria, Grywalska Ewelina, Partyka Malgorzata, Charytanowicz Malgorzata, Kiszczak-Bochynska Ewa, Rolinski Jacek
Department of Pediatric Endocrinology and Diabetology, Medical University of Lublin , Lublin , Poland .
Autoimmunity. 2014 May;47(3):201-11. doi: 10.3109/08916934.2013.879862. Epub 2014 Jan 20.
The role of T helper 17 (Th17) and T regulatory cells (Treg) in the pathogenesis of Graves' disease (GD) remains uncertain. The influence of methimazole (MMI) on the human immune system is still poorly understood. The aim of the present research was to assess changes in the frequencies of peripheral blood Th17 and Treg cells during GD treatment in the group of teenagers. The frequencies of Th17 and Treg were measured by flow cytometry in 60 adolescents at the time of GD diagnosis and after achieving MMI-induced euthyreosis. The control group consisted of 20 healthy volunteers. Lower percentages and absolute counts of Treg cells were found in the study group before the treatment in comparison with healthy controls (p = 0.032 and p = 0.006, respectively). Treatment with MMI caused an increase in the percentages and absolute counts of Treg lymphocytes (p = 0.037 and p = 0.007). After the treatment, no clinically significant differences in Treg cells between GD patients and controls were found. Higher absolute counts of Th17 lymphocytes were found in hyperthyroid adolescents before the treatment initiation and after achieving euthyreosis than in healthy individuals (p = 0.0001 and p = 0.047). Treatment with MMI caused a significant decrease in the percentages and absolute counts of Th17 lymphocytes (p = 0.047 and p = 0.043). The present study demonstrates that both Th17 and Treg cells might play a role in the pathogenesis of GD. Increased percentage of Treg after MMI therapy seems a predictor of response to anti-hypertensive treatment as it is associated with the normalization of thyroid hormone levels.
辅助性T细胞17（Th17）和调节性T细胞（Treg）在格雷夫斯病（GD）发病机制中的作用仍不明确。甲巯咪唑（MMI）对人体免疫系统的影响仍知之甚少。本研究的目的是评估青少年GD患者治疗期间外周血Th17和Treg细胞频率的变化。通过流式细胞术检测了60名青少年GD患者诊断时及MMI诱导甲状腺功能正常后Th17和Treg的频率。对照组由20名健康志愿者组成。与健康对照组相比，研究组治疗前Treg细胞的百分比和绝对计数较低（分别为p = 0.032和p = 0.006）。MMI治疗导致Treg淋巴细胞的百分比和绝对计数增加（p = 0.037和p = 0.007）。治疗后，GD患者和对照组之间的Treg细胞无临床显著差异。与健康个体相比，甲状腺功能亢进青少年在治疗开始前和甲状腺功能正常后Th17淋巴细胞的绝对计数更高（p = 0.0001和p = 0.047）。MMI治疗导致Th17淋巴细胞的百分比和绝对计数显著降低（p = 0.047和p = 0.043）。本研究表明，Th17和Treg细胞可能在GD的发病机制中起作用。MMI治疗后Treg百分比增加似乎是抗高血压治疗反应的一个预测指标，因为它与甲状腺激素水平的正常化有关。
