Kabel P J, Voorbij H A, de Haan-Meulman M, Pals S T, Drexhage H A
Department of Pathology, Free University Hospital, Amsterdam, The Netherlands.
J Clin Endocrinol Metab. 1989 Apr;68(4):744-51. doi: 10.1210/jcem-68-4-744.
High endothelial venules (HEVs) derive their name from the cuboidal high walled shape of the endothelial cells and are found in T-cell areas of a wide variety of lymphoid tissues. The function of HEVs is to attract lymphocytes to lymphoid tissues, and they are thus of importance in lymphocyte recirculation. We investigated the immunohistochemical presence and localization of HEVs in thyroid tissue obtained at surgery from 13 patients with Graves' disease and 3 patients with Hashimoto's disease using the monoclonal antibody HECA 452, which reacts with an epitope on human HEVs. HEVs were found in large confined lymphocytic accumulations in 7 of the 13 Graves' disease glands and all of the Hashimoto's disease glands. These lymphocytic accumulations showed a high grade of architecture and were composed of a central B-cell follicle and a T-cell area in which the HEVs were present. The HEV-containing T-cell area formed a corona around the B-cell follicle. Plasma cells were found at the periphery of the intrathyroidally developed lymphoid tissue. In BB rats, an animal model for spontaneous autoimmune thyroid disease, the development of such HEVs containing intrathyroidal lymphoid tissue was a rather late phenomenon in the autoimmune process occurring after the appearance of anticolloid antibodies in the circulation and after initial immune activity of the thyroid draining lymph nodes. The actual development of the intrathyroidal lymphoid tissue was initiated by accumulation of lymphocytes around dendritic cells forming small cellular clusters. These small clusters later developed into larger formation in which HEVs were detectable. The adherence of B- and T-lymphocytes to human intrathyroidal HEVs was additionally studied using an in vitro adherence assay. B-Lymphocytes preferentially adhered to thyroidal HEVs. This adherence pattern is similar to that of HEVs in mucosa-associated lymphoid tissue (tonsils and Peyer's patches). We conclude that lymphoid tissue with a lymphocyte recirculation pattern similar to that of mucosa-associated lymphoid tissue can be found in thyroid glands involved in a process of autoimmune reactivity; the BB rat study suggests that the development of such tissue occurs during the chronic phases of the process.
高内皮微静脉（HEVs）因其内皮细胞呈立方形且壁高而得名，存在于多种淋巴组织的T细胞区域。HEVs的功能是将淋巴细胞吸引至淋巴组织，因此在淋巴细胞再循环中具有重要作用。我们使用与人类HEVs上一个表位发生反应的单克隆抗体HECA 452，研究了13例格雷夫斯病患者和3例桥本氏病患者手术切除的甲状腺组织中HEVs的免疫组化存在情况和定位。在13个格雷夫斯病腺体中的7个以及所有桥本氏病腺体中，在大量局限的淋巴细胞聚集处发现了HEVs。这些淋巴细胞聚集显示出高度的组织结构，由一个中央B细胞滤泡和一个存在HEVs的T细胞区域组成。含有HEV的T细胞区域在B细胞滤泡周围形成一个冠状结构。在甲状腺内发育的淋巴组织周边发现了浆细胞。在自身免疫性甲状腺疾病的动物模型BB大鼠中，这种含有HEVs的甲状腺内淋巴组织的发育是在循环中出现抗胶体抗体以及甲状腺引流淋巴结出现初始免疫活性之后发生的自身免疫过程中相当晚出现的现象。甲状腺内淋巴组织的实际发育是由淋巴细胞围绕形成小细胞簇的树突状细胞聚集开始的。这些小细胞簇后来发展成更大的结构，其中可检测到HEVs。此外，我们使用体外黏附试验研究了B淋巴细胞和T淋巴细胞对人甲状腺内HEVs的黏附情况。B淋巴细胞优先黏附于甲状腺HEVs。这种黏附模式与黏膜相关淋巴组织（扁桃体和派伊尔氏结）中的HEVs相似。我们得出结论，在参与自身免疫反应过程的甲状腺中可发现具有与黏膜相关淋巴组织相似的淋巴细胞再循环模式的淋巴组织；BB大鼠研究表明，这种组织的发育发生在该过程的慢性阶段。
