Department of Endocrinology, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University Medical School, 197 Ruijin 2nd Road, Shanghai, 200025, People's Republic of China.
Department of Endocrinology, Suzhou Municipal Hospital, Nanjing Medical University, 26 Daoqian Road, Suzhou, 215002, People's Republic of China.
Sci Rep. 2021 Jun 29;11(1):13443. doi: 10.1038/s41598-021-92737-4.
Monocytes are important mediators of immune system and are reported to be altered in autoimmune disorders. Little is known about the pathological role of monocytes in Graves' disease (GD). Thus, we investigated monocytes in periphery and thyroid tissue in GD. Untreated GD patients were enrolled and followed up until remission. Monocytes were significantly increased and positively correlated with anti-thyrotropin receptor antibody (TRAb) in untreated GD (r = 0.269, P < 0.001; r = 0.338, P < 0.001). Flow cytometry showed CD14++ CD16+ monocytes were increased and CD14++ CD16- monocytes were decreased in untreated GD (both P < 0.001). Skewed monocyte subsets were recovered in GD with remission. Serum B cell-activating factor (BAFF) was positively correlated with TRAb (r = 0.384 and P = 0.001). CD14++ CD16+ monocytes expressed higher level of BAFF in untreated GD (P < 0.05). The frequency of CD14+ monocytes and CD14+ CD16+ monocytes were significantly higher in GD thyroid tissue than in normal thyroid tissue (both P < 0.001). Our study suggested CD14++ CD16+ monocytes were significantly expanded and involved in the production of TRAb via secreting a higher level of BAFF in periphery. Besides, monocytes infiltrated into thyroid tissue and thus could serve as an important participant in GD pathogenesis.
单核细胞是免疫系统的重要介质，据报道其在自身免疫性疾病中发生改变。关于单核细胞在格雷夫斯病（GD）中的病理作用知之甚少。因此，我们研究了 GD 患者外周血和甲状腺组织中的单核细胞。纳入未经治疗的 GD 患者，并进行随访直至缓解。未治疗的 GD 患者单核细胞显著增加，并与促甲状腺素受体抗体（TRAb）呈正相关（r=0.269，P<0.001；r=0.338，P<0.001）。流式细胞术显示未治疗的 GD 患者中 CD14++CD16+单核细胞增加，CD14++CD16-单核细胞减少（均 P<0.001）。缓解后的 GD 患者恢复了单核细胞亚群的偏斜。血清 B 细胞激活因子（BAFF）与 TRAb 呈正相关（r=0.384，P=0.001）。未治疗的 GD 中 CD14++CD16+单核细胞表达更高水平的 BAFF（P<0.05）。GD 甲状腺组织中 CD14+单核细胞和 CD14+CD16+单核细胞的频率明显高于正常甲状腺组织（均 P<0.001）。我们的研究表明，外周血中 CD14++CD16+单核细胞显著扩增，并通过分泌更高水平的 BAFF 参与 TRAb 的产生。此外，单核细胞浸润到甲状腺组织中，因此可以作为 GD 发病机制中的一个重要参与者。
