The Second Clinical Medical College of Fujian Medical University, Quanzhou, China.
Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Front Endocrinol (Lausanne). 2022 May 16;13:835880. doi: 10.3389/fendo.2022.835880. eCollection 2022.
The ongoing coronavirus disease 2019 (COVID-19) pandemic has forced the development of vaccines. Reports have suggested that vaccines play a role in inducing autoimmune diseases (AIDs). Scattered cases have reported that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines may promote thyroid disease, including Graves' disease (GD). However, the effect of inactivated SARS-CoV-2 vaccine on GD remains unclear. The aim of the present study was to investigate the response of thyrotropin receptor antibody (TRAB) to inactivated SARS-COV-2 vaccines.
We conducted a retrospective study to observe the differences in thyroid function and TRAB trends between pre-vaccination (n=412) and post-vaccination (n=231) groups at an interval of 2 months. We then retrospectively observed the differences in serum thyroid function and TRAB levels at 3 months before (n=280), 1 month before (n=294), 1 month after (n=306), and 3 months after (n=250) vaccination. Subsequently, 173 GD patients who were not vaccinated with inactivated SARS-COV-2 vaccines were selected for a prospective study. Thyroid function and TRAB assessment were performed before 3 and 1 months and 1 and 3 months after the first dose of vaccination and were then compared by repeated measures ANOVA to explore their dynamic changes.
A retrospective study preliminarily observed that the trend of TRAB post-vaccination was opposite of that pre-vaccination (p=0.000), serum TRAB levels decreased before vaccination and increased after vaccination. In this prospective study, repeated measures ANOVA indicated significant differences in serum FT3 (p=0.000), FT4 (p=0.000), TSH (p=0.000), and TRAB (p=0.000) levels at different time points before and after vaccination. Serum TRAB levels showed dynamic changes that decreased significantly at 1 month before vaccination (p=0.000), no significant differences at 1 month after vaccination (p=0.583), and reflected an upward trend at 3 months after vaccination (p=0.034). Serum FT3 and FT4 levels showed similar trends to serum TRAB levels before and after vaccination. Instead, the serum TSH levels showed a continuous upward trend over time.
Based on the results obtained in both retrospective and prospective studies, we concluded that serum TRAB levels decreased less after inactivated SARS-CoV-2 vaccination and showed an upward trend, which may be related to humoral immunity induced by vaccination.
正在进行的 2019 年冠状病毒病（COVID-19）大流行迫使疫苗的研发。有报道称，疫苗在诱发自身免疫性疾病（AIDs）方面发挥作用。有散发病例报告称，严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）疫苗可能会引发甲状腺疾病，包括格雷夫斯病（GD）。然而，灭活的 SARS-CoV-2 疫苗对 GD 的影响尚不清楚。本研究旨在探讨甲状腺刺激素受体抗体（TRAB）对灭活 SARS-COV-2 疫苗的反应。
我们进行了一项回顾性研究，以观察接种前（n=412）和接种后（n=231）2 个月间甲状腺功能和 TRAB 趋势的差异。然后，我们回顾性地观察了接种前 3 个月（n=280）、1 个月前（n=294）、1 个月后（n=306）和 3 个月后（n=250）血清甲状腺功能和 TRAB 水平的差异。随后，选择了 173 名未接种灭活 SARS-COV-2 疫苗的 GD 患者进行前瞻性研究。在接种疫苗前 3 个月和 1 个月、接种疫苗后 1 个月和 3 个月时进行甲状腺功能和 TRAB 评估，并通过重复测量方差分析进行比较，以探讨其动态变化。
回顾性研究初步观察到接种后 TRAB 的趋势与接种前相反（p=0.000），血清 TRAB 水平在接种前下降，接种后升高。在这项前瞻性研究中，重复测量方差分析表明，接种前后不同时间点的血清 FT3（p=0.000）、FT4（p=0.000）、TSH（p=0.000）和 TRAB（p=0.000）水平均有显著差异。血清 TRAB 水平呈动态变化，在接种前 1 个月显著下降（p=0.000），接种后 1 个月无显著差异（p=0.583），接种后 3 个月呈上升趋势（p=0.034）。血清 FT3 和 FT4 水平在接种前后呈现出与血清 TRAB 水平相似的趋势。相反，血清 TSH 水平呈持续上升趋势。
基于回顾性和前瞻性研究的结果，我们得出结论，灭活 SARS-CoV-2 疫苗接种后血清 TRAB 水平下降较少，并呈上升趋势，这可能与疫苗诱导的体液免疫有关。
