Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
The University of Oslo, Faculty of Medicine, Oslo, Norway.
Front Endocrinol (Lausanne). 2022 Jul 14;13:938633. doi: 10.3389/fendo.2022.938633. eCollection 2022.
Evidence points to viral infections as possible triggers of autoimmune thyroid disease (AITD), but little is known about the prevalence of common viruses in the thyroid gland. Using a novel approach based on virus enrichment in multiple cell lines followed by detection of the viral genome and visualization of viral proteins, we investigated the presence of multiple human viruses in thyroid tissue from AITD patients and controls.
Thyroid tissue was collected by core needle biopsy or during thyroid surgery from 35 patients with AITD (20 Graves' disease and 15 Hashimoto's thyroiditis). Eighteen thyroid tissue specimens from patients undergoing neck surgery for reasons other than thyroid autoimmunity served as controls. Specimens were tested for the presence of ten different viruses. Enteroviruses and human herpesvirus 6 were enriched in cell culture before detection by PCR and immunofluorescence, while the remaining viruses were detected by PCR of biopsied tissue.
Forty of 53 cases (75%) carried an infectious virus. Notably, 43% of all cases had a single virus, whereas 32% were coinfected by two or more virus types. An enterovirus was found in 27/53 cases (51%), human herpesvirus 6 in 16/53 cases (30%) and parvovirus B19 in 12/53 cases (22%). Epstein-Barr virus and cytomegalovirus were found in a few cases only. Of five gastroenteric virus groups examined, only one was detected in a single specimen. Virus distribution was not statistically different between AITD cases and controls.
Common human viruses are highly prevalent in the thyroid gland. This is the first study in which multiple viral agents have been explored in thyroid. It remains to be established whether the detected viruses represent causal agents, possible cofactors or simple bystanders.
有证据表明病毒感染可能是自身免疫性甲状腺疾病(AITD)的触发因素,但人们对甲状腺中常见病毒的流行情况知之甚少。本研究采用一种新方法,即在多种细胞系中富集病毒,然后检测病毒基因组并可视化病毒蛋白,以调查 AITD 患者和对照者甲状腺组织中多种人类病毒的存在情况。
通过细针穿刺活检或甲状腺手术,从 35 例 AITD 患者(20 例格雷夫斯病和 15 例桥本甲状腺炎)中采集甲状腺组织。18 例因甲状腺自身免疫以外的原因行颈部手术的患者甲状腺组织标本作为对照。对 10 种不同病毒进行检测。在聚合酶链反应(PCR)和免疫荧光检测之前,在细胞培养中富集肠道病毒和人类疱疹病毒 6,而其余病毒则通过活检组织的 PCR 检测。
53 例中有 40 例(75%)携带感染性病毒。值得注意的是,所有病例中有 43%为单一病毒感染,32%为两种或两种以上病毒混合感染。27 例(51%)发现肠道病毒,16 例(30%)发现人类疱疹病毒 6,12 例(22%)发现微小病毒 B19。仅在少数病例中发现 Epstein-Barr 病毒和巨细胞病毒。在所检查的 5 个肠道病毒组中,仅在单个标本中检测到 1 个。AITD 病例和对照者之间的病毒分布无统计学差异。
常见的人类病毒在甲状腺中高度流行。这是首次在甲状腺中探索多种病毒的研究。仍需确定所检测到的病毒是否代表致病因子、可能的协同因子或单纯的旁观者。