Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
J Neuroinflammation. 2024 Feb 17;21(1):51. doi: 10.1186/s12974-024-03044-4.
Thyroid eye disease (TED) is highly correlated with dysregulated immunoendocrine status. The insular cortex was found to regulate peripheral inflammation and immunomodulation in mice. This study aimed to explore whether the insular cortex in patients with TED played a modulatory role including the aberrant brain functional alteration and its association with immunoendocrine status.
This study included 34 active patients (AP), 30 inactive patients (IP) with TED, and 45 healthy controls (HC) matched for age, sex, and educational level. Comprehensive clinical details (especially immunoendocrine markers) and resting-state functional magnetic resonance imaging data were collected from each participant. The amplitude of low-frequency fluctuation (ALFF) was used to probe the aberrant alterations of local neural activity. The seed-based functional connectivity (FC) analysis was used to explore the relationship between the insular cortex and each voxel throughout the whole brain. The correlation analysis was conducted to assess the association between insular neurobiomarkers and immunoendocrine parameters.
When compared with the IP and HC groups, the AP group displayed significantly higher ALFF values in the right insular cortex (INS.R) and lower FC values between the INS.R and the bilateral cerebellum. None of the neurobiomarkers differed between the IP and HC groups. Besides, correlations between insular neurobiomarkers and immunoendocrine markers (free thyroxine, the proportion of T cells, and natural killer cells) were identified in both AP and IP groups.
This study was novel in reporting that the dysregulation of the insular cortex activity in TED was associated with abnormal peripheral immunoendocrine status. The insular cortex might play a key role in central-peripheral system interaction in TED. Further research is crucial to enhance our understanding of the central-peripheral system interaction mechanisms involved in autoimmune diseases.
甲状腺眼病（TED）与失调的免疫内分泌状态高度相关。研究发现，岛叶皮层在调节小鼠外周炎症和免疫调节方面发挥作用。本研究旨在探讨 TED 患者的岛叶皮层是否发挥调节作用，包括异常的脑功能改变及其与免疫内分泌状态的关系。
本研究纳入了 34 例活动期 TED 患者（AP）、30 例静止期 TED 患者（IP）和 45 名年龄、性别和教育程度相匹配的健康对照者（HC）。对每位参与者进行全面的临床详细信息（特别是免疫内分泌标志物）和静息态功能磁共振成像数据采集。采用低频振幅（ALFF）探测局部神经活动的异常改变。采用基于种子的功能连接（FC）分析来探讨岛叶皮层与全脑各体素之间的关系。进行相关性分析，以评估岛叶神经生物标志物与免疫内分泌参数之间的相关性。
与 IP 组和 HC 组相比，AP 组右侧岛叶皮层（INS.R）的 ALFF 值显著升高，INS.R 与双侧小脑之间的 FC 值显著降低。IP 组与 HC 组之间的神经生物标志物无差异。此外，在 AP 组和 IP 组中均发现了岛叶神经生物标志物与免疫内分泌标志物（游离甲状腺素、T 细胞比例和自然杀伤细胞）之间的相关性。
本研究创新性地报道了 TED 中岛叶皮层活动的失调与外周异常免疫内分泌状态有关。岛叶皮层可能在 TED 中心-外周系统相互作用中发挥关键作用。进一步的研究对于增强我们对自身免疫性疾病中涉及的中枢-外周系统相互作用机制的理解至关重要。
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