Department of Internal Medicine, Division of Endocrinology and Metabolism, University of Health Sciences, Konya, Turkey.
Department of Biochemistry, Konya State Hospital, Konya, Turkey.
Medicine (Baltimore). 2024 Oct 25;103(43):e40321. doi: 10.1097/MD.0000000000040321.
Hashimoto thyroiditis (HT) is chronic lymphocytic thyroiditis. Cytokines and chemokines such as tumor necrosis factor-alpha, interferon-gamma, and interleukin-1 beta originating from immune cells are involved in the etiopathogenesis of HT. Spexin (SPX) is a recently identified novel peptide hormone consisting of 14 amino acids and has been demonstrated in follicle epithelial cells in thyroid tissue. SPX has been shown to affect the inflammatory response and play a role in its regulation in various diseases. There is a need for markers for diagnosis and treatment of HT patients with negative antibody levels. We found that there is no study in the literature that investigates the HT and the role of spexin in this inflammatory process. Forty-five patients aged 18 to 70 years with HT or newly diagnosed HT and 42 healthy subjects as the control group were included in the study. Patients in the HT group were divided into 3 categories according to ultrasound findings. Mild heterogeneity was called grade 1 (G1), moderate heterogeneity was called grade 2 (G2), and high heterogeneity was called grade 3 (G3). Laboratory parameters and anthropometric measurements of all patients participating in the study were performed, and SPX was measured by the ELISA method. There was no significant difference between the HT and control groups in terms of SPX levels (P = .27). In HT subgroup analysis, SPX levels were found to be borderline statistically significantly higher in the G2 group, where antibody levels were higher compared to other groups (P = .061). In our study, we evaluated SPX levels in HT patients, which has never been done before in the literature. We found high SPX levels in HT patients with high antibody levels. Multicenter studies with high case series, especially at the tissue level, are needed to fully explain the role of SPX in HT immunoetiopathogenesis and to understand immune-checkpoint pathways more clearly.
桥本甲状腺炎（HT）是一种慢性淋巴细胞性甲状腺炎。免疫细胞产生的细胞因子和趋化因子，如肿瘤坏死因子-α、干扰素-γ和白细胞介素-1β，参与了 HT 的病因发病机制。Spexin（SPX）是一种新发现的由 14 个氨基酸组成的新型肽类激素，已在甲状腺组织的滤泡上皮细胞中得到证实。SPX 已被证明可影响炎症反应，并在各种疾病的调节中发挥作用。需要寻找针对抗体阴性 HT 患者的诊断和治疗标志物。我们发现，目前文献中尚无研究探讨 HT 及 spexin 在这一炎症过程中的作用。本研究纳入了 45 例年龄在 18 至 70 岁之间的 HT 患者或新诊断为 HT 的患者，以及 42 名健康对照者。根据超声检查结果，将 HT 组患者分为 3 类。轻度异质性称为 1 级（G1），中度异质性称为 2 级（G2），高度异质性称为 3 级（G3）。对所有参与研究的患者进行实验室参数和人体测量学测量，并采用 ELISA 法测量 SPX 水平。HT 组和对照组之间的 SPX 水平无显著差异（P=0.27）。在 HT 亚组分析中，与其他组相比，抗体水平较高的 G2 组 SPX 水平有统计学意义上的升高趋势（P=0.061）。在本研究中，我们评估了 HT 患者的 SPX 水平，这在文献中尚属首次。我们发现，抗体水平较高的 HT 患者的 SPX 水平较高。需要进行多中心、大样本病例系列研究，尤其是在组织水平上，以充分阐明 SPX 在 HT 免疫发病机制中的作用，并更清楚地了解免疫检查点途径。
