Fomina D V, Dogadin S A, Savchenko A A, Gvozdev I I
Krasnoyarsk State Medical University.
Krasnoyarsk State Medical University; Krasnoyarsk regional clinical hospital.
Probl Endokrinol (Mosk). 2025 May 20;71(2):14-21. doi: 10.14341/probl13444.
Autoimmune diseases such as Graves' disease are complex pathologies that often require intensive and long-term treatment. However, the mechanisms contributing to the development and maintenance of this pathology are still not fully understood. Understanding the role of the innate immune response, especially in the context of monocytes, in the development of Graves' disease remains a poorly understood aspect.
To study the level of ROS production in monocytes in patients with Graves' disease after RAI to identify the level of activation of the macrophage-monocyte system.
The hormonal status and monocyte activity were analyzed before and 1, 3 and 6 months after RAI. The level of ROS was determined using spontaneous and luminol- and luceginin-derived chemiluminescence.
The study included 48 patients with Graves' disease, aged from 18 to 65 years. In patients with Graves' disease, a decrease in the intensity of free radical processes in monocytes was detected compared to the control group. These changes were observed both before and after RAI. It has been shown that changes in ROS production are independent of thyroid function and antibody levels. The changes indicate the potential immunosuppressive effects of radionuclide treatment and its effect on monocyte NADPH oxidase activity. A decrease in the production of secondary ROS in monocytes was also noted, which may indicate a decrease in the activation of monocytes during antigenic stimulation and inhibition of autoimmune processes.
Reduced metabolic activity of monocytes and low levels of ROS synthesis correlate with inhibition of the autoimmune process and decreased activation of the macrophage-monocyte system. The study confirms the importance of the role of monocytes in the ROS production system and their influence on the autoimmune process in Graves' disease. These results may have clinical significance and contribute to the development of new immunotropic strategies for the treatment of this disease.
格雷夫斯病等自身免疫性疾病是复杂的病理状况，通常需要强化和长期治疗。然而，导致这种病理状况发生和维持的机制仍未完全明确。了解固有免疫反应的作用，尤其是在单核细胞背景下，在格雷夫斯病的发生发展中仍未得到充分认识。
研究放射性碘（RAI）治疗后格雷夫斯病患者单核细胞中活性氧（ROS）的产生水平，以确定巨噬细胞 - 单核细胞系统的激活水平。
在RAI治疗前以及治疗后1、3和6个月分析激素状态和单核细胞活性。使用自发以及鲁米诺和光泽精衍生的化学发光法测定ROS水平。
该研究纳入了48例年龄在18至65岁之间的格雷夫斯病患者。与对照组相比，格雷夫斯病患者单核细胞中自由基过程的强度降低。这些变化在RAI治疗前后均有观察到。已表明ROS产生的变化与甲状腺功能和抗体水平无关。这些变化表明放射性核素治疗具有潜在的免疫抑制作用及其对单核细胞烟酰胺腺嘌呤二核苷酸磷酸（NADPH）氧化酶活性的影响。还注意到单核细胞中次级ROS的产生减少，这可能表明在抗原刺激期间单核细胞的激活减少以及自身免疫过程受到抑制。
单核细胞代谢活性降低和ROS合成水平低与自身免疫过程的抑制以及巨噬细胞 - 单核细胞系统激活减少相关。该研究证实了单核细胞在ROS产生系统中的作用及其对格雷夫斯病自身免疫过程的影响的重要性。这些结果可能具有临床意义，并有助于开发治疗该疾病的新免疫调节策略。
