Mariotti S, del Prete G F, Maggi E, Pisani S, Russova A, Almerigogna F, Pinchera A, Romagnani S, Ricci M
J Clin Endocrinol Metab. 1984 Jan;58(1):18-24. doi: 10.1210/jcem-58-1-18.
The in vitro synthesis of antithyroglobulin (anti-Tg) and antithyroid microsomal (anti-M) autoantibodies by peripheral blood mononuclear cells (MNC) from patients with autoimmune thyroid diseases was investigated using sensitive immunoradiometric assays. Cultures were carried out in the presence or in the absence of pokeweed mitogen (PWM). Thyroid autoantibodies were undetectable in supernatants of MNC cultures from 9 normal subjects. Supernatants of MNC cultured without PWM had detectable levels of anti-Tg and anti-M in 5 (19.3%) and in 2 (7.7%) of 26 patients with autoimmune thyroid diseases, respectively. In the presence of PWM, a marked increment in the antibody concentrations occurred in all but 1 of these cultures, and the number of positive cultures increased to 13 (50.1%) for anti-Tg and to 15 (57.7%) for anti-M. Studies of MNC fractions depleted of T lymphocytes (non-T cells) were carried out on selected patients showing antibody synthesis only after PWM stimulation. Autoantibody production was not found with non-T cells, but the effect of the mitogen was restored by readdition of T cells. Irradiation (1000 rad) of T cells before coculturing significantly enhanced autoantibody production. With this model no significant functional difference was found between autologous and allogenic T cells from thyroid autoimmune disease patients or from normal subjects. The cells involved in PWM-driven thyroid autoantibody synthesis, as defined by depletion studies, were lymphocytes bearing DR antigens and surface immunoglobulin G (IgG) without detectable surface immunoglobulin M (IgM). Depletion from MNC suspensions of Tg-binding cells abolished PWM-stimulated anti-Tg production, but did not alter the synthesis of anti-M. Further studies were carried out on MNC from a single patient with Hashimoto's thyroiditis, whose non-T cells consistently produced large amounts of anti-M and total IgG in the absence of PWM. The addition of PWM to these unfractionated MNC slightly increased the production of anti-M, but inhibited antibody synthesis after depletion of T lymphocytes. Interestingly, the addition of autologous T lymphocytes to non-T cells inhibited the spontaneous synthesis of anti-M. These data indicate that in vitro synthesis of anti-Tg and anti-M by MNC may be frequently induced by stimulation with PWM in patients with thyroid autoimmune disorders. PWM-stimulated synthesis of thyroid autoantibodies appears to be T-cell dependent and modulated by radiosensitive T lymphocytes. The cells responsible for PWM-dependent thyroid autoantibody synthesis are B lymphocytes with surface membrane IgG and have receptors specific for the autoantigen.(ABSTRACT TRUNCATED AT 400 WORDS)
采用灵敏的免疫放射分析方法,研究了自身免疫性甲状腺疾病患者外周血单个核细胞(MNC)体外合成抗甲状腺球蛋白(抗-Tg)和抗甲状腺微粒体(抗-M)自身抗体的情况。培养在有或无商陆有丝分裂原(PWM)存在的条件下进行。9名正常受试者的MNC培养上清液中未检测到甲状腺自身抗体。在26例自身免疫性甲状腺疾病患者中,未添加PWM培养的MNC上清液中,分别有5例(19.3%)和2例(7.7%)检测到抗-Tg和抗-M。在PWM存在的情况下,除1例培养物外,所有培养物中的抗体浓度均显著增加,抗-Tg阳性培养物数量增至13例(50.1%),抗-M阳性培养物数量增至15例(57.7%)。对仅在PWM刺激后才显示抗体合成的部分患者进行了去除T淋巴细胞(非T细胞)的MNC组分研究。未发现非T细胞产生自身抗体,但重新加入T细胞后,有丝分裂原的作用得以恢复。共培养前对T细胞进行照射(1000拉德)可显著增强自身抗体的产生。利用该模型,未发现甲状腺自身免疫疾病患者或正常受试者的自体T细胞和异体T细胞之间存在明显的功能差异。根据去除研究确定,参与PWM驱动的甲状腺自身抗体合成的细胞是带有DR抗原和表面免疫球蛋白G(IgG)而未检测到表面免疫球蛋白M(IgM)的淋巴细胞。从MNC悬液中去除Tg结合细胞可消除PWM刺激的抗-Tg产生,但不改变抗-M的合成。对1例桥本甲状腺炎患者的MNC进行了进一步研究,该患者的非T细胞在无PWM的情况下持续产生大量抗-M和总IgG。向这些未分级的MNC中添加PWM可略微增加抗-M的产生,但在去除T淋巴细胞后抑制抗体合成。有趣的是,向非T细胞中添加自体T淋巴细胞可抑制抗-M的自发合成。这些数据表明,甲状腺自身免疫性疾病患者的MNC体外合成抗-Tg和抗-M可能经常由PWM刺激诱导。PWM刺激的甲状腺自身抗体合成似乎依赖于T细胞,并受放射敏感的T淋巴细胞调节。负责PWM依赖性甲状腺自身抗体合成的细胞是具有表面膜IgG且对自身抗原有特异性受体的B淋巴细胞。(摘要截短至400字)