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甲状腺功能亢进症患者体内循环中的选择素、细胞间黏附分子-1和血管细胞黏附分子-1

Circulating selectins, intercellular adhesion molecule-1, and vascular cell adhesion molecule-1 in hyperthyroidism.

作者信息

Wenisch C, Myskiw D, Gessl A, Graninger W

机构信息

Department of Infectious Diseases, University of Vienna, Austria.

出版信息

J Clin Endocrinol Metab. 1995 Jul;80(7):2122-6. doi: 10.1210/jcem.80.7.7541802.

Abstract

Serum concentrations of soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble E-selectin (sE-selectin), soluble P-selectin, and soluble L-selectin (sL-selectin), tumor necrosis factor-alpha, and interleukin-6 were measured in patients with Graves' disease (GD) (n = 33), in patients with toxic nodular goiter (n = 34), and in a group of healthy controls (n = 36). The serum levels of sICAM-1, sVCAM-1, sE-selectin, and sL-selectin were markedly elevated in patients with GD and in patients with toxic nodular goiter before treatment with methimazole (P < 0.05 for all). After 8 weeks of therapy, serum concentrations of sVCAM-1 and sE-selectin normalized, whereas serum levels of sL-selectin and sICAM-1 remained elevated. Hormone concentrations normalized after 2 weeks, clearly preceding falling levels of circulating adhesion molecules. Serum concentrations of soluble P-selectin, TNF-alpha, and interleukin-6 did not differ among patients with GD and toxic nodular goiter and healthy subjects. Serum levels of sVCAM-1 and sICAM-1 correlated with the serum concentrations of TSH receptor antibodies (n = 33; r = 0.921 and r = 0.792, respectively) and thyroid peroxidase antibodies (n = 33; r = 0.682 and r = 0.761, respectively) but not thyroglobulin antibodies. However, no correlation between serum levels of sE-selectin, sL-selectin, and soluble P-selectin or cytokines and serum levels of thyroid peroxidase antibodies, TSH receptor antibodies, or thyroglobulin antibodies, respectively, was found. In addition, no correlation between serum levels of adhesion molecules or cytokines and thyroid hormones was seen. We conclude that both the action of thyroid hormones and the autoimmune process in GD may contribute to elevated levels of soluble adhesion molecules.

摘要

对33例格雷夫斯病(GD)患者、34例毒性结节性甲状腺肿患者和36例健康对照者测定了血清可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞黏附分子-1(sVCAM-1)、可溶性E-选择素(sE-选择素)、可溶性P-选择素和可溶性L-选择素(sL-选择素)、肿瘤坏死因子-α及白细胞介素-6的浓度。GD患者和毒性结节性甲状腺肿患者在接受甲巯咪唑治疗前,血清sICAM-1、sVCAM-1、sE-选择素和sL-选择素水平均显著升高(所有P均<0.05)。治疗8周后,血清sVCAM-1和sE-选择素浓度恢复正常,而血清sL-选择素和sICAM-1水平仍升高。激素浓度在2周后恢复正常,明显早于循环黏附分子水平下降。GD患者、毒性结节性甲状腺肿患者和健康受试者的血清可溶性P-选择素、TNF-α及白细胞介素-6浓度无差异。血清sVCAM-1和sICAM-1水平分别与促甲状腺素受体抗体(n = 33;r = 0.921和r = 0.792)及甲状腺过氧化物酶抗体(n = 33;r = 0.682和r = 0.761)的血清浓度相关,但与甲状腺球蛋白抗体无关。然而,未发现血清sE-选择素、sL-选择素、可溶性P-选择素或细胞因子水平分别与甲状腺过氧化物酶抗体、促甲状腺素受体抗体或甲状腺球蛋白抗体水平之间存在相关性。此外,未观察到黏附分子或细胞因子血清水平与甲状腺激素之间存在相关性。我们得出结论,GD中甲状腺激素的作用和自身免疫过程可能都导致可溶性黏附分子水平升高。

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