Minelli R, Girasole G, Pedrazzoni M, Giuliani N, Schianchi C, Giuberti T, Braverman L E, Salvi M, Roti E
Centro per lo Studio, Prevenzione, Diagnosi e Cura delle Tireopatie, Universitá degli Studi di Parma, Italy.
J Investig Med. 1996 Aug;44(6):370-4.
Serum interleukin-6 (IL-6) concentrations are frequently elevated in inflammatory thyroid diseases, such as subacute thyroiditis and amiodarone induced thyroiditis. We and others have recently observed that recombinant interferon-alpha (rIFN-alpha) therapy for chronic, active viral hepatitis and malignant disorders may induce thyroid dysfunction, including thyrotoxicosis secondary to thyroiditis. Serum IL-6 and its soluble receptor (sIL-6R) have been measured for the first time in patients with chronic active hepatitis receiving rIFN-alpha therapy.
Studies were carried out in 37 patients treated with rIFN-alpha for chronic, active viral hepatitis. Thyroid function tests and serum IL-6 and sIL-6R were measured before and during rIFN-alpha therapy.
Six patients developed inflammatory or destructive thyrotoxicosis confirmed by elevated serum free T4 or free T3 concentrations, suppressed serum thyroid-stimulating hormone (TSH) values, and a low thyroid radioactive iodine uptake. Serum IL-6 and sIL-6R concentrations were not elevated in these patients with rIFN-alpha-induced thyroiditis.
These results suggest that serum IL-6 concentrations are not useful in differentiating between inflammatory thyrotoxicosis and hyperthyroidism induced by rIFN-alpha therapy as is the case in amiodarone-induced thyrotoxicosis. It is possible that rIFN-alpha therapy could be associated with an inhibitory effect of rIFN-alpha on the release of IL-6 from damaged thyroid cells and not on the basal secretion of IL-6.
血清白细胞介素-6(IL-6)浓度在炎症性甲状腺疾病中经常升高,如亚急性甲状腺炎和胺碘酮所致甲状腺炎。我们和其他人最近观察到,重组干扰素-α(rIFN-α)治疗慢性活动性病毒性肝炎和恶性疾病可能会诱发甲状腺功能障碍,包括继发于甲状腺炎的甲状腺毒症。首次对接受rIFN-α治疗的慢性活动性肝炎患者的血清IL-6及其可溶性受体(sIL-6R)进行了检测。
对37例接受rIFN-α治疗慢性活动性病毒性肝炎的患者进行研究。在rIFN-α治疗前和治疗期间检测甲状腺功能、血清IL-6和sIL-6R。
6例患者出现炎症性或破坏性甲状腺毒症,血清游离T4或游离T3浓度升高、血清促甲状腺激素(TSH)值降低以及甲状腺放射性碘摄取率降低可证实。这些rIFN-α诱导的甲状腺炎患者的血清IL-6和sIL-6R浓度并未升高。
这些结果表明,血清IL-6浓度在区分炎症性甲状腺毒症和rIFN-α治疗所致甲状腺功能亢进方面并无作用,而在胺碘酮所致甲状腺毒症中情况则不同。rIFN-α治疗可能与rIFN-α对受损甲状腺细胞释放IL-6的抑制作用有关,而与IL-6的基础分泌无关。