Ozata M, Bolu E, Sengül A, Altinsoy H I, Turan M, Corakci A, Hacibektasoglu A, Gundogan M A
Department of Endocrinology, Gülhane School of Medicine, Etlik-Ankara, Turkey.
Endocr J. 1996 Oct;43(5):517-25. doi: 10.1507/endocrj.43.517.
Increased circulating soluble ICAM-1 (sICAM-1) levels has been previously reported in Graves' disease (GD) patients with or without ophthalmopathy (GO) and in patients with toxic nodular goiter but not in patients with subacute thyroiditis. Conflicting results have also been reported about the usefulness of sICAM-1 levels as a marker for the activity of hyperthyroidism. We have therefore determined sICAM-1 levels by a sandwich enzyme linked immunosorbent assay (ELISA) method in 10 patients with subacute thyroiditis (Group 1), who are at the initial or acute phase of thyroiditis, in 10 hypothyroidic patients with Hashimoto's thyroiditis (Group 2), in 10 patients with euthyroid nodular goiter (Group 3), in 10 patients with untreated GD patients with active ophthalmopathy (Group 4), in 10 hyperthyroid GD patients without clinical ophthalmopathy (Group 5), in 10 patients with GO who are euthyroid and treated with glucocorticoids for 3 months (Group 6) and in 20 normal subjects (Control Group). Groups 1,2,4,5 and 6 (P < 0.00001 for Groups 1,4,5,6 and P < 0.05 for Group 2) but not Group 3 showed increased sICAM-1 levels compared with the control group. However Groups 4 and 6 (patient with GO) showed significantly higher sICAM-1 levels (P = 0.0003 for Group 4 and P = 0.00013 for Group 6) than Group 5. Furthermore Group 4 showed slightly but not significantly higher sICAM-1 levels than Group 6. Mean sICAM levels were significantly decreased 3 months after glucocorticoid treatment (Group 6), but had not returned to normal levels. Three patients did not respond to steroid therapy and their sICAM-1 levels were not decreased. We concluded that patients with GO with or without hyperthyroidism and patients with subacute thyroiditis have elevated sICAM-1 levels. Moreover, sICAM-1 levels reflect the degree of inflammatory activity in the thyroid gland or orbital tissue independent of the thyroidal status, since we found elevated levels in both hyperthyroidism and hypothyroidism.
先前的报道显示，无论有无眼病（GO）的格雷夫斯病（GD）患者以及毒性结节性甲状腺肿患者的循环可溶性细胞间黏附分子-1（sICAM-1）水平均升高，而亚急性甲状腺炎患者的该水平未升高。关于sICAM-1水平作为甲状腺功能亢进活动标志物的有用性，也有相互矛盾的报道。因此，我们采用夹心酶联免疫吸附测定（ELISA）方法测定了10例处于甲状腺炎初始或急性期的亚急性甲状腺炎患者（第1组）、10例桥本甲状腺炎所致甲状腺功能减退患者（第2组）、10例甲状腺功能正常的结节性甲状腺肿患者（第3组）、10例未治疗且患有活动性眼病的GD患者（第4组）、10例无临床眼病的甲状腺功能亢进GD患者（第5组）、10例甲状腺功能正常且接受糖皮质激素治疗3个月的GO患者（第6组）以及20名正常受试者（对照组）的sICAM-1水平。与对照组相比，第1、2、4、5和6组（第1、4、5、6组P < 0.00001，第2组P < 0.05）sICAM-1水平升高，但第3组未升高。然而，第4组和第6组（GO患者）的sICAM-1水平显著高于第5组（第4组P = 0.0003，第6组P = 0.00013）。此外，第4组的sICAM-1水平略高于第6组，但差异不显著。糖皮质激素治疗3个月后，第6组的sICAM平均水平显著下降，但未恢复到正常水平。3例患者对类固醇治疗无反应，其sICAM-1水平未下降。我们得出结论，无论有无甲状腺功能亢进的GO患者以及亚急性甲状腺炎患者的sICAM-1水平均升高。此外，sICAM-1水平反映了甲状腺或眼眶组织的炎症活动程度，与甲状腺状态无关,因为我们发现在甲状腺功能亢进和甲状腺功能减退时该水平均升高。
