ANTIBODIES PRODUCING COMPLEMENT-MEDIATED THYROID CYTOTOXICITY IN PATIENTS WITH ATROPHIC OR GOITROUS AUTOIMMUNE-THYROIDITIS
ANTIBODIES PRODUCING COMPLEMENT-MEDIATED THYROID CYTOTOXICITY IN PATIENTS WITH ATROPHIC OR GOITROUS AUTOIMMUNE-THYROIDITIS
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DOI：
10.1210/jc.77.6.1700
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发表时间：
1993-12-01
影响因子：
5.8
通讯作者：
PINCHERA, A
中科院分区：
文献类型：
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作者：
CHIOVATO, L;BASSI, P;PINCHERA, A
自身免疫性甲状腺炎患者体内存在甲状腺细胞毒性抗体（甲状腺细胞毒性抗体），但它们在甲状腺功能减退症发展中的作用仍有待阐明。在这项研究中，我们评估了 20 名萎缩性甲状腺炎（特发性粘液性水肿；AT）患者和 94 名甲状腺肿桥本甲状腺炎（HT）患者中甲状腺细胞毒性抗体的致病作用。在 HT 患者中，27 名甲状腺功能正常（HT-E），27 名患有亚临床甲状腺功能减退症（HT-SH），40 名患有明显甲状腺功能减退症（HT-H）。 17 名正常受试者和 8 名患有非甲状腺疾病的患者作为对照 (C)。为了检测甲状腺细胞毒性抗体，用 Cr-51 标记表达甲状腺过氧化物酶 (TPO) 的人甲状腺细胞，并用血清中的免疫球蛋白 G (IgG) 部分加兔补体进行攻击。 IgG 的细胞毒性作用计算为特异性裂解百分比 (% SL)，同时考虑补体单独的裂解作用和去垢剂产生的最大裂解。大多数 C-IgG 降低了补体的细胞毒性作用（中位 % SL，-3.3）。来自甲状腺功能减退伴甲状腺炎患者的 IgG 比 C-IgG 具有更大的细胞毒性作用，无论是作为一个整体 (P < 0.001)，还是根据临床诊断细分：HT-SH（中位数 % SL，4.8；P < 0.005）、HT-H（% SL，2.2；P < 0.0001）或 AT（% SL，0.9；P < 0.0001）或 AT（% SL，0.9；P < 0.005）。 0.01）。在HT患者中，亚临床和明显甲减患者的IgG裂解活性高于甲状腺功能正常患者的IgG（P < 0.05）。甲状腺功能正常的 HT 患者的 IgG 结果（中位 % SL，-0.9）与 C-IgG 的结果没有显着差异。通过对 C-IgG 产生的 % SL 上限 (>2) 进行截断，甲状腺细胞毒性抗体的患病率在 AT 中为 30%，在 HT-SH 中为 59%，在 HT-H 中为 55%。然而，37% 甲状腺功能正常的 HT 患者也存在甲状腺细胞毒性抗体。没有 IgG 含有低滴度的 TPO 抗体 (TPOAb)（
Thyroid-cytotoxic antibodies (thyroid-cytotoxic Abs) have been described in patients with autoimmune thyroiditis, but their role in the development of hypothyroidism remains to be clarified. In this study, we evaluated the pathogenetic role of thyroid-cytotoxic Abs in 20 patients with atrophic thyroiditis (idiopathic myxedema; AT) and 94 patients with goitrous Hashimoto's thyroiditis (HT). Among patients with HT, 27 were euthyroid (HT-E), 27 had subclinical hypothyroidism (HT-SH), and 40 had overt hypothyroidism (HT-H). Seventeen normal subjects and 8 patients with nonthyroidal illnesses were used as controls (C). To detect thyroid-cytotoxic Abs, human thyroid cells expressing thyroid peroxidase (TPO) were labeled with Cr-51,and challenged with the immunoglobulin G (IgG) fraction of serum plus rabbit complement. The cytotoxic effect of IgGs was calculated as the percent specific lysis (% SL), taking into account the lytic effect of complement alone and the maximal lysis produced by a detergent. Most C-IgGs decreased the cytotoxic effect of complement (median % SL, -3.3). IgGs from hypothyroid patients with thyroiditis had a greater cytotoxic effect than C-IgGs, either as a whole group (P < 0.001) or when subdivided according to clinical diagnosis: HT-SH (median % SL, 4.8; P < 0.005), HT-H (%SL, 2.2; P < 0.0001), or AT (%SL, 0.9; P < 0.01). Among patients with HT, the lytic activity of IgGs from patients with subclinical and overt hypothyroidism was higher than that of IgGs from euthyroid patients (P < 0.05). The results of IgGs from euthyroid patients with HT (median % SL, -0.9) did not significantly differ from those of C-IgGs. By taking a cut-off over the upper range of % SL produced by C-IgGs (>2), the prevalence of thyroid-cytotoxic Abs was 30% in AT, 59% in HT-SH, and 55% in HT-H. However, 37% of euthyroid patients with HT also had thyroid-cytotoxic Abs. No IgG containing TPO antibodies (TPOAb) at low titer (