The role of T helper 17 (Th17) and T regulatory cells (Treg) in the pathogenesis of Graves' disease (GD) remains uncertain. The influence of methimazole (MMI) on the human immune system is still poorly understood. The aim of the present research was to assess changes in the frequencies of peripheral blood Th17 and Treg cells during GD treatment in the group of teenagers. The frequencies of Th17 and Treg were measured by flow cytometry in 60 adolescents at the time of GD diagnosis and after achieving MMI-induced euthyreosis. The control group consisted of 20 healthy volunteers. Lower percentages and absolute counts of Treg cells were found in the study group before the treatment in comparison with healthy controls (p = 0.032 and p = 0.006, respectively). Treatment with MMI caused an increase in the percentages and absolute counts of Treg lymphocytes (p = 0.037 and p = 0.007). After the treatment, no clinically significant differences in Treg cells between GD patients and controls were found. Higher absolute counts of Th17 lymphocytes were found in hyperthyroid adolescents before the treatment initiation and after achieving euthyreosis than in healthy individuals (p = 0.0001 and p = 0.047). Treatment with MMI caused a significant decrease in the percentages and absolute counts of Th17 lymphocytes (p = 0.047 and p = 0.043). The present study demonstrates that both Th17 and Treg cells might play a role in the pathogenesis of GD. Increased percentage of Treg after MMI therapy seems a predictor of response to anti-hypertensive treatment as it is associated with the normalization of thyroid hormone levels.

Graves’ disease (GD) it the most common chronic organ-specific thyroid disorder without a fully recognized etiology. The pathogenesis of the disease accounts for an interaction between genetic, environmental, and immunological factors. The most important environmental factors include viral and bacterial infections. The Epstein-Barr virus (EBV) is one of the most common latent human viruses. Literature has suggested its role in the development of certain allergic and autoimmune diseases. EBV also exhibits oncogenic properties. The aim of the study was to analyze and compare the presence of EBV DNA in peripheral blood mononuclear cells (PBMCs) in patients with newly recognized GD and to find a correlation between EBV infection and the clinical picture of GD. The study included 39 untreated patients with newly diagnosed GD and a control group of 20 healthy volunteers who were gender and age matched. EBV DNA was detected with reverse transcription polymerase chain reaction (RT PCR) assay. The studies showed a significantly higher incidence of EBV copies in PBMCs among GD patients compared to the control group. Whereas, no significant correlations were found between the incidence of EBV copies and the evaluated clinical parameters. Our results suggest a probable role of EBV in GD development. EBV infection does not affect the clinical picture of Graves’ disease.

A -study Design, B -Data collection, C -statistical analysis, D -Data interpretation, E -Manuscript Preparation, F -literature search, G -Funds collection Background. autoimmune Polyglandular syndrome (aPs) forms a heterogeneous group of rare, genetically caused diseases, characterized by autoimmune activity against more than one endocrine organ, although non-endocrine organs can be also affected. aPs was classified into four types. the two major types are aPs-1 and aPs-2. Objectives. the aim of this study was to evaluate the type, number and sequence of appearance of autoimmune diseases forming different types of aPs in own material. Material and methods. the study involved 41 patients with aPs (32 F; 9 M), aged 19-72 years (mean 45.2 ± 13.5). the authors analyzed medical histories and the results of additional tests. Results. in the entire group of patients, as well as in each type of aPs, women predominated. the most frequently diagnosed type of aPs, confirmed in 51.2% of patients, was aPs-2. aPs-3 accounted for 41.5% of aPs. the most rarely observed, present in 7.3% of patients, was aPs-1. the most common pathology was autoimmune thyroid disease, followed by addison's disease, and third -type 1 diabetes. the majority of patients (58.5%) were diagnosed with only two coexisting disorders, mainly addison's disease and thyroid disease. in 36.6% of patients, three diseases were recognized, while four autoimmune disorders were discovered in only two women (4.9%). the onsets of consecutive autoimmune diseases in individual patients from study group were spread in time and spanned up to 29 years maximum. Conclusions. if the patient exhibits autoimmune disorders, the suspicion of a further autoimmune disease should be present. a family history of autoimmune disease is also very helpful. a patient with aPs needs life-long replacement therapy and observation by a family doctor, endocrinologist and other specialists to monitor the effectiveness of the treatment and detect new components of the syndrome. Key words: autoimmune polyglandular syndrome, aPs, autoimmune diseases, addison's disease, hashimoto's thyroiditis.

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