The pathogenesis of thyroid autoimmune diseases: New T lymphocytes – Cytokines circuits beyond the Th1−Th2 paradigm

Li, Qian; Wang, Bin; Mu, Kaida; Zhang, Jinan

doi:10.1002/jcp.27180

Cited by 102 publications

(78 citation statements)

References 157 publications

(257 reference statements)

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“…In addition, it is worth remembering that this cytokine may exert many different and complex effects through their two mechanisms of interaction with its cellular receptor. Finally, different and interesting recent data on the role of novel Th lymphocyte subsets (e.g., Th17, Th22) and their cytokines on the pathogenesis of Autoimmune Thyroid Disease (AITD), indicate that the Th1-Th2 paradigm regarding the pathogenesis of Hashimoto thyroiditis and GD requires to be revisited [4]. Other potential mechanisms, such as stress, could have also had a role in the Graves' relapse [5].…”

mentioning

confidence: 99%

COVID-19: a cause of recurrent Graves’ hyperthyroidism?

Jiménez-Blanco

Pla-Peris

Marazuela

2020

J Endocrinol Invest

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To the Editor Although recent evidence suggests that COVID-19 can affect practically all organs, data on the impact of SARS-CoV-2 on the thyroid gland are very scarce. Two patients with Graves' disease (GD) and COVID-19 have been recently published [1], and we would like to provide more evidence with two more cases. Patient 1 was a 45-year-old woman with a 12-year medical history of GD. She had 2 previous episodes of hyperthyroidism that were treated with antithyroid drugs (ATD), first in 2008 after diagnosis (ATD for 22 months) and then at a relapse in 2015 (ATD for 25 months). She also had Graves' ophthalmopathy that was treated with corticosteroids for 3 months in 2018. At the beginning of March 2020, her thyroid function was normal, with free thyroxine levels (FT4) of 1.36 ng/dL (normal range, 0.93-1.7 ng/dL) and serum thyroid-stimulating hormone levels (TSH) of 0.75 µIU/ mL (normal range, 0.27-4.2 µIU/mL), although anti-TSH receptor antibodies (anti-TSHR-Ab) were slightly elevated (1.9 mIU/mL; normal range < 1.5 mIU/mL). In May 2020, she developed bilateral pneumonia and was diagnosed with SARS-CoV-2 infection. This patient also presented palpitations and nervousness. Her blood test results showed a TSH of < 0.005 µIU/mL, a FT4 of > 7.7 ng/dL and an anti-TSHR-Ab of 28.7 mIU/mL. Thyroid ultrasound showed hypervascularization. She started methimazole (MMI) at a daily dose of 40 mg, which resulted in a rapid normalization of her thyroid function. No deterioration of her ophthalmopathy was observed. The MMI dosage of 40 mg/day was reduced to 5 mg/day during follow-up and she shows improvement in her condition after 3 months of treatment.

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mentioning

confidence: 99%

COVID-19: a cause of recurrent Graves’ hyperthyroidism?

Jiménez-Blanco

Pla-Peris

Marazuela

2020

J Endocrinol Invest

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“…Anti-β2GPI antibodies may trigger the TLR4-MyD88 signaling pathway or stimulate DNA sensors in the cytoplasm through binding to cell surface β2GPI and lead to activation of inflammatory signaling pathways and expression of tissue factor (TF) (Virachith et al., 2018). The patient was also diagnosed with hyperthyroidism and secondary hypothyroidism, which is suggestive of Graves’ disease, a subtype of autoimmune thyroid disease (Li et al., 2019). However, antibodies against thyroglobulin protein, thyroid peroxidase, and thyroxine receptor were in normal range, indicating that an autoinflammatory rather than autoimmune reaction was involved in the thyroid disease of the current patient (Martinez-Quiles and Goldbach-Mansky, 2018).…”

Section: Discussionmentioning

confidence: 99%

Autoinflammatory characteristics and short-term effects of delivering high-dose steroids to the surface of the intact endolymphatic sac and incus in refractory Ménière's disease

Zou

2019

Journal of Otology

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Objective To investigate immune-related genetic background in intractable Meniere’s disease (MD) and the immediate results of a novel therapy by delivering steroids to the surface of the intact endolymphatic sac (ES) and incus in a sustainable manner. Case report and methods Candidate genes involved in immune regulation were sequenced using a next-generation sequencing method in a patient with intractable MD. Mutations were confirmed using the Sanger sequencing method. The ES was exposed, and gelatin sponge particles were immersed in high-dose methylprednisolone solution and placed onto the surface of ES. “L”-shaped gelatin sponge strips were immersed in dexamethasone solution and served as a guiding device for the steroids by touching the incus and gelatin sponge particles on the surface of the ES. Gelatin sponge particles immersed in dexamethasone solution were placed around the gelatin sponge strips and sealed using fibrin glue. Results Autoinflammation in the refractory MD case was indicated by genotype, including novel heterozygous mutations of PRF1, UNC13D, SLC29A3, ITCH, and JAK3, as well as phenotype. The vertigo was fully relieved immediately after operation. Tinnitus and aural fullness were resolved 3 weeks after operation, whereas hearing improved in 2 mon postoperation. No recurrence was noted during the 5-monfollow-up, and the final MRI supported the novel therapeutic hypothesis. Conclusion Autoinflammation was involved in a refractory MD. This novel therapy, which involves the delivery of steroids to the surface of the intact ES and incus, is effective in relieving vertigo and tinnitus and improves hearing function of refractory MD.

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“…Among these cytokines, IL-17 is the most important pro-inflammatory factor. The IL-17 family has six members: IL-17A-IL-17F [ 29 ]. Th17 cells control bone mass in two ways.…”

Section: Introductionmentioning

confidence: 99%

The correlation between the Th17/Treg cell balance and bone health

et al. 2020

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With the ageing of the world population, osteoporosis has become a problem affecting quality of life. According to the traditional view, the causes of osteoporosis mainly include endocrine disorders, metabolic disorders and mechanical factors. However, in recent years, the immune system and immune factors have been shown to play important roles in the occurrence and development of osteoporosis. Among these components, regulatory T (Treg) cells and T helper 17 (Th17) cells are crucial for maintaining bone homeostasis, especially osteoclast differentiation. Treg cells and Th17 cells originate from the same precursor cells, and their differentiation requires involvement of the TGF-β regulated signalling pathway. Treg cells and Th17 cells have opposite functions. Treg cells inhibit the differentiation of osteoclasts in vivo and in vitro, while Th17 cells promote the differentiation of osteoclasts. Therefore, understanding the balance between Treg cells and Th17 cells is anticipated to provide a new idea for the development of novel treatments for osteoporosis.

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The pathogenesis of thyroid autoimmune diseases: New T lymphocytes – Cytokines circuits beyond the Th1−Th2 paradigm

Cited by 102 publications

References 157 publications

COVID-19: a cause of recurrent Graves’ hyperthyroidism?

COVID-19: a cause of recurrent Graves’ hyperthyroidism?

Autoinflammatory characteristics and short-term effects of delivering high-dose steroids to the surface of the intact endolymphatic sac and incus in refractory Ménière's disease

The correlation between the Th17/Treg cell balance and bone health

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