Thyroid Autoimmunity and its Association with Cellular and Humoral Immunity in Women with Reproductive Failures

Kim, Na Young; Cho, Hye Jin; Kim, Heun Yun; Yang, Kwang Moon; Ahn, Hyun Kyong; Thornton, Simon; Park, Joon Cheol; Beaman, Kenneth D.; Gilman‐Sachs, Alice; Kwak‐Kim, Joanne

doi:10.1111/j.1600-0897.2010.00911.x

Cited by 85 publications

(63 citation statements)

References 46 publications

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“…As to why women with tubal disorders have a high prevalence of TAI remains also speculative, but many of these patients have had infectious diseases (such as tuberculosis and/or Chlamydia trachomatis), a potential trigger for the development of (thyroid) autoimmunity (33). Furthermore in women with TAI and infertility, an impaired cellular and humeral immune response has been documented (34,35). In contrast to the results of a recent metaanalysis, indicating that women with idiopathic infertility have a high prevalence of TAI, the women in our study with idiopathic infertility had a prevalence of TAI comparable to that of the fertile controls.…”

Section: Discussionmentioning

confidence: 99%

Thyroglobulin Autoantibodies: Is There Any Added Value in the Detection of Thyroid Autoimmunity in Women Consulting for Fertility Treatment?

Unuane

Velkeniers

Anckaert

et al. 2013

Thyroid

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Background: Thyroid autoimmunity (TAI) is frequent in infertile women, but to what extent thyroglobulin autoantibodies (Tg-Abs) contribute to TAI is unclear in the literature. The aims of the present study were to determine the prevalence of TAI in women consulting for fertility problems and to investigate the impact of isolated Tg-Abs, isolated thyroid peroxidase autoantibodies (TPO-Abs), and the presence of both autoantibody types on thyroid function. Furthermore, thyroid function was compared between women with and without TAI and between infertile and fertile women. Methods: A cross-sectional data analysis nested within an ongoing prospective cohort study was performed in order to determine the prevalence of TAI in unselected women consulting our tertiary referral center for reproductive medicine (CRM). The women underwent a determination of serum thyrotropin (TSH), free thyroxine (FT4), TPOAbs, and Tg-Abs. The cause of infertility, age, body-mass index (BMI), and smoking habits were recorded. Results: The prevalence of TAI was 16% (163/992). In 8% of cases, both types of autoantibodies were present, in 5% isolated positive Tg-Abs were found, and 4% had isolated positive TPO-Abs ( p = 0.025 and p = 0.003 respectively). The prevalence of TAI was significantly higher in infertile women as compared to that in fertile controls (19% vs. 13%; p = 0.047). The median serum TSH level was significantly higher in the women with TAI and with isolated positive Tg-Abs compared to that in women without TAI (1.83 [1.44] and 1.90 [0.85] vs. 1.47 [0.94] mIU/L; p <0.001 respectively). The median FT4, age, BMI, and smoking habits were comparable between the study groups. Conclusions: The prevalence of TAI was higher in infertile women as compared to fertile women consulting our CRM. Five percent of the women had isolated positive Tg-Abs and a significantly higher serum TSH compared to that in women without TAI.

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Section: Discussionmentioning

confidence: 99%

Thyroglobulin Autoantibodies: Is There Any Added Value in the Detection of Thyroid Autoimmunity in Women Consulting for Fertility Treatment?

Unuane

Velkeniers

Anckaert

et al. 2013

Thyroid

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“…Kim et al [26] reported that serum tumor necrosis factor a(TNFa)/IL-10 expressing CD3þ/CD4þ were significantly higher in women with thyroid autoimmunity when compared to women with normal immune background. These observations suggest that there are activated T cells in the uteri of women with anti-thyroid antibodies that secrete cytokines that hamper successful pregnancy [22,23,26,27]. These adverse effects can be mediated directly through T cells or indirectly through other cells, such as natural killer cells [28].…”

Section: Referencementioning

confidence: 98%

“…In addition, reduced secretion of IL-4 and IL-10 was measured in the positive group for autoimmunity [25]. Kim et al [26] reported that serum tumor necrosis factor a(TNFa)/IL-10 expressing CD3þ/CD4þ were significantly higher in women with thyroid autoimmunity when compared to women with normal immune background. These observations suggest that there are activated T cells in the uteri of women with anti-thyroid antibodies that secrete cytokines that hamper successful pregnancy [22,23,26,27].…”

Section: Referencementioning

confidence: 99%

Pathogenesis of infertility and recurrent pregnancy loss in thyroid autoimmunity

Twig

Shina

Amital

et al. 2012

Journal of Autoimmunity

179

111

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“…[27][28][29][30][31][32] Elevated levels of peripheral blood NK cells were reported in the presence of TAI in women with RSA suggesting an interplay between NK cells and autoimmune thyroid disorders. 26,33 No studies have been carried out, to date, on the relationship between non-autoimmune thyroid diseases, such as SCH, and NK cells in women with reproductive failure.…”

Section: Introductionmentioning

confidence: 99%

Peripheral blood natural killer cells and mild thyroid abnormalities in women with reproductive failure

Triggianese

Perricone

Conigliaro

et al. 2015

Int J Immunopathol Pharmacol

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Abnormalities in peripheral blood natural killer (NK) cells have been reported in women with primary infertility and recurrent spontaneous abortion (RSA) and several studies have been presented to define cutoff values for abnormal peripheral blood NK cell levels in this context. Elevated levels of NK cells were observed in infertile/RSA women in the presence of thyroid autoimmunity (TAI), while no studies have been carried out, to date, on NK cells in infertile/ RSA women with non-autoimmune thyroid diseases. The contribution of this study is two-fold: (1) the evaluation of peripheral blood NK cell levels in a cohort of infertile/RSA women, in order to confirm related data from the literature; and (2) the assessment of NK cell levels in the presence of both TAI and subclinical hypothyroidism (SCH) in order to explore the possibility that the association between NK cells and thyroid function is not only restricted to TAI but also to SCH. In a retrospective study, 259 age-matched women (primary infertility [n = 49], primary RSA [n = 145], and secondary RSA [n = 65]) were evaluated for CD56+CD16+NK cells by flow cytometry. Women were stratified according to thyroid status: TAI, SCH, and without thyroid diseases (ET). Fertile women (n = 45) were used as controls. Infertile/RSA women showed higher mean NK cell levels than controls. The cutoff value determining the abnormal NK cell levels resulted ⩾15% in all the groups of women. Among the infertile/RSA women, SCH resulted the most frequently associated thyroid disorder while no difference resulted in the prevalence of TAI and ET women between patients and controls. A higher prevalence of women with NK cell levels ⩾15% was observed in infertile/RSA women with SCH when compared to TAI/ET women. According to our data, NK cell assessment could be used as a diagnostic tool in women with reproductive failure and we suggest that the possible association between NK cell levels and thyroid function can be described not only in the presence of TAI but also in the presence of non-autoimmune thyroid disorders.

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Thyroid Autoimmunity and its Association with Cellular and Humoral Immunity in Women with Reproductive Failures

Abstract: TAI is associated with impaired cellular and humoral immune responses in women with RSA or UI. In women with TAI, serial TFT is recommended when pregnancy is established.

Cited by 85 publications

References 46 publications

Thyroglobulin Autoantibodies: Is There Any Added Value in the Detection of Thyroid Autoimmunity in Women Consulting for Fertility Treatment?

Thyroglobulin Autoantibodies: Is There Any Added Value in the Detection of Thyroid Autoimmunity in Women Consulting for Fertility Treatment?

Pathogenesis of infertility and recurrent pregnancy loss in thyroid autoimmunity

Peripheral blood natural killer cells and mild thyroid abnormalities in women with reproductive failure

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