人桥本甲状腺炎甲状腺组织中miRNAs表达谱的差异性分析

目的：桥本甲状腺炎是一种自身免疫性甲状腺疾病，且其发病率呈逐年上升趋势，在医疗实践中，HT 被认为是原发性甲状腺 功能减退最常见的原因，同时较易发生甲状腺癌和淋巴瘤。另外，HT 缺乏早期诊断标准，临床上发病隐匿且表现多样，病人多不 易察觉而延误治疗。本文旨在应用microRNA 芯片技术系统筛查HT病变甲状腺组织，以此研究并揭示其HT 的miRNA 表达谱 变化。方法：本研究首先采用microRNA芯片技术，对正常甲状腺组织及桥本甲状腺炎甲状腺组织中microRNA 的表达进行比较， 筛选桥本甲状腺炎中差异性表达的miRNAs。结果：与正常甲状腺相比，在桥本甲状腺炎及其合并甲状腺乳头状癌的一侧桥本甲 状腺炎中分别有39 个和25 个miRNAs 分子发生了差异性表达（P<0.05），比较2 组中共有的miRNAs 发现，miR-142-3p、 miR-338-3p、miR-454、miR-146a、miR-29b-1*、miR-150、miR-223 表达上调，miR-654-5p、miR-601、miR-198、miR-1226* 表达下调 （log2 FC≥ 2，P＜0.05）；而miR-142-5p 在原发性桥本甲状腺炎中表达显著性升高近8 倍（log2 FC=7.959，P＜0.01）。结论：我们通 过microRNA芯片，首次直接系统筛查了桥本甲状腺炎病变组织相关miRNA 表达谱，总体上初步掌握了与正常甲状腺相比，桥 本甲状腺炎及合并甲状腺乳头状癌时其miRNA 表达谱的变化情况，为我们后续的研究提供了方向与基础。     

Clock gene PERIOD3 polymorphism is associated with susceptibility to Graves’ disease but not to Hashimoto’s thyroiditis

ABSTRACT

Circadian disruption has been linked with immune-related morbidities including autoimmune diseases. PERIOD3 (PER3) clock gene is a key player in the mammalian circadian system. This study evaluated the possible association of PER3 rs2797685 (G/A) polymorphism and susceptibility of autoimmune thyroid diseases (AITD) and assessed if this SNP contributes to disease characteristics and serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). The PER3 rs2797685 (G/A) polymorphism was assessed in 125 patients with AITD [Graves’ disease (GD), 69; Hashimoto’s thyroiditis (HT), 56] and 115 unrelated healthy controls. Subjects carrying at least one variant allele of PER3 rs2797685 (GA+AA) had increased risk for GD (OR 1.9, 95% CI 1–3.61, p= .05). There were no differences in the frequencies of genotypes and alleles of the PER3 rs2797685 polymorphism between HT patients and control subjects. No association was observed between genotypes of the studied SNP and any of the disease characteristics in GD and HT patients. The GA+AA genotype of PER3 rs2797685 was associated with lower levels of IL-6 in patients with Graves’ disease. There were no differences between genotypes of the studied SNP regarding TNF-α levels in GD, HT or control groups. In conclusion, this study provides the first evidence for a genetic association between GD and the PER3 gene, highlighting the possible relevance of polymorphisms in clock genes in the etiopathogenesis of AITD. However, functional studies to identify the underlying molecular mechanisms of this association are needed to translate these findings to clinical applications.     

Elevated blood Hsp60, its structural similarities and cross-reactivity with thyroid molecules,and its presence on the plasma membrane of oncocytes point to the chaperonin as an immunopathogenic factor in Hashimoto's thyroiditis

The role Hsp60 might play in various inflammatory and autoimmune diseases is under investigation, but little information exists pertaining to Hashimoto’s thyroiditis (HT). With the aim to fill this gap, in the present work, we directed our attention to Hsp60 participation in HT pathogenesis. We found Hsp60 levels increased in the blood of HT patients compared to controls. The chaperonin was immunolocalized in thyroid tissue specimens from patients with HT, both in thyrocytes and oncocytes (Hurthle cells) with higher levels compared to controls (goiter). In oncocytes, we found Hsp60 not only in the cytoplasm but also on the plasma membrane, as shown by double immunofluorescence performed on fine needle aspiration cytology. By bioinformatics, we found regions in the Hsp60 molecule with remarkable structural similarity with the thyroglobulin (TG) and thyroid peroxidase (TPO) molecules, which supports the notion that autoantibodies against TG and TPO are likely to recognize Hsp60 on the plasma membrane of oncocytes. This was also supported by data obtained by ELISA, showing that anti-TG and anti-TPO antibodies cross-react with human recombinant Hsp60. Antibody-antigen (Hsp60) reaction on the cell surface could very well mediate thyroid cell damage and destruction, perpetuating inflammation. Experiments with recombinant Hsp60 did not show stimulation of cytokine production by peripheral blood mononuclear cells from HT patients. All together, these results led us to hypothesize that Hsp60 may be an active player in HT pathogenesis via an antibody-mediated immune mechanism.     

小剂量糖皮质激素联合消炎痛治疗亚急性甲状腺炎的临床效果

目的:探讨小剂量糖皮质激素联合消炎痛治疗亚急性甲状腺炎(Subacute thyroiditis,ST)的临床效果及安全性。方法:选取我院内分泌科2012年6月-2014年7月收治的150例亚急性甲状腺炎患者,按照随机平均原则即药物治疗的不同将其分为三组,每组50例,即泼尼松与消炎痛联合治疗(A组)、泼尼松单独治疗(B组)、消炎痛单独治疗(C组),对比并分析三组的治疗效果,包括甲状腺疼痛和肿大平均消失时间,治疗1周的ESR平均水平,治疗4周后的血清TSH、FT3、FT4水平,并通过随访,观察治疗后8周患者不良反应的发生率、复发率。结果:(1)A组患者甲状腺疼痛和甲状腺肿大的消失时间与B组比较无显著差异(P0.05),A、B组均显著短于C组(P0.05)。A组患者治疗后1周、4周的ESR水平与B组对比差异不明显,无统计学意义(P0.05);A、B组患者治疗后1周的ESR水平明显低于C组(P0.05)。A、B组治疗后的血清TSH、FT3、FT4水平改善程度均优于C组,差异有统计学意义(P0.05)。(2)A组、C组的不良反应发生率、复发率均低于B组,差异具有统计学意义(P0.05)。结论:采用小剂量糖皮质激素联合消炎痛治疗亚急性甲状腺炎的临床效果显著,且不良反应和复发情况少。     

慢性淋巴细胞性甲状腺炎合并甲状腺结节的临床分析

目的:研究分析中国东北地区慢性淋巴细胞性甲状腺炎(CLT)合并甲状腺结节的诊断和治疗方式.方法:回顾性分析2009年9月--2010年12月收治经病理证实的CLT合并甲状腺结节的共151病例,依据不同的病理类型分组,就临床特点、诊断和治疗进行比较.结果:CLT合并甲状腺乳头状癌组共58例,女性51例,男性7例,平均年龄37.5±4岁,平均病程18个月,28例为腺体内单发结节,病灶平均直径为0.9± 0.56 cm,36例病灶直径小于1.0 cm,42例见结节内伴钙化.CLT合并良性结节组98例,女性患者93例,男性患者5例,平均年龄48.1±9岁,平均病程72个月,34例为腺体内单发结节,病灶平均直径1.8± 0.42 cm,35例病灶直径小于1.0 cm,10例见结节内伴钙化.两组在发病年龄、病程、结节个数及钙化方面的差异均有统计学意义.结论:CLT合并甲状腺癌微小癌多见,淋巴结转移率低,彩超提示单发结节或者结节合并钙化的病例,应行手术治疗.     

Multiorgan autoimmunity in a Turner syndrome patient with partial monosomy 2q and trisomy 10p

Turner syndrome is a condition caused by numeric and structural abnormalities of the X chromosome, and is characterized by a series of clinical features, the most common being short stature and gonadal dysgenesis. An increased frequency of autoimmune diseases as well as an elevated incidence of autoantibodies has been observed in Turner patients.     

桥本甲状腺炎患者血清miR-326、miR-155与甲状腺相关抗体和Th17/Treg细胞因子失衡的相关性分析

摘要 目的：探讨桥本甲状腺炎（HT）患者血清微小核糖核酸（miR）-326、miR-155与甲状腺相关抗体和辅助性T细胞17（Th17）/调节性T细胞（Treg）细胞因子失衡的相关性。方法：选择2021年1月至2022年10月空军军医大学唐都医院收治的HT患者82例作为研究组，同期接受体检的健康人80例作为对照组，比较两组血清miR-326、miR-155、甲状腺功能参数[促甲状腺激素（TSH）、游离三碘甲状原氨酸（FT₃）、游离甲状腺素（FT₄）]、甲状腺相关抗体[甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TGAb）]、Th17、Treg水平及其细胞因子水平，并分析HT患者血清miR-326、miR-155与甲状腺相关抗体和Th17/Treg细胞因子失衡的相关性。结果：研究组TSH、TPOAb、TGAb显著高于对照组，FT₃、FT₄显著低于对照组（P<0.05）。研究组血清miR-326、miR-155表达水平显著高于对照组（P<0.05）。研究组Th17、Th17/Treg、白细胞介素-17（IL-17）、γ干扰素（IFN-γ）显著高于对照组，Treg、白细胞介素-10（IL-10）水平显著低于对照组（P<0.05）。Pearson相关分析显示，HT患者血清miR-326、miR-155分别与TSH、TPOAb、TGAb、Th17、Th17/Treg、IL-17、IFN-γ呈正相关，与FT₃、FT₄、Treg、IL-10呈负相关（P<0.05）。结论：HT患者血清miR-326、miR-155水平异常升高，其水平与TPOAb、TGAb自身抗体及Th17/Treg失衡相关，血清miR-326、miR-155可能通过影响Th17/Treg免疫平衡，促进HT的发生和发展。     

夏枯草胶囊对自身免疫性甲状腺炎大鼠甲状腺组织及Fas、FasL表达的影响

目的:探讨夏枯草胶囊对自身免疫性甲状腺炎(AITD)大鼠甲状腺组织病理学及Fas、FasL表达的影响。方法:将40只雌性SD大鼠按照随机数表法随机分为空白对照组、模型组、夏枯草胶囊组、硒酵母组,每组10只,空白对照组予以正常饲养,模型组和药物组予以PTg皮下注射建立AITD模型,夏枯草胶囊组、硒酵母组分别给予夏枯草胶囊与硒酵母片的生理水溶液灌胃,药物干预6周后处死大鼠,取甲状腺组织,HE染色电镜下观察各组大鼠甲状腺组织形态,免疫组化法检测各组大鼠甲状腺组织Fas、FasL蛋白的表达。结果:1)模型组大鼠甲状腺组织滤泡大量破坏,形态不规则,胶质分布不均匀,滤泡间隙增大,可见大量淋巴细胞及浆细胞浸润。夏枯草胶囊组滤泡形态尚规则,胶质含量较空白组少,滤泡间有少量淋巴细胞浸润。与模型组对比,夏枯草胶囊组与硒酵母组滤泡破坏及淋巴细胞浸润有显著改善。2)对照组大鼠甲状腺组织中Fas、FasL蛋白仅呈少量表达,模型组大鼠甲状腺组织中Fas、FasL蛋白表达较对照组显著增加(P0.01),夏枯草胶囊组大鼠甲状腺组织中Fas、FasL蛋白表达较模型组及硒酵母组均显著减少(P0.01)。结论:夏枯草胶囊可能通过减少Fas、FasL的表达,抑制甲状腺滤泡细胞凋亡,从而减轻甲状腺滤泡上皮的破坏。     

Therapeutic effect of human amniotic epithelial cells in murine models of Hashimoto's thyroiditis and Systemic lupus erythematosus

Background aims

The chronic inflammation of autoimmune diseases develops repetitive localized destruction or systemic disorders, represented by Hashimoto's thyroiditis (HT) and Systemic lupus erythematosus (SLE) respectively. Currently, there are no efficient ways to treat these autoimmune diseases. Therefore, it is critically important to explore new therapeutic strategies. The aim of this study was to investigate the therapeutic efficacy of human amniotic epithelial cells (hAECs) in murine models of HT and SLE.

Fungal Thyroiditis: An Overview

The authors review the epidemiology, clinical manifestations, diagnosis, and treatment of fungal thyroiditis cases previously reported in the medical literature. Aspergillus was by far the most common cause of fungal thyroiditis. Immunocompromised patients, such as those with leukemia, lymphoma, autoimmune diseases, and organ-transplant patients on pharmacological immunosuppression were particularly at risk. Fungal thyroiditis was diagnosed at autopsy as part of disseminated infection in a substantial number of patients without clinical manifestations and laboratory evidence of thyroid dysfunction. Local signs and symptoms of infection were indistinguishable from other infectious thyroiditis and included fever, anterior cervical pain, thyroid enlargement sometimes associated with dysphagia and dysphonia, and clinical and laboratory features of transient hyperthyroidism due to the release of thyroid hormone from follicular cell damage, followed by residual hypothyroidism. Antemortem diagnosis of fungal thyroiditis was made by direct microscopy and culture of a fine-needle aspirate, or/and biopsy in most cases. Since most patients with fungal thyroiditis had disseminated fungal infection with delay in diagnosis and treatment, the overall mortality was high.