Effects Of¹³¹I Treatment On The Serum CXCL10、CCL22in Newly Onset Graves’ Disease

[Objective] To observe the effects of131I therapy on Th1/Th2interferon-inducible protein-10and Macrophage-derived chemokine in untreated hyperthyroid patients with Graves’disease (GD), analysis relationship between CXCL10、CCL22and thyroid function and thyroid antibody levels and explore the chemokines above in Graves’ disease pathogenes and the effects of131I therapy on immune function.[Methods] Selected newly untreated Graves’disease randomly in department of Endocrinology inAffiliated Hospital of Jining Medical College from October2010to April2011. The patients were screened according to the2008Guideline for the Management of Thyroid Disease in China of Graves’ disease (except for infiltration the exophthalmus), and patients who presented with diabetes mellitus, cardiovascular, renal, pulmonary, neoplasic, autoimmune or inflammatory diseases, chronic viral or bacterial infection or the use of corticosteroid or immunosuppressive agents were excluded from the study. Both the Graves’ disease patients were33cases,20-48years old, the average is36.1years old, which were all new-onset of untreated patients and which increasing thyroid radioactive iodine uptake in24-h.131I orthodox treatments, the dose calculation:thyroid <70g (per gram of thyroid tissue absorption of2.22～2.59MBq×thyroid weight g)/maximum absorption of131I rate; thyroid>70g (per gram of thyroid tissue was2.96-3.70MBq×thyroid weight g)/maximum suction1311rate, once orally. Determin relevant indicators before and after treatment, for example, in the1st,3rd and6th month.30healthy subjects matched for gender and age which were excluded any prior infectious, autoimmune diseases or family history of autoimmune thyroid diseases (AITD) comprised the control group. Collected relevant clinical information, sended fasting cubital vein blood5mL (3mL) to the hospital clinical laboratory using direct chemiluminescent technology for the determination on free three triiodothyronine (FT3), free thyroxine(FT4), thyroid stimulating hormone (TSH), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb) and thyroid-stimulating hormone receptor antibody (TRAb). The other2mL serum placed in centrifuge stored at-80℃was for the detection of in serum CXCL10, CCL22level by enzyme-linked immunosorbent assay (ELISA) kit.[Results] The serum levels of CXCL10, CCL22, CXCL10/CCL22ratio,FT3and FT4in newly-onset Graves’ disease paients before131I treatment and in the1st month after131I therapy were significantly higher than those of normal control group (p<0.05). CXCL10/CCL22ratio was no significant difference (P>0.05) in the3rd and6th months compared with the control group. However, serum CXCL10, CCL22level was still greater than the control group. There was no apparent change of CXCL10, CCL22, CXCL10/CCL22ratio level in the1st month after131I therapy. However, serum CXCL10, CCL22, CXCL10/CCL22ratio were gradually decreased in the3rd and6th month compared with untreated before and by a time-dependent manner (p<0.05). FT3and FT4levels were significantly decreased after131I therapy, but no correlations were founded among FT3, FT4and CXCL10, CCL22, CXCL10/CCL22ratio. The TPOAb, TGAb and TRAb levels were increased after the131I therapy. The levels of TPOAb, TGAb and TRAb in serum gradually increased and reached a peak at3rd and6th months after131I therapy, still there was no significant correlation between these antibodies and changes of chemokines and their ratio.[Conclusions]1. In conclusion, our data confirm that elevated serum CXCL10level in Graves’ disease patients was related to the activity of the disease.2. IP-10/CXCL10, MDC/CCL22were involved in the Graves’ disease’s autoimmune response. Chemotacticagent differentially exist in Graves’ disease patients, also expressed Thl/Th2chemotactic factors imbalances, Th1/Th2serum tends gradually balance after the131I therapy.3.131I therapy would suppress the autoimmune status in Graves’ disease patients. CXCL10, CCL22and CXCL10/CCL22ratio before and after treatment may play certain roles in the progress of Graves’ disease, and may reflect the immune dynamics and may be implicated in immunopathology Graves’disease and prognosis.