The Preliminary Study On The Imbalance Of Th1/Th2 Chemokines In Patient With Graves Disease

Objective:To observe the changes of Thl/Th2 chemokines in serum in the patient with Graves disease in different stage of treatment,and analyze combined with the thyroid function(FT3,FT4,sTSH),thyroid antibodys(TRAb,TGAb,TPOAb),liver function(ALT,AST,TBIL)and blood routine(WBC,Neutrophils Lymphocytes)。To explore the Th1/Th2 immune imbalance and its clinical significance in the patient with Graves disease.Method:We selected 76 outpatient with Graves disease in different stage of treatment in the General Hospital of Tianjin Medical University, including 34 cases of untreated group,22cases of remission,20 cases of stable group, and 15 cases as control group. We collected the data include general condition thyroid function,thyroid antibodys,liver function,and blood routine, as well as the level of serum CXCL10 and CCL22 detected by ELISA.To compare the level of CXCL10,CCL22 and the ratio(CXCL10/CCL22) among the four groups,and made the same comparison between before and after treatment in 13 cases.The untreat group were divided into incipient and relapse Graves disease, the thyroid function,thyroid antibodys,liver function,blood routine and chemokines were compared,And then these patient were redivided into goiter group and non-goiter group,GO group and non-GO group,hepatic lesion group and non-hepatic lesion group,above-mentioned indicator were compared again. At last, analyzed the correlation among chemokines and thyroid function,autoantibody.Results:1. Serum CXCL10,CCL22 level were significantly increased in untread group compared with other groups (p<0.001), after treatment CXCL10,CCL22 levels were significantly decreased(p<0.01),and in the remission group the levels were lower than normal(p<0.01).The levels were rebounded in stable group, close to the normal.After treatment, the ratio(CXCL10/CCL22)were decreased (p<0.01), but there was no significant difference compared with the normal.2. The levels of CXCL10,CCL22 and the ratio(CXCL10/CCL22) were significant different between before and after treatment in 13 cases through paired test(p<0.01).3. There were no significant difference between incipient and recurring Graves disease in the thyroid function and autoantibodys, so were the chemokines and the ratio(CXCL10/CCL22).4. The level of chemokines CXCL10,CCL22 in serum were relatively higher in goiter group, GO group and hepatic lesion group,but the difference was not statistically signifant. There were no significant difference in the ratio. The levels of CXCL10,CCL22 rather than the ratio(CXCL10/CCL22)were positively correlated with FT4(r=0.538, r=0.389, respectively).There were no significant correlation among CXCL10,CCL22,CXCL10/CCL22 and FT3,thyroid antibodys.Conclusion:1 The level of CXCL10,CCL22 in serum and the ratio (CXCL10/CCL22) were significantly increased in untreated patient with Graves disease, involved in its immune regulation,further suggested thatTh1,Th2 cell-mediated abnormal cellular and humoral immune response would play the role in the pathogenesis of Graves disease,and in the active stage,the Th1 cellular was in the ascendant in the active stage.2. After treatment,the level of chemokines were significantly decreased firstly,then gradually recovered to normal levels, and increased again in relapse patient, so may become new means to explore the inner links and process of the disease.3. There were no significant relation among chenmokine and thyroid function,autoantibodys,goiter,GO and hepatic lesion, further study would be carried to reavel the role of autoimmune factors in Graves disease.