| Objective: To observe the levels of IL-17,IL-22 and IP-10 in patients with Hashimoto's thyroiditis(HT)and the changes after treatment with selenium yeast,and to explore the immune mechanism of selenium yeast in the treatment of HT.Methods:This study adopts a randomized,controlled,prospective approach which collects 52 HT patients with hypothyroidism and 24 healthy subjects.Serum FT4,TSH,TPOAb,IL-17,IL-22 and IP-10 levels were measured in HT patients and healthy subjects.IL-22 and IP-10 levels were compared.The changes of IL-17,IL-22 and IP-10 levels were compared between the two groups.Correlation tests were performed with TPOAb,TSH and FT4,and statistical analysis was performed.Patients with HT were randomly divided into selenium yeast treatment group(n=26)and control group(n=26).Selenium yeast treatment group received selenium yeast(200 ug per day),plus levothyroxine to maintain TSH levels between 0.49-4.91uIU/mL.Patients of control group received levothyroxine to maintain TSH levels between 0.49-4.91uIU/mL.The changes of serum TPOAb,IL-17,IL-22 and IP-10 levels were measured before treatment,3 months after treatment and 6 months after treatment.The statistical software was used to analyze the effect of selenium yeast on cytokines.Results:1.The serum levels of IL-17,IL-22 and IP-10 in patients with HT were significantly higher than those in healthy subjects(p<0.05).2.In patients with HT,serum IL-17 was positively correlated with TPOAb(p<0.05),but not with TSH and FT4(p>0.05);IL-22 and IP-10 were not correlated with TPOAb,TSH,FT4(p>0.05).3.There was no significant difference in serum IL-17,IL-22 and IP-10 levels between the selenium yeast treatment group and the control group before treatment(p>0.05).4.After 3 months of treatment,serum IL-17 and IL-22 decreased significantly in the selenium yeast treatment group compared with those before treatment,and the difference was statistically significant(p<0.05).After 6 months of treatment,the selenium yeast treatment group Serum IL-17 and IL-22 were increased compared with the 3 months of treatment,and there was no significant difference compared with those before treatment(p>0.05).After 3 months of treatment,serum IL-17 levels in the control group increased slightly,IL-22 levels decreased slightly,and there was no significant difference compared with those before treatment(p>0.05).After 6 months of treatment,serum IL-17 levels were higher than pre-treatment levels in the control group,and IL-22 levels were slightly lower than pre-treatment levels,and the difference was not statistically significant(p>0.05).5.After treatment with selenium yeast,IP-10 decreased gradually in selenium yeast treatment group and control group at 3 months and 6 months after treatment,but there was no statistical difference(p>0.05).6.The concentration of TPOAb in the selenium yeast treatment group decreased significantly at 3 months and 6 months after treatment(p<0.05),while the concentration of TPOAb in the control group did not change significantly at 3 months and 6 months after treatment(p>0.05).Conclusion:1.Cytokines IL-17,IL-22 and chemokine IP-10 may be involved in the pathogenesis of HT.2.The levels of IL-17,IL-22 and IP-10 in HT can be decreased after 3 months treatment with selenium yeast.It is speculated that selenium yeast may block the pro-inflammatory cascade of serum IL-17A-TRAF6-NF-?B by inhibiting the activation of NF-?B and the differentiation of Th17 cells,and weaken the inflammatory effect of IL-22 and reduce the secretion of IP-10 by inhibiting the release of IFN-? and TNF-? from lymphocytes,which has a protective effect on the thyroid gland.3.The best therapeutic window for treating HT with selenium yeast may be 3 months.4.Selenium yeast has a significant effect on serum TPOAb concentration in HT patients. |
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