Changes Of Serum Cytokines In Children With Hashimoto Thyroiditis Before And After Treatment

Objectives1.To investigate the changes of serum free triiodothyronine（FT₃）,serum free thyroxine（FT₄）,thyroid stimulating hormone（TSH）,antibody thyroid globulin（Tg Ab）,thyroid peroxidase antibody（TPOAb）,interleukin-17（IL-17）,interleukin-23（IL-23）,interleukin-37（IL-37）,and leptin（LP）levels in children with Hashimoto’s thyroiditis（HT）before and after levothyroxine combined with immunomodulator treatment.2.To study on the correlation between serum cytokines（IL-17,IL-23,IL-37 and LP）and thyroid function（FT₃,FT₄,TSH）and thyroid autoantibodies（TPOAb,Tg Ab）in children with HT,and to explore their possible roles in the occurrence and development of HT,so as to provide a possible new approach for the treatment of this disease.3.To study the correlation between serum levels of IL-17,IL-23,IL-37 and LP in HT children,and to explore the possible internal relationship between them,and their role in the pathogenesis of HT.Materials and MethodFrom December 2018 to December 2019,45 children with HT were selected in endocrine clinic of Dalian Children’s Hospital,excluding follow-up and data anomalies lost 14 cases,a total of 31 cases were enrolled,including 7 boys and 24 girls.All subjects were initially diagnosed with HT and were not treatmented.HT diagnostic criteria:（1）ultrasound showed a diffuse goiter;（2）serum TPOAb and Tg Ab were positive.All children except for other thyroid diseases,other immune diseases,infections,severe liver and kidney dysfunction,and all children had not recently taken thyroid disease treatment drugs,glucocorticoids,immunomodulators,etc.All subjects signed informed consents and received routine treatment.FT₃,FT₄,TSH,Tg Ab,TPOAb,IL-17,IL-23,IL-37 and LP levels were measured Before and 6 months after Levothyroxine combined with immunomodulator treatment.Finally,SPSS 22.0 statistical software was used for data analysis,comparing the changes of serum FT₃,FT₄,TSH,TPOAb,Tg Ab and cytokines（IL-17,IL-23,IL-37 and LP）before and after treatment in HT patients.To respectively analysis the correlation of IL-17,IL-23,IL-37 and LP with thyroid function and the antibodies,and to investigate the correlation between IL-17,IL-23,IL-37 and LP pairwise.Results1.After treatment,the serum TSH concentration（m IU/L）and LP（ng/m L）levels[4.77（3.03,9.57）,2.64±0.82]were lower than those before treatment[16.23（6.87,48.08）,3.36±0.95].After treatment,the serum FT₄（pmol/L）and FT₃（pmol/L）concentrations[17.69（15.54,20.33）,5.95（5.30,7.48）]were higher than that before treatment[10.54（7.21,15.12）,4.76（3.47,5.97）],with statistically significant differences（P<0.05）.There was no significant difference in TPOAb,Tg Ab,IL-17,IL-23 and IL-37before and after treatment（P>0.05）.2.Serum levels of cytokines IL-17,IL-23 and IL-37 were not correlated with TPOAb,Tg Ab,FT₃,FT₄and TSH in children with HT before and after treatment（P>0.05）.3.Serum LP level was not correlated with FT₃and FT₄before and after treatment,and was not correlated with TSH before treatment,but was positively correlated with TSH concentration after treatment（r=0.473,P<0.05）.4.Before treatment,the serum IL-37,IL-23,IL-17 and LP were positively correlated（r=0.584,0.746,0.831,0.428,0.711,0.616,P<0.05）.After treatment,there was no correlation between serum IL-17 level and LP level（P>0.05）,and IL-37 level was positively correlated with IL-17,IL-23 and LP levels（r=0.598,0.589,0.709,P<0.05）.IL-23 was positively correlated with IL-17 and LP levels,respectively（r=0.405,0.432,P<0.05）.Conclusions1.Before and after treatment,IL-17,IL-23,IL-37 and LP in serum of HT children were correlated with each other,suggesting that they may influence each other during the process of HT autoimmunity.2.Before treatment,LP had no correlation with TSH in children with HT,but was positively correlated with TSH concentration after treatment,suggesting that LP changed with the improvement of TSH after treatment,indicating that LP may participate in the change of TSH axis.3.The thyroid function（TSH,FT₄and FT₃）of HT children improved after treatment.The serum LP level decreased after treatment,which may be affected by multiple factors including treatment and TSH level changes.