Relationship Between The Shift Of Serum Th1/Th2 Cytokines Balance And SCTLA-4 In Adult Patients With Graves' Disease

Objectives: The present study was designed to observe the shift of serum Thl/Th2 cytokines balance in adult patients with Graves' disease(GD), to research the serum level of soluble cytotoxic T lymphocyte associated gene-4(sCTLA-4), and to investigate the relationship between sCTLA-4 and the balance of Thl/Th2.Methods: The studied subjects include 30 cases of untreated GD patient, 20 cases of GD patients, who had gained clinical relief after therapy, and 20 cases of healthy donors as normal controls. Enzyme linked immunosorbant assay(ELISA) was used to measure the sreum levels of interferon-gamma(IFN- Y), interleukin-4 (IL-4), and sCTLA-4. the ratio of IFN- Y /IL-4 was used to reflect the immunity reactivity intensity of Thl/Th2. Immunoenzymetric Assay (Magnetic Solid Phase) (IEMA) was used to measure serum levels of free T3(FT3), freeT4(FT4), Thyroid stimulating hormone(TSH), Thyroglobulin antibody(TGA) and Thyroid peroxidase antibody(TPOAb). Thyrotropin receptor antibody (TRAb) was determined byELISA.Results: l.As compared with the healthy controls, the levels of IL-4 in adult GD patients significantly declined (PO.01) and the ratio of IFN- Y /IL-4 increase (P<0.05), while the level of IFN- Y was not different(P>0.05). No change of the levels of IFN- Y ,IL-4 and IFN- Y /IL-4 was found before and after therapy administered.2.The levels of sCTLA-4 in adult GD patients was higher than that in the healthy controls. No change of the levels of sCTLA-4 was found before and aftertherapy administered.3.In the GD patients, sCTLA-4 was negatively correlateed with IL-4, there was no correlation of sCTLA-4 with IFN- Y or IFN- Y /IL-4, The linear regression analysis showed there existed linear regression relationship between IL-4 and sCTLA-4. Given IL-4 regarded as in dependent variable and sCTLA-4 regardedAas dependant variable, the linear equation was Y=13.361-0.477X.4.There were no correlation of IFN- Y JL-4 ,IFN- Y /IL-4 or sCTLA-4with FT3,FT4,TSH,TGA,TPOAb orTRAb. There were no correlation with age, period of disease ,and the size of thyroid too.Conclusion: 1.There was an imbalance of helper T cell(Th) which exhibited Thl relatively dominant dued to Th2declining.No change of the imbalance of Thl/ Th2 was found in GD patients after therapy administered.2.The level of sCTLA-4 in GD patients was higher than that in healthy controls , and sCTLA-4 was negatively correlated with IL-4.Given IL-4 regarded as independant variable , sCTLA-4 regarded as dependant variable, the lenear equation was Y=13.361-0.477X.3.Either sCTLA-4 or Thl/Th2 cytokine has correlation with FT3,FT4,TSH, TGAJPOAb or TRAb.The study on the shift of Thl/Th2 cytokine balance and the relationship between sCTLA-4 and the imbalance of Thl/Th2 cyokine in GDpatients makes us deeper understand the pathogenesis of GD and provides the theory basis for immunity therapy on GD.