| Objective: Graves's disease (GD) is a common autoimmune thyroid disease (AITD) in children. Cytokine imbalance induced by the broken of Thl/Th2 cell balance is the main etiological. But it has always been controversial that the polarization direction of Th1/Th2 is to shift to the Th1 or Th2 cells. In our research,GD, HT and normal children's lymphocyte subsets, cytokine levels, the level of immune cells from the surface markers and transcription factor were detected to observe the polarization of Th1/Th2 cytokines in children Graves disease. Explore the immunological mechanisms of GD in children.Methods: The study object are 22 newly diagnosed GD patients, and follow-up were 36 children; 24 newly diagnosed HT, follow-up of 40 patients; 50 normal children. Flow cytometry, ELISA were employed to investigate peripheral blood T cell subsets, sCD30 levels and mononuclear cells in lipopolysaccharide, phytohemagglutinin the induction of IFN-γ, IL-4 and IFN-γand IL-4 ratio of thyroid disease and normal children. RT-PCR was used to detect early, peripheral T-bet, GATA3 and T-bet, GATA3 value in thyroid disease follow-up and normal children. The correlation between them was also analyzed.Results: 1.The levels of cytokine: IFN-γ, IL-4, IL-4/ IFN-γlevels in newly diagnosed GD group were : 3972±1403pg/ml,286±76pg/ml and 13.7±3.1; which in newly diagnosed HT group were 3578±1407 pg/ml,266±94pg/ml and 13.4±2.5, Both compared with normal control groups (2431±1137pg/ml. 385±173 ml, 6.5±2.1) were significant differences.2.T lymphcyte subsets: GD T lymphcyte subsets (CD3+:67.32±6.37%, CD4+:30.82±3.38%,CD8+:25.27±8.22%,CD4+/CD8+:1.31±0.32),HT(CD3+:65.54±4.97%,CD4+:31.92±3.2%,CD8+:26.63±4.19%,CD4+/CD8+:1.28±0.33), both compared with the control group (2431±1137pg/ml. 173±6.5pg/ml, 385±2.1), there were no significant difference.3.The levels of sCD30: sCD30 in the newly diagnosed GD group was 122±58U/ml, and 106±34U/ml in HT group. Both were significant difference with the control group (81±32U/ml). Correlation analysis of sCD30 with TT3, TT4 and TSH in lower thyroid function of HT group results: r=-0.592,P<0.05;r=-0.548,P<0.05;r=-0.311,P>0.05. This results in newly diagnosed GD is: r=0.444,P<0.05;r=0.604,P<0.05;r=0.298,P>0.05.4.The levels of transcription factor:T-bet and GATA3. T-bet, GATA3 expression levels of newly diagnosed and follow-up GD groups were: 1.23±0.3±0.51, 0.82, 1.51±0.46; newly diagnosed and follow-up HT groups: 1.11±0.20±0.45,0.81, 1.36±0.42; Compared with the control group (0.73±0.61±0.45,1.01, 0.76±0.31) both have significant differences.Conclusion: 1 Cytokine of GD children showed that IFN-increased, IL-4 decreased, which suggested that the imbalance of cytokines in those individual and the Th1/Th2 cell migration direction is shift to Th1.2 GD, HT subsets of T lymphocytes in children with normal control group was no significant difference, meanwhile, cytokine levels has changed, Thus, we can speculate that although no significant changes in the number of CD4 + T cells, its function has changed.3 Plasma sCD30 in GD patients were significantly higher than normal level, from this phenomenon we can deduce: The Th1/Th2 cell balance of GD in the late immune response gradually shift from Th1 to Th2 cells, which trigger antigen-antibody reaction in GD. Furthermore,the serum levels of sCD30 TT3, TT4 were positively correlated. sCD30 could be considered as a reference indicator of disease severity in GD.4 The expression of transcription factor GATA-3 in PBMC of GD was significantly lower than normal, and T-bet. T-bet/GATA-3 significantly decreased,which suggested that the T cells in GD children have Th1 differentiation trend. Furthermore, the level of transcription factor closely related to the extent of thyroid function in GD children, which could be considered as a reference indicator of disease severity.
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