| Objectives:To investigate the change of thyroid function and serum Th1/Th2/Th17 cytokines level in patients survivaled more than 12 monthes after hematopoietic stem cell transplantation (HSCT). Study the relationship between cytokines and thyroid function.Methods:1:Case data We collected 51 individuals who survivaled more than one year post hematopoietic stem cell transplantion from January 2015 to December 2015 during the First Affiliated Hospital of Guangxi Medical University. And during the same period we also collected 51 healthy subjects. Preoperative diagnosis were according to the diagnostic criteria of WHO related diseases. According to the diagnostic criteria of the 2005 version of NIH clear consensus,and then according to the results of thyroid function tests divided these 51 cases into normal and abnormal thyroid function subgroup.Finally, according to the expression of thyroid antibody we divided the abnormal thyroid function group into positive group and negative group2.Measurement of thyroid function in patients after transplantation Blood samples were collected after 12 hours overnight fasting state and the thyroid function?thyroid antibodies of these samples was detected by the department of nuclear medicine professional and technical personnel after centrifugated the serum.3.The determination of TH1/TH2/TH17 cytokines We used enzyme linked immunosorbent assay to detect the human IL-23 and cytometric bead array to detect the human IL-2?IL-4?IL-6?IL-10?IL-17?IFN-??TNF-a. To abserve the changes of cytokines and clarify its relation with the changes of thyroid function after transplantation.4. Data analyse Data processing used SPSS 16.0 software to deal with the analysis of data and compare the differences of thyroid function, thyroid auto antibodies, the cytokine levels in different groups. P value< 0.05 was considered statistically significant.Results:1.51 cases of patients after HSCT has 17 cases (33.3%) thyroid function abnormal, case group had 17 cases (33.3%) with abnormal thyroid function, among these 17cases there were:2cases with hypothyroidism (11.8%)?3 cases with subclinical hypothyroidism (17.6%)?10 cases with hypothyroxinemia (58.8%)?2 cases with hyperthyroidism (11.8%)?8 cases (47.1%) patients with thyroid autoantibodies were positive for the main performance of 17 cases of thyroid function in patients with abnormal.2. Patients'FT4, IL-23 levels in the case group were significantly lower than that of normal control group; and TSH, IL-2, IL-4, IL-6, IL-10, IL-17, TNF-a, IFN-y levels were significantly higher than the control group (all P value < 0.05).3. (1):IL-23 level among the 1-20 at the age of case group was significantly lower than control group. (2) FT4 and IL-23 levels was significantly lower than that control group, TSH, IL-2, IL-4, IL-6, IL-10, IFN-levels was significantly higher than that of control group among the 21-40 at the age of case group. (3) FT4 significantly lower than control group, TSH, IL-2, IL-4, IL-6, IL-10, IFN-? higher than control group among the 41-60 at the age of the case group (all P value< 0.05).4. Patients in the abnormal thyroid function group had lower FT4 level and HLA matched rate than the normal thyroid function group after HSCT; on the other hand they had higher TSH, IL-2, IL-6 and IL-17 concentration and the incidence of cGVHD, TBI radiation history, CY chemotherapy history wrer higher than normal thyroid function group after transplantation (all P value< 0.05).5. Antibody postive group had higher IL-6^ TSH than antibody negative group(P value< 0.05).6. After HSCT the concentration of FT3 was correlated with IL-6? IL-17(r=0.014,-0.011, P<0.05); FT4 was correlated with IL-2?IL-6 (r=-0.127,0.047, P<0.05) and TSH was correlated with IL-17?TNF-a(r=0.921,-1.391, alpha P<0.05).7. Logistic regression showed that with cGVHD (OR=4.4, 95%CI=1.25-15.48, P<0.05)?IL-2 (OR=1.12,95%CI=1.01-1.25, P<0.05) were independent risk factors of thyroid dysfunction among patients after HSCT.Conclusion:Patients are likely have the changes of thyroid function after HSCT and survialed more than 1 year. Patients with abnormal thyroid function had higher IL-2, IL-6, IL-17 level than patients with normal thyroid function and some cytokines are associated with thyroid function. Patients with cGVHD after HSCT and the high level of IL-2 were independent risk factors for abnormal thyroid function. |
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