| Objective: To observe and analyze the differences in distribution of Hashimoto’s thyroiditis(HT)patients and their related antibody levels in patients of different ages in men and women admitted to Yichang Central People’s Hospital in the five years from January 2014 to December 31,2018..In this study,a mouse model of Hashimoto’s thyroiditis was established.By examining the differences in tfh / tfr ratios between groups,the possible role of sex hormone levels in the pathogenesis of Hashimoto’s thyroiditis was explored.Methods: 1.Analysis of clinical data: 2014-01-01—2018-12-31,a total of 2705 HT patients treated in our hospital were divided into children group(n = 32)and adolescent group(n = 135)according to age.And the adult group(n = 2538),the females in the adult group were divided into ≤50 years old group(n = 1645)and> 50 years old group(n = 519),and the adult group was divided into TSH normal group(n = 1213)Compared with the TSH abnormal group(n = 1325),the sex ratio of HT men and women in different age groups was compared.Analysis of thyroid peroxidase antibody(TPOAb)and thyroid Changes in levels of globulin antibodies(Tg Ab).2.Mice experiment part:1)grouping: C57 mice aged 4-6 weeks were divided into eight groups after adaptive feeding for one week: normal female group,normal male group,female immune group,male immune group,ovariectomized female non immune group,ovariectomized female immune group,testicular male non immune group,and testicular male immune group,six in each group.2)Operation: according to the operation group,the mice were divided into two groups:ovariectomy and testicle removal.After the operation,the mice were rested for 3 weeks,during which the state of the mice was observed.3)Modeling: Pig thyroglobulin(PTG)was dissolved by PBS and mixed with Freund’s adjuvant.All mice were injected subcutaneously at multiple points on the back and neck once a week for two weeks.PTG antigen emulsified by incomplete Freund’s adjuvant was injected once a week for three weeks.The mice in the control group were injected subcutaneously at the same dose of PBS and adjuvant.Drinking high iodine water(0.05%)every day,observing the state change of mice during the experiment.4)One week after the completion of immunization,the samples were collected from serum,thyroid and spleen tissues.The levels of Tg Ab and TPOAb in serum were detected by ELISA,the pathological condition of thyroid tissue was detected by HE staining,and the follicular helper T cells(Tfh)and follicular regulatory T cells(follicular helper T cells)were detected by flow cytometry The cell number of regulatory T cells(Tfr)was calculated and the ratio between them was calculated.The difference of Tfh / Tfr ratio between groups was compared by t-test.3.Results:1.There was no significant difference in the proportion of HT between the male and female age groups.There was a certain difference in TPOAb and Tg Ab levels among the three groups.There was no significant difference in TPOAb and Tg Ab levels between the adult group and the adult group.The level of Tg Ab was significantly different between the normal and abnormal TSH groups.The results of HE staining showed that there were pathological differences between the immune group and the non immune group,and the levels of Tg Ab and TPOAb in the immune group were higher than those in the non immune group.The ratio of Tfh/Tfr in the immune group was significantly higher than that in the non immune group.The ratio of Tfh/Tfr in the female immune group was higher than that in the male immune group,the female immune group was higher than that in the ovariectomized female immune group,the testicle free male immune group and the male immune group.Conclusion: In the clinical analysis of Hashimoto’s thyroiditis,we found that the incidence of HT was significantly higher in women than in men,and although there was no significant difference in the incidence rate among the three groups in childhood,adolescence,and adulthood,the incidence of HT was higher in women than in men and increased in the three groups,suggesting that estrogen may be related to this difference.Through animal experiments,we found that the Tg Ab level of female mice after immunization was significantly higher than that of male mice after immunization,and the comparison between the groups revealed that the Tfh/Tfr ratio was significantly different in different estrogen levels.Therefore,we speculated that in the process of Hashimoto’s thyroiditis formation,estrogen may affect the difference in the incidence of Hashimoto’s thyroiditis between men and women by regulating the balance between Tfh and Tfr cells.In-depth exploration to investigate sex differences in incidence and their mechanisms in HT may provide new directions for future research on HT treatments. |
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