Thyroid specific T helper cell analysis by ELISPOT assay with thyrotropin receptor (TSH-R) peptides

We previously reported that a synthetic peptide induced humoral autoimmunity to thyrotropin receptor (TSH-R) and the expansion of antigen-specific type 2 helper T (Th2) cell population in mice. The peptide corresponds to the human TSH-R C-terminal region. In the present study, we undertook a similar approach in patients with Graves' disease (GD). Peripheral lymphocytes from 5 healthy controls and 11 GD patients were prepared and analyzed for cytokines from helper T cells by an antigen specific enzyme-linked immuno spot (ELISPOT) assay. In GD patients, the total number of IL-4 producing cells increased significantly and the number of interferon-gamma(IFN-gamma) producing cells decreased. Further, co-incubation with several of the 20 kinds of TSH-R extracellular peptides increased the number of IL-4 producing cells in patients with GD. Such stimulatory peptides appear frequently in a TSH-R sequence. These peptides did not affect the numbers of IFN-gamma producing cells significantly. These results indicated that GD patients have an expanded Th2 population responding to TSH-R and the dominance of the humoral immune system in such patients.