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Innate and acquired immune system in patients developing interferon-alpha-related autoimmune thyroiditis: a
G Mazziotti1, F Sorvillo, M Piscopo
1Department of Clinical and Experimental Medicine, F. Magrassi and A. Lanzara, Second University of Naples, Via Crispi 44, 80121 Naples, Italy.
The Journal of Clinical Endocrinology and Metabolism
|April 28, 2005
Summary
Interferon (IFN)-alpha-related autoimmune thyroiditis (IFN-AT) development correlates with cytokine changes. Euthyroid patients show early Type 2 immune response, while those with thyroid dysfunction exhibit a predominant Type 1 response.
Area of Science:
- Immunology
- Endocrinology
- Virology
Background:
- Interferon (IFN)-alpha therapy for Hepatitis C Virus (HCV) can induce autoimmune thyroiditis (IFN-AT).
- The specific cytokine profiles associated with the development and progression of IFN-AT remain incompletely understood.
Purpose of the Study:
- To investigate the correlation between sequential changes in peripheral lymphocyte cytokine patterns and the development of IFN-alpha-related autoimmune thyroiditis (IFN-AT).
- To differentiate cytokine responses in patients who develop euthyroid IFN-AT versus those who develop thyroid dysfunction.
Main Methods:
- Prospective study of 18 HCV-positive patients with IFN-AT (8 euthyroid, 10 with dysfunction) and 20 controls.
- Intracellular IFN-gamma and IL-4 expression in peripheral lymphocytes analyzed via multicolor flow cytometry after in vitro stimulation.
- Analysis conducted at the appearance of thyroid disease and at a 6-month follow-up.
Main Results:
- Both euthyroid and dysfunctional IFN-AT patients showed increased IFN-gamma at disease onset.
- Euthyroid IFN-AT patients additionally showed increased IL-4, maintained at 6 months.
- Thyroid-dysfunctional IFN-AT patients exhibited increased IFN-gamma and decreased IL-4 at 6 months.
Conclusions:
- A Type 2 immune response is activated early and specifically in euthyroid IFN-AT patients.
- A predominant Type 1 immune response, potentially earlier in the innate immune system, is observed in patients developing thyroid dysfunction.