RESUMEN
We addressed the role of soluble Fas (sFas), which suppresses Fas-mediated apoptosis, in the pathogenesis of Graves' disease (GD). The serum concentration of sFas was measured by enzyme-linked immunosorbent assay and the expression of sFas mRNA in thyroid tissues by reverse transcriptase-polymerase chain reaction. The serum concentration of sFas was significantly increased in untreated GD (mean+/-SD: 1.57+/-0.48 ng/mL) compared to age-matched control subjects (0.77+/-0.46 ng/mL). The serum sFas level tended to decrease after the medication of antithyroid drugs for 6 to 8 weeks and was significantly decreased in patients who were euthyroid for more than 3 years (0.98+/-0.23 ng/mL), compared to that in untreated GD. The concentration of serum sFas was significantly correlated with anti-thyrotropin (TSH) receptor antibody titers, but not with the other clinical parameters (free triiodothyronine [FT3], free thyroxine [FT4], TSH, antithyroglobulin antibody titer, antimicrosomal antibody titer, or 123I uptake). The sFas mRNA was detected in thyroid tissue, cultured thyrocytes, and intrathyroidal lymphocytes. sFas was detected in supernatant of cultured thyrocytes from patients with GD. Its production by thyrocytes was induced by culture with interleukin-1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha). The present study confirms serum sFas increases in GD and provides evidence of local production of sFas by thyrocytes and its regulation by cytokines. These data suggest that sFas may play a role in the pathogenesis of GD.
Asunto(s)
Enfermedad de Graves/sangre , Receptor fas/sangre , Adolescente , Adulto , Células Cultivadas , Niño , Citocinas/farmacología , Ensayo de Inmunoadsorción Enzimática , Femenino , Enfermedad de Graves/metabolismo , Enfermedad de Graves/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Concentración Osmolar , ARN Mensajero/metabolismo , Valores de Referencia , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Solubilidad , Glándula Tiroides/metabolismo , Glándula Tiroides/patología , Glándula Tiroides/fisiopatología , Receptor fas/genética , Receptor fas/metabolismoRESUMEN
We studied the utility of color Doppler ultrasonography in patients with subacute thyroiditis. Eighteen patients with subacute thyroiditis (SAT) with painful goiter and thyrotoxicosis underwent color Doppler ultrasonography during the acute and recovery stages of the disease. Thyroid vascularization in these patients was compared with that of 15 untreated patients with Graves' disease and 17 control subjects. During the acute stage of subacute thyroiditis, color Doppler ultrasonography showed low echogenicity without increased tissue vascularity in the affected swollen thyroid. In the recovery stage, color Doppler ultrasonography showed isoechogenicity with slightly increased vascularization. Vascularization became normal at 1 year follow-up time. In contrast, marked by increased vascularization was observed in patients with untreated Graves' disease. Color Doppler ultrasonography showed clear differences between SAT and Graves' disease patients. Vascularity was significantly correlated with serum free thyroxine (FT4) and thyrotropin (TSH) concentrations in the recovery stage (3 months after the initial ultrasonography). Color Doppler ultrasonography accurately visualized lesions without increased vascularity in the acute stage of SAT and lesions of slightly increased vascularity in the recovery stage. Color Doppler ultrasonography may be a useful, noninvasive, and rapid method for differentiating SAT from Graves' disease and for evaluating and monitoring the location and activity of lesions in SAT.