Introduction: Graves'disease (GD) is a polygenic and multifactorial disease.
The innate immune system is a complex network of structured cells and proteins, including the Toll-like receptors (TLRs), which are also expressed on the cells of the adaptive immune system.
The aim was to assess the relationship between the expression of TLR-2 on the surface of T CD4+ and CD8+ lymphocytes in patients with GD, and selected clinical and laboratory parameters.
Material and Methods: The study group consisted of 32 girls with newly diagnosed GD. The control group included 20 healthy girls. Peripheral blood (10 ml) was also taken from girls with GD after obtaining euthyreosis due to effective thyrostatic therapy. Immunophenotyping was performed using the flow cytometry method.
Results: The mean percentage of CD4+/ TLR-2+ T cells and CD8+/TLR-2+ T cells in the PB of patients with GD prior to treatment in comparison with the percentage of these lymphocytes in the control group was statistically significantly higher (P<0.0001). The mean percentage of CD4+/TLR-2+ T lymphocytes in the PB of patients with GD prior to treatment implementation was 1.32±0.59%. The average percentage of these cells in the group of healthy controls was 0.26±0.11%. After obtaining euthyreosis as a result of the treatment, the mean percentage of CD4+/TLR-2+ T cells in the PB of the studied group of patients with GD decreased to 0.59±0.09% and this difference was statistically significant compared to the pre-treatment value (P<0.0001), but still remained higher than in the control group (P=0.0003). A statistically significant correlation was found between the expression of TLR-2 antigen on CD4+ T lymphocytes and serum FT3 concentration in patients with GD before treatment (r=0.47, P=0.007). The mean percentage of CD8+/TLR-2+ T cells in the PB of patients with GD prior to treatment implementation was 4.01±2.37%. The average percentage of these cells in the group of healthy people was 1.30±1.46%. The mean percentage of CD8+/TLR-2+ T cells in the PB of the studied group of patients with GD before treatment compared to the percentage of these cells in patients with GD after obtaining euthyreosis (2.35±1.27%) was statistically significantly higher (P=0.0163). After obtaining euthyreosis no statistically significant differences were found between patients with GD and control group.
Conclusion: Toll-like receptor 2 is expressed on significant percentage of T lymphocytes in patients with Graves' disease and is associated with the clinical response to treatment.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology