Clinical immunology
Pathogenetic interdependence of thyroid endocrine dysfunction and disturbancies of thymic-dependent immunoregulation

Close functional connections between neuroendocrine homeostasis and thymic dependent regulation of immunity constitute the grounds for supposition that thymic-dependent immunoregulatory dysfunction may participate in pathogenesis of thyroid endocrine hyper- or hypofunction. The suggestion has been confirmed by the results of hormonal and immunological examinations performed in the groups of hyper- and hypothyroid patients. The serum level of TSH, fT3 and fT4, the ATPO and ATG antibodies and cytokine (TNF-, IL-1, IL-1ra, IL-6, IL-8, IL-10) concentrations were determined. In population of mononuclear cells isolated from the blood (PBMC) the quantities of CD3, CD4, and CD8 phenotypes were measured and in the PBMC microcultures the parameters of T lymphocyte immunocompetence (response to mitogens, T cell suppressive activity) and monokine production (LM index, IL-1/IL-1ra ratio) were estimated. The tests were performed in all the patients three times, once before and twice after the one and two months of the course of routine substitutive or modulatory hormonal treatment. The results indicate that the kind and range of immune dysfunctions observed in hyper- and hypothyroid patients were different and dependent on the kind of thyroid malfunction. As a result of routine hormonal treatment the partial improvements of the values of tested immune parameters were achieved, more distinct in the group of hyperthyroid patients. Conclusions: 1) distorted function in pituitary-thyroid axis and thymic-dependent immunoregulatory abnormalities are pathogeneticaly interdependent. 2) immunocorrective treatment with thymic hormones can be expected to further improve the therapeutic results of the routine hormonal treatment of hyper- and hypothyroid patients.