Stress-Related Immune Response and Selenium Status in Autoimmune Thyroid Disease Patients

Autoimmune thyroid disease (AITD), including Graves' disease (GD) or Hashimoto's thyroiditis (HT), occurs due to genetic susceptibility and environmental factors, among which the role of stressful events remains controversial. This study investigated the relationship between the number and impact of stressful life events in AITD patients with selenium status, and the Th1/Th2/Th17 immune response. The study population included three groups: HT ( n = 47), GD ( n = 13), and a control group ( n = 49). Thyroid function parameters, autoantibody levels, and the plasma levels of cytokines, selenium, selenoprotein P (SeP), and glutathione peroxidase 3 (GPx) activity were measured. Participants filled out the Life Experiences Survey. No significant differences in the number of stressful life events were found among the patients with HT, GD, and the controls. A higher (median (interquartile range)) negative stress level (8 (4-12)) than a positive stress level (3 (1-9)) was found in the HT group. The HT group showed a correlation between SeP and the positive stress level: r s = -0.296, p = 0.048, and the GD group between GPx and the negative stress level (r s = -0.702, p = 0.011). Significant positive correlations between thyroid peroxidase antibody level and the total number of major life events ( p = 0.023), the number of major life events in the last 7-12 months, and the number of major life events with no impact and a negative stress level were found. We suggest that the measurements of Th2-related cytokines and selenoproteins could be used as biomarkers for the development of AITD in cases where stress is considered a component cause of the pathogenic mechanism of the disease.publishersversionPeer reviewe

The role of stress in the pathogenesis of autoimmune thyroid diseases

MedicīnaVeselības aprūpeMedicineHealth CareIevads Autoimūnās vairogdziedzera slimības ir multifaktoriālās saslimšanas. Stresa kā ārējās vides faktora loma vairogdziedzera autoimūno slimību patoģenēzē joprojām nav skaidra, neskatoties uz labu teorētisko pamatojumu. Mērķis Noteikt un aprakstīt saistību starp psihosociālo stresu un vairogdziedzera autoimūno slimību patoģenēzi. Materiāli un metodes Pētījumā tika iekļauti 99 pacienti. Pētāmā kohorta tika sadalīta divās daļās: pacienti ar vairogdziedzera autoimūno slimību (n=61) (Greivsa slimība vai autoimūnais tireoidīts) un kontroles grupa (n=38). Asiņu paraugi tika paņemti lai noteiktu anti-TPO antivielu koncentrāciju, anti-TSHR antivielu koncentrāciju, brīva tiroksīna un brīva trijodtironīna koncentrāciju. Psihosociālā stresa līmenis tika novērtēts izmantojot specializēto anketu par nozīmīgiem dzīves notikumiem. Pacienti aizpildīja arī anketu par citiem faktoriem, kas ietekmē vairogdziedzera autoimūno slimību patoģenēzi. Iegūtie dati tika analizēti IBM SPSS 26.0 versijas programmā. Rezultāti Ir atrasta vāja, bet statistiski nozīmīga korelācija starp anti-TPO antivielu koncentrāciju un negatīva psihosociālā stresa līmeni r(87)=0,337, p=0,001. Atrastās saistības lineārās regresijas analīze parādīja, ka negatīvajam stresam palielinoties par vienu vienību, anti-TPO antivielu koncentrācija palielinās par 14,288 vienībām un šī sakarība ir statistiski nozīmīga (t=2,093; p=0,039; 95% CI 0,717- 27,86). Binārās loģistiskās regresijas modelis liecina, ka negatīva stresa līmeņa palielināšanās par vienu vienību, palielina izredzes konstatēt vairogdziedzera autoimūno slimību par 9,3% (p=0,025; 95% CI 1,1% - 18,1%). Netika atrastas statistiski nozīmīgas korelācijas starp negatīvo stresu, vairogdziedzera hormoniem un antivielām pret TSH receptoru: fT3 (p=0,052); fT4 (p=0,236); anti-TSHR antivielas (p=0.271). Secinājumi Rezultāti liecina, ka psihosociālā stresa sakarībai ar vairogdziedzera autoimūnajām slimībām ir lielākā nozīme autoimūnā tireoidīta attīstībā nekā Greivsa slimības attīstībā.Objectives. Autoimmune thyroid diseases are multifactorial disorders. The role of psychosocial stress as the environmental factor in the pathogenesis of autoimmune thyroid diseases is still unclear despite a good theoretical base. This research aims to describe the relationship between psychosocial stress and the pathogenesis of thyroid autoimmune diseases. Methods. In this research, 99 patients were included. The study cohort was divided into two groups: patients with autoimmune thyroid disease (Graves’ disease or Autoimmune thyroiditis) (n=61) and healthy controls (n=38). Blood samples were obtained to assess the levels of thyroid peroxidase (TPO) antibodies, TSH receptor antibodies, free triiodothyronine, and thyroxine. The level of psychosocial stress was assessed by an international questionnaire on Recent Experienced Stressful Life Events. Patients were asked to fill the survey about other lifestyle factors that influence the pathogenesis of thyroid autoimmune disorders. Data were analyzed by using IBM SPSS version 26.0. Results. There is a weak but statistically significant relationship between TPO antibodies level and negative psychosocial stress r(87)=0,337, p=0,001. Linear regression analysis showed that when the level of negative stress increases by 1 unit, the level of TPO antibodies increases by 14,288 units (95% CI 0,717- 27,86) and this relationship is statistically significant (t=2,093; p = 0,039). According to the binary logistic regression model, an increase in the level of negative stress by one unit increases the odds of being diagnosed with autoimmune thyroid disease by 9,3% (95% CI 1,1% - 18,1%) after adjusting for age. The relationship between thyroid hormones, TSH receptor antibodies and negative psychosocial stress was not statistically significant- fT3 (p=0,052); fT4 (p=0,236); TSH-R antibodies (p=0.271). Conclusions. The data suggest that the relationship between psychosocial stress and autoimmune thyroid diseases is of greater importance in patients with autoimmune thyroiditis, but not in patients with Graves’ disease

Stress-Related Immune Response and Selenium Status in Autoimmune Thyroid Disease Patients

Autoimmune thyroid disease (AITD), including Graves’ disease (GD) or Hashimoto’s thyroiditis (HT), occurs due to genetic susceptibility and environmental factors, among which the role of stressful events remains controversial. This study investigated the relationship between the number and impact of stressful life events in AITD patients with selenium status, and the Th1/Th2/Th17 immune response. The study population included three groups: HT (n = 47), GD (n = 13), and a control group (n = 49). Thyroid function parameters, autoantibody levels, and the plasma levels of cytokines, selenium, selenoprotein P (SeP), and glutathione peroxidase 3 (GPx) activity were measured. Participants filled out the Life Experiences Survey. No significant differences in the number of stressful life events were found among the patients with HT, GD, and the controls. A higher (median (interquartile range)) negative stress level (8 (4–12)) than a positive stress level (3 (1–9)) was found in the HT group. The HT group showed a correlation between SeP and the positive stress level: rs = −0.296, p = 0.048, and the GD group between GPx and the negative stress level (rs = −0.702, p = 0.011). Significant positive correlations between thyroid peroxidase antibody level and the total number of major life events (p = 0.023), the number of major life events in the last 7–12 months, and the number of major life events with no impact and a negative stress level were found. We suggest that the measurements of Th2-related cytokines and selenoproteins could be used as biomarkers for the development of AITD in cases where stress is considered a component cause of the pathogenic mechanism of the disease