Skip to main content
SpringerLink
Log in

Long-Term Immunological Study in Graves’ Disease Treated with Thyroid Arterial Embolization

  • Published:
Journal of Clinical Immunology Aims and scope Submit manuscript

Abstract

Objective

The aim of this study was to investigate long-term immunological changes after the treatment of Graves’ disease (GD) with thyroid arterial embolization and the effect of thyroid arterial embolization on the body’s immunological functions.

Materials and methods

Forty-one patients with clinically and laboratorily ascertained GD were treated with thyroid arterial embolization and followed up for 3–54 months following embolization. Prior to embolization and at 1, 3, 6, 12, and 36 months following embolization, thyroid autoimmune antibodies were tested respectively, including thyroid stimulating antibody (TSAb), thyrotropin antibody (TRAb), thyroglobulin antibody (TGAb), and thyroid microsomal antibody (TMAb), as well as subgroup lymphocytes of CD16+CD56+, CD19+, CD3+, CD3+CD4+ and CD3+CD8+. The autoimmune status of GD patients prior to embolization and the dynamic changes of the immunological function after embolization were analyzed.

Results

The therapy of thyroid arterial embolization could effectively decrease the activity/titer and positive rate of TRAb and the ratio of CD4+/ CD8+ to normal levels at 6 months following embolization, while the ratio of CD3+CD8+ increased gradually to normal level at 1 year following embolization. In patients with recurrence, TSAb and TRAb remained at a higher level, while the rate of CD3+CD8+ and the ratio of CD4+/CD8+ were not statistically significantly different from those before embolization.

Conclusion

Immunological functional disorder exists in GD patients. The treatment method of thyroid arterial embolization can effectively resume the basic immunological function to normal range while patients with recurrence have no significant improvement, suggesting that thyroid arterial embolization has an effective role in adjusting the immunological function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Boger MS, Perrier ND. Advantages and disadvantages of surgical therapy and optimal extent of thyroidectomy for the treatment of hyperthyroidism. Surg Clin North Am 2004;84:849–74.

    Article  PubMed  Google Scholar 

  2. Cunnien AJ, Hay ID, Gorman CA, Offord KP, Scanlon PW. Radioiodine-induced hypothyroidism in Graves’ disease: factors associated. J Nucl Med 1982;23:978–83.

    PubMed  CAS  Google Scholar 

  3. Pearce EN, Braverman LE. Hyperthyroidism: advantages and disadvantages of medical therapy. Surg Clin North Am 2004;84:833–47.

    Article  PubMed  Google Scholar 

  4. Chen CR, Pichurin P, Nagayama Y, Latrofa F, Rapoport B, McLachlan SM. The thyrotropin receptor autoantigen in Graves disease is the culprit as well as the victim. J Clin Invest 2003;111:1897–904.

    PubMed  CAS  Google Scholar 

  5. Mitsiades N, Poulaki V, Mitsiades CS, Koutras DA, Chrousos GP. Apoptosis induced by FasL and TRAIL/Apo2L in the pathogenesis of thyroid diseases. Trends Endocrinol Metab: TEM 2001;12:384–90.

    Article  PubMed  CAS  Google Scholar 

  6. Prabhakar BS, Bahn RS, Smith TJ. Current perspective on the pathogenesis of Graves’ disease and ophthalmopathy. Endocr Rev 2003;24:802–35.

    Article  PubMed  CAS  Google Scholar 

  7. Weetman AP. Grave’s disease 1835–2002. Horm Res 2003;59(Suppl 1):114–8.

    Article  PubMed  CAS  Google Scholar 

  8. Cappelli C, Gandossi E, Castellano M, Pizzocaro C, Agosti B, Delbarba A, et al. Prognostic value of thyrotropin receptor antibodies (TRAb) in Graves’ disease: a 120 months prospective study. Endocr J 2007;54:713–20.

    Article  PubMed  CAS  Google Scholar 

  9. Okamoto T, Iihara M, Obara T. Management of hyperthyroidism due to Graves’ and nodular diseases. World J Surg. 2000;24:957–61.

    Article  PubMed  CAS  Google Scholar 

  10. Feldt-Rasmussen U, Glinoer D, Orgiazzi J. Reassessment of antithyroid drug therapy of Graves’ disease. Annu Rev Med 1993;44:323–34.

    Article  PubMed  CAS  Google Scholar 

  11. Toft AD, Weetman AP. Screening for agranulocytosis in patients treated with antithyroid drugs. Clin Endocrinol 1998;49:271.

    Article  CAS  Google Scholar 

  12. Weetman AP. Graves’ disease. N Engl J Med 2000;343:1236–48.

    Article  PubMed  CAS  Google Scholar 

  13. Abraham P, Avenell A, Park CM, Watson WA, Bevan JS. A systematic review of drug therapy for Graves’ hyperthyroidism. Eur Jo Endocrinol 2005;153:489–98.

    Article  CAS  Google Scholar 

  14. Izumi Y, Takeoka K, Amino N. Usefulness of the 2nd generation assay for anti-TSH receptor antibodies to differentiate relapse of Graves’ thyrotoxicosis from development of painless thyroiditis after antithyroid drug treatment for Graves’ disease. Endocr J 2005;52:493–7.

    Article  PubMed  Google Scholar 

  15. Levy EG. Treatment of Graves’ disease: the American way. Baillière’s Clin Endocrinol Metab 1997;11:585–95.

    Article  CAS  Google Scholar 

  16. Galkin EV, Grakov BS, Protopopov AV. First clinical experience of radio-endovascular functional thyroidectomy in the treatment of diffuse toxic goiter. Vestn Rentgenol Radiol. 1994;29–35.

  17. Xiao H, Zhuang W, Wang S, Yu B, Chen G, Zhou M, et al. Arterial embolization: a novel approach to thyroid ablative therapy for Graves’ disease. J Clin Endocrinol Metab 2002;87:3583–9.

    Article  PubMed  CAS  Google Scholar 

  18. Zhao W, Gao BL, Yang HY, Li H, Song DP, Xiang ST, et al. Thyroid arterial embolization to treat Graves’ disease. Acta Radiol 2007;48:186–92.

    Article  PubMed  CAS  Google Scholar 

  19. Trowbridge FL, Matovinovic J, McLaren GD, Nichaman MZ. Iodine and goiter in children. Pediatrics 1975;56:82–90.

    PubMed  CAS  Google Scholar 

  20. Dworkin HJ, Meier DA, Kaplan M. Advances in the management of patients with thyroid disease. Semin Nucl Med 1995;25:205–20.

    Article  PubMed  CAS  Google Scholar 

  21. Lazarus JH. Guidelines for the use of radioiodine in the management of hyperthyroidism: a summary. Prepared by the radioiodine audit subcommittee of the royal college of physicians committee on diabetes and endocrinology, and the research unit of the royal college of physicians. J R Coll Physicians Lond 1995;29:464–9.

    PubMed  CAS  Google Scholar 

  22. Singer PA, Cooper DS, Levy EG, Ladenson PW, Braverman LE, Daniels G, et al. Treatment guidelines for patients with hyperthyroidism and hypothyroidism. Standards of Care Committee, American Thyroid Association. Jama 1995;273:808–12.

    Article  PubMed  CAS  Google Scholar 

  23. Dai WX, Zhang JD, Zhan SW, Xu BZ, Jin H, Yao Y, et al. Retrospective analysis of 18 cases of antithyroid drug (ATD)-induced agranulocytosis. Endocr J 2002;49:29–33.

    PubMed  Google Scholar 

  24. McIver B, Morris JC. The pathogenesis of Graves’ disease. Endocrinol Metab Clin N Am 1998;27:73–89.

    Article  CAS  Google Scholar 

  25. Abe Y. Apoptosis in the pathogenesis of autoimmune thyroid disease. Nippon Rinsho 1999;57:1717–22.

    PubMed  CAS  Google Scholar 

  26. Giovanella L, Ceriani L, Garancini S. Evaluation of the 2nd generation radio-receptional assay for anti-TSH receptor antibodies (TRAb) in autoimmune thyroid diseases. Comparison with 1st generation and anti-thyroperoxidase antibodies (AbTPO). Q J Nucl Med 2001;45:115–9.

    PubMed  CAS  Google Scholar 

  27. Fisfalen ME, Palmer EM, Van Seventer GA, Soltani K, Sawai Y, Kaplan E, et al. Thyrotropin-receptor and thyroid peroxidase-specific T cell clones and their cytokine profile in autoimmune thyroid disease. J Clin Endocrinol Metab 1997;82:3655–63.

    Article  PubMed  CAS  Google Scholar 

  28. Li L, Paul S, Tyutyulkova S, Kazatchkine MD, Kaveri S. Catalytic activity of anti-thyroglobulin antibodies. J Immunol 1995;154:3328–32.

    PubMed  CAS  Google Scholar 

  29. McIntosh RS, Asghar MS, Weetman AP. The antibody response in human autoimmune thyroid disease. Clin Sci (Lond) 1997;92:529–41.

    CAS  Google Scholar 

  30. Song YH, Li Y, Maclaren NK. The nature of autoantigens targeted in autoimmune endocrine diseases. Immunol Today 1996;17:232–8.

    Article  PubMed  CAS  Google Scholar 

  31. Weetman AP, McGregor AM. Autoimmune thyroid disease: further developments in our understanding. Endocr Rev 1994;15:788–830.

    Article  PubMed  CAS  Google Scholar 

  32. Okita N, Row VV, Volpe R. Suppressor T-lymphocyte deficiency in Graves’ disease and Hashimoto’s thyroiditis. J Clin Endocrinol Metab 1981;52:528–33.

    PubMed  CAS  Google Scholar 

  33. Tamai H, Uno H, Hirota Y, Matsubayashi S, Kuma K, Matsumoto H, et al. Immunogenetics of Hashimoto’s and Graves’ diseases. J Clin Endocrinol Metab 1985;60:62–6.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

This study was supported by the Association of Science and Technology of Yunnan Province (2002C0012Z), China.

Author information

Authors and Affiliations

  1. Medical Imaging Center, First Affiliated Hospital, Kunming Medical College, 295 Xicang Road, Kunming, Yunnan Province, China

    Wei Zhao, Bu-Lang Gao, Cang-Zheng Jin, Gen-Fa Yi, Ji-Hong Hu & Yong-Neng Jiang

  2. Endocrinology Department, First Affiliated Hospital, Kunming Medical College, Kunming, Yunnan Province, China

    Hui-Ying Yang, Hong Li & Dian-Ping Song

Authors
  1. Wei Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bu-Lang Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cang-Zheng Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gen-Fa Yi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hui-Ying Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hong Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Dian-Ping Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ji-Hong Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yong-Neng Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bu-Lang Gao.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhao, W., Gao, BL., Jin, CZ. et al. Long-Term Immunological Study in Graves’ Disease Treated with Thyroid Arterial Embolization. J Clin Immunol 28, 456–463 (2008). https://doi.org/10.1007/s10875-008-9209-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10875-008-9209-0

Keywords

Search

Navigation