Lymphocyte profile in patients with Grave’s disease depending on the degree of its compensation

Abstract

Background. In Ukraine today, the main method for the treatment of Grave’s disease (GD) is the administration of antithyroid drugs in order to achieve euthyroidism. At the same time, the leading role in the onset of GD and its relapses belongs to the violation of various links of the immune system, so specification of such disorders remains an urgent task in the development of a system for the prevention of GD relapses. The purpose of this work is to establish the influence of antithyroid drugs on the lymphocyte profile of peripheral blood in patients with GD in order to prescribe adequate immunotropic therapy. Materials and methods. A comparative analysis of peripheral blood lymphocytes was carried out in women with GD on the background of hyperthyroidism and drug compensation. Deviations of individual indicators were established, which could become triggers for disease recurrence. Results. In the group of women with GD during remission after therapy with thyrostatic agents, the normalization of thyroid homeostasis occurred. This was accompanied by a positive dyna­mics (decrease) in the activity of T-helpers and B-lymphocytes that is necessary to reduce the formation of antibodies. At the same time, there was a decrease in suppressor activity with an increase in the immunoregulatory T-suppression index, as well as the formation of a natural killer deficiency. There was an increase in the CD4/CD16 and CD8/CD16 indices, which indicates the predominance of the antibody-dependent immune process over nonspecific cellular cytotoxicity. Conclusions. GD therapy with thyrostatic drugs not only contributes to medical compensation, but also has an immunomodulatory effect. Lymphogram of peripheral blood in treated patients with GD is characterized by a decrease in T-helper acti­vity and B-lymphocyte level (p < 0.05) that reduces antibody formation, by a decrease in T-suppressors and natural killers (p < 0.001) leading to the disease recurrence. Patients with GD receiving thyrostatic agents require additional administration of immunomodulators (including selenium-containing ones), which can increase suppressor activity.

Keywords

• Grave’s disease
• drug therapy
• peripheral blood lymphocyte profile