Endocrine Abstracts

Context: Autoimmune thyroid pathology can lead to serious complications of pregnancy and can be combined with generalized autoimmune imbalance, in particular, in the endometrium. The imbalance in the regulation of the immunocompetent cells activity and the increase of cytokines production are one of the reasons for the failed implantation or disruption of embryo development with future consequences

Objective: To assess the role of paracrine factors (expression of autoantibodies against cytokine receptors IL-1 alpha, IL-2, TNF-alpha, interferon-gamma) in the endometrium in women with autoimmune thyroid diseases and misscariages.

Methods: Immunohistochemical endometrium study was performed on the immunostimulator Leica Bond-Max (Leica Microsystems, Germany). The expression value of markers IL-2 receptor, IL-1α, TNFα, INF-γ was performed using mouse/monoclonal antibodies (Santa Cruz Biotechnology). The immunohistochemical reactions were assessed by a quantitative score method for immunointensity of 0 to 3 (0 - negative; 1 - weak; 2 - moderate; 3 - strong). For reliability of the differences was used Spearman’s nonparametric rank correlation method. Statistically significant differences were considered for P<0.05.

Patients: 84 women, considering pregnancy, divided into 4 groups: 1- women with reproductive losses and hypothyroidism as outcome of Hashimoto disease, n=21, mean age - Me 34 [30; 37], 2- TPOAb⁺ positive women with a history of reproductive losses, n=21, mean age - Me 33 [30; 38], 3- women with reproductive failures without autoimmune thyroid disease, n=21, mean age - Me 30 [26; 35], 4- healthy women of the control group, n=21, mean age - Me 29 [27; 34].

Main outcome Measures: In comparative analysis in all 4 groups was negative expression of IL- 1 alpha and IL-2/CD 25 (P>0,05). Significant differences in the expression level of IFN gamma were observed in glands in the group with hypothyroidism and TPOAb⁺ positive women (P=0,06 and P=0,001 respectively) than in control group. Furthermore, a negative correlation of expression TNF alpha was observed between the group of women with autoimmune thyroid pathology and women with misscariage and normal thyroid function.

Results: In the course of the research work was revealed an increased level of IFN expression in the group of women with with both hypothyroidism and TPOAb⁺ positive women.

Conclusion: Expression of IFN gamma is helpful to assess the risk of a possible complication of pregnancy in women with autoimmune thyroid disease, but further research is required. Supported by Grant of President of Russian Federation ND MK-4717.2012.7