Environmental factors can play an important role in the development of autoimmune thyroiditis (AT) and other autoimmune diseases. This article reviews the role of heavy metals and infectious agents in AT. Currently, the genes responsible for a metal-induced pathology are known in experimental animals but similar knowledge is lacking in man. Metals such as nickel or mercury induce delayed type T cell hypersensitivity (allergy) which is relatively common, especially in women. T-cell allergy can be studied with the lymphocyte transformation test, LTT-MELISA. It has been found that patients with AT and other autoimmune diseases, such as multiple sclerosis, psoriasis, systemic lupus erythematosus and atopic eczema, show increased lymphocyte reactivity in vitro to inorganic mercury, nickel and other metals compared to healthy controls. The important source of mercury is dental amalgam. Replacement of amalgam in mercury-allergic subjects resulted in improvement of health in about 70% of patients. Several laboratory parameters such as mercury-specific lymphocyte responses in vitro and anti-thyroid autoantibodies were normalized as well. In contrast, no changes in health and laboratory results were observed in mercury-allergic patients who did not have their amalgams replaced. The same was true for non-allergic patients who underwent amalgam replacement. Infectious agents such as Helicobacter pylori (Hp) may cause chronic inflammation and autoimmune reactivity in susceptible subjects. The results of in vitro experiments performed with lymphocytes from Hp infected patients indicate that Hp can cause immunosuppression which might be eliminated by successful eradication therapy. In conclusion, heavy metals and Hp infection may play an important role in AT. Laboratory tests, such as LTT-MELISA, can help to determine the specific etiological agents causing inflammation in individual patients. The treatment of AT and other autoimmune diseases might be improved if such agents are eliminated and any future exposure restricted.
- MeSH
- aktivace lymfocytů účinky léků MeSH
- autoimunitní tyreoiditida chemicky indukované komplikace imunologie MeSH
- Helicobacter pylori imunologie MeSH
- lidé MeSH
- těžké kovy škodlivé účinky MeSH
- vystavení vlivu životního prostředí škodlivé účinky MeSH
- zánět chemicky indukované komplikace imunologie MeSH
- zubní amalgam škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
Helicobacter pylori (Hp) contributes to the development of gastric and extra-gastric diseases such as autoimmune thyroiditis (AT), and causes persistent life-long infection despite local and systemic immune response. We determined the specific cellular immune response to Hp antigens and PWM (control mitogen) in two groups of Hp infected patients--group A (n = 21), involving patients with autoimmune thyroiditis and group B (n = 13) of patients without AT--using modified lymphocyte transformation test before and after eradication therapy in comparison with healthy controls (group C, n = 15). Immune reactivity to the majority of Hp antigens (aHp, hHp, HpAg, CagA) was significantly lower in group B before eradication therapy in comparison with healthy Hp negative controls. A significant increase in immune reactivity was observed in group B to certain Hp antigens after successful eradication. The same levels (but insignificant) of immune reactivity were shown in group A. Our results indicate that Hp can cause the inhibition of the specific cellular immune response in Hp infected patients with or without autoimmune diseases such as AT, which can be abrogated by successful eradication of Hp. Lymphocyte transformation test appears to be a good tool for detection of immune memory cellular response in patients with Hp infection
- MeSH
- antigeny bakteriální imunologie MeSH
- autoimunitní tyreoiditida imunologie komplikace MeSH
- dospělí MeSH
- financování organizované MeSH
- Helicobacter imunologie MeSH
- imunologická tolerance MeSH
- infekce vyvolané Helicobacter pylori imunologie klasifikace MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfocyty imunologie MeSH
- proliferace buněk MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
Lymfocytární transformační test nebo test blastické transformace či proliferační aktivity lymfocytů patří mezi in vitro vyšetřovací metody v imunologii, zaměřené na hodnocení specifické buněčné imuni ty u pacientů s imunodeficiencemi, autoimunitními, infekčními a nád orovými onemocněními. O jeho využití v klinické praxi se v poslední době vedou polemiky vzhledem k celé řadě technických a koncepčních faktorů, které mohou ovlivnit výsledky. Proto je v některých oblastech imun ologické diagnostiky nahrazován jinými metodami (vyšetření aktivačn ích znaků lymfocytů, stanovení produkce intracelulárních cytokinů). Propraco vání a validace lymfocytárního transformačního testu však můž e přispět k lepší diagnostice některých alergických a infekčních onemocnění.
The lymphocyte transformation test or the test of lymphocyte transformation or proliferation activity of lymphocytes belongs to in vitro diagnos- tic methods in immunology for evaluation of specific cellular imunity in patiens with immunodeficiences, autoimmune, infectious and tumor diseases. In the last time, its use in clinical practice is discussed because of many technical and conceptual factors affectin g results. Accordingly, this test is often replaced by other methods (detection of lymphocyte activation markers, detection of production of intracellu lar cytokines). Therefore the modification and validation of the lymphocyte transf ormation test can contribute to improvement of diagnostics of some allergic and infectious diseases.
