tretinoin and Hashimoto-Disease

TCR γδ(+) Τ cells are important in the pathogenesis of inflammatory and autoimmune conditions. This study investigated the effect of γδ T cells on autoantibody production in patients with Hashimoto's thyroiditis (HT). A total of 148 subjects were enrolled, including 99 patients with HT, 5 with simple goiters, and 44 healthy controls. Peripheral blood and thyroid mononuclear cells were subjected to flow cytometric analysis. Thyroid tissues underwent immunofluorescent staining and immunohistochemistry for γδ T cells and anti-thyroid antibody detection. Antibody production was measured by ELISA and automated chemiluminescent immunoassays. And activation and apoptosis of peripheral blood γδT cells and B cells were measured by flow cytometric analysis. The percentage of γδ T cells were greater in thyroid tissue from HT patients than that of goiter patients (n = 5, 5.33 ± 1.20 vs. 2.07 ± 0.44 %; P < 0.05), with the Vδ1(+) γδ T cell subset especially dominant. Frequencies of CD69 (8.42 ± 1.08 vs. 1.60 ± 0.38 %, P < 0.001), HLA-DR (58.12 ± 6.36 vs. 37.82 ± 3.70 %, P < 0.05), CD40L (1.58 ± 0.35 vs. 0.15 ± 0.05 %, P < 0.01), and ICOS (2.78 ± 0.66 vs. 0.28 ± 0.13 %, P < 0.01) expressed on γδ T cells from HT patients (n = 19) were significantly increased compared with those of healthy controls (n = 15). More importantly, γδ T cells from HT patients enhanced B cells for antibody production, and all-trans retinoic acid (ATRA) treatment inhibited the effect by inducing apoptosis of γδ Τ cells. γδ Τ cells appear to play an important role in the pathogenesis of HT, and ATRA might be an effective regulator for HT patients.

Topics: Adult; Aged; Antibody Formation; Apoptosis; B-Lymphocytes; Case-Control Studies; Cell Communication; Female; Hashimoto Disease; Humans; Male; Middle Aged; T-Lymphocytes; Tretinoin; Young Adult

A 58-year-old woman presented with a seven-year history of an eruption on her lower legs that was associated with edema, weeping, pruritus, and a burning sensation. Past medical history included Hashimoto thyroiditis, which was diagnosed eight years prior to presentation. Histopathologic examination was consistent with necrobiosis lipoidica (NL). To our knowledge, NL that is associated with Hashimoto thyroiditis has been described in only one prior report. NL is a chronic, cutaneous, granulomatous condition with degenerative connective-tissue changes of unknown etiology. Our patient responded well to a potent topical glucocorticoid and topical tretinoin. Although our patient did not have diabetes mellitus, 75 percent of patients with NL have diabetes mellitus at the time of diagnosis or will subsequently develop diabetes mellitus. This association with diabetes mellitus mandates screening for glucose intolerance in all patients with NL.

Topics: Administration, Cutaneous; Biopsy; Drug Therapy, Combination; Female; Glucocorticoids; Glycated Hemoglobin; Hashimoto Disease; Humans; Middle Aged; Necrobiosis Lipoidica; Tretinoin