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CLINICAL STUDY |
Medical Department M, 1 Medical Department C, and 2 Immunoendocrine Research Unit, Medical Department M, Aarhus University Hospital, Aarhus, Denmark, 3 Institute of Clinical Medicine, and 4 Institute of Medical Microbiology and Immunology, Aarhus University, 8000 Aarhus, Denmark
(Correspondence should be addressed to Anne Lene D Riis; Email: anne.lene.riis{at}ki.au.dk)
Background: Recent studies have indicated the existence of causal links between the endocrine and immune systems and cardiovascular disease. Mannan-binding lectin (MBL), a protein of the innate immune system, may constitute a connection between these fields.
Methods: To test whether thyroid hormone regulates MBL levels, we studied eight patients with Graves hyperthyroidism before and after methimazole therapy, eight healthy subjects before and after short-term experimental hyperthyroidism, and eight hypothyroid patients with chronic auto-immune thyroiditis before and after L-thyroxine substitution.
Results: In all hyperthyroid patients, MBL levels were increased median (range), 1886 ng/ml (14787344) before treatment and decreased to 954 ng/ml (3123222) after treatment (P = 0.01, paired comparison: Wilcoxons signed ranks test). The healthy subjects had MBL levels of 1081 ng/ml (3121578). Administration of thyroid hormones to these persons induced mild hyperthyroidism and increased MBL levels significantly to 1714 ng/ml (3562488) (P = 0.01). Two of the eight hypothyroid patients had undetectably low levels of MBL both before and after L-thyroxine substitution. The other six hypothyroid patients had decreased levels of MBL of 145 ng/ml (20457) compared with 979 ng/ml (2141533) after L-thyroxine substitution (P = 0.03, paired comparison: Wilcoxons signed ranks test).
Conclusion: Our data show that thyroid hormone increases levels of MBL. MBL is part of the inflammatory complement system, and this modulation of complement activation may play a role in the pathogenesis of a number of key components of thyroid diseases.
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