As the most important endocrine gland in the human body, the thyroid gland is responsible for maintaining metabolism and promoting growth and development. Thyroid follicular cells can generate significant amounts of cytokines, which in turn regulate cell growth and promote the emergence of autoimmune inflammation and malignancy. Several in vitro analyses have endorsed that cytokines, especially IL-1 and TNF-α, impede thyrotropin (TSH) uptake and release of labeling products, eventually impacting thyroid function. In addition, inflammation-related cells and cytokines in the tumor microenvironment may play a significant role in the development, progression, invasion, and metastasis of thyroid cancer (TC). In addition, numerous clinical studies indicate that patients with various autoimmune thyroid diseases, such as Graves' disease (GD) and Hashimoto's thyroiditis (HT), have abnormal levels of IL-6 and IL-17.
Figure 1. Autoimmune response in Hashimoto's thyroiditis. (Ehlers M, et al., 2014)
Two antigens, thyroglobulin (Tg) and thyroid peroxidase (TPO), are present in the thyroid follicles. Normally, the thyroid follicular epithelial cells and tight junctions between cells separate them from the extrafollicular space. In vitro experiments demonstrate that IL-1α disturbs this barrier and induces AITD by promoting local antigen-antibody reactions. In addition, research has demonstrated that the expression of IL-1β is significantly increased in the thyroid tissue of individuals with HT.
IL-6 is a versatile cytokine involved in numerous cellular functions. Research indicates that IL-6 can impair the secretory and iodine uptake functions of thyroid cells. Additionally, IL-6 can activate the trans-signaling pathway to induce expression of monocyte chemotactic protein-1 (MCP-1) and clonogenic stimulating factor (CSF), resulting in peripheral blood monocytes and T-lymphocytes congregating within thyroid tissues and provoking an immune-inflammatory response. Due to its high expression in primary GD, IL-6 can serve as an indicator of immune dysfunction in GD.
TNF-α is a significant factor in the inflammatory response process which can stimulate the extensive secretion of inflammatory factors and support neutrophil chemotaxis. An in vitro analysis has confirmed that TNF-α can prompt the expression of intercellular adhesion molecule (ICAM)-1 in human thyroid cells, thereby participating in the autoimmune response of the thyroid gland. Furthermore, the fluctuations of TNF-α and thyroid hormone levels can serve as a crucial determinant for evaluating the status and potential outcomes of critically unwell patients.
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