Fibroblasts expressing the thyrotropin receptor overarch thyroid and orbit in Graves' disease

格雷夫斯病中表达促甲状腺激素受体的成纤维细胞覆盖甲状腺和眼眶

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作者:Terry J Smith, Dolly A Padovani-Claudio, Ying Lu, Nupur Raychaudhuri, Roshini Fernando, Stephen Atkins, Erin F Gillespie, Andrew G Gianoukakis, Barbra S Miller, Paul G Gauger, Gerard M Doherty, Raymond S Douglas

Conclusions

ColI(+)CXCR4(+)TSHR(+) thyroid fibroblasts resemble orbital fibroblasts and circulating fibrocytes. CD34(+) fibrocytes appear to infiltrate both tissues in GD. Thyroid fibroblasts lose CD34 display in culture, unlike orbital fibroblasts and circulating fibrocytes. Fibrocytes and their fibroblast derivatives may participate in the pathogenesis of thyroid autoimmunity after TSHR activation. They could represent a therapeutic target for these diseases.

Objective

The aim of the study was to identify and characterize CD34(+) fibrocytes in thyroid tissue. Design/setting/participants: Patients undergoing surgical thyroidectomy at two academic medical centers were recruited to the study. Main outcome measures: We performed immunohistochemistry, flow cytometry, real-time PCR, cytokine-specific ELISA, and cell differentiation.

Results

CD34(+)ColI(+)CXCR4(+)TSHR(+) cells can be identified in situ in thyroid tissue from donors with GD, Hashimoto's thyroiditis, or in normal-appearing tissue. Thyroid fibroblasts cultivated from these glands express a CD34(-)ColI(+)CXCR4(+)TSHR(+) phenotype. TSHR levels are higher than those in orbital fibroblasts. When treated with TSH, thyroid fibroblasts generate IL-6 and IL-8. The induction of IL-6 can be blocked by dexamethasone, a chemical inhibitor of Akt/Pkb, and by knocking down Akt with a specific small interfering RNA. When treated with TGF-β or rosiglitazone, thyroid fibroblasts differentiate into myofibrocytes or adipocytes, respectively. Conclusions: ColI(+)CXCR4(+)TSHR(+) thyroid fibroblasts resemble orbital fibroblasts and circulating fibrocytes. CD34(+) fibrocytes appear to infiltrate both tissues in GD. Thyroid fibroblasts lose CD34 display in culture, unlike orbital fibroblasts and circulating fibrocytes. Fibrocytes and their fibroblast derivatives may participate in the pathogenesis of thyroid autoimmunity after TSHR activation. They could represent a therapeutic target for these diseases.

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