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Third Department of Internal Medicine, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo City, Yamanashi 409-3898, Japan
(Correspondence should be addressed to T Endo; Email: endot{at}yamanashi.ac.jp)
This is an Open Access article distributed under the terms of the Society for Endocrinology's Re-use Licence which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
| Abstract |
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| Introduction |
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Chronic autoimmune thyroiditis is characterized by serum autoantibodies against thyroglobulin (Tg) and thyroid peroxidase (TPO), and histologically by fibrosis and varying degrees of lymphocytic infiltration in the thyroid (Dayan & Daniels 1996). The appearance of MHC class II molecules on thyroid cells which has been correlated with
-interferon-containing T cells (Bottazzo et al. 1983), has been thought to be the initiating factor in chronic autoimmune thyroiditis (Hamilton et al. 1991). Patients with Graves' disease also produce autoantibodies against Tg and TPO, and the disease is characterized by thyroid-stimulating autoantibody (TSAb) against thyrotropin receptor (TSHR). This functional autoantibody stimulates hormone synthesis, secretion, and cell growth, and induces thyrotoxicosis and goiter in the disease (Kohn & Shifrin 1982). However, the precise mechanisms in which TSHR peptides are presented as antigens still remain unclear.
Shimojo et al. (1996) succeeded in producing a mouse model of Graves' disease by immunization with fibroblasts expressing both TSHR and MHC class II molecules, after they clearly demonstrated that co-expression of MHC class II molecule and TSHR on the cell surface were necessary for producing TSAb in AKR/N mice. Therefore, clarification of the conditions or the environments that induce aberrant expression of MHC class II molecules in the antigen-presenting cells are important for understanding the pathogenesis of Graves' disease.
We hypothesize here that pathological conditions such as autoimmune thyroiditis and lymphocytic infiltration in thyroid glands must precede the production of TSAb. Thus, we have produced experimental autoimmune thyroiditis in mice by immunizing them with Tg and we monitored the iodide uptake activity of their thyroid glands. We found that some of them exhibited the symptoms of Graves' disease.
| Materials and methods |
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All studies performed were approved by the Animal Research Committee, Yamanashi University. Female AKR/N mice and C57BL6 mice were obtained from CLEA Japan, Inc., Tokyo, Japan. All mice were specific pathogen free and checked for pathogens once every 2 months. All mice were 12–14 weeks old at the beginning of the experiments. Bovine Tg (0.5 mg/ml) purchased from Sigma–Aldrich Chemical Co. or saline was emulsified with the same volume of complete Freund's adjuvant (Wako Chemical Co., Tokyo, Japan) and then 50 µl emulsion (25 µg of Tg/mouse) was injected into the soleus muscle once every 2 weeks.
All immunizations were performed in the presence of complete Freund's adjuvant.
125I uptake and measurement of thyroid hormones
125I–Na (3.7 GBq/ml) was obtained from GE Healthcare, Japan. The solution was at first diluted with sterile saline to 9.25x104 Bq/100 µl. In experiment 1, 100 µl of this diluted solution was administrated into the peritoneal space at 1–3 months after the first immunization. After 24 h, the mice were anesthetized with pentobarbital and the iodide uptake into the thyroid glands was monitored by neck counter and scintigraphy. In experiments 2 and 3, we did not carry out the monitoring of thyroid iodide uptake activities. At 3 months after the first immunization, accurate radioactivity of the resected thyrotracheal unit was also measured with a gamma-counter (Aloka, Autowell Gamma System, Model ARC-380, Tokyo, Japan) in all experiments. Serum free thyroxine (T4) and free tri-iodothyronine (T3) levels were assayed by an ECLusis system (Roche Diagnostic Co).
Detection of anti-Tg antibody and assay for thyroid-stimulating antibody activity
Detection of antibody against Tg and TPO was carried out with a commercial detection kit (Cosmic Co., Tokyo, Japan). For measuring TSAb activity, mouse IgG was partially purified with polyethylene glycol and the activity was assayed using a commercial kit for TSAb (Yamasa Shoyu Co., Chiba, Japan). Thyroid-stimulating antibody activity (%) was calculated as follows: (cAMP increase by test IgG/cAMP increase by control IgG)x100, as previously described (Ohmori et al. 1991). The cut-off value was set as 180%.
| Results |
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To know whether our observation is specific to the AKR/N strain, we immunized C57BL6 mice (n=10) with bovine Tg using the same protocol (experiment 3). Again, we obtained the results that mean serum free T3 and free T4 levels and mean 125I uptake activity in the thyroid glands of the immunized mice were significantly higher than those of the control mice (Table 1). Mice with high serum free T3 and free T4 levels exhibited high TSAb activity (Tg 2, 5, and 6), suggesting that immunization with Tg also produce Graves'-like disease in C57BL6 mice.
| Discussion |
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Recently, many groups have developed animal models of Graves' disease by immunizing with TSHR peptides (Endo et al. 1991), TSHR protein (Kaithamana et al. 1999), or TSHR-expressing fibroblasts (Shimojo et al. 1996), or by using the expression plasmid of TSHR (Costagliola et al. 2000) and adenovirus-mediated TSHR (Nagayama et al. 2002). All of these data support that TSHR autoantibody is the cause of Graves' disease. Thus, our next concern was the antigen-presenting mechanism of TSHR in its autoimmune process. From this point of view, Shimojo's model is extremely important, because the co-existence of MHC class II molecules and TSHR on the cell surface of fibroblasts can produce TSAb in mice, but not the co-existence of MHC class I molecules and TSHR. The evidence supports the previous hypothesis that aberrant expression of MHC class II molecule on thyroid epithelial cells may trigger a cascade of self-directed, uncontrolled immune response in Graves' disease (Hanafusa et al. 1983).
However, it is still controversial whether TSHR peptides are presented as antigens by specifically antigen-presenting cells (macrophages) or by other cells (thyroid epithelial cells). In the former, destructive or degenerative changes of thyroid epithelial cells may precede the process, and in case of the latter, infiltration of
-interferon containing T cells may precede the process.
Twarog & Rose (1968) produced experimental autoimmune thyroiditis in mice by immunizing mice with thyroid extracts emulsified with Freund's complete adjuvant. After that, this disease has been readily induced in many strains of mice by immunization with mouse Tg emulsified in Freund's complete adjuvant. In some strains (low responders to Tg), there is only minor thyroid damage after immunization with Tg, whereas in other strains (high responders), the thyroid damage is extensive (Vladutiu & Rose 1971). It is widely believed that these mouse models of autoimmune thyroiditis are in a hypothyroid state, but there are few studies of thyroid function in mice with induced autoimmune thyroiditis. Vladutiu & Kenney (1985) investigated the thyroid function of mice immunized with Tg. They found that in all mice (low and high responders), the lowest levels of T4 were observed 2 weeks after immunization, and in the fourth week, T4 concentration was, surprisingly and inexplicably, higher than the pre-immunization values. We demonstrate here that immunization of mice with Tg induces thyrotoxicosis. A detailed comparison of our data with that of Vladutiu & Kenney is difficult because their experimental conditions and protocols were different from ours, but thyrotoxicosis might occur after 4 weeks from the first immunization with Tg.
However, iodide uptake activity of Tg immunized mice was not suppressed, but was instead enhanced, so it is unlikely that the increase of serum thyroid hormone levels was merely due to the destruction of thyroid epithelial cells. The phenomenon was observed not only in AKR/N mice (high responders) but also in C57BL6 mice (low responders), suggesting that it is not strain specific. In addition, some of the Tg immunized AKR/N mice as well as C57BL6 mice had high iodide uptake activity and high titers of TSAb.
To obtain clear thyroid image with short exposure time to the imaging plate, we administrated 9.25x104 Bq of 125I to each mouse in experiment 1, the dose (4.6 MBq/kg) of which is almost comparable with that used for therapy for Graves' disease in human. Recently, it has been reported that TSAb may occur shortly after radioiodine therapy in toxic multinodular goiter, in which pre-existing autoimmunity may not be a requirement for the induction of the antibodies (Hovens et al. 2007). So the possibility remains that administration of 125I to mice in the course of experiment 1 might induce TSAb in these mice. However, in experiments 2 and 3, we omitted monitoring of thyroid iodide uptake activities by neck counter so, we administrated 125I to the animals only at 3 months point. Thus, we think it likely that Graves'-like disease in these mice was induced by immunization of Tg. It would be important to know whether immunization with other thyroid antigens such as TPO also induce Graves' like disease in mice. However, our results suggest that immunization with Tg induces Graves'-like disease in mice and also that the pathogenesis of two disorders are closely related.
| Declaration of interest |
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| References |
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Received in final form 18 May 2009
Accepted 2 June 2009
Made available online as an Accepted Preprint 2 June 2009
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