Immunoglobulin e and or thyrotropin receptor antibodies : are they making a link between graves’ disease and atopy?

الملخص EN

BACKGROUND: some evidence suggested a relationship between thyroid autoimmunity and the allergic response.

First, IgE as well as IgG and IgM deposit in some Graves’ thyroid tissue and ocular muscles of hyperthyroid Graves’ disease.

Second, associations have been reported between recurrence of hyperthyroid Graves’ disease and allergic rhinitis of pollen allergy, as well as between thyroid auto antibodies and chronic urticaria or angioedema.

Furthermore, some TSH receptor specific T-cell clones from a Graves’ patient secreted TH2 cytokines including IL-4. Objective: The aim of this study is to investigate the possible participation of immunoglobulin E (IgE ) and thyrotropin receptor antibodies (TRAb) in the process of Graves’ disease and atopy, respectively. Study Design: our study was conducted on 70 subjects.

They were divided into 3 groups: Control group: included 10 healthy subjects.

Atopy group included 30 patients with newly diagnosed atopy (10 patients with skin allergy, 10 patients with allergic rhinitis, and 10 patients with bronchial asthma).

Graves, group: included 30 patients with newly diagnosed Graves' disease (15 patients with Graves, ophthalmopathy, and 15patients without ophthalmopathy). All the studied groups were subjected to full clinical history, thorough clinical examination, Skin prick test for diagnosis of atopy.

All patients were tested for Free T3, Free T4, TSH, TSH receptor antibody (TRAb), total immunoglobulin E and measurement of proptosis by Hertel exophthalmometer Results: In the present study there was a highly significant statistical elevation of TSHR- antibody in patients with atopy and, Graves' disease compared to the controls (p<0.001 respectively).

There was a highly significant statistical elevation of serum IgE in patients with Graves' disease and patients with atopy, in comparison to the control group (p<0.001 for both group). There was positive significant correlation between serum level of TSHR-antibody and serum level of total IgE among patients with Graves' disease (p<0.05). There was also positive significant correlation between the serum level of TSHR antibody and the degree of exophthalmos (p<0.05), and a positive significant correlation between the serum level of total IgE and the degree of exophthalmos .(p<0.05) Conclusion : From the previous results we concluded that IgE and TSHR-antibody might play an important role in the pathogenesis of Graves’ disease and Graves' ophthalmopathy and thus both Th1 and Th2 immune responses may interact in the progression of Graves, disease and Graves, ophthalmopathy.

Furthermore, TSHR-Abs may have a role in atopic diseases.