Abstract
The aim of the study: to assess the role of caspase-1 and IL-18 in the implementation of the inflammatory response in young patients with autoimmune thyroiditis (AIT) associated with gastroesophageal reflux disease (GERD).
 Materials and methods. The study was conducted in two groups of patients homogeneous by gender and age. The first group included 42 patients with an isolated AIT and the second group – 120 patients with a comorbid course of AIT and GERD. The contingent of the surveyed was students. Median age was from 18 to 25 years: 23.1±1.2 years in group with isolated AIT and 21.9±2.7 years in group with combined pathology. The activity of caspase-1 was determined using “Elabscience” kits, USA (China) by immunoassay method. The content of IL-18 was investigated using commercial kits “Bender MedSystems GmbH” (Austria) according to the proposed methods by immunoassay method. Statistical data processing was carried out using the local universal software package Statistica Basic Academic 13 for Windows En Local. Methods of non-parametric statistics were used: Kruskal-Wallis test, median test, Mann-Whitney test.
 Results. It has been found that caspase-1 is activated in patients both in the isolated course of AIT and in its combination with GERD. At the same time, a significant increasing in the synthesis of IL-18 was established, which has pro-inflammatory and autoimmune effects. Re-examination after 2 months of caspase-1 and IL-18 in examined persons determined decreasing their levels, but control results were not achieved.
 Conclusion. In young patients, the combination of GERD and AIT, as well as an isolated AIT is accompanied by an increasing the levels of caspase-1 and IL-18 in blood serum related to inflammatory process in the thyroid gland and esophageal mucosa with autoimmune component. These biomarkers may reflect the severity of clinical course of diseases and serve as prognostic indicator of outcome in case of comorbidity.
Highlights
The development of an inflammatory reaction in any disease of internal organs obeys to the basic law of inflammation – the participation of the immune system in its implementation
The aim of the research was to assess the role of caspase-1 and IL-18 in the implementation of the inflammatory response in young patients with autoimmune thyroiditis (AIT) associated with gastroesophageal reflux disease (GERD)
Assessment of indicators of caspase-1 and IL-18 in dynamics showed a decrease in the levels of these parameters compared to the initial levels, but the control figures were not achieved
Summary
The development of an inflammatory reaction in any disease of internal organs obeys to the basic law of inflammation – the participation of the immune system in its implementation. The sequence of the inclusion of its various components, the volume of the cellular and humo ral response depends on many factors: the action and the virulence of the pathogen, the state of (2021), «EUREKA: Health Sciences» Number 1 the immune system both in general and its individual links, concomitant diseases and a number of others [1]. The cytokine cascade is triggered by the activation of an caspase-1, which is precursor to all inflammatory states. The development of autoimmune thyroiditis (AIT) was considered from the position of impaired immunogenesis. This theory is supplemented by the participation of a complex of cytokine and chemokine-mediated reactions. Lymphocytic infiltration of the thyroid gland in patients with AIT occurs against the background of a «cytokine explosion», since the lymphocytes themselves are the main producers of these information biomolecules [6, 7]
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