Abstract
Aim: To verify a possible association between overall H. pylori and CagA+ H. pylori infection and autoimmune thyroid diseases (AITDs). Methods: Consecutive patients with AITDs admitted to one single centre of Endocrinology during one solar year were examined. The diagnoses were Hashimoto thyroiditis (HT) in 76, Graves’ Disease (GD) in 39, and aspecific thyroiditis (AT) in 44 patients. Controls were 136 individuals without AITDs. Median values of fT3, fT4, anti-thyreoglobulin (Tg) antibodies, IL-1β, IL-6, and TNF-α in patients were compared with those in controls. H. pylori infection and CagA status were determined serologically. Structural homology of some thyroid proteins with H. pylori antigens was investigated. Results: H. pylori infection prevalence was significantly increased in GD (66.6%) and HT (64.4%) patients, vs. 29.4% of controls and 34.0% of AT. CagA seropositivity was significantly more frequent in GD (46.1%) and HT (46.9%) infected patients, vs. infected controls (20%). fT3 and fT4 median values were significantly decreased in infected CagA+ GD patients vs. uninfected GD patients. IL-1β median values were increased in patients respect to controls, independently of the clinical form of AITD. Median values of IL-6, TNF-α and anti-Tg autoantibodies in CagA infected patients were significantly higher than those measured in infected CagA− and uninfected patients and in infected CagA+ controls. The examined thyroid proteins shared putative conserved domains with numerous bacterial antigens. Conclusions: Overall H. pylori and CagA+ H. pylori infection were associated with GD and HT, putatively through an increased inflammatory status and molecular mimicry.
Highlights
Autoimmune disorders (ADs) are very frequent and encompass a broad variety of diseases [1,2,3].The organ most frequently involved in ADs, either independently of, or in concomitance with other organs, is the thyroid [4,5,6]
autoimmune thyroid diseases (AITDs) originate from an autoimmune response against gland antigens: The thyroid peroxidase (TPO), thyroglobulin (Tg) and the thyroid stimulating hormone receptor (TSHr)
The results of the present study have shown that the expression of CagA by the infecting organisms may play an important additional role in the development or worsening of AITDs, despite there is not a complete agreement on this point [30]
Summary
Autoimmune disorders (ADs) are very frequent and encompass a broad variety of diseases [1,2,3].The organ most frequently involved in ADs, either independently of, or in concomitance with other organs, is the thyroid [4,5,6]. Autoimmune disorders (ADs) are very frequent and encompass a broad variety of diseases [1,2,3]. Antibiotics 2020, 9, 12 heavily infiltrated by lymphocytes; (b) Hashimoto thyroiditis (HT), characterized by hypothyroidism; or (c) Graves’ (GD) or Basedow disease, characterized by hyperthyroidism [6]. These three different functional conditions affect 2–5% of the general population, but they occur far more frequently in people with the human leucocyte histocompatibility antigen HLA-DRB1*03 [7]. Two-thirds of HT patients and one third of those with GD possess circulating anti-Tg antibodies. Being the hallmark of GD, the presence of agonistic anti-TSHr antibodies concerns most cases of this pathology [10]
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