Methimazole has no dose-related effect on the serum concentrations of soluble class I major histocompatibility complex antigens, soluble interleukin-2 receptor, and beta 2-microglobulin in patients with Graves' disease.
Soluble class I major histocompatibility antigens (sHLA), beta 2-microglobulin (beta 2-M), and soluble interleukin-2 receptor (sIL-2R), are secreted by B and T lymphocytes upon activation, and have been used as markers of immune activation in several diseases. Thirty-two Graves' disease patients were randomly assigned to three methimazole (MMI) regimens of treatment: (1) low-dose, starting with 45 mg/day, and lowering the dose thereafter to maintain normal serum thyroid hormones; (2) MMI 60 mg/day + levothyroxine, and (3) MMI 30 mg/day + levothyroxine. Serum sHLA, beta 2-M, sIL-2R, TSH receptor antibodies (TSH-R Ab), T3, and free T4 (fT4) were measured at diagnosis and at weeks 4, 12, and 24 (end of treatment). Patients were followed-up after treatment for at least 24 weeks (24 to 89). At diagnosis, serum levels of sIL-2R, beta 2-M, sHLA, and TSH-R Ab were elevated. Serum sIL-2R, beta 2-M, sHLA, and TSH-R Ab decreased with treatment. No effect of the varying MMI regimens on these parameters was observed. Soluble IL-2R correlated positively with T3, fT4, beta 2-M, sHLA, and TSH-R Ab. Statistically significant, but weak, correlations (r < 0.35) were observed between beta 2-M, sHLA, and TSH-R Ab, between beta 2-M, T3, and fT4, and between TSH-R Ab and T3. Recurrence rates were not associated either with the MMI regimen or any of the parameters studied, with the exception of elevated initial TSH-R Ab levels. Serum sHLA, beta 2-M, and sIL-2R are increased in untreated Graves' disease, and decrease during treatment. No MMI dose-related differences were observed in these parameters, and in the recurrence rate. Unfortunately, sHLA, beta 2-M, and sIL-2R were not useful predictors of prolonged remission after MMI treatment.
Escobar-Morreale
H F
HF
Department of Endocrinology, Hospital Ramón y Cajal, Madrid, Spain.
Serrano-Gotarredona
J
J
Villar
L M
LM
García-Robles
R
R
González-Porqué
P
P
Sancho
J M
JM
Varela
C
C
D000293:Adolescent; D000328:Adult; D013956:Antithyroid Agents / Q000494:pharmacology*; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D006111:Graves Disease / Q000097:blood / Q000276:immunology*; D015395:Histocompatibility Antigens Class I / Q000096:biosynthesis*; D006801:Humans; D008297:Male; D008713:Methimazole / Q000494:pharmacology*; D008875:Middle Aged; D015375:Receptors, Interleukin-2 / Q000096:biosynthesis*; D013960:Thyroid Function Tests; D013963:Thyroid Hormones / Q000097:blood; D001613:beta 2-Microglobulin / Q000096:biosynthesis*
D013956:Antithyroid Agents; D015395:Histocompatibility Antigens Class I; D015375:Receptors, Interleukin-2; D013963:Thyroid Hormones; D001613:beta 2-Microglobulin; D008713:Methimazole