Graves' disease and Hashimoto's thyroiditis in monozygotic twins: case study as well as transcriptomic and immunohistological analysis of thyroid tissues.
OBJECTIVE
To report on the rare simultaneous occurrence of Graves' disease (GD) and Hashimoto's thyroiditis (HT) in monozygotic twins.


METHODS
We compared the pattern of thyroid tissue-derived cDNAs to gain insight into previous and ongoing immune destruction and reconstruction processes using microarrays. The results were confirmed by immunohistology and real-time PCR.


RESULTS
Destruction of thyroid tissue in HT reduced levels of thyrocyte-related cDNAs and cDNAs encoding extracellular matrix components, but increased levels of proteases involved in extracellular matrix degradation compared with GD. Lymphocytic infiltrates forming ectopic follicles replaced the thyroid tissue almost completely in HT. Thus, lymphocyte-related cDNA levels were higher in HT than in GD. The same was true for many chemokines and their receptors, which not only enable migration towards the thyroid but also maintain the lymphocytic infiltrate. HT also showed increased levels of cDNAs encoding molecules related to apoptosis than did GD. Surprisingly, the Th1- and Th2-specific cytokine profiles suggested for HT and GD respectively could not be confirmed. cDNAs encoding factors and receptors involved in angiogenesis were increased in GD compared with HT.


CONCLUSIONS
Comparison of gene expression reflects the cellular differences between the two types of autoimmune thyroid disease in twins with identical genetic and similar environmental background.
Aust
G
G
Research Laboratories, Center of Surgery, University of Leipzig, Germany. ausg@medizin.uni-leipzig.de
Krohn
K
K
Morgenthaler
N G
NG
Schröder
S
S
Schütz
A
A
Edelmann
J
J
Brylla
E
E
D000293:Adolescent; D042501:Angiogenic Proteins / Q000235:genetics; D051017:Apoptosis Regulatory Proteins / Q000235:genetics; D018925:Chemokines / Q000235:genetics; D004200:Diseases in Twins / Q000235:genetics* / Q000473:pathology*; D005260:Female; D049970:Graves Ophthalmopathy / Q000235:genetics* / Q000473:pathology*; D050031:Hashimoto Disease / Q000235:genetics* / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D020411:Oligonucleotide Array Sequence Analysis; D013961:Thyroid Gland / Q000737:chemistry / Q000473:pathology; D014158:Transcription, Genetic; D014430:Twins, Monozygotic; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis
D042501:Angiogenic Proteins; D051017:Apoptosis Regulatory Proteins; D018925:Chemokines; D042461:Vascular Endothelial Growth Factor A