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Biomedical subjects

M Iitaka

Publications and source records attributed to M Iitaka.

At least 19 recordsLinked to original sources

Incidence of anti-mouse IgG in normal subjects and patients with autoimmune thyroid disease.

Serum antibodies to mouse IgG occasionally interfere with two-site immunometric assays in which mouse monoclonal antibodies are used. We examined the titers of antibodies to mouse IgG in serum samples from normal subjects and patients with autoimmune thyroid disease (AITD) using an enzyme-linked immunosorbent assay. Anti-mouse IgG antibodies were positive in 7/119 patients with Graves' disease (5.9%) and 3/60 patients with Hashimoto's thyroiditis (5.0%). One of the 15 patients with a thyroid neoplasm (6.7%) also had antibodies to mouse IgG, as did 5/60 healthy subjects (8.3%). These antibodies were either of the IgG or IgM class. There was no significant difference in the incidence of positive anti-mouse IgG antibody between normal subjects and patients with AITD. It is important to note this high incidence of antibodies to mouse IgG due to the potential of interference with immunometric assays employing mouse monoclonal antibodies.

Antibodies, Anti-Idiotypic

[Studies on thyroid hormone autoantibody (THAA) in 2 cases of Graves' disease with spuriously high free thyroxine values].

Two patients with Graves' disease treated with methimazole (MMI) showed a discrepancy between serum free T4 (FT4) values and other hormone values (especially total T4) which was due to the presence of potent binding activity to labelled T4 analogue (125I-aT4) in their serum. This activity was demonstrated to be in immunoglobulin G (IgG) with kappa light chain isotype in both patients. The binding of 125I-aT4 to their serum was inhibited by unlabelled T4 in a dose-dependent manner. Autoantibodies had almost identical binding affinity to T4 and aT4, although they precipitated more radioactivity when 125I-aT4 was used. The binding of IgG purified from patients' sera to labelled T4 or aT4 was not greater than the corresponding sera, suggesting that the thyroxine binding proteins did not interfere with the assay. Since the specific radioactivity of 125I-aT4 is almost 10 times higher than that of 125I-T4, autoantibodies can precipitate almost 10 times more radioactivity in the FT4 assay than the total T4 assay, thus leading to the spuriously high FT4 values and large discrepancy between FT4 and TT4 values.

Adult

Disturbance of thyroidal iodine metabolism in BB/W rat.

To investigate the thyroid function in Bio-Breeding Worcester (BB/W) rats, we have examined the iodine metabolism, serum TSH and thyroid hormone levels in 8- and 16-week-old BB/W and normal Wistar (W) rats. At 8 weeks of age, serum TSH levels were significantly higher in BB/W rats than in W rats, although there was no difference in the serum levels of free T3 and free T4. Furthermore, the thyroidal radioactive iodine incorporation at 48 h was significantly lower in BB/W rats, suggesting that they might have some defects in iodine organification. At 16 weeks of age, serum TSH levels were also significantly higher in BB/W rats than in W rats. Furthermore, serum TSH levels in 16-week-old BB/W rats were significantly higher than in 8-week-old BB/W rats. The thyroid weight was significantly greater in BB/W rats, probably due to the increased serum TSH. The thyroidal radioactive iodine uptake at 48 h and the iodine content in the thyroid homogenates were significantly lower in BB/W rats. These results suggest that BB/W rats have some defect in iodine metabolism resulting in impaired thyroid hormone synthesis.

Animals

A case of Graves' disease with false hyperthyrotropinemia who developed silent thyroiditis.

We encountered a patient who developed silent thyroiditis during the course of Graves' disease. The diagnosis of silent thyroiditis was made on the basis of a low thyroidal 131I uptake, no response to the thyrotropin releasing hormone (TRH) test, and subsequent hypothyroidism despite the presence of high titers of thyrotropin (TSH) receptor antibody (TRAb) and thyroid stimulating antibody (TSAb). The patient, in addition, had a discrepancy between serum TSH and thyroid hormone values. This was due to the presence of interfering substances that react to mouse IgG in the sera since serum TSH levels were decreased in a dose dependent manner by the addition of increasing amounts of mouse IgG to the sera. It should therefore be noted that silent thyroiditis can develop in patients with Graves' disease. Furthermore, clinicians should be aware that two-site immunoassay kits that use mouse monoclonal antibodies are subject to interference by some substances, possibly antibodies which react to mouse IgG.

Adult

Effect of cholera toxin on serum levels of thyrotropin and thyroid autoantibodies in biobreeding/Tokyo (BB/TKY) rats.

The effect of cholera toxin (CT) on the thyroid-pituitary axis and the immune system was examined in Bio-Breeding/Tokyo (BB/TKY) rats, which spontaneously develop insulin-dependent diabetes mellitus (DM) and lymphocytic thyroiditis (LT). Intravenous administration of CT (5 micrograms/100 g body weight) every other week starting at 6 weeks of age resulted in a significant decrease in the serum thyrotropin (TSH) level at 12 and 14 weeks of age when compared with saline treated littermates. CT stimulated rat thyroid cells to proliferate in vitro. Furthermore, serum anti-thyroglobulin antibody (ATA) titers were also significantly decreased in 14-week-old rats treated with CT. In vitro ATA production by spleen cells from BB/TKY rats was inhibited by CT. Antibodies to thyroxine were detected in both CT-treated and control rats. It is of interest that the ratio of W3/25+ helper/inducer cells to OX8+ suppressor/cytotoxic cells was significantly decreased in CT-treated rats. However, there was no significant difference in the incidence of DM and LT between the two groups of rats. The present study showed that CT suppressed ATA production both in vivo and in vitro, and had a stimulatory effect on thyrocytes in BB/TKY rats.

Animals

CD4 cells from patients with autoimmune thyroid disease secrete interferon gamma after stimulation by thyroid microsomal antigen; CD8 cells suppress this secretion.

The production of interferon gamma (IFN gamma) by peripheral blood mononuclear cells (PBMC) from normal persons and patients with autoimmune thyroid disease (AITD) has been studied in vitro either spontaneously or after stimulation with thyroid microsomal antigen (TMc) or liver microsomal antigen (LMc). The numbers of IFN gamma secreting cells were measured by a spot-ELISA technique. AITD PBMC spontaneously contained significantly more IFN gamma secreting cells than did normal control PBMC. Moreover, TMc antigen caused a significantly greater number of IFN gamma secreting cells in AITD PBMC than did LMc antigen, whereas there was no significant difference between the two antigens in the normal control PBMC preparations. Thus TMc antigen caused a stimulation of the number of IFN gamma secreting cells only in the AITD PBMC and not in the normal PBMC. CD4 plus B cells or CD4 cells alone (with monocytes in both instances) contained more IFN gamma secreting cells under unstimulated conditions than did CD8 cells in both groups. AITD CD4 plus B cells (or CD4 cells) contained more IFN gamma secreting cells than did normal cells, but there was no significant difference between both groups in terms of the number of CD8 IFN gamma secreting cells. Normal CD4 plus B cells (or CD4 cells) responded to TMc antigen significantly more than did total normal PBMC at 10 and 1,000 ng/ml TMc. This was not the case when patients' CD4 plus B cells (or CD4 cells) were compared with patients' total PBMC, in which there were no significant differences. This suggests that CD8 suppressor activity was inadequate in AITD and thus the deletion of CD8 cells did not result in an increase in IFN gamma secreting cells. When TMc antigen was added to AITD CD8 cells, there was a significant diminution of IFN gamma secreting cell numbers at 10 and 1,000 ng/ml TMc. Moreover, adding autologous CD8 cells to CD4 plus B cells resulted in a significant suppression of IFN gamma production at 100 and 1,000 ng/ml TMc in both groups. AITD CD8 cells appeared to be somewhat less effective than normal CD8 cells, but this did not reach significance. It is thus concluded that AITD CD4 cells respond specifically to TMc antigen. CD4 production of IFN gamma appears to be suppressed by CD8 cells activated with antigen and the CD8 cells appear to be involved in the regulation of IFN gamma production by the CD4 cells.

Adult

Lack of effect of methimazole on thyrocyte cell-surface antigen expression.

The nature of the immunosuppressive effect of antithyroid drugs has been a subject of controversy. It has been claimed that these agents exert a direct effect on the immune system, although we and others have suggested that the drugs affect the thyroid cells primarily with consequent reduced thyrocyte-immunocyte signalling. This may occur from reduced thyroid hormone production and/or reduced antigen presentation by the thyrocytes to local T lymphocytes. Using a cytotoxicity assay system, with chromium-51 labelling, monoclonal antibodies against thyroperoxidase (TPO) and HLA-DR, and complement, we have measured the expression of TPO and HLA-DR on cultured normal human thyroid cells; we have also measured thyroglobulin (Tg) release by radioimmunoassay into the medium of the cultured cells. The thyroid cells were stimulated with TSH or thyrotropin binding inhibitory immunoglobulin (TBII) for 48 hours before measuring for TPO induction, and with interferon gamma (IFN-gamma) (with or without TSH or TBII) for thyrocyte HLA-DR expression. A dosage of 1.6 milliunits per ml of TSH resulted in a significant increase in TPO expression on thyrocytes when compared with control unstimulated thyroid cells (p less than 0.001). The concentrations of Tg released into the medium with TSH or TBII were also significantly higher than those of the control thyrocytes. IFN-gamma at 200 units per ml induced HLA-DR expression, but did not induce thyrocyte TPO expression, or Tg release. Addition of the antithyroid drug, methimazole (MMI), at different concentrations, in addition to the other stimulators, IFN-gamma, TSH, or TBII, did not result in any inhibition of TPO, Tg release, or HLA-DR expression on the thyroid cells. It would thus appear that the pathways for stimulation for the expression of TPO and HLA-DR appear to be different. Finally, MMI does not cause its immunosuppressive effect by any reduction of thyroid antigen expression or release.

Antigens, Surface

Studies of the effect of suppressor T lymphocytes on the induction of antithyroid microsomal antibody-secreting cells in autoimmune thyroid disease.

The suppressor function in CD8 (suppressor/cytotoxic) T lymphocytes from patients with autoimmune thyroid disease and normal subjects has been studied. CD8 and CD4 (helper/inducer) cells were separated by the panning method. Patient's non-T cells and autologous CD4 cells were cultured with or without autologous or allogeneic CD8 cells in the presence of either pokeweed mitogen or Staphylococcus aureus strain Cowan 1 plus human thyroid microsomal antigen. Antithyroid microsomal antibody (AMA) and total immunoglobulin G (IgG)-secreting non-T cells were measured by enzyme-linked immunosorbent spot assay. With pokeweed mitogen stimulation, the suppressor effect of CD8 cells from patients with serum AMA on the induction of AMA (of IgG type)-secreting cells was significantly less than that of CD8 cells from normal subjects. CD8 cells from patients with no serum AMA suppressed the induction of AMA-secreting cells as much as did normal CD8 cells. CD8 cells from both patients and normal subjects suppressed the induction of IgG-secreting cells equally well. On the other hand, with the combination of S. aureus strain Cowan 1 and human thyroid microsomal antigen (1 mg/L) stimulation, CD8 cells from both normal subjects and patients only slightly suppressed the induction of IgG-secreting cells. However, under these circumstances, once again, CD8 cells from both normal subjects and patients with no serum AMA suppressed the induction of AMA-secreting cells, whereas CD8 cells from patients with serum AMA suppressed the induction of the AMA-secreting cells significantly less. Higher TMc concentrations enhanced the suppressor effect of CD8 cells from patients with serum AMA on the induction of AMA-secreting cells. Furthermore, Concanavalin A, when added to the stimuli described above, further inhibited the induction of both AMA- and IgG-secreting cells by CD8 cells from patients with serum AMA. There thus appears to be a relative defect of antigen-specific suppressor T lymphocyte function in CD8 cells from patients with autoimmune thyroid disease, which may result in the presence of autoantibody-secreting cells in those patients.

Adult

Studies of HLA-DR expression on cultured human thyrocytes: effect of antithyroid drugs and other agents on interferon-gamma-induced HLA-DR expression.

There have been conflicting reports on whether antithyroid drugs (ATD) act as immunosuppressive agents in patients with autoimmune thyroid disease. While some have claimed that methimazole (MMI) affects the immune system directly, we and others have suggested that its apparent immunosuppressive activity is due to its ability to inhibit thyrocyte, rather than immunocyte, activity. To further address the question, we studied the action of ATD on interferon-gamma (IFN gamma)-induced HLA-DR expression on thyrocytes in tissue culture. We used a cytotoxicity assay, using chromium-51-labeled Graves' disease (GD) thyrocytes and normal thyrocytes incubated sequentially with a monoclonal antibody against HLA-DR and complement, with a cytotoxicity index as the measure of thyrocyte HLA-DR expression. MMI and propylthiouracil (PTU) were added along with 200 U/mL IFN gamma to thyrocytes cultured for 10-14 days. IFN gamma or supernatants from leukoagglutinin-stimulated peripheral blood mononuclear cells (PBMC) stimulated thyrocyte HLA-DR expression; however, the addition of MMI or PTU to either the PBMC or thyrocytes caused no inhibition of the IFN gamma or PBMC IFN gamma stimulation of thyrocyte HLA-DR expression, using either normal or GD thyrocytes. Potassium perchlorate and sodium iodide also had no effect on IFN gamma-induced thyrocyte HLA-DR expression. TSH (either bovine or human) did not induce HLA-DR expression on thyrocytes by itself, but did enhance IFN gamma-induced HLA-DR expression in normal, but not GD, thyrocytes; once again, the further addition of MMI or PTU did not inhibit the enhancing effect of TSH on thyrocyte HLA-DR expression. Low concentrations of TSH binding inhibitory immunoglobulin (TBII; 100 micrograms/mL) did not alter the cytotoxicity index, but at 400 micrograms/mL or more it enhanced HLA-DR expression on normal, but not GD, thyrocytes in a manner similar to TSH; like TSH, it did not induce thyrocyte HLA-DR expression by itself. Moreover, addition of MMI to the combination of IFN gamma and TBII did not inhibit the response of thyrocytes in terms of HLA-DR expression. We conclude that ATD do not alter thyrocyte HLA-DR expression in vitro; however, the ATD may still cause immune effects in vivo secondary to their influence on thyroid hormone formation or synthesis or by inhibition of thyroid antigen presentation which indirectly may result in an immunomodulatory effect. While TSH and TBII similarly enhanced the IFN gamma-induced expression of HLA-DR on normal thyrocytes, they did not do so in GD thyrocytes.(ABSTRACT TRUNCATED AT 400 WORDS)

Carbimazole

In vitro induction of anti-thyroid microsomal antibody-secreting cells in peripheral blood mononuclear cells from normal subjects.

Secretion of immunoglobulin G (IgG) and IgM antithyroid microsomal antibodies (AMA) was induced in vitro by coculturing non-T cells (B lymphocytes) and autologous CD4 (helper/inducer) cells from normal subjects stimulated with pokeweed mitogen (PWM) or a combination of human thyroid microsomal antigen (McAg) and Staphylococcus aureus Cowan I (SAC) strain. With PWM stimulation, AMA production was induced in more IgM-secreting cells (AMA-M) than IgG-secreting cells (AMA-G). However, McAg plus SAC stimulation resulted in similar numbers of AMA-G- and AMA-M-secreting cells. PWM induced a significantly greater number of both AMA-M (and generalized IgM)-secreting cells than did McAg plus SAC, while the number of AMA-G-secreting cells induced by the two stimuli were similar. There were no significant differences between autologous or allogeneic CD4 cells from normal subjects or patients with autoimmune thyroid disease (AITD) when cocultured with B cells from normal subjects in terms of helper activity in the induction of AMA-M- or IgM-secreting cells with PWM stimulation. However, with McAg plus SAC, CD4 cells from patients with AITD induced a significantly greater number of AMA-M-secreting cells than did autologous or allogeneic CD4 cells from normal subjects. There was no difference in helper activity between autologous and allogeneic normal CD4 cells in the induction of generalized IgM-secreting cells regardless of the stimulus used. Normal autologous or allogeneic CD8 (suppressor/cytotoxic) cells cocultured with normal B cells and autologous CD4 cells suppressed the induction of AMA-M-secreting cells by PWM stimulation. On the other hand, CD8 cells from patients with AITD suppressed the induction of AMA-M-secreting cells significantly less effectively. All CD8 cells suppressed the induction of IgM-secreting cells equally well. We conclude that 1) B lymphocytes from normal subjects are capable of producing autoantibodies in vitro in the presence of CD4 cells; 2) the helper activity of CD4 cells from patients with AITD to induce AMA-M secreting cells is greater than that of normal CD4 cells with thyroid antigen stimulation; and 3) this helper activity may be due to relatively impaired suppressor activity in thyroid antigen-specific CD8 cells from patients with AITD, whereas the immunoregulatory function of CD8 cells from normal subjects appears to play an important role in the maintenance of self-tolerance.

Adult

Thyroid functions before and after maintenance hemodialysis in patients with chronic renal failure.

To study the factors involved in the low thyroid hormone levels in patients with chronic renal failure (CRF), we investigated thyroid functions just before and after hemodialyses (HD) in 32 such patients who were on maintenance HD. In addition, we measured serum thyroid hormone binding inhibitor activities (THBI) in another set of 37 patients. None of the patients had been suspected of having thyroid diseases. HD duration and aging did not have a significant effect on the results of the thyroid function tests. Before each HD, the serum concentrations of T3, T4, FT3, FT4, rT3, PBI, FT3I, FT4I, FT3/T3, FT4/T4, T4/TBG, T4/TSH and FT4/TSH were lower, and those of TSH, TBG, and thyroglobulin (Tg) were higher in the patients than in normal controls. The thyroid hormone concentrations were negatively correlated with the BUN and creatinine levels. The Tg levels were positively correlated with the BUN levels. After each HD, almost all the thyroid function tests including T4/TBG ratio showed improvements, which indicated that hemodilution and a decrease in the T4-binding affinity of TBG with thyroid hormones were the major factors in the low thyroid hormone levels in CRF patients. However, even after HD, T3, FT3, rT3, T4/TSH and FT4/TSH were still lower and TSH and Tg were still higher in the patients. These data suggested that the CRF patients were in a subclinical hypothyroid state. THBI was high in patients with CRF and did not change following HD. NEFA did not seem to contribute to the high THBI before HD, because they were in the normal range. However, as NEFA became very high after HD and possessed THBI, we calculated the corrected THBI (C-THBI) by subtracting the effect of NEFA from total THBI. C-THBI was high before HD and decreased after HD. Therefore, it was suggested that this C-THBI contributed to the abnormalities in the affinity of TBG with thyroid hormones. From these studies, it is concluded that (1) the patients with CRF may be in a subclinical hypothyroid state, although hemodilution was seen to have a strong effect on the thyroid hormone concentrations, and (2) C-THBI may have an effect on the affinity of TBG with thyroid hormones and play an additional role in low thyroid hormone levels in these patients. The mechanisms of hypothyroidism and the nature of C-THBI remain to be clarified.

Adolescent

Production of antigen specific procoagulant activity; effect of various culture supernatants.

Culture supernatants (CS) of peripheral blood mononuclear cells (PBM) from normal subjects and patients with autoimmune thyroid disease (AITD) have been tested for procoagulant inducing activity. CS of PBM from patients with AITD stimulated with solubilized thyroid antigen induced significantly greater procoagulant activity (PCA) in a human monocyte-like cell line, U937, than CS of PBM from normal subjects similarly tested, suggesting that PBM from patients released a procoagulant inducing factor(s) into ambient fluid in response to thyroid antigen stimulation. There was a significant correlation between PCA inducing activity in PBM and that in CS from those same PBM cultures. CS from normal T lymphocytes stimulated with large amounts of thyroid antigen (putative suppressor factor) had no suppressive effect on thyroid antigen-induced PCA production in PBM from patients with AITD. These observations suggest that the helper activity for antigen-induced PCA production appears to be mediated, at least in part, by soluble factor(s); conversely, these helper cells were not apparently subject to suppressor influences under these circumstances.

Adolescent

Effect of HLA-DR positive thyrocytes on in vitro thyroid autoantibody production.

The function of HLA-DR positive thyrocytes on thyroid autoantibody production has been examined to test the hypothesis that such HLA-DR positive thyrocytes may initiate or aggravate autoimmune thyroid disease. Thyrocytes were cultured (precultured) with leucoagglutinin (which stimulated thyrocyte expression of HLA-DR, beta 2-microglobulin (beta 2-m) and thyroid microsomal antigens) and then cocultured with peripheral blood mononuclear cells. Thyroid antibody production by the latter was then measured. There was no evidence of induction or enhancement of thyroid-microsomal and thyroglobulin autoantibody production in supernatants from the cocultures of autologous peripheral blood mononuclear cells and HLA-DR positive thyrocytes from normal controls and patients with Graves' disease. Furthermore, stimulation of B lymphocytes from patients with autoimmune thyroid disease with a combination of Staphylococcus aureus Cowan I plus supernatants from autologous cocultures of peripheral blood mononuclear cells and HLA-DR positive thyrocytes from normal controls and Graves' disease, produced significantly less microsomal antibody and thyroglobulin antibody than similar cocultures with HLA-DR negative thyrocytes, although total immunoglobulin G (IgG) was similar in both groups. The effect of supernatants from allogeneic cocultures on microsomal antibody thyroglobulin antibody and total IgG production was no different between HLA-DR positive and HLA-DR negative thyrocytes. These data suggest that HLA-DR positive thyrocytes may have a protective role against thyroid autoimmunity rather than a pathogenic role for it.

Antigen-Presenting Cells

Induction of monocyte procoagulant activity with OKT3 antibody.

OKT3 monoclonal antibody (MoAb), a mouse MoAb against cluster of differentiation 3 (CD3) molecule, induced a large amount of procoagulant activity (PCA) in human peripheral blood mononuclear cells (PBM). The PCA-inducing capability in OKT3 MoAb was abolished by absorption with T lymphocytes or Sepharose-conjugated antibody to mouse IgG. Most of the PCA in PBM was associated with monocytes. There was a dose-dependent increase in PCA when increasing numbers of T cells were added to the monocytes in the presence of OKT3 MoAb. OKT3 MoAb did not induce PCA in either T cells or monocytes alone. T cells pulsed with OKT3 MoAb only in the presence of monocytes could induce PCA in monocytes. Culture supernatants (CS) from PBM stimulated with OKT3 MoAb did not enhance PCA in monocytes; however, it did induce PCA in the human monocyte-like cell line (U937) which differs in some properties from monocytes; this activity could be abolished by the MoAb against human interferon-gamma (IFN-gamma). Nevertheless, neither human IFN-gamma nor interleukin 1 or 2 had significant direct effect in inducing PCA in U937 cells; CS from either monocytes or T cells alone stimulated with OKT3 MoAb did not induce PCA in U937 cells. This apparent discrepancy suggests that there may be factors in CS that induce PCA in U937 cells only in the presence of IFN-gamma. The PCA induced in monocytes or U937 cells was tissue factor-like because of the dependence on coagulation factors V, VII, and X. These observations suggest that OKT3 MoAb is a potent T cell-dependent monocyte PCA inducer and stimulates T cells only in the presence of monocytes. The direct cellular interaction between monocytes and stimulated T cells appears to be necessary to elicit monocyte PCA with OKT3 MoAb stimulation. Thus, monocytes may play a dual role, not only as effector cells, but also as cells that collaborate with T cells after OKT3 MoAb stimulation so as to produce PCA.

Antibodies, Monoclonal

Immunomodulatory effect of the treatment of Graves' disease on antigen-specific monocyte procoagulant activity production.

The monocyte procoagulant activity (PCA) production assay has been shown to be a good parameter of cell-mediated immunity. We have studied antigen-specific PCA production in peripheral blood mononuclear cells from patients with Graves' disease to determine the effect of the treatment on the cell-mediated immune response. Peripheral blood mononuclear cells from patients with untreated or relapsed Graves' disease produced significantly greater PCA with thyroid antigen stimulation than those from normal subjects. Patients both on antithyroid drugs in the hyperthyroid state and within 3 months post-131I therapy also produced significantly larger amount of PCA than normal subjects. However, there was no significant difference in PCA production with thyroid antigen stimulation between normal subjects and patients on anti-thyroid drugs in the euthyroid state, or patients over 3 months post-131I therapy. The ratio of positive to negative PCA production in patients on anti-thyroid drugs in the euthyroid state or over 3 months post-131I therapy was significantly lower than in untreated or relapsed Graves' disease patients. Mononuclear cells from patients on propylthiouracil responded to propylthiouracil in vitro by production of PCA. Cells from normal subjects, untreated Graves' disease patients, or patients with Hashimoto's thyroiditis did not produce PCA with propylthiouracil stimulation. Mononuclear cells from patients who were on propylthiouracil for more than 3 months produced greater PCA than those on the drug for less than 3 months, suggesting sensitization of lymphocytes to propylthiouracil during the course of treatment. However, after 131I therapy, they gradually became unresponsive to propylthiouracil. This study has shown that the activity of the antigen-specific response assessed by PCA production in mononuclear cells from Graves' disease patients declined after treatment, suggesting that the treatment exerted immunomodulatory effects.

Adolescent

Separate induction of MHC and thyroid microsomal antigen (McAg) expression on thyroid cell monolayers: enhancement of lectin-induced McAg expression by interferon-gamma.

Interferon-gamma (IFN gamma) induced the expression of the MHC class II antigens HLA-DR and -DQ on 1- to 2-week-old thyrocytes from normal thyroid tissue and thyroid tissue from patients with autoimmune thyroid disease; it also enhanced the expression of B2-microglobulin, which is associated with MHC class I molecules. However, the expression of thyroglobulin and thyroid microsomal antigen (McAg) was not detected after IFN gamma stimulation. Autologous and allogeneic peripheral blood mononuclear cells had the same ability as IFN gamma to induce antigen expression when cocultured with thyrocytes. In contrast, leucoagglutinin (LAG) induced McAg as well as HLA-DR and B2-microglobulin expression on thyrocytes, but not thyroglobulin expression. Concanavalin A and pokeweed mitogen also induced McAg expression. The time course of LAG induction of McAg was not always correlated with that of HLA-DR. Anti-IFN gamma, antiinterleukin-2 receptor, and anti-HLA-DR monoclonal antibodies inhibited LAG or peripheral blood mononuclear cell induction of HLA-DR expression, but not LAG induction of McAg expression. Anti-HLA-DR reduced the IFN gamma induction of HLA-DR. INF gamma enhanced thyrocyte McAg expression induced by LAG, especially when thyrocytes were incubated with IFN gamma for 24 h before LAG stimulation. In contrast, in the absence of LAG stimulation, IFN gamma suppressed already present spontaneous McAg expression. TSH did not induce McAg and HLA-DR expression on DR-negative thyrocytes, but enhanced weak DR expression induced by other stimulants, e.g. IFN gamma or lectins. These data suggest that in vitro induction mechanisms of MHC class I and II antigens and McAg are different; MHC antigens are induced by IFN gamma, whereas McAg is induced by lectin, probably acting on thyrocytes directly; and IFN gamma has an enhancing effect on LAG-induced thyrocyte McAg expression.

Antigens