Allele 2 of interleukin‐1 receptor antagonist gene increases the risk of thyroid peroxidase antibodies in subacute thyroiditis

Abstract

Subacute granulomatous thyroiditis (SAT) is a self-limiting systemic inflammatory disorder with possible transient expression of thyroid antibodies. Persistent hypothyroidism is uncommon. The interleukin-1 receptor antagonist IL-1ra is an inhibitor of IL-1 activity and allele 2 of the IL-1ra gene is associated with inflammatory diseases and IL-1ra production. Forty-eight subjects with SAT were investigated. Polymorphisms of IL-1ra, IL-1beta-511 and TNFalpha genes were studied with respect to thyroid peroxidase antibodies (TPOab), thyroglobulin antibodies, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Serum IL-1ra levels were measured. An increased allelic frequency (43% vs 22%, p=0.039) and carriage rate (79% vs 41%, p=0.018) for IL-1ra allele 2 were observed with expression of TPOab in 14 (29.2%) subjects compared with those with negative findings. The carriage rate for both IL-1ra allele 2 and IL-1beta-511 allele 2 was also increased with TPOab expression (71% vs 27%, p=0.004, respectively). No difference in allele frequency or carriage rate was found compared with healthy controls. Serum IL-1ra levels correlated with S-CRP (r=0.41, p=0.004) and ESR (r=0.34, p=0.016), but the association with genes or thyroid antibodies was statistically insignificant. S-CRP levels and ESR were lower and negatively correlated with expression of TPOab (r=-0.27, p=0.046 and r=-0.32, p=0.017). This study describes the multiplicity of the mechanisms responsible for the severity of the acute-phase response during the course of SAT. IL-1ra may have a significant anti-inflammatory role in SAT. Presence of IL-1ra allele 2 increases the risk of developing TPOab.

Subacute thyroiditis as evidence of SARS-CoV2 related autoimmune disorders and case descriptions

“…Interestingly, this HLA allele has also been reported in association with a chronic and severe form of other viral infection, such as hepatitis (102,103). Other immune-related factors, such as interleukin -1 receptor antagonist and TNF have been demonstrated in association with subacute thyroiditis (104)(105)(106). There are also other data suggesting the role of the immune system in developing subacute thyroiditis.…”

De Quervain’s thyroiditis: current concepts and a report of four cases

“…L'interleuchina-6 (IL-6) sembra essere la citochina maggiormente coinvolta nel processo distruttivo della tiroide [19], mentre l'antagonista recettoriale della IL-1 eserciterebbe un significativo ruolo antinfiammatorio [20]. Due rari casi di associazione con la sindrome di Sweet [21] e un caso di SATdQ associata a carcinoma renale (paraneoplastica?)…”