Graves’ disease and Hashimoto’s thyroiditis in monozygotic twins: case study as well as transcriptomic and immunohistological analysis of thyroid tissues

Abstract

Objective: To report on the rare simultaneous occurrence of Graves' disease (GD) and Hashimoto's thyroiditis (HT) in monozygotic twins. Design: 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.European Journal of Endocrinology 154 13-20

Global gene expression changes in type 1 diabetes: Insights into autoimmune response in the target organ and in the periphery

“…Transcriptomic analyses have been performed to characterize affected organs in patients with type 1 diabetes [25], myositis [50], lupus nephritis [51], SSj [52], rheumatoid arthritis [53], thyroid autoimmune disease [54], arthritic psoriasis [55], multiple sclerosis [56], celiac disease [57] and inflammatory bowel disease (IBD) [58] among others. Overall, transcriptional alterations in those diseases affected mainly the immune system, some of which are common in several diseases [59].…”

Hashimoto's thyroiditis in childhood: presentation modes and evolution over time

“…Although GD and HT have different phenotypes and the mechanisms leading to their dichotomy are unknown, they are generally believed to share a number of common etiological factors. In fact, there have been reports on monozygotic twins in whom one twin had GD and the other one had HT [1-3]. Moreover, both conditions may aggregate in the same families [4] or may even coexist in the same thyroid gland [5], and some individuals may progress from one form to the other.…”

Autoimmune Thyroid Diseases in Children

“…Monozygotic twins show a higher concordance rate of disease than dizygotic twins. However, even with identical twins the concordance rate is only about 50%, emphasizing that other important factors, such as the environment, play a role in disease pathogenesis [5–7]. The identified ATDs susceptibility genes can be divided into two broad groups: …”