CYTOKINES AND GRAVES-DISEASE

Cytokines are an extraordinarily diverse group of molecules, with plei otropic and often overlapping effects. They are crucial to the autoimm une response, and, in particular, regulation of CD4(+) and CD8(+) T-ce ll function depends on the balance of cytokines produced during an imm une response. It is also now clear that cytokines are produced by a wi de array of cells, including the thyroid follicular cells (TFCs). Intr athyroidal lymphocytes produce a heterogeneous pattern of cytokines an d we have summarized the likely effects of these. In Graves' disease, TFCs can themselves express immunologically important molecules as the result of cytokine stimulation and these could contribute to the perp etuation of the autoimmune process. In addition, cytokines have a numb er of generally inhibitory effects on thyroid hormone production which would tend to counter the stimulatory effects of thyroid-stimulating hormone receptor antibodies in Graves' disease.