CORRELATION OF ACTIVATED MONOCYTES OR B-CELLS WITH T-LYMPHOCYTE SUBSETS IN PATIENTS WITH GRAVES-DISEASE

We analyzed the phenotypic characteristics of PBMC from 34 patients wi th Graves' disease (GD) at different stages of the disease to explore the sequence of immunological events associated with it. In all cases their monocytes were in a state of activation and differentiation more advanced than those of a group of 23 healthy individuals. Strikingly, some patients had CD14(++)DR(-) immature monocytes, which were absent in healthy individuals. CD14(+)CD16(+)DR(high) monocytes were more ab undant in patients. We found a positive correlation between the CD14(+)DR(-) monocyte and CD4(+)CD45RA(-) helper cells and a negative corre lation between the same monocyte subset and CD4(+)CD45RA(+) naive cell s. CD14(+/++)DR(low) monocytes directly correlated with this latter T4 subset and CD14(+) CD16(+)DR(high) with CD4(+)CD45RO(+) memory lympho cytes. There was also a positive correlation between memory T4 cells a nd the subset of activated B lymphocytes (CD19(+)CD5(+)) and suppresso r T8 cells (CD8(+)CD11b(+)). T8 cytotoxic dells (CD8(+)CD11b(-)) posit ively correlated with T4 naive cells. The circulating levels of T3 and TSI (thyroid-stimulating immunoglobulin) directly correlated with a d ecrease in naive cells and an increase in T8 suppressors. The results suggest that the imbalance suppression/cytotoxicity in GD may be due t o a reiterated presentation of autoantigens, or mimetic antigens, to T helpers by mature monocytes and activated B cells.