Peripheral Blood and Intrathyroidal Mononuclear Cell Populations in Patients with Autoimmune Thyroid Disorders Enumerated using Monoclonal Antibodies*

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Abstract
Peripheral blood and intrathyroidal mononuclear cell populations were enumerated in patients with immunologically mediated thyroid disorders using the monoclonal antibodies 0KT3 (pan T cells), 0KT4 (helper⁄inducer T cells), 0KT8 (suppressor⁄cytotoxic T cells), 0KM1 [monocytes, null cells, and natural killer (NK) cells], OKIa (B cells, monocytes, null cells, and activated T cells), and HNK (NK cells). Mononuclear cells were isolated from tissue obtained by thyroid needle biopsy using a discontinuous Percoll gradient. The following abnormalities, compared to normal subjects, of blood mononuclear cell populations were found: 1) a decreased percentage of 0KT3 positive (+) cells and an increased percentage of OKIa+ cells in patients with untreated Graves' hyperthyroidism, 2) an increased percentage of OKIa+ cells, an increased percentage of HNK+ cells, and an increased percentage of 0KM1+ cells in patients with subacute thyroiditis, and 3) an increased percentage of OKIa+ cells in patients with Hashimoto's thyroiditis. There was a significant positive correlation between the percentage of blood Ia+ cells and TSH receptor antibody levels in patients with Graves’ hyperthyroidism. Peripheral blood and intrathyroidal mononuclear cell populations were, generally, similar for patients with Graves' hyperthyroidism, Hashimoto's thyroiditis, and nonimmunological disorders (nodules and multinodular goiter), the only significant differences, compared to peripheral blood, being a decreased percentage of 0KT3+ cells in patients with Graves' hyperthyroidism and an increased percentage of OKIa+ cells in patients with nodular goiter. There was no close correlation for any mononuclear cell population tested with serum T4 levels in any group of patients. In two patients, with Graves' hyperthyroidism and multinodular goiter, respectively, mononuclear cells were isolated from thyroid aspiration biopsy material and from tissue removed at operation. In both patients there was a marked increase in the percentage of 0KM1+ cells and a decrease in the percentage of 0KT8+ cells in thyroid tissue compared to those in both biopsy material and peripheral blood. Abnormalities of major mononuclear cell populations in Graves' hyperthyroidism may reflect hyperthyroxinemia while those in subacute thyroiditis reflect the putative viral infection, rather than the underlying immunological abnormalities.