Zhang Lu, He Mengfan, Liu Yanyan, Wang Baohua, Xie Xingjie, Liu Haixia
Department of Endocrinology and Metabolism, The Second Hospital of Dalian Medical University, Dalian, 116027, People's Republic of China.
J Endocrinol Invest. 2025 Apr;48(4):845-859. doi: 10.1007/s40618-024-02501-4. Epub 2024 Dec 6.
Hashimoto's thyroiditis (HT) is the most common autoimmune thyroid disease (AITD), which is distinguished by high thyroid peroxidase antibody (TPOAb) or thyroglobulin antibody (TgAb). The differentiation of CD4T cell subsets in patients with HT is imbalanced, with Treg cells decreased and Th17 cells abnormally activated. Fatty acid oxidation supports the differentiation of Th17 cells and induces inflammation, but the specific mechanism is still unknown. This study aimed to explore the role of fatty acid oxidation and its pathway in the pathogenesis of autoimmune thyroiditis and the immune mechanism.
In in vitro experiments, a total of 60 HT patients and 20 healthy controls were selected and their CD4T cells were sorted by magnetic beads. All 80 samples were divided into 4 groups on average: HC group (Healthy control group), HT group (Hashimoto thyroiditis CD4T cell inactive group), TCC group(Hashimoto thyroiditis CD4T cell activation), TCC + ETO group(Hashimoto thyroiditis CD4T cell activation + Etomoxir group). In in vivo experiments, the mice were randomly divided into 3 groups: Con group(Control group), mTg group (CBA/J mice were injected with mTg for modeling, that is EAT mice group), and mTg + ETO group (Etomoxir intervention in EAT mice group). Fatty acid oxidation substrates of CD4T cells in human peripheral blood were detected by targeted metabolomics. The expressions of key fatty acid oxidation proteins mTOR, ACC1 and CPT1A were detected by Western blotting. The proportion of CD4T cell subtype differentiation in human and mouse models was detected by flow cytometry. The severity of EAT was detected by HE staining.
Compared with healthy controls, the level of CPT1A in CD4T cells of HT patients was increased, and the intracellular fatty acid content was significantly decreased, indicating that the level of fatty acid oxidation was enhanced in HT patients. After adding Etomoxir, the level of fatty acid oxidation was significantly inhibited, and the imbalance of CD4T cell subpopulation differentiation in HT patients was reversed. In EAT mice, the mTOR/ACC1/CPT1A pathway was significantly activated, and its expression level was decreased after adding Etomoxir. At the same time, Etomoxir could reverse the reprogramming of abnormal metabolism in EAT mice cells, reduce the spleen index, and improve lymphocyte infiltration in the thyroid.
The mTOR/ACC1/CPT1A fatty acid oxidation pathway of CD4T cells in Hashimoto's thyroiditis was increased, and treatment with Etomoxir could inhibit the activation of this pathway, and reverse the reprogramming of abnormal metabolism in CD4T cells, thereby reducing Hashimoto's thyroiditis.
桥本甲状腺炎(HT)是最常见的自身免疫性甲状腺疾病(AITD),其特征为甲状腺过氧化物酶抗体(TPOAb)或甲状腺球蛋白抗体(TgAb)升高。HT患者CD4T细胞亚群分化失衡,调节性T细胞(Treg细胞)减少,辅助性T细胞17(Th17细胞)异常活化。脂肪酸氧化支持Th17细胞分化并诱导炎症,但具体机制尚不清楚。本研究旨在探讨脂肪酸氧化及其途径在自身免疫性甲状腺炎发病机制及免疫机制中的作用。
在体外实验中,共选取60例HT患者和20例健康对照,通过磁珠分选其CD4T细胞。80个样本平均分为4组:HC组(健康对照组)、HT组(桥本甲状腺炎CD4T细胞非活化组)、TCC组(桥本甲状腺炎CD4T细胞活化组)、TCC + ETO组(桥本甲状腺炎CD4T细胞活化+依替莫司组)。在体内实验中,将小鼠随机分为3组:Con组(对照组)、mTg组(CBA/J小鼠注射mTg进行建模,即实验性自身免疫性甲状腺炎小鼠组)、mTg + ETO组(依替莫司干预实验性自身免疫性甲状腺炎小鼠组)。采用靶向代谢组学检测人外周血CD4T细胞的脂肪酸氧化底物。通过蛋白质免疫印迹法检测关键脂肪酸氧化蛋白mTOR、乙酰辅酶A羧化酶1(ACC1)和肉碱/有机阳离子转运体1A(CPT1A)的表达。通过流式细胞术检测人和小鼠模型中CD4T细胞亚群分化比例。通过苏木精-伊红(HE)染色检测实验性自身免疫性甲状腺炎的严重程度。
与健康对照相比,HT患者CD4T细胞中CPT1A水平升高,细胞内脂肪酸含量显著降低,表明HT患者脂肪酸氧化水平增强。添加依替莫司后,脂肪酸氧化水平显著受到抑制,HT患者CD4T细胞亚群分化失衡得到逆转。在实验性自身免疫性甲状腺炎小鼠中,mTOR/ACC1/CPT1A途径显著激活,添加依替莫司后其表达水平降低。同时,依替莫司可逆转实验性自身免疫性甲状腺炎小鼠细胞异常代谢的重编程,降低脾脏指数,并改善甲状腺淋巴细胞浸润。
桥本甲状腺炎中CD4T细胞的mTOR/ACC1/CPT1A脂肪酸氧化途径增强,依替莫司治疗可抑制该途径的激活,并逆转CD4T细胞异常代谢的重编程,从而减轻桥本甲状腺炎。