Objectives: The thymus plays a central role in immune tolerance, which prevents autoimmunity. Myasthenia gravis (MG) is commonly associated with thymoma or thymus hyperplasia, and it can coexist with autoimmune thyroid diseases. However, the role of the thymus in thyroid autoimmunity remains to be clarified, which we investigated here. Study Design: The study design entailed the inclusion of consecutive MG patients and the measurement of anti-thyroid autoantibodies at baseline and, limited to autoantibody-positive patients, also at 24 and 48 weeks. One hundred and seven MG patients were studied. The main outcome measure was the behaviour of anti-thyroglobulin autoantibodies (TgAbs) and anti-thyroperoxidase autoantibodies (TPOAbs) over time in relation to thymectomy. Results: Serum TgAbs and/or TPOAbs were detected in ∼20% of patients in the absence of thyroid dysfunction. The prevalence of positive serum TgAbs and/or TPOAbs decreased significantly (p = 0.002) over the follow-up period in patients who underwent thymectomy, but not in patients who were not thymectomized. When the analysis was restricted to TgAbs or TPOAbs, findings were similar. On the same line, there was a general trend towards a reduction in the serum concentrations of anti-thyroid autoantibodies in patients who underwent thymectomy, which was significant for TPOAbs (p = 0.009). Conclusions: Our findings suggest a role of the thymus in the maintenance of humoral thyroid autoimmunity.
Eur Thyroid J

中文翻译：

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重症肌无力患者胸腺切除术后抗甲状腺自身抗体消失

目的：胸腺在免疫耐受中起着核心作用，可防止自身免疫。重症肌无力（MG）常与胸腺瘤或胸腺增生有关，可与自身免疫性甲状腺疾病共存。然而，胸腺在甲状腺自身免疫中的作用仍有待阐明，我们在这里进行了调查。研究设 研究了 107 名 MG 患者。主要结果测量是抗甲状腺球蛋白自身抗体 (TgAbs) 和抗甲状腺过氧化物酶自身抗体 (TPOAbs) 随时间与胸腺切除术相关的行为。结果：在没有甲状腺功能障碍的情况下，约 20% 的患者检测到血清 TgAb 和/或 TPOAb。在接受胸腺切除术的患者中，血清 TgAb 和/或 TPOAbs 阳性的发生率在随访期间显着下降 ( p = 0.002)，但在未切除胸腺的患者中则没有。当分析仅限于 TgAb 或 TPOAb 时，结果相似。在同一条线上，接受胸腺切除术的患者血清中抗甲状腺自身抗体的浓度总体呈下降趋势，这对 TPOAbs 具有显着性意义（p = 0.009）。结论：我们的研究结果表明胸腺在维持体液甲状腺自身免疫中的作用。
欧洲甲状腺杂志