Dissertation committee:
Γεώργιος Μαστοράκος Καθηγητής Ιατρική Σχολή ΕΚΠΑ
Νικόλαος Βραχνής Αναπληρωτής Καθηγητής Ιατρική Σχολή ΕΚΠΑ
Χαράλαμπος Συριστατίδης Αναπληρωτής Καθηγητής Ιατρική Σχολή ΕΚΠΑ
Νικόλαος Βλάχος Καθηγητής Ιατρική Σχολή ΕΚΠΑ
Ειρήνη Λαμπρινουδάκη Καθηγήτρια Ιατρική Σχολή ΕΚΠΑ
Σταυρούλα Μιχαλά Επίκουρος Καθηγήτρια Ιατρική Σχολή ΕΚΠΑ
Πέτρος Δρακάκης Καθηγητής Ιατρική Σχολή ΕΚΠΑ
Summary:
Thyroid physiology and autoimmunity are altered in pregnancy. While oestradiol, cortisol, and TGF- β1 are implicated in these phenomena outside pregnancy, their associations with thyroid autoantibodies during pregnancy and postpar-tum are not thoroughly examined. This study aimed to unravel their eventual associations during pregnancy and postpartum in the same cohort of 93 pregnant women studied prospectively from 2015 to 2017. Blood samples were drawn at the 24th and the 36th gestational week and at the 1st postpartum week for measurements of thyroid hormones, TSH, anti- TPO, anti- Tg, oestradiol, cortisol, and TGF-β1. Serum anti- TPO was greater (P < 0.05) at the 1st postpartum than at the 24th and 36th gestational weeks. At the 36th gestational week, cortisol was greater (P < 0.05) and TGF- β1 lower (P < 0.05) than at the 24th gestational and the 1st post -partum weeks. Mean TGF-β1 and cortisol concentrations evolve throughout pregnancy and postpartum in a mirror image pattern. At the 1st postpartum week mean rT3 concentrations were lower than those at 24 and 36 gestational weeks (P<0.001 and P<0.001 respectively). At the 1st postpartum week, cortisol correlated negatively with anti- Tg (r = −0.419) (P < 0.05). ΔTGF- β1 was the best negative and Δoestradiol the best positive predictor of the 1st postpartum week anti- TPO (P < 0.05, b = −0.509; P < 0.05, b = 0.459 respectively). To our knowledge this the first work to have studied TGF-β1 concentrations in the same cohort of women during pregnancy and postpartum. At postpartum, increased TGF- β1 is related to a less pronounced anti- TPO increase as compared to the 3rd trimester, suggesting an immunosuppressive role for TGF- β1. During pregnancy and postpartum, oestradiol, cortisol, and TGF-β1 are associated with suppression of thyroid autoantibodies.
Keywords:
Thyroid, Autoimmunity, Estradiol, Cortisol, TGFβ1
