{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T03:02:03Z","timestamp":1792551723386,"version":"4.5.0"},"reference-count":44,"publisher":"The Endocrine Society","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,12,1]]},"abstract":"<jats:p>Hyperthyroidism in Graves\u2019 disease is caused by thyroid-stimulating autoantibodies to the TSH receptor (TSHR), whereas hypothyroidism in Hashimoto\u2019s thyroiditis is associated with thyroid peroxidase and thyroglobulin autoantibodies. In some Graves\u2019 patients, thyroiditis becomes sufficiently extensive to cure the hyperthyroidism with resultant hypothyroidism. Factors determining the balance between these two diseases, the commonest organ-specific autoimmune diseases affecting humans, are unknown. Serendipitous findings in transgenic BALB\/c mice, with the human TSHR A-subunit targeted to the thyroid, shed light on this relationship. Of three transgenic lines, two expressed high levels and one expressed low intrathyroidal A-subunit levels (Hi- and Lo-transgenics, respectively). Transgenics and wild-type littermates were depleted of T regulatory cells (Treg) using antibodies to CD25 (CD4+ T cells) or CD122 (CD8+ T cells) before TSHR-adenovirus immunization. Regardless of Treg depletion, high-expressor transgenics remained tolerant to A-subunit-adenovirus immunization (no TSHR antibodies and no hyperthyroidism). Tolerance was broken in low-transgenics, although TSHR antibody levels were lower than in wild-type littermates and no mice became hyperthyroid. Treg depletion before immunization did not significantly alter the TSHR antibody response. However, Treg depletion (particularly CD25) induced thyroid lymphocytic infiltrates in Lo-transgenics with transient or permanent hypothyroidism (low T4, elevated TSH). Neither thyroid lymphocytic infiltration nor hypothyroidism developed in similarly treated wild-type littermates. Remarkably, lymphocytic infiltration was associated with intermolecular spreading of the TSHR antibody response to other self thyroid antigens, murine thyroid peroxidase and thyroglobulin. These data suggest a role for Treg in the natural progression of hyperthyroid Graves\u2019 disease to Hashimoto\u2019s thyroiditis and hypothyroidism in humans.<\/jats:p>","DOI":"10.1210\/en.2007-1024","type":"journal-article","created":{"date-parts":[[2007,9,7]],"date-time":"2007-09-07T00:48:03Z","timestamp":1189126083000},"page":"5724-5733","source":"Crossref","is-referenced-by-count":99,"title":["The Link between Graves\u2019 Disease and Hashimoto\u2019s Thyroiditis: A Role for Regulatory T Cells"],"prefix":"10.1210","volume":"148","author":[{"given":"Sandra M.","family":"McLachlan","sequence":"first","affiliation":[{"name":"Autoimmune Disease Unit (S.M.M., P.N.P., Y.M., C.-R.C., A.M., H.A.A., B.R.), Cedars-Sinai Research Institute and University of California, Los Angeles, School of Medicine, Los Angeles, California 90048;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Nagayama","sequence":"first","affiliation":[{"name":"Department of Medical Gene Technology (Y.N.), Molecular Medicine Unit, Atomic Bomb Disease Institute, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavel N.","family":"Pichurin","sequence":"first","affiliation":[{"name":"Autoimmune Disease Unit (S.M.M., P.N.P., Y.M., C.-R.C., A.M., H.A.A., B.R.), Cedars-Sinai Research Institute and University of California, Los Angeles, School of Medicine, Los Angeles, California 90048;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumiko","family":"Mizutori","sequence":"first","affiliation":[{"name":"Autoimmune Disease Unit (S.M.M., P.N.P., Y.M., C.-R.C., A.M., H.A.A., B.R.), Cedars-Sinai Research Institute and University of California, Los Angeles, School of Medicine, Los Angeles, California 90048;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Rong","family":"Chen","sequence":"first","affiliation":[{"name":"Autoimmune Disease Unit (S.M.M., P.N.P., Y.M., C.-R.C., A.M., H.A.A., B.R.), Cedars-Sinai Research Institute and University of California, Los Angeles, School of Medicine, Los Angeles, California 90048;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Misharin","sequence":"first","affiliation":[{"name":"Autoimmune Disease Unit (S.M.M., P.N.P., Y.M., C.-R.C., A.M., H.A.A., B.R.), Cedars-Sinai Research Institute and University of California, Los Angeles, School of Medicine, Los Angeles, California 90048;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly A.","family":"Aliesky","sequence":"first","affiliation":[{"name":"Autoimmune Disease Unit (S.M.M., P.N.P., Y.M., C.-R.C., A.M., H.A.A., B.R.), Cedars-Sinai Research Institute and University of California, Los Angeles, School of Medicine, Los Angeles, California 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