The Role of Various Autoantibodies and Alpha2-Macroglobulin in Patients with Hashimoto Disease: Does the Presence of Elevated Antibodies Correlate with Alpha 2-Macroglobulin Levels in Hashimoto Disease?

Introduction: Autoimmune Thyroiditis (AIT) is caused by defects in the immune system in people with a genetic predisposition to the disease. The most prevalent type of autoimmune thyroiditis is Hashimoto's thyroiditis (HT). The present article reviews the possible relationship between α2-macroglobulin levels and autoantibodies in patients suffering from Hashimoto's disease.

Methods: A total of 170 patients with Hashimoto's disease, categorized into subclinical (96 patients) and manifest (74 patients) forms, were enrolled in the study. The control group comprised 65 individuals without thyroid pathologies or other autoimmune diseases. The levels of α2-macroglobulin and autoantibodies, including both organ-specific and non-organ-specific, were determined in all study participants.

Results: Organ-specific antibody and α2-macroglobulin levels were elevated in all patients studied compared to controls. Analysis of organ non-specific antibody levels in patients revealed elevated levels of antibodies to double-stranded (native) DNA in both the subclinical and manifest groups of patients. There were no statistically significant differences in antibody levels to single-stranded (denatured) DNA between the total patient group and the control groups.

Discussion: The data obtained demonstrated that there is no significant correlation between α2-- macroglobulin levels and autoantibody titres, as well as the severity of autoimmune thyroiditis. This finding suggests that α2-macroglobulin may have an unlikely role in the pathogenesis or as a biomarker of disease activity, including in the presence of antibody-dependent cellular damage. Conversely, antibodies directed against double-stranded DNA have exhibited enhanced informativeness and can be regarded as potential markers of the severity of autoimmune thyroid lesions.

Conclusion: Consequently, α2-macroglobulin has no diagnostic value as an indicator of autoimmune process exacerbation in Hashimoto's thyroiditis. Conversely, the presence and level of antibodies to double-stranded DNA may offer a means to assess the severity of the disease and should be the focus of further studies as prognostic markers.