Iranian Journal of Pathology

Association of Serum IL-35 and TGF-β Levels with the Incidence, Severity, and Treatment Response in Iraqi Patients with Graves’ Disease

Document Type : Original Research

Authors

Zahraa Louy Hussein
Karrar Saleem Zayed

Department of Laboratory Investigations, Faculty of Science, University of Kufa, Najaf, Iraq

https://doi.org/10.30699/ijp.2025.2066164.3489
Abstract
Background & Objective: Graves’ disease (GD) is a common autoimmune thyroid disorder characterized by thyroid hormone hypersecretion and autoantibody formation against the thyrotropin receptor (TRAb). Interleukin-35 (IL-35), a novel immunosuppressive cytokine of the IL-12 family secreted primarily by regulatory T and B cells, has been implicated in the modulation of autoimmune responses. Transforming growth factor β (TGF-β) is a cytokine with immunoregulatory properties that plays a central role in T-regulatory cell differentiation. This study aimed to investigate serum IL-35 and TGF-β levels in Iraqi patients with GD and assess their association with disease severity, clinical manifestations, and response to carbimazole therapy.
Methods: A total of 103 participants were enrolled, including 66 patients with GD (mean age, 41.6 [SD, 13.95] years) and 37 healthy controls (mean age, 37.43 [SD, 10.25] years). Serum IL-35 and TGF-β concentrations were measured using enzyme-linked immunosorbent assay (ELISA).
Results: IL-35 levels were significantly reduced in untreated GD patients compared with healthy controls and partially increased after carbimazole therapy (P < .001). TGF-β levels were highest in untreated patients and declined after treatment (P < .001). IL-35 showed no correlation with FT3, FT4, or TRAb but was elevated in patients with disease duration longer than 5 years (P = .046) and in those with severe exophthalmos (P = .03). TGF-β levels were inversely correlated with FT3, FT4, and TRAb (P < .05) and were higher in carbimazole nonresponders and in patients with severe exophthalmos (P < .05).
Conclusion: IL-35 may serve as a promising biomarker for monitoring disease activity, prognosis, and therapeutic response in patients with GD.

Keywords

Graves’ disease
IL-35
TGF-β
thyrotropin receptor antibody
carbimazole

Subjects

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Iranian Journal of Pathology
Volume 20, Issue 4
Summer 2025
Pages 446-453

  • Receive Date 17 June 2025
  • Revise Date 08 July 2025
  • Accept Date 01 August 2025

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