The impact of chronic stress associated with active armed conflict in Ukraine on the state of immunity in patients with autoimmune thyroiditis
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background. In the context of prolonged war-related stress in Ukraine, the prevalence of psychoemotional disorders has markedly increased, significantly influencing the course of autoimmune diseases. Autoimmune thyroiditis (AIT) combines endocrine dysfunction with chronic immune inflammation that is highly sensitive to stress exposure. However, the immunological consequences of long-term military stress in AIT patients remain poorly understood. The purpose was to determine the effect of prolonged war-induced stress on immune parameters in patients with autoimmune thyroiditis with different levels of situational anxiety. Materials and methods. Patients with AIT who had been exposed to chronic military stress for four years were examined. They were divided into two groups, with moderate and high levels of situational anxiety. The control group included apparently healthy individuals with high anxiety. Levels of CD3+, CD4+, CD8+, CD16+, and CD22+ lymphocytes, the immunoregulatory index (IRI = CD4+/CD8+) and anti-thyroid peroxidase antibodies were analyzed. Results. Patients with AIT demonstrated a significant decrease in CD3+ and CD4+ cells compared to controls (p < 0.05). In the moderate anxiety group, CD8+ levels and IRI were reduced, suggesting stress-induced suppression of T-cell immunity. CD22+ B-cell counts were lower than in controls, possibly reflecting their migration into thyroid tissue. No significant differences were observed in CD16+ (NK-cells). Summarizing analysis of our studies, we can conclude that autoimmune thyroiditis causes more significant changes in T-cell immunity than stress. There was a significant decrease in CD3+, CD4+, and CD22+ counts compared to controls in both groups with AIT. Stress caused a greater percentage of decreases in these parameters below reference values in the group with high situational anxiety (CD3+ — 17 %, CD4+ — 42.5 %, CD22+ — 25.3 %) and simultaneously stimulated an increase in CD8+ by 10.6 % and CD16+ by 12.8 % above reference values. Conclusions. Chronic psychoemotional stress in patients with AIT is associated with a subclinical decrease in CD3+, CD4+, CD8+, and CD22+ while maintaining CD16+ NK-cell levels. The findings indicate a combined effect of autoimmune inflammation and long-term stress on immune homeostasis, which may contribute to AIT destabilization under additional adverse factors.
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7196997708