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[碘与甲状腺自身免疫]

[Iodine and thyroid autoimmunity].

作者信息

Schumm-Draeger Petra-Maria

机构信息

Endokrinologie, Diabetologie und Angiologie, Krankenhaus München-Bogenhausen.

出版信息

Z Arztl Fortbild Qualitatssich. 2004 May;98 Suppl 5:73-6.

Abstract

The pathogenetic mechanisms leading to the development of autoimmune disease of the thyroid are based on several different factors. The resultant immune response is related to both the genetic predisposition and other influencing factors such as iodine intake, a very important modulator of thyroid autoimmunity. To a large extent, the details of the mechanisms that induce the immune response and lead to chronic autoimmune thyroid reactions are still poorly understood. In genetically predisposed individuals the iodine intake modulates autoimmune thyroid reactions. Especially with acute or chronic increase of iodine intake it leads to a significant increase in the incidence and intensity of autoimmune thyroid disease. There is a need to further investigate whether the results of experimental animal studies can be generalised to humans. Epidemiological data from countries with sufficient or high nutritional iodine intake clearly show that in comparison to countries with iodine deficiency there is an increase in the incidence of autoimmune thyroid disease and a change in the pattern of manifestation, e.g. in the proportion of autoimmune thyroiditis and hyperthyroidism due to Graves' disease. At the same time, thyroid diseases related to iodine deficiency significantly decrease, which is to be expected with a continuously higher iodine intake.

摘要

导致甲状腺自身免疫性疾病发生的发病机制基于多种不同因素。由此产生的免疫反应与遗传易感性以及其他影响因素有关,如碘摄入量,碘是甲状腺自身免疫的一个非常重要的调节因子。在很大程度上,诱导免疫反应并导致慢性自身免疫性甲状腺反应的机制细节仍知之甚少。在具有遗传易感性的个体中,碘摄入量调节自身免疫性甲状腺反应。特别是碘摄入量急性或慢性增加时,会导致自身免疫性甲状腺疾病的发病率和严重程度显著增加。有必要进一步研究实验动物研究的结果是否可以推广到人类。来自营养碘摄入量充足或高的国家的流行病学数据清楚地表明,与碘缺乏国家相比,自身免疫性甲状腺疾病的发病率增加,表现形式发生变化,例如自身免疫性甲状腺炎和格雷夫斯病所致甲状腺功能亢进症的比例。与此同时,与碘缺乏相关的甲状腺疾病显著减少,随着碘摄入量持续升高,这是可以预料的。

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