甲状腺自身免疫：真的是散发性先天性甲状腺功能减退症的一个重要病因吗？

Thyroid autoimmunity: really an important cause of sporadic congenital hypothyroidism?

作者信息

Bona G, Chiovato L, Campra D, Paniccia P, Zaffaroni M, Costa L, Tonacchera M, Gallina M R, Giusti L F

机构信息

Institute of Puericulture, University of Turin, Italy.

出版信息

Panminerva Med. 1991 Jul-Sep;33(3):145-51.

PMID:1685233

Abstract

The transplacental transfer of maternal antithyroid antibodies has recently been hypothesised as an aetiological factor in CH. In order to test this hypothesis, mothers and newborns identified by neonatal screening as suffering from hypothyroidism were tested for TgAb, MAb and TSHBAb. Significant titres of MAb and TgAb antibodies were found in 5% of the newborns and their mothers. TSHBAb was found in 1 out of 18 newborns and 1 out of 14 mothers. A causal link was found between the transplacental transfer of IgG inhibiting thyroid growth and function induced by TSH from a mother with Hashimoto's thyroiditis a newborn with CH and in her CH newborn. However the present series did not reveal the high percentage of cases with CH and thyroid antibodies reported by others and particularly not among the neonates born to mothers without any kind of maternal thyroid pathology. It therefore seems that the role of autoimmunity in the pathogenesis of CH and TH is yet to be clarified.

摘要

最近有人提出，母体抗甲状腺抗体的经胎盘转移是先天性甲状腺功能减退症（CH）的一个病因。为了验证这一假设，对通过新生儿筛查确定患有甲状腺功能减退症的母亲和新生儿进行了甲状腺球蛋白抗体（TgAb）、微粒体抗体（MAb）和促甲状腺素结合抑制性抗体（TSHBAb）检测。在5%的新生儿及其母亲中发现了显著滴度的MAb和TgAb抗体。在18名新生儿中有1名以及14名母亲中有1名检测到TSHBAb。在患有桥本甲状腺炎的母亲所生的患CH的新生儿及其CH新生儿中，发现了抑制TSH诱导的甲状腺生长和功能的IgG经胎盘转移之间存在因果关系。然而，本系列研究并未揭示出其他人所报道的CH和甲状腺抗体病例的高比例，尤其是在没有任何母体甲状腺病变的母亲所生的新生儿中。因此，自身免疫在CH和甲状腺疾病发病机制中的作用似乎仍有待阐明。