Dong Y H, Fu D G
Department of Oncology, Xiangyang Hospital Affiliated to Hubei University of Medicine, Xiangyang, Hubei, P.R. China.
Eur Rev Med Pharmacol Sci. 2014;18(23):3611-8.
Recent epidemiological studies recognized a steady increase in the incidence of different autoimmune endocrine disorders, including autoimmune thyroid disease (AITD). The etiology of AITD is multifactorial and involves genetic and environmental factors and apparently with a strong preponderance in females. There are mainly two types of AITD, Graves' disease and Hashimoto's disease and both of these show strong association in age groups above 45-50 years. Among environmental factors smoking and alcohol have significant effects, both protective as well as for aggravating the disease, even though the precise nature of these effects are not clearly known. There are elevated levels of circulating antibodies against the thyroid proteins, mainly thyroid oxidase, thyroglobulin and thyroid stimulating hormone receptor, in patients with Graves' disease or Hashimoto's disease. Linkage and association studies in AITD identified several major genes that are relevant for the onset of AITD, including the thyroid-specific genes, thyroglobulin and thyroid-stimulating hormone receptor and also many immune-regulatory genes. In this review we addressed many aspects of AITD including disease mechanisms, involved thyroid antigens, environmental factors and genetic factors.
近期的流行病学研究发现，包括自身免疫性甲状腺疾病（AITD）在内的不同自身免疫性内分泌疾病的发病率呈稳步上升趋势。AITD的病因是多因素的，涉及遗传和环境因素，而且明显在女性中更为常见。AITD主要有两种类型，即格雷夫斯病和桥本氏病，这两种疾病在45 - 50岁以上的年龄组中都表现出很强的关联性。在环境因素中，吸烟和饮酒都有显著影响，既有保护作用，也有加重病情的作用，尽管这些影响的确切性质尚不清楚。患有格雷夫斯病或桥本氏病的患者体内，针对甲状腺蛋白（主要是甲状腺氧化酶、甲状腺球蛋白和促甲状腺激素受体）的循环抗体水平会升高。AITD的连锁和关联研究确定了几个与AITD发病相关的主要基因，包括甲状腺特异性基因、甲状腺球蛋白和促甲状腺激素受体，以及许多免疫调节基因。在这篇综述中，我们探讨了AITD的许多方面，包括发病机制、涉及的甲状腺抗原、环境因素和遗传因素。
