King's College London, London, UK.
King's College London, London, UK; Nutristasis Unit, Viapath, St. Thomas' Hospital, London, UK.
Autoimmun Rev. 2015 Sep;14(9):763-8. doi: 10.1016/j.autrev.2015.04.011. Epub 2015 May 1.
Pernicious anaemia (PA) and some types of thyroid disease result from autoimmune processes. The autoimmune mechanisms in these conditions have not been fully elucidated. This review discusses the autoimmune mechanisms involved in PA and how these affect diagnosis and disease progression. In addition to gastric antibodies, antibodies to the vitamin B12 binding protein transcobalamin which can result in high serum B12 levels are also addressed with regard to how they affect clinical practice. The role of autoimmune susceptibility is investigated by comparing PA to one of its most common comorbidities, autoimmune thyroid disease (AITD). Thyroid disease (although not exclusively AITD) and B12 deficiency are both also implicated in the pathology of hyperhomocysteinemia, an elevated homocysteine in plasma. Since hyperhomocysteinemia is a risk factor for cardiovascular occlusive disease, this review also addresses how thyroid disease in particular leads to changes in homocysteine levels.
恶性贫血（PA）和某些类型的甲状腺疾病是由自身免疫过程引起的。这些疾病中的自身免疫机制尚未完全阐明。本综述讨论了 PA 中涉及的自身免疫机制，以及这些机制如何影响诊断和疾病进展。除了胃抗体外，还讨论了与维生素 B12 结合蛋白转钴胺素结合的抗体，这些抗体可能导致高血清 B12 水平，以及它们如何影响临床实践。通过将 PA 与最常见的合并症之一自身免疫性甲状腺疾病（AITD）进行比较，研究了自身免疫易感性的作用。甲状腺疾病（尽管不仅仅是 AITD）和 B12 缺乏也与高同型半胱氨酸血症的病理学有关，即血浆中同型半胱氨酸升高。由于高同型半胱氨酸血症是心血管闭塞性疾病的一个危险因素，因此本综述还讨论了甲状腺疾病特别是如何导致同型半胱氨酸水平的变化。
