Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, No.74, Linjiang Rd, Yuzhong Dist, Chongqing 404100, China.
Int J Med Sci. 2020 Aug 29;17(16):2402-2415. doi: 10.7150/ijms.48128. eCollection 2020.
Hashimoto's thyroiditis (HT) is the most prevalent autoimmune thyroid disease (ATD) worldwide and is strongly associated with miscarriage and even recurrent miscarriage (RM). Moreover, with a deepening understanding, emerging evidence has shown that immune dysfunctions caused by HT conditions, including imbalanced subsets of CD4+ T-helper cells, B regulatory (Breg) cells, high expression levels of CD56dim natural killer (NK) cells, and cytokines, possibly play an important role in impairing maternal tolerance to the fetus. In recent years, unprecedented progress has been made in recognizing the specific changes in immune cells and molecules in patients with HT, which will be helpful in exploring the mechanism of HT-related miscarriage. Based on these findings, research investigating some potentially more effective treatments, such as selenium (Se), vitamin D3, and intravenous immunoglobulin (IVIG), has been well developed over the past few years. In this review, we highlight some of the latest advances in the possible immunological pathogenesis of HT-related miscarriage and focus on the efficacies of treatments that have been widely introduced to clinical trials or practice described in the most recent literature.
桥本甲状腺炎（HT）是全球最常见的自身免疫性甲状腺疾病（ATD），与流产甚至复发性流产（RM）密切相关。此外，随着认识的深入，新出现的证据表明，HT 引起的免疫功能紊乱，包括 CD4+辅助性 T 细胞亚群失衡、B 调节性（Breg）细胞、CD56dim 自然杀伤（NK）细胞高表达和细胞因子，可能在损害母体对胎儿的耐受性方面发挥重要作用。近年来，人们在认识 HT 患者免疫细胞和分子的特定变化方面取得了前所未有的进展，这将有助于探索 HT 相关流产的机制。基于这些发现，过去几年一直在研究一些潜在更有效的治疗方法，如硒（Se）、维生素 D3 和静脉注射免疫球蛋白（IVIG）。在这篇综述中，我们重点介绍了 HT 相关流产可能的免疫学发病机制的最新进展，并关注了最近文献中广泛介绍到临床试验或实践的治疗方法的疗效。
