Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Australian Regenerative Medicine Institute, Monash University, Clayton, Australia.
J Mol Endocrinol. 2021 Feb;66(2):R33-R55. doi: 10.1530/JME-20-0078.
Autoimmune thyroid disease (AITD) accounts for 90% of all thyroid diseases and affects 2-5% of the population with remarkable familial clustering. Among AITDs, Graves' disease (GD) is a complex disease affecting thyroid function. Over the last two decades, case-control studies using cutting-edge gene sequencing techniques have detected various susceptible loci that may predispose individuals to GD. It has been presumed that all likely associated genes, variants, and polymorphisms might be responsible for 75-80% of the heritability of GD. As a result, there are implications concerning the potential contribution of environmental and epigenetic factors in the pathogenesis of GD, including its initiation, progression, and development. Numerous review studies have summarized the contribution of genetic factors in GD until now, but there are still some key questions and notions that have not been discussed concerning the interplay of genetic, epigenetic, and immunological factors. With this in mind, this review discusses some newly-identified loci and their potential roles in the pathogenicity of GD. This may lead to the identification of new, promising therapeutic targets. Here, we emphasized principles, listed all the reported disease-associated genes and polymorphisms, and also summarized the current understanding of the epigenetic basis of GD.
自身免疫性甲状腺疾病 (AITD) 占所有甲状腺疾病的 90%,影响 2-5%的人群,且具有显著的家族聚集性。在 AITD 中,格雷夫斯病 (GD) 是一种影响甲状腺功能的复杂疾病。在过去的二十年中,使用尖端基因测序技术的病例对照研究已经检测到了各种易感基因座,这些基因座可能使个体易患 GD。人们推测,所有可能相关的基因、变体和多态性可能导致 GD 的遗传率为 75-80%。因此,GD 的发病机制中存在环境和表观遗传因素的潜在作用的影响,包括其起始、进展和发展。许多综述研究已经总结了遗传因素在 GD 中的作用,但仍有一些关键问题和概念尚未讨论,即遗传、表观遗传和免疫因素之间的相互作用。有鉴于此,本综述讨论了一些新鉴定的基因座及其在 GD 发病机制中的潜在作用。这可能会导致新的、有前途的治疗靶点的确定。在这里,我们强调了原理,列出了所有报道的与疾病相关的基因和多态性,并总结了目前对 GD 的表观遗传学基础的理解。