Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China.
Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Hubei Province, Wuhan, PR China.
Clin Immunol. 2021 Mar;224:108663. doi: 10.1016/j.clim.2020.108663. Epub 2021 Jan 2.
Autoimmune thyroiditis (AIT) is a common organ-specific autoimmune disease with a high incidence among women of childbearing age. Recent studies have reported that women with AIT are more susceptible to infertility, miscarriage and preterm birth. It has been investigated that abnormal changes in maternal immune system and maternal-fetal interface can dampen the immune tolerance between mother and fetus, which underlie the pathogenesis of adverse pregnancy outcomes. Hence, we summarize the immunological changes related to adverse reproductive outcomes in AIT and highlight the respective contributions of both humoral and cellular immune dysfunctions to pregnancy failures. Moreover, the direct impacts of AIT on maternal-fetal immune activation and biological influences to trophoblasts are discussed as well. All these associations require confirmation in larger studies, and the pathogenic mechanisms need to be better understood, which might provide useful information for clinical diagnosis and therapy of AIT.
自身免疫性甲状腺炎（AIT）是一种常见的器官特异性自身免疫性疾病，在育龄妇女中的发病率较高。最近的研究表明，患有 AIT 的女性更容易不孕、流产和早产。研究表明，母体免疫系统和母体-胎儿界面的异常变化会削弱母婴之间的免疫耐受，这是不良妊娠结局的发病机制。因此，我们总结了与 AIT 不良生殖结局相关的免疫学变化，并强调了体液和细胞免疫功能障碍对妊娠失败的各自贡献。此外，还讨论了 AIT 对母体-胎儿免疫激活的直接影响以及对滋养层的生物学影响。所有这些关联都需要在更大的研究中得到证实，并且需要更好地了解发病机制，这可能为 AIT 的临床诊断和治疗提供有用的信息。
