Wu Jialu, Huang Hui, Yu Xijie
Laboratory of Endocrinology and Metabolism/Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, 37 Guoxue Lane, 610041, Chengdu, P.R. China.
Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, 37 Guoxue Lane, 610041, Chengdu, P.R. China.
Rev Endocr Metab Disord. 2023 Apr;24(2):191-205. doi: 10.1007/s11154-022-09778-x. Epub 2022 Dec 13.
Bone marrow contains resident cellular components that are not only involved in bone maintenance but also regulate hematopoiesis and immune responses. The immune system and bone interact with each other, coined osteoimmunology. Hashimoto's thyroiditis (HT) is one of the most common chronic autoimmune diseases which is accompanied by lymphocytic infiltration. It shows elevating thyroid autoantibody levels at an early stage and progresses to thyroid dysfunction ultimately. Different effects exert on bone metabolism during different phases of HT. In this review, we summarized the mechanisms of the long-term effects of HT on bone and the relationship between thyroid autoimmunity and osteoimmunology. For patients with HT, the bone is affected not only by thyroid function and the value of TSH, but also by the setting of the autoimmune background. The autoimmune background implies a breakdown of the mechanisms that control self-reactive system, featuring abnormal immune activation and presence of autoantibodies. The etiology of thyroid autoimmunity and osteoimmunology is complex and involves a number of immune cells, cytokines and chemokines, which regulate the pathogenesis of HT and osteoporosis at the same time, and have potential to affect each other. In addition, vitamin D works as a potent immunomodulator to influence both thyroid immunity and osteoimmunology. We conclude that HT affects bone metabolism at least through endocrine and immune pathways.
骨髓含有常驻细胞成分，这些成分不仅参与骨骼维持，还调节造血和免疫反应。免疫系统和骨骼相互作用，这一领域被称为骨免疫学。桥本甲状腺炎（HT）是最常见的慢性自身免疫性疾病之一，伴有淋巴细胞浸润。它在早期表现为甲状腺自身抗体水平升高，最终发展为甲状腺功能障碍。在HT的不同阶段，对骨代谢有不同影响。在这篇综述中，我们总结了HT对骨骼长期影响的机制以及甲状腺自身免疫与骨免疫学之间的关系。对于HT患者，骨骼不仅受甲状腺功能和促甲状腺激素（TSH）值的影响，还受自身免疫背景的影响。自身免疫背景意味着控制自身反应系统的机制出现故障，其特征是免疫异常激活和自身抗体的存在。甲状腺自身免疫和骨免疫学的病因复杂，涉及多种免疫细胞、细胞因子和趋化因子，它们同时调节HT和骨质疏松症的发病机制，并且有可能相互影响。此外，维生素D作为一种有效的免疫调节剂，对甲状腺免疫和骨免疫学都有影响。我们得出结论，HT至少通过内分泌和免疫途径影响骨代谢。
