Department of Nuclear Medicine, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia.
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51000 Rijeka, Croatia.
Int J Mol Sci. 2023 Oct 22;24(20):15442. doi: 10.3390/ijms242015442.
Autoimmune thyroid disease (AITD) is the most common organ-specific autoimmune disorder clinically presented as Hashimoto thyroiditis (HT) and Graves' disease (GD). The pathogenesis of AITD is caused by an inappropriate immune response related to genetic, non-genetic, and environmental factors. Pregnancy is one of the factors that have a great influence on the function of the thyroid gland because of the increased metabolic demand and the effects of hormones related to pregnancy. During pregnancy, an adaptation of the maternal immune system occurs, especially of the innate immune system engaged in maintaining adaptive immunity in the tolerant state, preventing the rejection of the fetus. Pregnancy-related hormonal changes (estrogen, progesterone, hCG) may modulate the activity of innate immune cells, potentially worsening the course of AITD during pregnancy. This especially applies to NK cells, which are associated with exacerbation of HD and GD. On the other hand, previous thyroid disorders can affect fertility and cause adverse outcomes of pregnancy, such as placental abruption, spontaneous abortion, and premature delivery. Additionally, it can cause fetal growth retardation and may contribute to impaired neuropsychological development of the fetus. Therefore, maintaining the thyroid equilibrium in women of reproductive age and in pregnant women is of the highest importance.
自身免疫性甲状腺疾病（AITD）是最常见的器官特异性自身免疫性疾病，临床上表现为桥本甲状腺炎（HT）和格雷夫斯病（GD）。AITD 的发病机制是由遗传、非遗传和环境因素引起的不适当免疫反应引起的。妊娠是甲状腺功能影响很大的因素之一，因为代谢需求增加以及与妊娠相关的激素的影响。在妊娠期间，母体免疫系统发生适应性变化，特别是参与维持适应性免疫耐受状态的固有免疫系统。妊娠相关的激素变化（雌激素、孕激素、hCG）可能调节固有免疫细胞的活性，从而潜在地使妊娠期间 AITD 的病程恶化。这尤其适用于与 HD 和 GD 恶化相关的 NK 细胞。另一方面，既往甲状腺疾病会影响生育能力并导致妊娠不良结局，如胎盘早剥、自然流产和早产。此外，它还会导致胎儿生长迟缓，并可能导致胎儿神经心理发育受损。因此，维持育龄妇女和孕妇的甲状腺平衡至关重要。
