Chiovato L, Lapi P, Santini F, Bona G, Weber G, Siragusa V, Chiumello G, Pinchera A
Istituto di Endocrinologia, Università degli Studi, Pisa.
Ann Ist Super Sanita. 1994;30(3):317-23.
The involvement of thyroid autoimmunity in the pathogenesis of sporadic congenital hypothyroidism is still incompletely understood. While antithyroglobulin and anti-thyroperoxidase antibodies are harmless, the transplacental passage of TSH receptor antibodies with blocking activity from a mother with autoimmune thyroiditis to the fetus is responsible of transient neonatal hypothyroidism in the baby. This is however a rare condition. Thyroid growth blocking antibodies have been described in healthy mothers of children with permanent congenital hypothyroidism due to thyroid dysgenesis, but this observation was not confirmed in other studies including our own. Antibodies producing cell mediated cytotoxicity (ADCC), either transferred from the mother or due to an autoimmune thyroiditis developing in utero, might be involved in the pathogenesis of permanent congenital hypothyroidism. However, this hypothesis requires confirmation in more extensive studies.
甲状腺自身免疫在散发性先天性甲状腺功能减退症发病机制中的作用仍未完全明确。虽然抗甲状腺球蛋白抗体和抗甲状腺过氧化物酶抗体并无危害，但具有阻断活性的促甲状腺激素受体抗体经胎盘从患有自身免疫性甲状腺炎的母亲传递给胎儿，是导致婴儿暂时性新生儿甲状腺功能减退症的原因。不过，这是一种罕见情况。在因甲状腺发育异常导致永久性先天性甲状腺功能减退症患儿的健康母亲中，曾有甲状腺生长阻断抗体的相关描述，但包括我们自己的研究在内，其他研究并未证实这一观察结果。产生细胞介导细胞毒性的抗体（ADCC），无论是从母亲传递而来还是由于子宫内发生自身免疫性甲状腺炎所致，都可能参与永久性先天性甲状腺功能减退症的发病机制。然而，这一假说需要在更广泛的研究中得到证实。
