The genetics of autoimmune thyroid disease

摘要: Autoimmune thyroid disease (AITD) comprises a series of interrelated conditions including hyperthyroid Graves’ (GD), Hashimoto’s (goitrous) thyroiditis, atrophic autoimmune hypothyroidism, postpartum thyroiditis (PPT), and thyroid-associated orbitopathy (TAO). These different manifestations AITD may occur synchronously, most frequently as the combination GD TAO. Different phenotypes also sequentially in same individual, for instance, spontaneous hypothyroidism following an episode or PPT. This clustering within individual suggests that these have common pathophysiological basis. Together, AITDs are commonest disorders population, affecting between 2% 4% women up to 1% men (1–3). Furthermore, prevalence increases with advancing age, more than 10% subjects over 75 yr age having biochemical evidence mild (subclinical) majority which is due (2, 3). A widely accepted model pathogenesis each subject has background inherited predisposition autoimmunity, additional environmental hormonal factors trigger contribute development disease. In support this model, there good both cigarette smoking adverse psychosocial events associated (4– 6). Similarly, female preponderance human (1), modulation animal models gonadal steroids (7), amelioration during pregnancy, occurrence PPT all important role sex disorders. contrast, little convincing infective agents, thought classical precipitants (8). recent statistical based on data from large twin study, found 79% genetic factors, only 21% nongenetic (environmental hormonal) influences (9). study profound implications if we make progress understanding molecular basis AITDs, elucidation likely hold key. Recent years seen flurry activity research field, article will review advances about AITDs.