Affiliation:
1. Division of Cardiovascular and Diabetes Research, Leeds Institute of
Cardiovascular and Metabolic Medicine, University of Leeds, Leeds,
UK
2. Department of Human Metabolism, University of Sheffield, Sheffield,
UK
Abstract
AbstractHashimoto’s thyroiditis (HT) is part of a spectrum of thyroid autoimmune
conditions and this review provides an update on the latest developments in the
field. HT has a genetic predisposition with a number of immune-related and
thyroid-specific genes conferring disease susceptibility. However, disentangling
genes with protective and predisposing effect is a complex process that requires
further work. The recent increase in the incidence of HT implicates
environmental factors in disease pathogenesis including improved hygiene,
increased dietary iodine intake, new treatment modalities and chemical agents.
Additional unmodifiable predisposing factors include stress, climate, age and
gender. Both cellular and humoral immunity play a role in HT pathogenesis.
Defects in T regulatory cells and increased activation of follicular helper T
cells may have a role in disease initiation/perpetuation. Infiltrating
lymphocytes can be directly cytotoxic to thyroid follicular cells (TFC) or may
affect cell viability/function indirectly through cytokine production, which
alters TFC integrity and modulates their metabolic and immune function. Thyroid
peroxidase and thyroglobulin antibodies are present in the majority of HT
patients and help with management decisions. Antibodies against the sodium
iodide symporter and pendrin are present in a minority with little known about
their clinical relevance. In addition to immune cells, recent work has
identified DNA fragments, generated following cell death, and micro RNA as
potential factors in HT pathogenesis. Despite the large number of studies, the
mechanistic pathways in HT are still not fully understood and further work is
required to enhance our knowledge and identify novel preventative and
therapeutic clinical targets.
Subject
Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,General Medicine,Endocrinology, Diabetes and Metabolism
Reference111 articles.
1. Zur Kenntniss der lymphomatösen Veränderung der Schilddrüse (Struma
lymphomatosa);H Hashimoto;Arch Lin Chir,1912
2. Lymphadenoid goitre (Hashimoto’s disease); diagnostic and biochemical
aspects;D Doniach;Br Med J,1957
3. Thyroid volume in hypothyroidism due to autoimmune disease follows a unimodal
distribution: evidence against primary thyroid atrophy and autoimmune
thyroiditis being distinct diseases;A Carle;J Clin Endocrinol Metab,2009
4. Hashimoto’s thyroiditis: history and future outlook;Y Hiromatsu;Hormones (Athens),2013
5. The immunopathogenesis of chronic autoimmune thyroiditis one century after
hashimoto;A P Weetman;Eur Thyroid J,2013
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