The role of the immune system and cytokines involved in the pathogenesis of autoimmune thyroid disease (AITD)
The role of the immune system and cytokines involved in the pathogenesis of autoimmune thyroid disease (AITD)
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DOI：
10.5603/ep.2014.0021
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发表时间：
2014-01-01
影响因子：
2.1
通讯作者：
Niedziela, Marek
中科院分区：
文献类型：
--
作者：
Mikos, Hanna;Mikos, Marcin;Niedziela, Marek
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。 AITD 的发生是由于免疫耐受性和对甲状腺自身抗原的反应性丧失所致：甲状腺过氧化物酶 (TPO)、甲状腺球蛋白 (TG) 和促甲状腺激素受体 (TSHR)。这导致 T 细胞和 B 细胞浸润腺体，产生针对格雷夫斯病 (GD) 和慢性自身免疫性甲状腺炎 (cAIT) 甲状腺功能亢进症临床表现的特异性抗体。此外，桥本甲状腺炎中的 T 细胞会诱导甲状腺滤泡细胞凋亡，最终导致腺体遭到破坏。细胞因子参与甲状腺疾病的发病机制，在免疫系统中发挥作用并直接针对甲状腺滤泡细胞。它们参与免疫反应和炎症的诱导期和效应期，在自身免疫性甲状腺疾病的发病机制中发挥关键作用。已证明多种细胞因子的存在：炎症细胞和甲状腺滤泡细胞内的 IL-1 α、IL-1b、IL-2、IL-4、IL-6、IL-8、IL-10、IL-12、IL-13、IL-14、TNF-α 和 IFN-γ。最后，T细胞衍生的细胞因子可以直接损伤甲状腺细胞，导致功能障碍，还可能刺激一氧化氮（NO）和前列腺素（PG）的产生，从而增加AITD的炎症反应。AITD发病机制中涉及的免疫学机制彼此密切相关，但cAIT和GD表型的图像差异可能是由于在这两种相互对抗的临床甲状腺疾病中观察到的不同类型的免疫反应所致。本文描述了细胞因子和免疫机制在 AITD 发病机制中的潜在作用。
Autoimmune thyroid disease (AITD) is the most common organ-specific autoimmune disorder. AITD development occurs due to loss of immune tolerance and reactivity to thyroid autoantigens: thyroid peroxidase (TPO), thyroglobulin (TG) and thyroid stimulating hormone receptor (TSHR). This leads to infiltration of the gland by T cells and B cells that produce antibodies specific for clinical manifestations of hyperthyroidism in Graves' disease (GD) and chronic autoimmune thyroiditis (cAIT). In addition, T cells in Hashimoto's thyroiditis induce apoptosis in thyroid follicular cells, leading ultimately to the destruction of the gland. Cytokines are involved in the pathogenesis of thyroid diseases working in both the immune system and directly targeting the thyroid follicular cells. They are involved in the induction and effector phase of the immune response and inflammation, playing a key role in the pathogenesis of autoimmune thyroid disease. The presence of multiple cytokines has been demonstrated: IL-1 alpha, IL-1b, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-13, IL-14, TNF-alpha and IFN-gamma within the inflammatory cells and thyroid follicular cells. Finally, cytokines derived from T cells can directly damage thyroid cells, leading to functional disorders and may also stimulate the production of nitric oxide (NO) and prostaglandin (PG), thus increasing the inflammatory response in AITD.Immunological mechanisms involved in the pathogenesis of AITD are strongly related to each other, but differences in the image of cAIT and GD phenotype are possibly due to a different type of immune response observed in these two counteracting clinical thyroid diseases. This article describes the potential role of cytokines and immune mechanisms in the pathogenesis of AITD.