Autoimmune thyroid disorder

自身免疫性甲状腺疾病
  • 文章类型: Journal Article
    碘缺乏导致甲状腺球蛋白(Tg)浓度升高,高碘Tg比低碘Tg更具免疫原性。该研究调查了通过尿碘浓度(UIC)确定的不同碘营养状态下血清碘浓度与甲状腺球蛋白自身抗体(TgAb)水平之间的相关性。通过问卷收集了1,482名参与者的人口统计信息。收集血液和斑点尿液以测量促甲状腺激素(TSH),TgAb,甲状腺抗过氧化物酶抗体(TPOAb),血清碘(SIC),血清非蛋白结合碘(snPBI),尿碘(UIC),肌酐(UCr)。UIC和SIC中位数分别为146.5μg/L和74.9μg/L,分别。观察到SIC之间的线性关系,snPBI,和血清蛋白结合碘(sPBI)(P<0.001)。SIC的90%参考区间,snPBI,sPBI为50.7-120.7μg/L,21.9-52.9μg/L,和19.7-77.9μg/L,分别。女性TgAb水平升高的患病率明显高于男性(P<0.001)。低和高水平的snPBI和sPBI与升高的TgAb水平的风险增加相关。在女性中,低于snPBI参考值(OR=2.079,95CI:1.166,3.705)和sPBI参考值(OR=2.578,95CI:1.419,4.684)组TgAb阳性风险较高。在男人中,低于SIC参考值组TgAb阳性的风险更高(OR=3.395,95CI:1.286,8.962)。碘可能通过与蛋白质的结合对TgAb水平产生影响,主要是Tg,从而改变Tg的碘含量。性别因素的相互作用进一步增加了TgAb出现的风险。
    Iodine deficiency results in elevated thyroglobulin (Tg) concentrations, with high iodine Tg being more immunogenic than low iodine Tg. The study investigated the correlation between serum iodine concentration and thyroglobulin autoantibody (TgAb) levels across diverse iodine nutritional statuses as determined by urine iodine concentration (UIC). Demographic information was collected from 1,482 participants through a questionnaire. Blood and spot urine were collected to measure thyroid-stimulating hormone (TSH), TgAb, thyroid anti-peroxidase antibody (TPOAb), serum iodine (SIC), serum non-protein-bound iodine (snPBI), urine iodine (UIC), creatinine (UCr). The median UIC and SIC were 146.5 μg/L and 74.9 μg/L, respectively. A linear relationship was observed between SIC, snPBI, and serum-protein-bound iodine (sPBI) (P < 0.001). The 90% reference intervals for SIC, snPBI, and sPBI were 50.7-120.7 μg/L, 21.9-52.9 μg/L, and 19.7-77.9 μg/L, respectively. The prevalence of elevated TgAb levels was significantly higher in women than in men (P < 0.001). Both low and high levels of snPBI and sPBI were associated with an increased risk of elevated TgAb levels. In women, the risk of positive TgAb in the group below the reference value of snPBI (OR = 2.079, 95%CI: 1.166, 3.705) and sPBI (OR = 2.578, 95%CI: 1.419, 4.684) was higher. In men, the risk of positive TgAb in the group below the reference value of SIC was higher (OR = 3.395, 95%CI: 1.286, 8.962). Iodine might exert an influence on TgAb levels through its binding to proteins, primarily Tg, thereby altering the iodine content of Tg. The interplay of gender factors further enhanced the risk of TgAb emergence.
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  • 文章类型: Journal Article
    干燥综合征是人体外分泌腺的一种自身免疫性疾病;然而,众所周知,它在体内有许多腺外和内分泌表现。此外,其他自身免疫性也有报道在干燥综合征患者中患病率高,包括甲状腺疾病。因此,在这项研究中,我们旨在确定已有干燥综合征患者发生甲状腺疾病的风险增加.系统评价是根据系统评价和荟萃分析(PRISMA)指南的首选报告项目进行的。PubMed上的在线搜索,PubMedCentral(PMC),谷歌学者,和Cochrane一直到2022年6月5日,以过滤过去20年发表的研究。根据纳入-排除标准,最初选择了167项研究。他们通过质量评估工具进行了筛选和评估,产生了七项研究,包括一个荟萃分析,三项非随机对照试验,和三个系统的审查。这项研究证明,干燥综合征患者有发生甲状腺疾病的显著风险,尤其是自身免疫性甲状腺炎.这也凸显了对这些患者进行高级研究以及更好的诊断和筛查方案的需求,以减少疾病的严重性。
    Sjogren\'s syndrome is an autoimmune disorder of the body\'s exocrine glands; however, it is known to have numerous extra-glandular and endocrine manifestations in the body. Moreover, other autoimmune have also been reported with high prevalence in patients with Sjogren\'s syndrome, including thyroid diseases. Therefore in this study, we aimed to ascertain the increased risk of developing thyroid disorders in patients with pre-existing Sjogren\'s syndrome. The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Online searches on PubMed, PubMed Central (PMC), Google Scholar, and Cochrane were done till 5th June 2022 to filter out studies published in the last twenty years. Based on the inclusion-exclusion criteria, 167 studies were initially selected. They were screened and assessed by quality assessment tools that yielded seven studies, including one meta-analysis, three non-randomized control trials, and three systematic reviews. The study proved that patients with Sjogren\'s syndrome are at significant risk of developing thyroid disorders, especially autoimmune thyroiditis. This also highlights the need for advanced research and better diagnostic and screening protocols for these patients to reduce the seriousness of the disease.
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  • 文章类型: Journal Article
    人类妊娠导致许多生理改变,这些改变在胎盘发育中达到顶峰,在许多其他功能中,是一种短暂但高度有效的内分泌器官。胎盘的激素活性以其连续产生和分泌高水平孕酮的能力为标志。孕酮在整个妊娠期间保护胎儿胎盘单元的健康,该原理的拟议机制之一涉及局部和全身免疫耐受的发展,这主要是由于CD4淋巴细胞活化的障碍。然而,尽管这些改变已经存在并且已经确立,自身免疫并不完全罕见,广泛的疾病可以继续,或者从头发展,在整个妊娠期间甚至分娩后。最新数据支持所选自身免疫性疾病的临床病程与循环性类固醇水平之间存在关系。孕妇最常见的自身免疫性内分泌疾病是桥本病,严重的疾病,and,很少,以阿狄森病形式出现的原发性肾上腺功能不全。妊娠会影响受孕前诊断的患者这些内分泌疾病的临床过程。多个粒子,像促甲状腺激素受体刺激抗体,甲状腺激素,糖皮质激素,和抗甲状腺药物,可以穿过胎盘屏障并在胎儿组织中引起生物学作用。产后甲状腺炎形式的甲状腺病理在抗甲状腺过氧化物酶和抗甲状腺球蛋白抗体阳性的患者中特别普遍。某些人群更容易发生多种妊娠并发症,需要定期随访。在我们的论文中,我们想解决生理问题,病理生理学,以及整个人类妊娠期间内分泌自身免疫的临床方面,以及特殊情况下孕妇要考虑。
    Human gestation leads to a number of physiological alterations which peak at the development of placentta known for, among many other functions, being a transient but highly potent endocrine organ. Hormonal activity of placenta is marked by its ability to continuously produce and secrete high levels of progesterone. Progesterone guards the well-being of the fetoplacental unit throughout the gestation and one of the proposed mechanisms of this principle involves the development of local and systemic immune tolerance mainly due to impediment of CD4+ lymphocyte activation. However, though these alterations are present and well-established, autoimmunity is not entirely rare and a wide spectrum of diseases can continue, or develop de novo, throughout the gestation or even after the delivery. Up-to-date data supports the existence of a relationship between the clinical course of chosen autoimmune diseases and levels of circulating sex steroids. The most common autoimmune endocrinopathies in pregnant women are Hashimoto\'s disease, Graves\' disease, and, more rarely, primary adrenal insufficiency in the form of Addison\'s disease. Gestation can influence the clinical course of these endocrinopathies in patients who were diagnosed before conception. Multiple particles, like TSH-receptor stimulating antibodies, thyroid hormones, glucocorticoids, and anti-thyroid medications, can cross the placental barrier and evoke biological action in fetal tissues. Thyroid pathology in the form of postpartum thyroiditis is particularly prevalent in patients with positive anti-thyroperoxidase and anti-thyroglobulin antibodies. Certain populations are more at risk of developing numerous gestational complications and require regular follow-up. In our paper, we would like to address physiological, physiopathological, and clinical aspects of endocrine autoimmunity throughout human gestation, as well as special circumstances to consider in pregnant women.
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  • 文章类型: Journal Article
    尽管最近有证据表明,低血清25-羟基维生素D(25(OH)D)水平和偏转可能会影响自身免疫性甲状腺疾病(AITD)的出现,维生素D缺乏与Graves病(GD)和桥本甲状腺炎(HT)的关系,其中包括AITD,尚不清楚。我们从PubMed/Medline检索了描述维生素D与HT和GD相关的研究,谷歌学者,还有Cochrane图书馆.我们纳入了比较AITD病例(如HT和GD病例)与对照受试者之间维生素D水平和缺乏或充足性的研究。最终评估包括11项研究,这些研究招募了2011年至2021年之间发布的1952年AITD病例(HT和GD);这些都包括在最终审查中。所有纳入的研究都是观察性的,更确切地说,招募健康受试者和对照组的病例对照研究。审查的大多数研究表明,HT和GD患者维生素D缺乏或血清25(OH)-D水平低的患病率更高。两项研究未能确定维生素D缺乏与HT和GD疾病之间的关联。总之,维生素D缺乏或不足可增加自身免疫性疾病如HT和GD的发病率。需要长期随访的随机对照试验来确认自身免疫性甲状腺疾病与维生素D之间的因果关系,并为维生素D治疗或补充治疗效果的相关性提供更可靠的见解。
    Despite recent evidence that low serum 25-hydroxyvitamin D (25(OH)D) levels and deflects may influence the emergence of autoimmune thyroid disorders (AITD), the relationship between vitamin D deficiency and Graves\' disease (GD) and Hashimoto\'s thyroiditis (HT), which comprise AITD, remains unclear. We retrieved studies that described vitamin D association with HT and GD from PubMed/Medline, Google Scholar, and the Cochrane Library. We included research studies that compared vitamin D levels and deficiency or sufficiency between AITD cases such as HT and GD cases and control subjects. The final assessment comprised 11 studies that recruited 1952 AITD cases (HT and GD) that were published between 2011 and 2021; these were included in the final review. All the included studies were observational, and more precisely, case-control studies that recruited healthy subjects as well as controls. The majority of the studies reviewed indicated that HT and GD patients have a greater prevalence of vitamin D deficiency or low serum 25 (OH)-D levels. Two studies failed to establish an association between vitamin D deficiency and HT and GD disease. In conclusion, vitamin D deficiency or insufficiency can increase the rate of autoimmune diseases such as HT and GD. Randomized controlled trials with a longer follow-up period are needed to confirm the causal relationship between autoimmune thyroid disorder and vitamin D and to provide more reliable insights into the relevance of treatment effects of vitamin D therapy or supplementation.
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  • 文章类型: Journal Article
    未经授权:甲状腺激素对于器官发育和维持体内平衡是不可缺少的。甲状腺疾病,包括甲状腺炎和甲状腺癌,影响激素的正常分泌,导致甲状腺功能异常。
    UNASSIGNED:本综述主要关注干细胞在甲状腺疾病中的治疗应用。
    UNASSIGNED:对Medline和PubMed进行了文献检索(2000年1月至2021年7月),以确定有关干细胞治疗甲状腺疾病的最新报道。
    未经鉴定:干细胞是部分发育的细胞类型。它们具有形成特化细胞的能力。除了胚胎干细胞和间充质干细胞,据报道,器官固有干细胞和癌症干细胞在形成器官特异性细胞和癌症中具有重要作用。干细胞,尤其是间充质干细胞,具有抗炎和抗癌功能。
    未经评估:这篇综述概述了胚胎干细胞的治疗能力,间充质干细胞,甲状腺驻留干细胞,和甲状腺癌干细胞在甲状腺细胞再生,甲状腺功能调节,甲状腺炎抑制,和抗甲状腺癌。干细胞代表了甲状腺疾病的一种有希望的治疗形式。
    UNASSIGNED: Thyroid hormones are indispensable for organ development and maintaining homeostasis. Thyroid diseases, including thyroiditis and thyroid cancer, affect the normal secretion of hormones and result in thyroid dysfunction.
    UNASSIGNED: This review focuses on therapeutic applications of stem cells for thyroid diseases.
    UNASSIGNED: A literature search of Medline and PubMed was conducted (January 2000-July 2021) to identify recent reports on stem cell therapy for thyroid diseases.
    UNASSIGNED: Stem cells are partially developed cell types. They have the capacity to form specialized cells. Besides embryonic stem cells and mesenchymal stem cells, organ resident stem cells and cancer stem cells are recently reported to have important roles in forming organ specific cells and cancers. Stem cells, especially mesenchymal stem cells, have anti-inflammatory and anticancer functions as well.
    UNASSIGNED: This review outlines the therapeutic potency of embryonic stem cells, mesenchymal stem cells, thyroid resident stem cells, and thyroid cancer stem cells in thyroid cells\' regeneration, thyroid function modulation, thyroiditis suppression, and antithyroid cancers. Stem cells represent a promising form of treatment for thyroid disorders.
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  • 文章类型: Journal Article
    最近发表的科学论文的作者越来越关注维生素D对免疫过程的影响。在这种维生素缺乏的情况下,观察到免疫系统的不平衡,这与体内炎症反应的加剧和自身免疫反应的可能性增加有关。因此,由于科学家对维生素D的作用与自身免疫性疾病发展之间的关系越来越感兴趣,本文考虑了维生素D在自身免疫疗法中的应用。然而,维生素D对个体自身免疫性疾病的作用机制至今尚未阐明,因此有必要进一步研究。其他研究的作者已经证明了维持正常血浆维生素D水平以降低患自身免疫性疾病的风险的重要性。他们表明维生素D水平影响了病程,自身免疫性甲状腺疾病的症状严重程度和复发频率,炎症性肠病,和类风湿性关节炎。
    The authors of recently published scientific papers are focusing increasingly often on the effect of vitamin D on immune processes. In the case of deficiencies of this vitamin, an imbalance in the immune system is observed, which is associated with the intensification of the inflammatory reaction in the body and the increased possibility of an autoimmune reaction. Therefore, due to the growing interest of scientists in the relationship between the effects of vitamin D and the development of autoimmune diseases, this paper considers the use of Vitamin D in autoimmune therapies. However, the mechanism of vitamin D on individual autoimmune diseases has not been elucidated so far, therefore there is a need for further research. The importance of maintaining normal plasma vitamin D levels to reduce the risk of developing autoimmune diseases has been demonstrated by the authors of other studies. They showed that vitamin D levels influenced the course, severity of symptoms and frequency of relapses of autoimmune thyroid disease, inflammatory bowel disease, and rheumatoid arthritis.
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  • 文章类型: Comparative Study
    OBJECTIVE: Activity of vitiligo has not been considered as a patient selection criteria in previous studies; we decided to compare the presence of elevated thyroid auto-antibodies in patients with progressive and stable vitiligo.
    METHODS: Seventy-two patients with vitiligo were examined for thyroid problems and were divided into 2 groups of stable and progressive vitiligo according to their history and physical examination. Anti-thyroid peroxidase antibodies (anti-TPO antibodies), thyroxine (T4), and thyroid stimulating hormone (TSH) levels were assessed for all patients.
    RESULTS: Elevated levels of anti-TPO antibodies were observed in 43.7% of the patients with stable vitiligo and in 37.5% of patients with progressive vitiligo, which was not statistically significant (P = .315).
    CONCLUSIONS: This study not only confirmed thyroid dysfunction in patients with vitiligo but also showed that there was no difference in thyroid dysfunction and anti-TPO antibody levels in the subgroups of patients with stable or progressive vitiligo.
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