Is Graves’ disease a primary immunodeficiency? New immunological perspectives on an endocrine disease

BMC Medicine

Review

Stefan Fischli¹  Christian Meier²  Mike Recher³  Alexander Kutz⁴  Tristan Struja⁴  Beat Mueller⁵  Philipp Schuetz⁵ 

[1] Medical Clinic, Department for Endocrinology, Diabetes & Metabolism, Kantonsspital Luzern, Luzern, Switzerland;Medical Faculty of the University of Basel, Basel, Switzerland;Division of Endocrinology, Diabetes & Metabolism, University Hospital and University Basel, Basel, Switzerland;Medical Faculty of the University of Basel, Basel, Switzerland;Medical Outpatient Clinic and Immunodeficiency Laboratory, Department of Biomedicine, University Hospital and University Basel, Basel, Switzerland;Medical University Department, Clinic for Endocrinology, Diabetes & Metabolism, Kantonsspital Aarau, Aarau, Switzerland;Medical University Department, Clinic for Endocrinology, Diabetes & Metabolism, Kantonsspital Aarau, Aarau, Switzerland;Medical Faculty of the University of Basel, Basel, Switzerland;

关键词: Graves’ disease;    Review;    Etiology;    Pathophysiology;    Primary immunodeficiency;   

DOI  :  10.1186/s12916-017-0939-9

 received in 2017-06-09, accepted in 2017-09-04,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundUncertainty about factors influencing the susceptibility and triggers for Graves’ disease persists, along with a wide variation in the response to anti-thyroid drugs, currently at approximately 50% of non-responders. The aim of this narrative review is to summarize immunological concepts, with a combined endocrine and immunological perspective, to highlight potential new areas of research.Main textRelevant studies were identified through a systematic literature search using the PubMed and EMBASE databases in March 2016. No cut-offs regarding dates were imposed. We used the terms “Graves’ Disease” or “Basedow” or “thyrotoxicosis” together with the terms “etiology”, “pathophysiology”, “immunodeficiency”, “causality”, and “autoimmunity”. The terms “orbitopathy”, “ophthalmopathy”, and “amiodarone” were excluded. Articles in English, French, German, Croatian, Spanish, and Italian were eligible for inclusion.ConclusionsWhile concepts such as the impact of iodine, smoking, human leucocyte antigen, infections, and ethnicity are established, new ideas have emerged. Pertaining evidence suggests the involvement of autoimmunity and immunodeficiency in the pathophysiology of Graves’ disease. Recent studies point to specific immunological mechanisms triggering the onset of disease, which may also serve as targets for more specific therapies.

【 授权许可】

CC BY   
© The Author(s). 2017

【 图 表 】

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