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The environment and autoimmune thyroid diseases.

Mark F Prummel1, Thea Strieder, Wilmar M Wiersinga

  • 1Department of Endocrinology and Metabolism, F5-171, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. m.f.prummel@amc.uva.nl

European Journal of Endocrinology
|May 11, 2004
PubMed
Summary

Environmental factors significantly influence autoimmune thyroid disease (AITD) development in genetically susceptible individuals. Key factors include diet, infections, and lifestyle choices, underscoring the need for further research.

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Area of Science:

  • Endocrinology
  • Immunology
  • Genetics

Background:

  • Genetic predisposition is a major factor in autoimmune thyroid disease (AITD), accounting for significant susceptibility to conditions like Graves' disease.
  • However, concordance rates in identical twins are low, indicating a crucial role for environmental and hormonal influences.

Purpose of the Study:

  • To conduct a comprehensive review of environmental and hormonal risk factors contributing to AITD in genetically predisposed individuals.
  • To identify specific factors that trigger or exacerbate autoimmune thyroid conditions.

Main Methods:

  • Literature review of existing studies on AITD pathogenesis.
  • Analysis of environmental, hormonal, and lifestyle factors associated with AITD development.
  • Inclusion of data on drug-induced autoimmunity and emerging research areas.

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Main Results:

  • Identified numerous environmental factors implicated in AITD, including iodine levels, selenium deficiency, stress, smoking, infections, and radiation.
  • Noted the role of parity, oral contraceptive use, reproductive span, and fetal microchimerism.
  • Highlighted specific drugs like lithium and interferon-alpha as risk factors for thyroid autoimmunity.

Conclusions:

  • A multitude of environmental and hormonal factors interact with genetic susceptibility to drive AITD.
  • Further investigation is crucial for understanding the roles of fetal microchimerism and viral infections in AITD pathogenesis.
  • This review emphasizes the complex interplay of factors contributing to autoimmune thyroid disorders.