The thyroid, the eyes and the gut: a possible connection

Area of Science:

• Endocrinology and Immunology

Background:

• Graves' disease (GD) causes most thyrotoxicosis, with Graves' orbitopathy (GO) as its frequent extrathyroidal manifestation.
• Both GD and GO stem from an autoimmune process influenced by genetic and environmental factors, but their precise triggers remain unclear.
• Current therapies manage symptoms but do not prevent disease onset, highlighting a need for novel therapeutic strategies.

Purpose of the Study:

• To explore the role of gut bacteria in the autoimmune pathogenesis of Graves' disease (GD) and Graves' orbitopathy (GO).
• To understand how environmental factors influencing GD and GO affect gut microbial balance and immune cell populations.

Main Methods:

• A comprehensive literature search was conducted on PubMed and the Cochrane Library up to July 2016.
• Keywords used included 'graves disease,' 'microbiome,' 'orbitopathy,' and 'autoimmune pathogenesis.'
• Reference lists of identified studies were manually reviewed for additional relevant research.

Main Results:

• The gut microbiome is being investigated for its potential role in GD and GO pathogenesis.
• Environmental factors linked to GD and GO can disrupt gut microbial composition.
• Alterations in gut bacteria may influence immune system balance, specifically Treg and TH17 cell proportions.

Conclusions:

• The gut microbiome represents a novel area of investigation for understanding Graves' disease and orbitopathy.
• Understanding the gut bacteria's role could lead to new targets for preventing and treating these autoimmune conditions.
• The INDIGO project is actively researching the gut microbiome's influence on GD and GO pathogenesis.