Role of genetic and non-genetic factors in the etiology of Graves鈥?disease

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• 作者：M. Marin貌 ; F. Latrofa ; F. Menconi ; L. Chiovato…
• 关键词：Graves鈥?disease ; Hyperthyroidism ; Autoimmunity ; Genetics ; Environment
• 刊名：Journal of Endocrinological Investigation
• 出版年：2015
• 出版时间：March 2015
• 年：2015
• 卷：38
• 期：3
• 页码：283-294
• 全文大小：
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• 作者单位：M. Marin貌 (1) (2)
  F. Latrofa (1) (2)
  F. Menconi (1) (2)
  L. Chiovato (3)
  P. Vitti (1) (2)
  
  1. Department of Clinical and Experimental Medicine, University Of Pisa, Pisa, Italy
  2. Endocrinology Unit, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy
  3. Unit of Endocrinology, Department of Internal Medicine and Medical Therapy, University of Pavia, Fondazione Salvatore Maugeri IRCCS, Pavia, Italy
  
• 刊物类别：Medicine/Public Health, general; Endocrinology; Metabolic Diseases;
• 刊物主题：Medicine/Public Health, general; Endocrinology; Metabolic Diseases;
• 出版者：Springer International Publishing
• ISSN：1720-8386

文摘

In spite of the advancements in understanding the pathogenic mechanisms of Graves鈥?disease (GD), its ultimate cause remains elusive. The majority of investigators agree that GD is likely a multifactorial disease, due to a complex interplay of genetic and non-genetic factors that lead to the loss of immune tolerance to thyroid antigens and to the initiation of a sustained autoimmune reaction. Twin and family studies support a role of genetic factors, among which the HLA complex, CD40, CTLA-4, PTPN22, FCRL3, thyroglobulin, and the TSH receptor may be involved. Among non-genetic factors, iodine, infections, psychological stress, gender, smoking, thyroid damage, vitamin D, selenium, immune modulating agents, and periods of immune reconstitution may contribute the development of the diseases. Here we review in detail the respective role of genetic and non-genetic factors in the etiology of GD, taking advantage of the great bulk of data generated especially over the past 30 years. Keywords Graves鈥?disease Hyperthyroidism Autoimmunity Genetics Environment