Chapter 54 - Infection and Autoimmune Thyroid Diseases

Abstract

The etiology of autoimmune thyroid diseases (AITDs) remains unclear, but it is now generally believed that both genetic and environmental factors contribute to their development. Findings have begun to directly and indirectly implicate infectious agents in the pathogenesis of AITDs, and these data serve as the basis for this review. Classical AITD (i.e. Graves' disease and Hashimoto's thyroiditis) have been shown to be associated with a variety of infectious agents. However, a causative role for infectious agents in AITD has not been definitively demonstrated in humans. Infectious agents may induce thyroid autoimmunity by a variety of diverse mechanisms, such as inducing modifications of self-antigens, mimicking self-molecules, altering the idiotypic network, forming immune complexes, and inducing expression of MHC molecules on thyroid epithelial cells. While indirect data suggesting the involvement of the infecting organisms in the pathogenesis of human AITD is abundant, only a limited number of studies have used direct approaches. It is this area of research where further studies are needed.