Abstract
Autoimmune hypothyroidism is the prototype for autoimmune diseases, and is one of the most common, with a prevalence of around 1% in Caucasian women and 0.5% in men. The chronicity of the disease, the characterization of autoantigens (Chapter 2) and the availability of several animal models (see Chapter 1) have all helped in its study. This chapter provides an overview of the main features of autoimmune hypothyroidism and summarizes recent research on its pathogenesis.
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References
Williams ED, Doniach I. The post-mortem incidence of focal thyroiditis. J Pathol Bacteriol. 1962;83:255–264.
Okayasu I, Hara Y, Nakamura K, Rose NR. Racial and age-related differences in incidence and severity of focal autoimmune thyroiditis. Am J Clin Pathol. 1994;101:698–702.
Yoshida H, Amino N, Yagawa K et al. Association of serum antithyroid antibodies with lymphocytic infiltration of the thyroid gland: studies of seventy autopsied cases. J Clin Endocrinol Metab. 1978;46:859–862.
Vanderpump MPJ, Tunbridge WMG, French JM et al. The incidence of thyroid disorders in the community: a twenty year follow-up of the Whickham Survey. Clin Endocrinol. 1995;43: 55–68.
Mariotti S, Sansoni P, Barbesino G et al. Thyroid and other organ-specific autoantibodies in healthy centenarians. Lancet. 1992;339:1506–1508.
Matsuzuka F, Miyauchi A, Katayama S et al. Clinical aspects of primary thyroid lymphoma: diagnosis and treatment based on our experience of 119 cases. Thyroid. 1993;3: 93–99.
Zimmerman RS, Brennan MD, McConahey WM, Goellner JR, Gharib H. Hashimoto’s thyroiditis: an uncommon cause of painful thyroid unresponsive to corticosteroid therapy. Ann Intern Med. 1986;104:355–357.
Takasu N, Yamada Y, Takasu M et al. Disappearance of thyrotropin-blocking antibodies and spontaneous recovery from hypothyroidism in autoimmune thyroiditis. New Engl J Med. 1992;326:513–518.
Li Volsi VA. Pathology of thyroid disease. In: Falk SA, ed. Thyroid Disease: Endocrinology, Surgery, Nuclear Medicine and Radiotherapy. New York: Raven Press; 1990:127–175.
Hayashi Y, Tamai H, Fukata S et al. A long term clinical, immunological, and histological follow-up study of patients with goitrous chronic lymphocytic thyroiditis. J Clin Endocrinol Metab. 1985;61:1172–1177.
Burek CL, Hoffman WH, Rose NR. The presence of thyroid autoantibodies in children and adolescents with autoimmune thyroid disease and in their siblings and parents. Clin Immunol Immunopathol. 1982;25:395–404.
Hall R, Owen SG, Smart GS. Evidence for genetic predisposition to formation of thyroid autoantibodies. Lancet. 1964;ii:187–188.
Phillips DIW, Shields DC, Dugoujon JM, Prentice L, McGuffin P, Rees Smith B. Complex segregation analysis of thyroid autoantibodies: are they inherited as an autosomal dominant trait? Hum Hered. 1993;43:141–146.
Irvine WJ. The immunology and genetics of autoimmune endocrine disease. In: N.R. Rose, P.E. Bigazzi, N.L. Warner, eds. Genetic Control of Autoimmune Disease. Amsterdam: Elsevier; 1978:77–97.
Moens H, Farid NR. Hashimoto’s thyroiditis is associated with HLA-DRw3. New Engl J Med. 1978;299:133–134.
Weissel M, Hofer R, Zasmeta H, Mayr WR. HLA-DR and Hashimoto’s thyroiditis. Tissue Antigens. 1980;16:256–259.
Thomsen M, Ryder LP, Bech K et al. HLA-D in Hashimoto’s thyroiditis. Tissue Antigens. 1983;21:173–175.
Thompson C, Farid NR. Post-partum thyroiditis and goitrous (Hashimoto’s) thyroiditis are associated with HLA-DR4. Immunol Lett. 1985;11:301–303.
Stenszky V, Balazs C, Kraszits E et al. Association of goitrous autoimmune thyroiditis with HLA-DR3 in eastern Hungary. J Immunogenet. 1987;14:143–148.
Vargas MT, Briopnes-Urbina R, Gladman D, Papsin FR, Walfish PG. Antithyroid microsomal autoantibodies and HLA-DR5 are associated with postpartum thyroid dysfunction: evidence supporting an endocrine pathogenesis. J Clin Endocrinol Metab. 1988;67:327–333.
Badenhoop K, Schwarz G, Walfish PG et al. Susceptibility to thyroid autoimmune disease:molecular analysis of HLA-D region genes identifies new markers for goitrous Hashimoto’s thyroiditis. J Clin Endocrinol Metab. 1990;71:1131–1137.
Tandon N, Zhang L, Weetman AP. HLA associations with Hashimoto’s thyroiditis. Clin Endocrinol. 1991;34:383–386.
Mangklabruks A, Cox N, De Groot LJ. Genetic factors in autoimmune thyroid disease analyzed by restriction fragment length polymorphisms of candidate genes. J Clin Endocrinol Metab. 1991;73:236–244.
Jenkins D, Penny MA, Fletcher JA et al. MC. HLA class II gene polymorphism contributes little to Hashimoto’s thyroiditis. Clin Endocrinol. 1992;37:141–145.
Bogner U, Badenhoop K, Peters H et al. HLA-DR/DQ gene variation in nongoitrous autoimmune thyroiditis at the serological and molecular level. Autoimmunity. 1992; 14:155–158.
Hawkins BR, Lam KSL, Ma JTC, Wang C, Yeung RTT. Strong association between HLA-DRw9 and Hashimoto’s thyroiditis in Southern Chinese. Acta Endocrinol. 1987;114:543–546.
Honda K, Tamai J, Morita T, Kuma K, Nishimura Y, Sasazuki T. Hashimoto’s thyroiditis and HLA in Japanese. J Clin Endocrinol Metab. 1989;69:1268–1273.
Inoue D, Sato K, Enomoto T et al. Correlation of HLA types and clinical findings in Japanese patients with hyperthyroid Graves’ disease: evidence indicating the existence of four subpopulations. Clin Endocrinol. 1992;36:75–82.
Cho BY, Chung JH, Shong YK et al. A strong association between thyrotropin receptor-blocking antibody-positive atrophic autoimmune thyroiditis and HLA-DR8 and HLA-DQB1*0302 in Koreans. J Clin Endocrinol Metab. 1993;77:611–615.
Ewins DL, Rossor MN, Butler J, Roques PK, Mullan MJ, McGregor AM. Association between autoimmune thyroid disease and familial Alzheimer’s disease. Clin Endocrinol. 1991;35:93–96.
Kotsa K, Watson PF, Weetman AP. A CLTA-4 gene polymorphism is associated with both Graves’disease and Hashimoto’s thyroiditis. Clin Endocrinol. 1997;46:551–554.
Hayward PAR, Satsangi J, Jewell DP. Inflammatory bowel disease and the X chromosome. Q J Med. 1996;89:713–718.
Olsen NJ, Kovacs WJ. Gonadal steroids and immunity. Endocrine Rev. 1996;17:369–384.
Ferrari C, Boghen M, Paracchi A et al. Thyroid autoimmunity in hyperprolactinaemic disorders. Acta Endocrinol. 1983;104:35–41.
Phillips DIW, Cooper C, Fall C et al. Fetal growth and autoimmune thyroid disease. Q J Med. 1993;86:247–253.
Many M-C, Maniratunga S, Varis J, Dardenne M, Drexhage HA, Denef J-F. Two-step development of Hashimoto-like thyroiditis in genetically autoimmune prone non-obese diabetic mice: effects of iodine-induced cell necrosis. J Endocrinol. 1995;147:311–320.
Boukis IA, Koutras DA, Souvantzoglou A, Evangelopolou A, Vrontakis A, Moulopoulos SD. Thyroid hormone and immunological studies in endemic goitre. J Clin Endocrinol Metab. 1983;57:859–862.
Harach HR, Escalante DA, Onativia A, Lederer Outes J, Saravia Day E, Williams ED. Thyroid carcinoma and thyroiditis in an endemic goitre region before and after iodine prophylaxis. Acta Endocrinol. 1985;108:55–60.
Weetman AP. Infection and endocrine autoimmunity. In: H. Friedman, NR Rose, M Bendinelli, eds. Microorganisms and Autoimmune Disease. Plenum Press: New York; 1996: 257–275.
Nagataki S, Shibata Y, Inoue S, Yokoyama N, Izumi M, Shimaoka K. Thyroid diseases amongst atomic bomb survivors in Nagasaki. J Am Med Assoc. 1994;272:364–370.
Marazuela M, Garcia-Buey L, Gonzalez-Fernandez B et al. Thyroid autoimmune disorders in patients with chronic hepatitis C before and during interferon-a therapy. Clin Endocrinol. 1996;44:635–642.
Lazarus JH, John R, Bennie EH, Chalmers RJ, Crockett G. Lithium therapy and thyroid functions long-term study. Psychol Med. 1981;11:85–92.
Rose NR, Kong YM, Okayasu I, Giraldo AA, Beisel K, Sundick RS. T-cell regulation in autoimmune thyroiditis. Immunol Rev. 1981;55:299–314.
Weetman AP, McGregor AM, Wheeler MH, Hall R. Extrathyroidal autoantibody synthesis in Graves’ disease. Clin Exp Immunol. 1984;56:330–336.
Thielemans C, Vanhaelst L, De Waele M, Jonckheer M, Van Camp B. Autoimmune thyroiditis: a condition related to a decrease in T-suppressor cells. Clin Endocrinol. 1981;15: 259–263.
Fournier C, Chen H, Leger A, Charreire J. Immunological studies of autoimmune thyroid disorders: abnormalities in the inducer T cell subset and proliferative responses to autologous and allogeneic stimulation. Clin Exp Immunol. 1983;54:539–546.
Chan JYC, Walfish PG Activated (Ia) T-lymphocytes and their subsets in autoimmune thyroid diseases: analysis by dual laser flow microfluoricytometry. J Clin Endocrinol Metab. 1989;62:403–409.
Ohashi H, Okugawa T, Itoh M. Circulating activated T-cell subsets in autoimmune thyroid diseases — differences between untreated and treated patients. Acta Endocrinol. 1991;125:502–509.
Gessl A, Wilfing A, Agis H, Steiner G, Czernin S, Boltznitulescu G, Vierhapper H, Waldhausl W. Activated naive CD4(+) peripheral-blood T-cells in autoimmune thyroid disease. Thyroid. 1995;5:117–123.
Jansson R, Karlsson A, Forsum U. Intrathyroidal HLA-DR expression and T lymphocyte phenotypes in Graves’ thyrotoxicosis, Hashimoto’s thyroiditis, and nodular colloid goitre. Clin Exp Immunol. 1984;58:264–272.
Canonica GW, Caria M, Torre G et al. Autoimmune thyroid disease: purification and phenotypic analysis of intrathyroidal T cells. J Endocrinol Invest. 1984;7:641–645.
Aichinger G, Fill H, Wick G. In situ immune complexes, lymphocyte subpopulations and HLA-DR positive epithelial cells in Hashimoto’s thyroiditis. Lab Invest. 1985;52:132–140.
Teng WP, Cohen SB, Posnett DN, Weetman AP. T cell receptor phenotypes in autoimmune thyroid disease. J Endocrinol Invest. 1990;13:339–342.
Iwatani Y, Amino N, Hidaka Y et al. Decreases in αβ T cell receptor negative T cells and CD8+ cells, and an increase in CD4+ CD8+ cells in active Hashimoto’s disease and subacute thyroiditis. Clin Exp Immunol. 1992;87:444–449.
Paolieri F, Pronzato C, Battifora M, Fiorino N, Canonica GW, Bagnasco M. Infiltrating gamma/delta T-cell receptor-positive lymphocytes in Hashimoto’s thyroiditis, Graves’ disease, and papillary thyroid cancer. J Endocrinol Invest. 1995;18:295–298.
Catalfamo M, Roura Mir C, Sospedra M et al. Self-reactive γδ T lymphocytes in Graves’ disease specifically recognise thyroid epithelial cells. J Immunol. 1996;156:804–811.
Adorini L, Guery J-C, Rodriguez-Tarduchy G, Trembleau S. Selective immunosuppression. Immunol Today. 1993;14:285–289.
Davies TF, Martin A, Concepcion ES, Graves P, Cohen L, Ben Nun A. Evidence for limited variability of antigen receptors on intrathyroidal T cells in autoimmune thyroid disease. New Engl J Med. 1991;325:238–244.
Davies TF, Martin A, Concepcion ES et al. Evidence for selective accumulation of intrathyroidal T lymphocytes in human autoimmune thyroid disease based on T cell receptor V gene usage. J Clin Invest. 1992;89:157–162.
Davies TF, Concepcion ES, Ben-Nun A, Graves P, Tarjan G. T-cell receptor gene use in autoimmune thyroid disease: direct assessment by thyroid aspiration. J Clin Endocrinol Metab. 1993;76:660–666.
Mcintosh RS, Tandon N, Pickerill AP, Davies R, Barnett D, Weetman AP. IL-2 receptor-positive intrathyroidal lymphocytes in Graves’ disease: analysis of Vα transcript microheter-ogeneity. J Immunol. 1993;91:3884–3893.
Caso-Pelaez E, McGregor AM, Banga JP. A polyclonal T cell repertoire of V-α and V-β T cell receptor gene families in intrathyroidal T lymphocytes of Graves’ disease patients. Scand J Immunol. 1995;41:141–147.
Lehmann PV, Sercarz EE, Forsthuber T, Dayan CM, Gammon G Determinant spreading and the dynamics of the autoimmune T-cell repertoire. Immunol Today. 1993;14:203–212.
Mcintosh RS, Watson PF, Weetman AP. Analysis of the T cell receptor Voc repertoire in Hashimoto’s thyroiditis: evidence for the restricted accumulation of CD8+ T cells in the absence of CD4+ T cell restriction. J Clin Endocrinol Metab. 1997;82:1140–1146.
Volpé R. The immunoregulatory disturbance in autoimmune thyroid disease. Autoimmunity. 1988;2:55–72.
Okita N, Kidd A, Row VV, Volpé R. Sensitisation of T-lymphocytes in Graves’ and Hashimoto’s disease. J Clin Endocrinol Metab. 1980;51:316–320.
Topliss DJ, Okita N, Lewis M et al. Allosuppressor T lymphocytes abolish migration inhibition factor production in autoimmune thyroid disease. Clin Endocrinol. 1981; 15:335–341.
Ludgate ME, Ratanachaiyavong S, Weetman AP, Hall R, McGregor AM. Failure to demonstrate cell-mediated immune responses to thyroid antigens in Graves’ disease using in vitro assays of lymphokine-mediated migration inhibition. J Clin Endocrinol Metab. 1985; 60:98–102.
Tao TW, Gatenby PA, Leu SL, Pham H, Kriss JP. Helper and suppressor activities of lymphocytes on anti-thyroglobulin production in vitro. J Clin Endocrinol Metab. 1985;61: 520–524.
Iitaka M, Aguayo JF, Iwatani Y, Row VV, Volpé R. Studies of the effect of suppressor T lymphocytes on the induction of antithyroid microsomal antibody-secreting cells in autoimmune thyroid disease. J Clin Endocrinol Metab. 1988;66:708–714.
Mori H, Hamada N, DeGroot LJ. Studies on thyroglobulin-specific suppressor T cell function in autoimmune thyroid disease. J Clin Endocrinol Metab. 1985;61:306–312.
Davies TF, Platzer M. The T cell suppressor defect in autoimmune thyroiditis: evidence for a high set ‘autoimmunostat’. Clin Exp Immunol. 1985;63:73–79.
Volpé R. Immunoregulation in autoimmune thyroid disease. Thyroid. 1994;4:373–377.
Martin A, Davies TF. T cells in human autoimmune thyroid disease. Emerging data shows lack of need to invoke suppressor T cell problems. Thyroid. 1992;2:247–261.
Aoki N, DeGroot J. Lymphocyte blastogenic response to human thyroglobulin in Graves’ disease, Hashimoto’s thyroiditis, and matastatic thyroid cancer. Clin Exp Immunol. 1979;38: 523–530.
Canonica GW, Cosulich ME, Croci R et al. Thyroglobulin-induced T cell in vitro proliferation in Hashimoto’s thyroiditis: identification of the responsive subset and effect of monoclonal antibodies directed to Ia antigens. Clin Immunol Immunopathol. 1984;32:132–141.
Fukuma N, McLachlan SM, Rapoport B et al. Thyroid autoantigens and human T cell responses. Clin Exp Immunol. 1990;82:275–283.
Tandon N, Freeman M, Weetman AP. T cell responses to synthetic thyroid peroxidase peptides in autoimmune thyroid disease. Clin Exp Immunol. 1991;86:56–60.
Dayan CM, Londei M, Corcoran AE et al. Autoantigen recognition by thyroid-infiltrating T cells in Graves’ disease. Proc Natl Acad Sci USA. 1991;88:7415–7419.
Ewins CL, Barnett PS, Ratanchaiyavong S et al. Antigen-specific T cell recognition of affinity-purified and recombinant thyroid peroxidase in autoimmune thyroid disease. Clin Exp Immunol. 1992;90:93–98.
Fisfalen ME, Soliman M, Okamoto Y, Soltani K, DeGroot LJ. Proliferative responses of T-cells to thyroid antigens and synthetic thyroid peroxidase peptides in autoimmune thyroid disease. J Clin Endocrinol Metab. 1995;80:1597–1604.
Quaratino S, Feldmann M, Dayan CM, Acuto O, Londei M. Human self-reactive T cell clones expressing identical T cell receptor beta chains differ in their ability to recognize a cryptic self-epitope. J Exp Med. 1996;183:349–358
Del Prete GF, Tiri A, Mariotti S, Pinchera A, Ricci M, Romagnani S. Enhanced production of γ-interferon by thyroid-derived T cell clones from patients with Hashimoto’s thyroiditis. Clin Exp Immunol. 1987;69:323–331.
Del Prete GF, Tiri A, De Carli M et al. High potential for tumor necrosis factor α (TNF-α) production of thyroid infiltrating T lymphocytes in Hashimoto’s thyroiditis: a peculiar feature of destructive thyroid autoimmunity. Autoimmunity. 1989;4:267–276.
Mariotti S, Del Prete GF, Chiovato L et al. Cytokines and thyroid autoimmunity. Int J Immunopath Pharmacol. 1992;5:103–113.
Grubeck-Loebenstein B, Turner M, Pirich K et al. CD4+ T-cell clones from autoimmune thyroid tissue cannot be classified according to their lymphokine production. Scand J Immunol. 1990;32:433–440.
Paschke R, Schuppert F, Taton M, Velu T. Intrathyroidal cytokine gene expression profiles in autoimmune thyroiditis. J Endocrinol. 1994;141:309–315.
Ajjan RA, Watson PF, Mcintosh RS, Weetman AP. Intrathyroidal cytokine gene expression in Hashimoto’s thyroiditis. Clin Exp Immunol. 1996;105:523–528.
Hueur M, Aust G, Odehakim S, Scherbaum WA. Different cytokine messenger RNA profiles in Graves’ disease, Hashimoto’s thyroiditis, and non-autoimmune thyroid disorders determined by quantitative reverse transcriptase polymerase chain reaction (RT-PCR). Thyroid. 1996;6:97–106.
Roitt IM, Doniach D, Campbell PN, Vaughan Hudson R. Autoantibodies in Hashimoto’s disease (lymphadenoid goitre). Lancet. 1956;ii:820–821.
Beever K, Bradbury J, Phillips D et al. Highly sensitive assays of autoantibodies to thyroglobulin and to thyroid peroxidase. Clin Chem. 1989;35:1949–1954.
Weetman AP, Black CM, Cohen SB, Tomlinson R, Banga JP, Reimer CB. Affinity purification of IgG subclasses and the distribution of thyroid autoantibody reactivity in Hashimoto’s thyroiditis. Scand J Immunol. 1989;30:73–82.
Weetman AP, Cohen SB, Oleesky DA, Morgan BP. Terminal complement complexes and C1/C1 inhibitor complexes in autoimmune thyroid disease. Clin Exp Immunol. 1989;77:25–30.
Ruf J, Feldt-Rasmussen U, Hegedüs L, Ferrand M, Carayon P. Bispecific thyroglobulin and thyroperoxidase autoantibodies in patients with various thyroid and autoimmune diseases. J Clin Endocrinol Metab. 1994;79:1404–1409.
Saller B, Hörmann R, Mann K. Heterogeneity of autoantibodies against thyroid peroxidase in autoimmune thyroid disease: evidence against antibodies directly inhibiting peroxidase activity as regulatory factors in thyroid hormone metabolism. J Clin Endocrinol Metab. 1991;72:188–195.
Rees Smith B, McLachlan SM, Furmaniak J. Autoantibodies to the thyrotropin receptor. Endocr Rev. 1988;9:106–121.
Paschke R, van Sande J, Parma J, Vassart G. The TSH receptor and thyroid diseases. Ballière’s Clin Endocrinol Metab. 1996;10:9–27.
Dallas JS, Cunningham SJ, Patibandla SA et al. Thyrotropin (TSH) receptor antibodies (TSHrAb) can inhibit TSH-mediated cyclic adenosine 3′,5′-monophosphate production in thyroid cells by either blocking TSH binding or affecting a step subsequent to TSH binding. Endocrinology. 1996;137:3329–3339.
Drexhage HA. Autoimmunity and thyroid growth. Where do we stand? Eur J Endocrinol. 1996;135:39–45.
Kraiem Z, Cho BY, Sadeh O, Shong MH, Pickerill P, Weetman AP. The IgG subclass distribution of TSH receptor blocking antibodies in primary hypothyroidism. Clin Endocrinol. 1992;37:135–140.
Hexham JM, Furmaniak J, Pegg C, Burton DR, Rees Smith B. Cloning of a human autoimmune response: preparation and sequencing of a human anti-thyroglobulin autoantibody using a combinatorial approach. Autoimmunity. 1992;12:135–141.
Prentice L, Kiso Y, Fukuma N et al. Monoclonal thyroglobulin autoantibodies: variable region analysis and epitope recognition. J Clin Endocrinol Metab. 1995;80:977–986.
Mcintosh RS, Asghar MS, Watson PF, Kemp EH, Weetman AR Cloning and analysis of IgGκ and IgGγ, anti-thyroglobulin autoantibodies from a patient with Hashimoto’s thyroiditis: evidence for in vivo antigen-driven repertoire selection. J Immunol. 1996;157:927–935.
McLachlan SM, Rapoport B. Genetic and epitopic analysis of thyroid peroxidase (TPO) autoantibodies: markers of the human thyroid autoimmune response. Clin Exp Immunol. 1995;101:200–206.
Hexham JM, Partridge LJ, Furmaniak J et al. Cloning and characterisation of TPO autoantibodies using combinatorial phage display libraries. Autoimmunity. 1994;17:167–179.
Hexham JM, Pegg CAS, Burton DR et al. Variable region sequence of a human monoclonal thyroid peroxidase autoantibody. Autoimmunity. 1992;14:169–172.
Okuda J, Akamizu T, Sugawa H, Matsuda F, Hua L, Mori T. Preparation and characterization of monoclonal antithyrotropin receptor antibodies obtained from peripheral lymphocytes of hypothyroid patients with primary myxedema. J Clin Endocrinol Metab. 1994; 79: 1600–1604.
Morgenthaler NG, Kim MR, Tremble J et al. Human-immunoglobulin G autoantibodies to the thyrotropin receptor from Epstein Barr virus-transformed B lymphocytes: characterization by immunoprecipitation with recombinant antigen and biological activity. J Clin Endocrinol Metab. 1996;81:3155–3161.
Kosugi S, Ban T, Akamizu T, Valente W, Kohn LD. Use of thyrotropin receptor (TSHR) mutants to detect stimulating TSHR antibodies in hypothyroid patients with idiopathic myxedema, who have blocking TSHR antibodies. J Clin Endocrinol Metab. 1993;77:19–24.
McLachlan SM, Rapoport B. Monoclonal, human autoantibodies to the TSH receptor: the holy grail and why are we looking for it? J Clin Endocrinol Metab. 1996;81:3152–3154.
Arscott PL, Koenig RJ, Kaplan MM, Glick GD, Baker JR Jr. Unique autoantibody epitopes in an immunodominant region of thyroid peroxidase. J Biol Chem. 1996;271:4966–4973.
Ruf J, Toubert M-E, Czarnocka B, Durand-Gorde J-M, Ferrand M, Carayon P. Relationship between immunological structure and biochemical properties of human thyroid peroxidase. Endocrinology. 1989;125:1211–1218.
Kosugi S, Ban T, Akamizu T, Kohn LD. Site-directed mutagenesis of a portion of the extracellular domain of the rat thyrotropin receptor important in autoimmune thyroid disease and nonhomologous with gonadotropin receptors. Relationship of functional and immunogenic domains. J Biol Chem. 1991;266:19413–19418.
Kosugi S, Ban T, Akamizu T, Kohn LD. Identification of separate determinants on the thyrotropin receptor reactive with Graves’ thyroid-stimulating antibodies and with thyroid-stimulating blocking antibodies in idiopathic myxedema: these determinants have no homologous sequence on gonadotropin receptors. Mol Endocrinol. 1992;6:168–180.
Bottazzo GF, Pujol-Borrell R, Hanafusa T, Feldmann M. Role of aberrant HLA-DR expression and antigen presentation in induction of endocrine autoimmunity. Lancet. 1983; ii:1115–1119.
Hamilton F, Black M, Farquharson MA, Stewart C, Foulis AK. Spatial correlation between thyroid epithelial cells expressing class II MHC molecules and interferon-gamma-containing lymphocytes in human thyroid autoimmune disease. Clin Exp Immunol. 1991;83:64–68.
Weetman AP Antigen presentation in the pathogenesis of autoimmune endocrine disease. J Autoimmunity. 1995;8:305–312.
Tandon N, Metcalfe R, Barnet D, Weetman AP Expression of the costimulatory molecule B7/BB1 in autoimmune thyroid disease. Q J Med. 1994;87:231–236.
Lombardi G, Arnold K, Uren J et al. Antigen presentation by IFN-γ-treated thyroid follicular cells inhibits IL-2 and supports IL-4 production by B7-dependent human T cells. Eur J Immunol. 1997;27:62–71.
Dayan CM, Chu NR, Londei M, Rapoport B, Feldmann M. T cells involved in human autoimmune disease are resistant to tolerance induction. J Immunol. 1993;151:1606–1613.
Weetman AP, Freeman MA, Borysiewicz LK, Makgoba MW. Functional analysis of intercellular adhesion molecule-1 expressing human thyroid cells. Eur J Immunol. 1990;20: 271–25.
Zheng RQH, Abney ER, Grubeck-Loebenstein B, Dayan C, Maini RN, Feldmann M. Expression of intercellular adhesion molecule-1 and lymphocyte function-associated antigen-3 on human thyroid epithelial cells in Graves’ and Hashimoto’s diseases. J Autoimmunity. 1990;3:727–726.
Tandon N, Makgoba MW, Gahmberg CG, Weetman AR The expression and role in T cell adhesion of LFA-3 and ICAM-2 on human thyroid cells. Clin Immunol Immunopathol. 1992;64:30–35.
MacKenzie WA, Schwartz AE, Friedman EW, Davies TF. Intrathyroidal T cell clones from patients with autoimmune thyroid disease. J Clin Endocrinol Metab. 1987;64:818–823.
Sugihara S, Fujiwara H, Niimi H, Shearer GM. Self-thyroid epithelial cell (TEC)-reactive CD8+ T cell lines/clones derived from autoimmune thyroiditis lesions. J Immunol. 1995; 155: 1619–1628.
Wu Z, Podack ER, McKenzie JM, Olsen KJ, Zakarija M. Perforin expression by thyroid-infiltrating T cells in autoimmune thyroid disease. Clin Exp Immunol. 1994;98:470–477.
Zheng RQH, Abney E, Chu CG et al. Detection of interleukin-6 and interleukin-1 production in human thyroid epithelial cells by non-radioactive in situ hybridization and immunohistochemical methods. Clin Exp Immunol. 1991;83:314–319.
Zheng RQH, Abney ER, Chu CQ et al. Detection of in vitro production of tumour necrosis factor-alpha by human thyroid epithelial cells. Immunology. 1992;75:456–462.
Weetman AP, Bennett GL, Wong WLT. Thyroid follicular cells produce interleukin-8. J Clin Endocrinol Metab. 1992;75:328–330.
Ajjan R, Watson PF, Weetman AP. Detection of IL-12, IL-13 and IL-15 mRNA in the thyroid of patients with autoimmune thyroid disease. J Clin Endocrinol Metab. 1997;82:666–669.
Tandon N, Yan SL, Morgan BP, Weetman AP. Expression and function of multiple regulators of complement activation in autoimmune thyroid disease. Immunology. 1994;81:643–647.
Tandon N, Morgan BP, Weetman AP. Expression and function of membrane attack complex inhibitory proteins on thyroid follicular cells. Immunology. 1992;75:372.
Weetman AP, Tandon N, Morgan BP. Antithyroid drugs and release of inflammatory mediators by complement-attacked thyroid cells. Lancet. 1992;340:633–636.
Green LM, La Bue M, Lazarus JP, Jennings JC. Reduced cell-cell communication in experimentally induced autoimmune thyroid disease. Endocrinology. 1996;137:2823–2832.
Weetman AP, McGregor AM. Autoimmune thyroid disease: developments in our understanding. Endocrine Rev. 1984;5:309–355.
Weetman AP, McGregor AM. Autoimmune thyroid disease: further developments in our understanding. Endocrine Rev. 1994;15:788–830.
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Weetman, A.P., McIntosh, R.S., Watson, P.F. (1998). Autoimmune hypothyroidism. In: Weetman, A.P. (eds) Endocrine Autoimmunity and Associated Conditions. Immunology and Medicine Series, vol 27. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5044-6_3
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