Graves' disease: Epidemiology, genetic and environmental risk factors and viruses.

Alessandro Antonelli, Silvia Martina Ferrari, Francesca Ragusa, Giusy Elia, Sabrina Rosaria Paparo, Ilaria Ruffilli, Armando Patrizio, Claudia Giusti, Debora Gonnella, Alfonso Cristaudo, Rudy Foddis, Yehuda Shoenfeld, Poupak Fallahi

Journal: Best practice & research. Clinical endocrinology & metabolism 2020;34(1):101387

PMID: 32107168

Full Text on Elsevier Science View on PubMed

Abstract

Graves' disease (GD) is the most common cause of hyperthyroidism in developed Countries. It is more common between 30 and 60 years; 5-10 times more frequent in women. The genetic predisposition accounts for 79% of the risk for GD, while environmental factors for 21%. About 70% of genes associated with autoimmune thyroid disorders (AITD) are implicated in T-cell function. Among GD endogenous factors, estrogens, X-inactivation and microchimerism are important. Among environmental risk factors, smoking, iodine excess, selenium and vitamin D deficiency, and the occupational exposure to Agent Orange have been associated with GD. Many studies showed that HCV is associated with thyroid autoimmunity and hypothyroidism, in patients with chronic HCV hepatitis (CHC); a significant link has been shown also between HCV-related mixed cryoglobulinemia and risk for GD. Moreover, IFN-α-treated CHC patients develop GD more frequently. Novel studies are needed about possible risk factors to reduce the occurence of GD in West Countries.

Address: Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. Electronic address: [email protected].; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. Electronic address: [email protected].; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. Electronic address: [email protected].; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. Electronic address: [email protected].; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. Electronic address: [email protected].; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. Electronic address: [email protected].; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. Electronic address: [email protected].; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. Electronic address: [email protected].; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. Electronic address: [email protected].; Department of Translational Research of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy. Electronic address: [email protected].; Department of Translational Research of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy. Electronic address: [email protected].; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Russia. Electronic address: [email protected].; Department of Translational Research of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy. Electronic address: [email protected].

DOI: 10.1016/j.beem.2020.101387

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MeSH Terms: Autoimmunity, Environment, Female, Gene-Environment Interaction, Genetic Predisposition to Disease, Graves Disease, Humans, Life Style, Male, Prevalence, Risk Factors, Virus Physiological Phenomena, Viruses