Endocrine Abstracts

Autoimmune endocrine diseases are seen as multifactorial ‘complex’ diseases in which immune reactions against self-antigens from endocrine glands develop against a particular genetic background facilitated by exposure to environmental factors. A number of these factors have been identified, and most interestingly they can be protective for one disease but a risk for another disease. Much has still to be learned about gene-environment interactions. As an example we will discuss autoimmune thyroid disease (AITD), in which environmental factors contribute for about 30% to the development of AITD. Smoking is a well-known risk factor for Graves’ disease, but protects against Hashimoto’s disease. Moderate alcohol intake decreases the risk on both Graves’ and Hashimoto’s disease. Stress exposure is a risk for Graves’ but not Hashimoto’s disease. There is insufficient evidence that Yersinia enterocolitica infection is linked to AITD, despite its biological plausibility. Low selenium and low vitamin D levels might increase the risk of developing AITD, but data are still inconclusive. Current options for preventive interventions in subjects at risk to develop AITD (like family members of AITD patients) are very limited.