1.广州医科大学附属妇女儿童医疗中心遗传与内分泌科,广州 510180
2.南方医科大学附属珠江医院内分泌代谢科,广州 510280
Received:04 September 2025,
Revised:2025-10-27,
Accepted:07 November 2025,
Published:28 December 2025
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杜丹,黄梓恩,徐爱晶,等.1型糖尿病合并自身免疫性甲状腺疾病的易感基因研究进展[J].重庆医科大学学报,2025,50(12):1609-1614.
Du Dan,Huang Zien,Xu Aijing,et al.Research progress on susceptibility genes for type 1 diabetes mellitus complicated with autoimmune thyroid disease[J].Journal of Chongqing Medical University,2025,50(12):1609-1614.
杜丹,黄梓恩,徐爱晶,等.1型糖尿病合并自身免疫性甲状腺疾病的易感基因研究进展[J].重庆医科大学学报,2025,50(12):1609-1614. DOI: 10.13406/j.cnki.cyxb.003979.
Du Dan,Huang Zien,Xu Aijing,et al.Research progress on susceptibility genes for type 1 diabetes mellitus complicated with autoimmune thyroid disease[J].Journal of Chongqing Medical University,2025,50(12):1609-1614. DOI: 10.13406/j.cnki.cyxb.003979.
1型糖尿病(type 1 diabetes mellitus,T1DM)与自身免疫性甲状腺疾病(autoimmune thyroid disease,AITD)共患构成自身免疫性多腺体综合征Ⅲ型(autoimmune polyendocrinopathy syndrome Ⅲ,APS3),T1DM患者的AITD患病率明显高于普通人群。遗传学研究表明,APS3发病与多种易感基因相关,其中主要组织相容性复合体Ⅱ类DR分子(human leukocyte antigen-D related,HLA-DR)、非受体型蛋白酪氨酸磷酸酶22(protein tyrosine phosphatase non-receptor-type 22,PTPN22)、细胞毒性T淋巴细胞相关蛋白4(cytotoxic T-lymphocyte-associated antigen 4,CTLA4)、叉头框蛋白P3(forkhead box protein P3,FOXP3)为核心易感基因,均参与免疫突触调控与T淋巴细胞活化,此外白细胞介素2受体α链(interleukin-2 receptor alpha chain,IL2RA)、维生素D受体(vitamin D receptor,VDR)、肿瘤坏死因子(tumor necrosis factor,TNF)、G蛋白偶联受体103(G protein-coupled receptor 103,GPR103)等基因区域也被证实与APS3有关,但作用机制还需深入研究。这些易感基因与T1DM的核心抗体产生相关,且可能共同调控T1DM与甲状腺自身抗体,为两者共病的风险评估、早期干预及个体化治疗提供遗传层面依据。本文系统综述了T1DM与AITD的病理关联、免疫机制及最新的易感基因研究进展。
The coexistence of type 1 diabetes mellitus(T1DM) and autoimmune thyroid disease(AITD) constitutes autoimmune polyendocrinopathy syndrome Ⅲ(APS3). The prevalence of AITD in patients with T1DM is significantly higher than that in the general population. Genetic studies have shown that the pathogenesis of APS3 is associated with a variety of susceptibility genes,among which HLA-DR(human leukocyte antigen-D related),PTPN22(protein tyrosine phosphatase non-receptor-type 22),CTLA4(cytotoxic T-lymphocyte-associated antigen 4) and FOXP3(forkhead box protein P3) are core susceptibility genes,all involved in the regulation of immune synapses and the activation of T lymphocytes. In addition,gene regions such as IL2RA(interleukin-2 receptor),VDR(vitamin D receptor),TNF(tumor necrosis factor),GPR103(G protein-coupled receptor 103) have also been confirmed to be related to APS3,but their mechanisms of action still need in-depth research. These susceptibility genes are associated with the production of core antibodies in T1DM and may jointly regulate T1DM and thyroid autoantibodies,providing a genetic basis for risk assessment,early intervention,and individualized treatment of the comorbidity of the two diseases. This article systematically reviews the pathological association,immune mechanism,and latest research progress on susceptibility genes between T1DM and AITD.
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