ReviewEndocrine reviews2014
Breaking tolerance to thyroid antigens: changing concepts in thyroid autoimmunity.
Review in Endocrine reviews, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 120 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
120 citing papers in PubMed, 5 syntheses or guidelines pooled it, 238 citations in OpenAlex.
- 2026 ETA guideline on interference in immunoassay measurements used in assessment of thyroid function.European thyroid journal · 2026Guideline
- TSHR Gene (rs179247) Polymorphism and Susceptibility to Autoimmune Thyroid Disease: A Systematic Review and Meta-Analysis.Endocrinology and metabolism (Seoul, Korea) · 2024Pooled it
- Salivary Alterations in Autoimmune Thyroid Diseases: A Systematic Review.International journal of environmental research and public health · 2023Pooled it
- Association of polymorphisms of rs179247 and rs12101255 in thyroid stimulating hormone receptor intron 1 with an increased risk of Graves' disease: A meta-analysis.Journal of Huazhong University of Science and Technology. Medical sciences = Hua zhong ke ji da xue xue bao. Yi xue Ying De wen ban = Huazhong keji daxue xuebao. Yixue Yingdewen ban · 2016Pooled it
- Increased risk of thyroid autoimmunity in rheumatoid arthritis: a systematic review and meta-analysis.Endocrine · 2015Pooled it
- Predicting response and toxicity to PD-1 inhibition using serum autoantibodies identified from immuno-mass spectrometry.F1000Research · 2020Trial
- Antibody-mediated thyroid dysfunction during T-cell checkpoint blockade in patients with non-small-cell lung cancer.Annals of oncology : official journal of the European Society for Medical Oncology · 2017Trial
- A randomized-controlled, double-blind study of the impact of selenium supplementation on thyroid autoimmunity and inflammation with focus on the GPx1 genotypes.Journal of endocrinological investigation · 2015Trial
- Causal Association Between Antidepressant Use and Thyroid Disease Risk: A Two-Sample Mendelian Randomization Study.Actas espanolas de psiquiatria · 2026Article
- Preliminary Evidence for Autoimmune Regulator Occupancy at Promoter Regions of Known Autoantigens in Human Peripheral Lymphocytes Obtained by Chromatin Immunoprecipitation Assay.International journal of molecular sciences · 2026Article
- CD8+ T cells in Hashimoto's thyroiditis-associated papillary thyroid carcinoma.European thyroid journal · 2026Article
- Thyroid nodule and autoimmune thyroid disease frequency in adults with inborn errors of immunity: a case-control study.BMC immunology · 2026Article
- Beyond levothyroxine: a narrative review of adjunctive management strategies for Hashimoto's thyroiditis.Gland surgery · 2026Review
- Metabolic reprogramming of Th17/Treg imbalance in autoimmune thyroid diseases.Cell communication and signaling : CCS · 2026Review
- Immunological mechanisms of autoimmune gastritis.Clinical and experimental medicine · 2026Review
- Cytokines and drugs targeting cytokines in Graves' disease and thyroid eye disease.Frontiers in immunology · 2026Review
- Taming autoimmune thyroiditis: cellular immunomodulation through MSCs, Tregs, and tolDCs.Frontiers in immunology · 2026Review
- Application Value of Chemiluminescence Immunoassay in Thyroid Function Biochemical Testing.Journal of fluorescence · 2025Article
- PDGFRαAdvanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Article
60 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
Thyroid autoimmunity involves loss of tolerance to thyroid proteins in genetically susceptible individuals in association with environmental factors. In central tolerance, intrathymic autoantigen presentation deletes immature T cells with high affinity for autoantigen-derived peptides. Regulatory T cells provide an alternative mechanism to silence autoimmune T cells in the periphery. The TSH receptor (TSHR), thyroid peroxidase (TPO), and thyroglobulin (Tg) have unusual properties ("immunogenicity") that contribute to breaking tolerance, including size, abundance, membrane association, glycosylation, and polymorphisms. Insight into loss of tolerance to thyroid proteins comes from spontaneous and induced animal models: 1) intrathymic expression controls self-tolerance to the TSHR, not TPO or Tg; 2) regulatory T cells are not involved in TSHR self-tolerance and instead control the balance between Graves' disease and thyroiditis; 3) breaking TSHR tolerance involves contributions from major histocompatibility complex molecules (humans and induced mouse models), TSHR polymorphism(s) (humans), and alternative splicing (mice); 4) loss of tolerance to Tg before TPO indicates that greater Tg immunogenicity vs TPO dominates central tolerance expectations; 5) tolerance is induced by thyroid autoantigen administration before autoimmunity is established; 6) interferon-α therapy for hepatitis C infection enhances thyroid autoimmunity in patients with intact immunity; Graves' disease developing after T-cell depletion reflects reconstitution autoimmunity; and 7) most environmental factors (including excess iodine) "reveal," but do not induce, thyroid autoimmunity. Micro-organisms likely exert their effects via bystander stimulation. Finally, no single mechanism explains the loss of tolerance to thyroid proteins. The goal of inducing self-tolerance to prevent autoimmune thyroid disease will require accurate prediction of at-risk individuals together with an antigen-specific, not blanket, therapeutic approach.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.