Otoimmün Tiroid Hastalıklarında D Vitamininin Rolü

Öz

Otoimmünite, immün sistemi hücrelerinin vücudun kendi hücrelerini tanıması ve kendi hücrelerine karşı tolerans geliştirerek ayırt edebilmesine dayanmaktadır. Bu durum immün self tolerans olarak da bilinmektedir. Son yıllarda genetik ve çevresel faktörlerin etkisiyle immün sistem hücrelerinde self toleransın azalmasına bağlı olarak kronik otoimmün hastalıkların prevalansında artış görülmektedir. D vitamini ise sterol türevi bir vitamin olup ilk olarak kemik ve iskelet sağlığında rol alan bir vitamin olarak tanımlanmıştır. D vitamini fonksiyonlarını vücutta vitamin D reseptörlerine (VDR) bağlanarak göstermektedir. Yapılan araştırmalarda iskelet sistemi dışında sinir sistemi, immün sistem ve endokrin sistemdeki bazı doku ve organ hücrelerinde de D vitamini reseptörlerinin yer aldığı belirlenmiş ve böylece iskelet sistemi dışındaki rolleri öne çıkmıştır. Bu nedenle eksikliği vücutta çeşitli doku ve organların sağlıklı işleyişini etkilemektedir. Özellikle immün sistem hücrelerinde ve endokrin organ hücrelerinde D vitamini reseptörlerinin bulunması D vitamini eksikliğinin otoimmün endokrin hastalıklarda potansiyel rolünü güçlendirmiştir. Otoimmün endokrin hastalıkların başında tiroid bezinin otoimmün hastalıkları gelmektedir. Otoimmün tiroid hastalıkları (OİTH) arasında Hashimoto tiroidit (HT), Graves hastalığı (GH) ve postpartum tiroidit (PPT) en yaygın türleridir. D vitamininin otoimmün tiroiditlerde rolü henüz tam olarak aydınlatılmasa da immün ve immün sistem dışı bazı rolleri ile otoimmün tiroid hastalıklarında olumlu etkileri olabileceğini gösteren çalışmalar bulunmaktadır. Ayrıca D vitamininin eksiklik ve/veya yetersizlik düzeylerinin hastalık klinik tablosunu olumsuz etkileyebileceğini gösteren çalışmalar yapılmıştır. Bu derleme makalede D vitamininin otoimmün tiroid hastalıklarında etkilediği mekanizmalar ile bazı otoimmün tiroid hastalıklarla ilişkisi güncel yaklaşımlara göre değerlendirilmiştir.

Anahtar Kelimeler

• D vitamini
• hashimoto tiroidit
• graves hastalığı
• D vitamini
• otoimmün tiroidit
• hashimoto tiroidit
• graves hastalığı
• postpartum tiroidit.

The Role Of Vitamin D in Autoimmune Thyroid Diseases

Öz

Autoimmunity is the ability of immune system cells to recognize body’s own cells by developing immun tolerance. This situation is also known as immune self-tolerance. In recent years, an increase has been observed in prevalence of autoimmune diseases due to the decrease in self-tolerance of immune system cells. Vitamin D, is a sterol-derived vitamin and was first defined with its role in bone and skeletal health. It acts as by binding to vitamin D receptors(VDR) in the body. Studies have shown that vitamin D receptors are involved in cells in the nervous system, immune system, and endocrine system as well as skeletal system. Therefore, vitamin D deficiency affects healthy functioning of several systems in body. The presence of vitamin D receptors, especially in immune system cells and endocrine cells, has strengthened role of vitamin D deficiency in autoimmune endocrine diseases. Autoimmune thyroid diseases (AITD) are among autoimmune endocrine diseases. Hashimoto thyroiditis (HT), Graves’ disease (GD), postpartum thyroiditis (PPT) are common autoimmune thyroid diseases. Although the role of vitamin D in autoimmune thyroid diseases has not been fully elucidated yet, there are studies showing that it may have positive effects in autoimmune thyroiditis’ with its roles on immune and non-immune system Additionally, it has been indicated that vitamin D deficiency and/or insufficiency may adversely affect the clinical progression of AITD. In this review article, the mechanisms that vitamin D affects in autoimmune thyroid diseases and its relationship with some autoimmune thyroid diseases were evaluated according to current approaches.

Anahtar Kelimeler

• Vitamin D
• hashimoto thyroiditis
• postpartum thyroiditis
• Vitamin D
• autoimmune thyroiditis
• hashimoto thyroiditis
• graves’ disease
• postpartum thyroiditis

Kaynakça

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