[Anonymous March 21, 1997 at 7:23 pm Post count: 93172]

#1056465

My step-daughter is being montiored and has Graves disease the Hyper
kind. How true is it this may be inherited trait???

[Anonymous March 21, 1997 at 8:49 pm Post count: 93172]

#1163499

It is hereditary. Off the top of my head, I think on chromosome twenty-one, but
not mapped yet.

[Anonymous March 22, 1997 at 8:22 am Post count: 93172]

#1163500

A susceptibility to GD is hereditary, but the disease is multifactorial, that is you need the genetic part plus environmental trigger factors. This means you could have the hereditary part and not develop the disease.

[Anonymous March 22, 1997 at 6:30 pm Post count: 93172]

#1163501

RE: the complex factors which contribute to GD….
I read( please note, I wish I could say I understood, but I did
learn alot of new words..) a very interesting article.

Even though much of the immunological info was beyond my lay grasp,
I was able to learn alot from this article. For those of you who would like to
read it…
Published in THYROID TODAY vol XIX April/May/June 1996
Recent Progress in Thyroid Autoimmunity: an Overview for Clinicians
by anthony P. Weetman, MD DSc University of Sheffield UK
I’ll try to summarize some points:
1. Headway has been made in understanding the key interactions in the
autoimmune response and how autoimmunity is normally( in the body )
prevented. …”there seem to be excellent prospects for novel forms of immunotherapy for
these disorders, based on a refined understanding of the sequential
development of autoreactivity, which will permit appropriate targeting
of treatment to critical stages of this process.” (READ HOPE !!!)
2. Thyroid autoimmunity arises from the INTERACTION of genetic,
endogenous and and environmental factors.
3.GENETIC FACTORS may have to do with the (MHC) Major Histocompatibility
complex-a large group of genes encoding proteins involved in immune recognition and signaling.
The MCH in humans is termed HLA (human leuckocyte antigen) and lies on chromosome 6.
There are various other canidate genes that have been examined( maybe the one Joan mentioned?)
Automated DNA amplification and fragment sizing can now allow such ambitious work!!

ENDOGENOUS FACTORS
1. Hormonal influences are important but incompletely understood,
but estrogens, progesterone and testosterone can modify the disease.
Presumably changes in these hormones are at least part responsible for the ameliorartion
of GD during pregnancy and the later exacerbation postpartum.
The role of other hormones is even less clear..but glucocorticoid levels measured after
after stimulation of the pituitary-adrenal axis play some role…they have immunosuppresive properties.
2. LOW BIRTH WEIGHT is assoc with increased risk of thyroid autoantibody
production in mid-aged or elderly woman. ( this may also account for some family clustering)
3. In the same study thyroid autoantibodies ROSE with increasing body
mass but FELL with increasing waist to hip ratio.( assoc with high free testosterone)

ENVIRONMENTAL FACTORS ( DIET,INFECTION,STRESS,DRUGS,TOXINS)
1. “Increased iodine in take is associated with an increase in the
frequency of thyroiditis and thyroid autoantibody production in humans, but the data are
less compelling than those from animal models.” Poorly iodinated
thyroglobulin (TG) is less antigenic( i.e. less able to stimulate T and B cells)
than highly iodinated forms, indicating that iodine is an important
component of antigenic epitopes. on this molecule.”
2. Infection may provoke….. and GD has been assoc, with attacks of allergic rhinitis
3.Stress has long been suspected as a precipitant of GD…Big Life
events preceding GD … the effect of stress on the hypothalamo-pituitary
adrenal-axis, and thus on the immune system, provides a biologically plausible mechanism,
Caution is stil required in interpreting these results because the influence
of moderating factors was not analyzed in detail.
*****
Varying combinations of these three realms of factors make some people
more likely to develop autoimmune thyroid disease than others.
these individuals ( that is us, folks)have sufficent thyroid reqctive T cells to initiate
the pathogenic events…However the T cells still have to be stimulated.
AT THIS POINT THE DISCUSSION GET GETS REALLY THINCK AND I AM NOT GOING TO TRY TO SUMMARIZE IT.

But I hope this is helpful in answering some questions. I like knowing
that someone is really looking at this all in such depth.
The hormone info was interesting because I had read a book about how
veggies( sorry, can’t get away from the topic, probably reminding you
all of your mother hope she was/is nice- now eat your vegetables)
help increase natural progesterone in the system which has many postive effects
including blocking some of the ( false) xenoestrogens which can cause celkl receptors
to be desensitized to their regular jobs…etc..the long and short was eat your yams kids,)

Jeannette

[Anonymous March 22, 1997 at 8:15 pm Post count: 93172]

#1163502

This is fascinating stuff, but you are right it is far too technical for the layman. However, I have been wondering about the stress induced by hormone fluctuations during menopause and pregnancy. I recently read an article which stated that at the moment there was no significant increase in menopausal women. However the author thought that this ight change as the baby boomers hit 50.

Brenda

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