天疱疮并发自身免疫性甲状腺疾病影响因素的研究进展

Research Progress on the Influencing Factors of Pemphigus Complicated with Autoimmune Thyroid Disease

摘要: 天疱疮作为自身抗体介导的自身免疫性大疱性疾病，除皮肤与黏膜受累外，越来越多证据提示其可与其他自身免疫病呈聚集或共病现象。自身免疫性甲状腺疾病(AITD)是最常见的器官特异性自身免疫病之一，部分研究显示天疱疮患者甲状腺功能异常及甲状腺自身抗体阳性率升高，提示二者可能共享一定的免疫遗传背景与触发因素。现有证据认为，遗传易感、环境暴露、免疫调控失衡以及性激素差异，可能在天疱疮并发AITD的发生具有协同作用，临床治疗因素对天疱疮和AITD也具有潜在影响。本文围绕上述影响因素作一综述，以期对两者共病机制阐释和临床风险识别提供参考。

Abstract: Pemphigus is an autoantibody-mediated autoimmune blistering disease that primarily affects the skin and mucous membranes. Increasing evidence suggests that pemphigus is frequently associated with other autoimmune disorders, reflecting a tendency toward autoimmune clustering or comorbidity. Autoimmune thyroid disease (AITD) is one of the most common organ-specific autoimmune diseases. Several studies have reported a higher prevalence of thyroid dysfunction and thyroid autoantibody positivity in patients with pemphigus, suggesting that the two conditions may share common immunogenetic backgrounds and triggering factors. Current evidence indicates that genetic susceptibility, environmental exposure, immune dysregulation, and sex hormone differences may act synergistically in the development of pemphigus complicated with AITD. In addition, therapeutic factors used in clinical practice may also exert potential effects on both pemphigus and AITD. This review summarizes the above influencing factors, aiming to provide insights into the mechanisms underlying their comorbidity and to improve clinical risk identification.