The
anti
-
sodium
-
iodide
symporter
,
antithyroglobulin
,
____________________
antithyroid
peroxidase
antibodies
appear
to
have
little
role
in
the
etiology
of
hyperthyroidism
in
Graves
disease
.
____________________
,
they
are
markers
of
autoimmune
disease
against
the
thyroid
.
Intrathyroidal
lymphocytic
infiltration
is
the
initial
histologic
abnormality
____________________
persons
with
autoimmune
thyroid
disease
and
can
be
correlated
with
the
titer
of
thyroid
antibodies
.
Besides
being
the
source
of
autoantigens
,
the
thyroid
cells
express
molecules
that
mediate
T
cell
adhesion
and
complement
regulation
(
Fas
and
cytokines
)
that
participate
and
interact
with
the
immune
system
.
In
these
patients
,
the
proportion
of
CD4
lymphocytes
is
lower
in
the
thyroid
than
in
____________________
peripheral
blood
.
The
increased
Fas
expression
in
intrathyroidal
CD4
T
lymphocytes
____________________
be
the
cause
of
CD4
lymphocyte
reduction
in
these
individuals
.
Several
autoimmune
thyroid
disease
susceptibility
genes
have
been
identified
:
CD40
,
CTLA
-
4
,
thyroglobulin
,
TSH
receptor
,
and
PTPN22
.
Some
____________________
these
susceptibility
genes
are
specific
to
either
Graves
disease
or
Hashimoto
thyroiditis
,
while
others
confer
susceptibility
to
both
conditions
.
The
genetic
predisposition
to
thyroid
autoimmunity
may
interact
with
environmental
factors
____________________
events
to
precipitate
the
onset
of
Graves
disease
.
