T cells in autoimmune thyroid disease and pregnancy: an emerging immunological interface
9 affiliations
- 1Department of Endocrinology, Diabetes and Metabolic Diseases, Clinical Hospital Centre Rijeka
- 2Department of Nuclear Medicine, Faculty of Medicine, University of Rijeka
- 3Clinical Department of Nuclear Medicine, Clinical Hospital Centre Rijeka
- 4Department of Obstetrics and Gynecology, Faculty of Medicine, University of Rijeka
- 5Department of Anesthesiology, Reanimatology and Intensive Care Medicine, Faculty of Medicine, University of Rijeka
- 6Department of Clinical Medical Sciences II, Faculty of Health Studies, University of Rijeka
- 7Clinic of Anesthesiology, Intensive Care Medicine and Pain Management, Clinical Hospital Centre Rijeka
- 8Department of Medical Chemistry, Biochemistry and Clinical Chemistry, Faculty of Medicine, University of Rijeka
- 9Department of Internal Medicine, Faculty of Medicine, University of Rijeka
Abstract
Pregnancy is a condition that requires highly coordinated immunological adaptations to ensure maternal–fetal tolerance while preserving effective immune defense. Among adaptive immune cells, T lymphocytes play a central role in regulating the balance between immune activation and immune tolerance throughout gestation. Distinct T-cell subsets—including T helper (Th)1, Th2, Th17, regulatory T (Treg), and T follicular helper (Tfh) cells—contribute to the dynamic immune changes necessary for a successful pregnancy. Autoimmune thyroid disease (AITD), encompassing Hashimoto’s thyroiditis and Graves’ disease, is characterized by dysregulated T-cell–mediated immune responses, including enhanced Th1 and Th17 activity and impaired Treg-mediated immune regulation. As AITD frequently affects women of reproductive age, the interaction between AITD and pregnancy-related immune adaptation represents a clinical and immunological challenge. Increasing evidence suggests that persistent immune dysregulation may contribute to thyroid dysfunction and adverse pregnancy outcomes, including pregnancy loss, preterm birth, preeclampsia, and fetal growth restriction. This review summarizes current evidence on T-cell–mediated immune regulation in normal pregnancy and AITD, with particular emphasis on the immunological interactions between these conditions. We discuss physiological changes in major T-cell subsets during pregnancy, mechanisms of immune dysregulation in AITD, and their potential implications for maternal and fetal outcomes. The potential roles of T-cell memory and postpartum immune changes are also briefly considered. A better understanding of T-cell dynamics at the intersection of pregnancy and thyroid autoimmunity may provide further insight into underlying immunological mechanisms and, with further validation, potentially inform future approaches to risk stratification and individualized management.
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BibTeX
@article{peric2026cells,
title = {{T cells in autoimmune thyroid disease and pregnancy: an emerging immunological interface}},
author = {Ivona Perić and Leo Fischer and Maja Ilić Tomaš and Igor Iskra and Ines Krištofić and Vlatka Sotošek and Lara Batičić and Sanja Klobučar and Tatjana Bogović Crnčić},
journal = {Frontiers in Immunology},
year = {2026},
month = oct,
doi = {10.3389/fimmu.2026.1958382},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1958382/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - T cells in autoimmune thyroid disease and pregnancy: an emerging immunological interface
AU - Ivona Perić
AU - Leo Fischer
AU - Maja Ilić Tomaš
AU - Igor Iskra
AU - Ines Krištofić
AU - Vlatka Sotošek
AU - Lara Batičić
AU - Sanja Klobučar
AU - Tatjana Bogović Crnčić
PY - 2026
DA - 2026/10/22
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1958382
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1958382/full
AB - Pregnancy is a condition that requires highly coordinated immunological adaptations to ensure maternal–fetal tolerance while preserving effective immune defense. Among adaptive immune cells, T lymphocytes play a central role in regulating the balance between immune activation and immune tolerance throughout gestation. Distinct T-cell subsets—including T helper (Th)1, Th2, Th17, regulatory T (Treg), and T follicular helper (Tfh) cells—contribute to the dynamic immune changes necessary for a successful pregnancy. Autoimmune thyroid disease (AITD), encompassing Hashimoto’s thyroiditis and Graves’ disease, is characterized by dysregulated T-cell–mediated immune responses, including enhanced Th1 and Th17 activity and impaired Treg-mediated immune regulation. As AITD frequently affects women of reproductive age, the interaction between AITD and pregnancy-related immune adaptation represents a clinical and immunological challenge. Increasing evidence suggests that persistent immune dysregulation may contribute to thyroid dysfunction and adverse pregnancy outcomes, including pregnancy loss, preterm birth, preeclampsia, and fetal growth restriction. This review summarizes current evidence on T-cell–mediated immune regulation in normal pregnancy and AITD, with particular emphasis on the immunological interactions between these conditions. We discuss physiological changes in major T-cell subsets during pregnancy, mechanisms of immune dysregulation in AITD, and their potential implications for maternal and fetal outcomes. The potential roles of T-cell memory and postpartum immune changes are also briefly considered. A better understanding of T-cell dynamics at the intersection of pregnancy and thyroid autoimmunity may provide further insight into underlying immunological mechanisms and, with further validation, potentially inform future approaches to risk stratification and individualized management.
SN - 1664-3224
ER -