Immunotherapeutic strategies for autoimmune thyroiditis

Rationale. Autoimmune thyroiditis (AIT) is an organ-specific autoimmune disorder characterized by lymphocytic infiltration of the thyroid tissue, impaired tolerance to thyroid antigens, and the production of organ-specific autoantibodies. Objective. The aim of this study is to review current data regarding immunotherapeutic approaches to the treatment of AIT. Methods. The analysis was conducted based on literature published between 2019 and 2025, selected from the PubMed, Scopus, Web of Science, and eLIBRARY databases. Included were publications focused on the pathogenesis of AIT and immunotherapeutic approaches that met the criteria of originality and scientific validity. Results. Key immunopathogenetic mechanisms implicated in AIT development were examined, including activation of autoreactive CD4+ cells, deficiency and dysfunction of regulatory T cells, hyperactivity of B-lymphocytes, and dysregulation of pro-inflammatory cytokines. Contemporary immunotherapeutic approaches are presented, encompassing monoclonal antibodies (particularly anti-CD20), therapies utilizing regulatory T cells, administration of synthetic peptide vaccines, and targeting of Toll-like receptors. Conclusion. Immunotherapy aimed at restoring antigen-specific immune tolerance represents a promising direction in the pathogenetic treatment of AIT. The most substantiated strategies involve selective modulation of critical immune components. Despite encouraging experimental findings, the integration of these approaches into clinical practice is currently limited by the absence of large-scale randomized trials and insufficient evidence base.