{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T10:46:33Z","timestamp":1785753993860,"version":"3.56.0"},"reference-count":93,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Autoimmune thyroid diseases (AITDs), mainly Hashimoto\u2019s thyroiditis and Graves\u2019 disease, are common organ-specific autoimmune disorders driven by complex interactions among genetic susceptibility, immune dysregulation, environmental exposure, and microbial factors. Increasing evidence supports the relevance of the gut\u2013thyroid axis, in which gut microbiota may influence thyroid hormone metabolism, intestinal barrier integrity, systemic inflammation, and thyroid-directed autoimmunity. Among gut commensals, Lactobacillus-related taxa have attracted attention because selected strains can modulate cytokine production, Treg\/Th17 balance, short-chain fatty acid metabolism, epithelial barrier function, and inflammatory signaling pathways such as TLR4\/NF-\u03baB, AhR, and PPAR\u03b4-related pathways. However, most mechanistic evidence is derived from non-AITD animal, cellular, or metabolic disease models, and direct validation in AITD patients remains limited. This review summarizes current evidence on Lactobacillus-related strains in AITDs, emphasizing strain-specific effects, updated taxonomy, mechanistic plausibility, clinical heterogeneity, and translational limitations. We also discuss inconsistent microbial signatures, neutral or inconclusive clinical findings, and safety concerns, including probiotic-associated infection, antibiotic resistance genes, horizontal gene transfer, and potential pro-autoimmune effects. Overall, Lactobacillus-related interventions remain investigational, and future studies should prioritize standardized strain identification, disease-specific mechanisms, long-term safety, and well-designed clinical trials.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1905146","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T10:14:56Z","timestamp":1785752096000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lactobacillus in autoimmune thyroid diseases: benefit or risk?"],"prefix":"10.3389","volume":"17","author":[{"given":"Jin-min","family":"Yang","sequence":"first","affiliation":[{"name":"Thyroid-otolaryngology Department, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng-fei","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Suining Municipal Hospital of Traditional Chinese Medicine (TCM)","place":["Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai-ying","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University","place":["Luzhou, Sichuan, China"]},{"name":"Department of Pain Management, The Affiliated Hospital, Southwest Medical University","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-pathol-012513-104713","article-title":"Mechanisms of autoimmune thyroid diseases: from genetics to 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