Precision Medicine in Autoimmune Thyroid Diseases: Decoding Biomarkers, Targeted Therapies and Digital Innovation

INTRODUCTION: Autoimmune thyroid diseases (AITDs), including Graves' disease and Hashimoto's thyroiditis, arise from genetic, epigenetic, and environmental disruption of immune tolerance. These conditions represent the extremes of thyroid autoimmunity and contribute substantially to global endocrine morbidity. AREAS COVERED: Recent advances in precision medicine have identified novel biomarkers, such as circulating microRNAs (miR-22, miR-375) and exosomal proteins (VAMP8, hsa_circRNA_000102), which enhance early detection and disease monitoring. Immunogenetic profiling highlights polymorphisms in HLA-DR, CTLA4, and PTPN22 as susceptibility loci. Emerging therapies, including rituximab (anti-CD20), teprotumumab (anti-IGF-1 R), and SYD5115 (TSH-R antagonist), target specific immune pathways. Artificial intelligence improves diagnostic accuracy through radiomics and wearable biosensors, while epigenetic studies and microbiota research further refine pathophysiological understanding. EXPERT OPINION: Despite these advances, major challenges remain in predicting phenotypic conversion and personalizing long-term therapy. Integration of multi-omics with digital health tools is expected to transform patient stratification and management. Within the next decade, precision medicine will likely redefine treatment algorithms, enabling individualized, dynamic care in AITDs.