LATS and human-specific thyroid stimulator; their relation to graves' disease

Abstract

Graves' disease is characterised by many autoimmune features (see Table 1). Whether or not it can be accurately classified as an autoimrnune disease depends on whether any of these features can be shown to be causative. Notable is the presence of thyroid-specific autoantibodies; some of these have little functional significance but others may be responsible for the hyperthyroidism and perhaps also for the extrathyroidal manifestations of the disease. They are therefore of significance in the pathogenesis of the disease and the cell-stimulating effect of these antibodies is of considerable immunological interest. The first of these thyroid-stimulating autoantibodies, long-acting thyroid stimulator (LATS), has now been extensively studied. It is a thyroid-specific autoantibody which stimulates the thyroid, but LATS is not alone responsible for the hyperthyroidism of Graves' disease. The evidence concerning LATS and its pathogenic significance is reviewed. Human-specific thyroid stimulator (HSTS) is probably identical to LATSprotector (LATS-P). Much less is known about LATS-P than about LATS but the subject of LATS-P and HSTS is dealt with in some detail because of its present interest. Lastly the relevance of these findings is discussed in relation to the pathogenesis of Graves' disease as a whole.