Antithyroid Microsomal Autoantibodies Research Articles

Significantly higher frequencies of presence of serum autoantibodies in Chinese patients with oral lichen planus

Previous studies have shown the presence of serum anti-nuclear (ANA), anti-smooth muscle (SMA), anti-mitochondrial (AMA), anti-gastric parietal cell (GPCA), anti-thyroglobulin (TGA) and anti-thyroid microsomal autoantibodies (TMA) in small groups of patients with oral lichen planus (OLP). In this study, the serum levels of ANA, SMA, AMA, GPCA, TGA and TMA were measured in a group of 320 Chinese OLP patients and 53 healthy control subjects to assess whether Chinese OLP patients had significantly higher frequencies of serum autoantibodies than healthy control subjects and to assess which risk factors had a significant influence on the possession of a specific serum autoantibody in OLP patients. We found that autoantibodies were present in 195 (60.9%) of the 320 OLP patients. The frequencies of presence of serum ANA (28.1%), GPCA (26.3%), TGA (21.3%) and TMA (24.4%) in OLP patients were significantly higher than those (5.7%, 1.9%, 1.9% and 1.9%, respectively) in healthy control subjects (all P-values were < 0.005). Forty-one (12.8%) OLP patients also had anti-hepatitis C virus antibody (HCVA) in their sera. The multivariate logistic regression found that major erosive OLP (EOLP) [odds ratio (OR) = 1.786], TGA/TMA-positivity (OR = 2.517), and HCVA-positivity (OR = 2.214) were significant risk factors to influence ANA-positivity in OLP patients. Moreover, only major EOLP (OR = 1.879) and ANA-positivity (OR = 2.581) were significant risk factors to influence TGA/TMA-positivity in OLP patients. There are significantly higher frequencies of presence of ANA, GPCA, TGA and TMA in Chinese OLP patients than in healthy control subjects.

Comparison of clinical diagnostic value between chemiluminescence immunoassay and radioimmunoassay for serum anti-thyroid peroxidase antibodies or anti-microsomal autoantibodies and anti-thyroglobulin antibodies

目的 应用自动化学发光免疫分析法(CLIA)测定血清抗甲状腺球蛋白抗体(抗TgAb)和抗甲状腺过氧化物酶抗体(抗TPOAb)及应用放射免疫分析(RIA)测定血清抗TgAb和抗甲状腺微粒体抗体(抗TMAb),比较两种方法测定结果的临床诊断价值.方法应用CLIA法和RIA法检测437例不同种类的甲状腺病患者和88名健康对照者的血清抗TgAb和抗TPOAb或抗TMAb水平,以病理诊断作为诊断的金指标,评定每种测定方法诊断的敏感度、特异度和准确度,比较两种测定方法对自身免疫性甲状腺疾病(AITD)和桥本甲状腺炎的诊断价值.结果 CLIA法测定血清抗TPOAb对AITD诊断的敏感度和准确度显著高于RIA法(敏感度 CLIA 73.9 %, RIA 58.3 %,P 0.05).CLIA法测定血清抗TPOAb对桥本甲状腺炎诊断的敏感度和准确度显著高于RIA法(敏感度 CLIA 68.4%, RIA 25.4%,准确度:CLIA 73.1 %,RIA 45.0 %,均P<0.001),特异度显著低于RIA法(CLIA法77.0 %,RIA法96.0 %, P<0.001).结论应用CLIA法测定血清抗TgAb和抗TPOAb对AITD的诊断价值优于应用RIA法测定血清抗TgAb和抗TMAb,其中应用CLIA法测定血清抗TPOAb对诊断AITD有更大的临床价值。

The prevalence of Antithyroglobulin and Antithyroid Microsomal Autoantibodies in Euthyroid Fertile and Infertile Nigerian Women with recurrent spontaneous Abortion and Unexplained Infertility

Plasma levels of antithyroglobulin {TG} and microsomal thyroid peroxidase {TPO} autoantibodies were determined using the ELISA methods, in 87 euthyroid women. These were made up of 44 control women which included 8{18%} nulligravidae, 18{41%} non pregnant multiparous and 18{41%}, pregnant subjects. The infertile groups were made up of 43 women which included 18{42%} with secondary infertility, 17{39%} recurrent spontaneous aborters {RSA} and 8{19%} unexplained {Primary} infertility subjects. The microsomal antithyroid peroxidase and the anti-thyroglobulin auto-antibodies, micro titer mean values, in the infertility subjects were 347.55 units/ml and 35.23 units/ml respectively. These values were higher compared with the micro titer mean values of the control subjects with 284.40 units/ml and 32.51 units/ml respectively. The Micro titer mean value levels of the microsomal antithyroid peroxidase auto-antibodies in the primary infertility group was 437.19 units/ml and in the secondary infertility group was 362.50 units/ml compared with the micro titer mean value of control groups of 284.40 units/ml at P KEY WORDS: Autoimmunity, Reproduction, Infertility, Thyroid antibodies. Nigerian Journal of Health and Biomedical Sciences Vol.3(2) 2004: 96-99

Frequency and Levels of Autoantibodies in Healthy Adult Omanis

A previous pilot study showed a high frequency of anti-smooth muscle autoantibody in Omani blood donors and pregnant women. We conducted this larger-scale study to investigate the frequency and significance of several autoantibodies in healthy individuals from different regions of Oman. Sera obtained from 1537 healthy Omanis (1153 males and 384 females), ranging in age from 18 to 57 years, were tested for the presence of ten different autoantibodies using indirect immunofluorescence, haemagglutination and latex agglutination techniques. Low levels of autoantibodies were detected in 33.5%, whereas a few individuals (1.8%) showed high autoantibody titres. Anti-smooth muscle autoantibodies (ASMA) were the most prevalent (11%). Anti-nuclear autoantibodies (ANA) were the second most prevalent (7.6%). Anti-thyroid microsomal autoantibodies (ATMA) and anti-thyroglobulin autoantibodies (ATA) were present in 6.5% and 4.4% of individuals, respectively. The other autoantibodies were detected much less frequently: anti-parietal cells autoantibodies (APCA) were found in 1.6%, anti-brush border antibodies (ABBA) in 1.3%, anti-reticulin autoantibodies (ARA) in 1%, antimitochondrial antibodies (AMA) in 0.8%, antiglomerular basement membrane antibodies (AGBMA) in 0.7% and rheumatoid factor (RF) in 0.4%. The data indicate that autoantibodies are present in healthy Omani individuals, and therefore caution should be taken when interpreting laboratory results of patients suspected of having autoimmune disease.

Level of Serum Neopterin and Interleukin-6 In Patients with Thyroid Diseases

Summary The purpose of the study was to characterize the immune status in 88 patients (64 women and 24 men) with thyroid diseases and in 36 healthy blood donors as control group. The clinical material consisted of 37 patients with nontoxic nodular goitre, 10 patients with thyroiditis, 27 patients with thyroid adenoma and 14 patients with thyroid carcinoma. The studied parameters included serum neopterin,interleukin-6 (IL-6), also anti-thyroglobulin autoantibodies (ATG) and anti-thyroid microsomal autoantibodies (MAB). The aim of the study was to investigate whether serum neopterin, IL-6, ATG and MAE have any value in distinction between non-toxic nodular goitre, thyroiditis, thyroid adenoma and thyroid carcinoma. 36.4% patients with thyroid carcinoma, 16.7% patients with nontoxic nodular goitre and 9.1 % patients with thyroid adenoma had neopterin levels higher than 10 nmol/1. In patients and in the control group the mean serum levels of neopterin were in normal range. The highest mean level of neopterin was found in patients with thyroid carcinoma (7.14± 5.95 nmol/1). The difference was statistically significant in comparison to the control (p &lt; 0.001) and patients with thyroiditis and thyroid adenoma (p &lt; 0.05). The significantly higher levels of IL-6 were in all patients in comparison to the control (p &lt; 0.0001). Autoantibodies ATG were detected in serum of 45 patients (51.1 %) and autoantibodies MAE were in serum of 34 patients (38.6 % ). Mean levels of these autoantibodies in patients were statistically significantly higher than in the control ' p &lt; 0.05). In patients with ATG and/or MAE mean level of neopterin was significantly higher than in patients without these autoantibodies (p &lt; 0.05). This study has shown that neopterin represents an additional parameter with potential interest in clinical diagnosis of thyroid diseases.

Enhanced expression of complement regulatory proteins on thyroid epithelial cells of Graves' disease.

Cytotoxic anti-thyroid microsomal autoantibodies are highly prevalent in sera of patients with Graves' disease, but in Graves' disease thyroid tissues rarely show destructive changes. We postulated that this might be due to membrane-associated complement regulatory proteins which protect target cells from injury by complement activation. We, therefore, investigated the expression of membrane attack complex inhibitory factor (MACIF) and decay accelerating factor (DAF) in the thyroid tissues from patients with Graves' disease, Hashimoto's thyroiditis, thyroid adenocarcinoma and normal human thyroid tissues. We found a high level of expression of MACIF and DAF in Graves' thyroid tissues. Using the membrane immunofluorescence and cell-ELISA techniques, we also investigated the factors which enhanced the MACIF and DAF expression in cultured thyroid cells. Thyroid stimulating hormone, phorbol 12, 13-dibutyrate and thyroid stimulating autoantibody enhanced the MACIF and DAF expression. These findings suggest that the membrane complement regulatory proteins increase in response to the thyroid stimulating factors such as thyroid stimulating autoantibody in Graves' disease and that this increase then protects the cells from damage due to complement activation by thyroid autoantibodies.

Thyroid autoantibodies in thyroid cancer: incidence and relationship with tumour outcome.

In the present investigation we studied serum anti-thyroglobulin and anti-thyroid microsomal autoantibodies, measured by hemagglutination technique, in 600 patients with thyroid cancer seen by us from 1975 to 1985 (mean follow-up 46 months). Positive thyroglobulin antibodies and/or microsomal antibodies were found in 138 (23%) patients (23.9% with papillary, 25% with follicular, 16.1% with anaplastic, and 4.1% with medullary thyroid carcinomas). The incidence of positive tests was similar in each decade of life (ranging between 21.9% and 27.9%), whereas in a normal sex-matched population with no evidence of thyroid disease, the frequency of positive tests was very low in young people and increased to 23% in people older than 60. In 64 patients with no evidence of residual or metastasic thyroid tissue after surgery and radioiodine, initially positive antibody titres became negative in 54.6%, decreased in 32.8%, did not change in 3.1%, and increased in 9.3%. On the contrary, antibody titres of patients with persistent disease became undetectable in 8.3%, decreased in 16.6%, remained unchanged in 25%, and increased in 50%. The clinical course of differentiated thyroid cancer was unaffected by the presence of thyroid antibodies and no difference was found in the death rate between antibody-positive and antibody-negative patients (11.5% and 13.6%, respectively). In conclusion, our data indicate that: 1) autoimmune phenomena are not an infrequent finding in thyroid cancer; 2) as in non-malignant thyroid diseases, positive-antibody tests are more frequently observed in females than in males; 3) at variance with normal controls, no age-dependent increase in serum anti-thyroid antibodies was found in thyroid cancer; 4) the presence of metastatic thyroid tissue seems to be necessary to perpetuate the autoantibody synthesis, and 5) anti-thyroid autoantibodies are not a protective or worsening factor in the tumour outcome.

Antithyroid microsomal autoantibodies and HLA-DR5 are associated with postpartum thyroid dysfunction: evidence supporting an autoimmune pathogenesis.

Antithyroid microsomal antibodies (AMA) and human leukocyte antigen (HLA) haplotypes were assessed as markers for the occurrence of postpartum thyroid dysfunction (all forms) and postpartum painless thyroiditis with transient hyperthyroidism, respectively. AMA titers and thyroid function tests were measured sequentially in 261 mothers from delivery to up to 1 yr postpartum. To test for the association of HLA haplotypes in the subgroup of women with postpartum painless thyroiditis with hyperthyroidism, typing for HLA-A, -B, -C, -DR, and -DQ antigens was carried out in a selected group of 38 mothers with this syndrome. Their results were compared to those in 60 women with hypothyroid goitrous autoimmune thyroiditis and 98 regional controls. In the AMA study, 40 (15%) of the 261 mothers had positive AMA titers (titer, less than or equal to 1:80) at delivery, 54 (21%) 2-4 months postpartum, 69 (26%) 5-7 months postpartum, and 60 (23%) 1 yr postpartum. Among 55 mothers who developed postpartum thyroid dysfunction, 25 (47%) had positive AMA at delivery [relative risk (RR), 10.0; P less than 0.001; sensitivity, 45%; specificity, 95%]. Two to 4 months postpartum, 46 mothers had thyroid dysfunction, of whom 35 (76%) had positive AMA, while only 19 of the 215 euthyroid mothers (9%) had positive tests for AMA. Positive AMA tests at these times resulted in a RR for postpartum thyroid dysfunction of 32.8 (P less than 0.0001; sensitivity, 76%; specificity, 91%). Five to 7 months postpartum, 55 mothers had thyroid dysfunction, of whom 47 (86%) had positive AMA, while only 22 of 206 euthyroid mothers (11%) were positive (RR, 59.0; P less than 0.0001; sensitivity, 86%; specificity, 90%). In the HLA studies, DR5 occurred in 11 of 38 (29%) women with postpartum painless thyroiditis with hyperthyroidism vs. 12 of 98 (12%) controls, resulting in a RR of 2.9 (P less than 0.05). HLA-DR5 was present in 22 of 60 (37%) patients with goitrous autoimmune thyroiditis (RR, 4.2; P less than 0.01). HLA-DR4 and HLA-DQw3 were slightly but not significantly increased in women with postpartum painless thyroiditis with hyperthyroidism and goitrous autoimmune thyroiditis compared to those in normal controls. DQw1 was reciprocally decreased (P less than 0.025) in the women with goitrous autoimmune thyroiditis, but not in the women with postpartum painless thyroiditis with hyperthyroidism compared to that in normal controls...

The Mechanism of Spontaneous Hypothyroidism in Patients with Graves’ Disease after Antithyroid Drug Treatment

The natural course of Graves' disease results in hypothyroidism in up to 20% of patients previously treated with antithyroid drugs. The precise mechanisms are not known, although autoimmune destruction of thyroid tissue has been proposed. We studied sequentially obtained serum samples from three patients with hyperthyroid Graves' disease previously treated with an antithyroid drug who became hypothyroid to determine possible causes of their hypothyroidism. Antithyroglobulin and antithyroid microsomal autoantibodies, TSH binding inhibitory immunoglobulin (TBII), thyroid-stimulating antibody (TSAb), and thyroid stimulation-blocking activity were measured. Autoantibodies were markedly elevated throughout the clinical course in all three patients. Patient 1 had no TBII and blocking activity and extremely high TSAb when she was euthyroid as well as hypothyroid. Hypothyroidism was probably the result of autoimmune thyroid destruction. In patient 2, TSAb disappeared, and TBII and blocking activity increased markedly when she developed hypothyroidism, which thus appeared to result from blocking antibodies. Patient 3 had intermittent periods of hyper- and hypothyroidism before becoming and remaining euthyroid. While initially hypothyroid, TBII was weakly positive, and TSAb was strongly positive; subsequently, when hyperthyroidism recurred, TBII and TSAb were strongly positive. Hypothyroidism appeared to result from focal autoimmune thyroiditis. Patients with hyperthyroid Graves' disease may develop hypothyroidism later by different means. Autoimmune thyroiditis, diffuse or focal, with thyroid destruction is one mechanism. The appearance of antibodies that block TSH stimulation may be another.

Serum thyroid autoantibodies as a risk factor for development of hypothyroidism after radioactive iodine therapy for single thyroid 'hot' nodule.

Hypothyroidism is often observed after radioiodine treatment in Graves' disease, but it is considered a rare complication in single hyperfunctioning thyroid nodule ('hot' nodule). This concept has been recently challenged, but the available data are conflicting. In the present study we therefore assessed the development of permanent hypothyroidism in 126 patients with thyroid hot nodule treated with 131I (180 muCi/g of estimated nodule weight, total dose 5.5-28.9 mCi). Follow-up ranged between 1 to 11 years. Hypothyroidism was observed in 5 (4%) patients, corresponding to a cumulative incidence by life-table analysis of 4.8% ten years after treatment. No relationship was found between the development of hypothyroidism and the size of the nodule or the total amount of administered dose. Fifty-six patients with euthyroid hot nodule at the time of treatment had higher cumulative incidence of hypothyroidism after 10 years (9.7%) than those with toxic adenoma (1.5%) (0.1 greater than P greater than 0.05 by logrank test). When the patients were analyzed according to the presence or absence of serum antithyroglobulin and/or antithyroid microsomal autoantibodies, the prevalence of hypothyroidism after 131I treatment was higher (4/25 = 16%) in patients with significant serum antibody titres (greater than or equal to 1/400 by passive haemagglutination), when compared to that observed in subjects with negative antibody tests (1/101 = 1.0%). Life-table analysis showed in antibody positive patients a cumulative incidence of hypothyroidism after 10 years of 18.0% vs 1.4% in antibody negative patients (P less than 0.001 by logrank test).(ABSTRACT TRUNCATED AT 250 WORDS)

Increased frequency of autoantibodies in men with sperm antibodies

Autoantibodies to thyroid microsomes were more frequent in 102 infertile men with complement-dependent sperm-immobilizing activity (sperm immobilization test [SIT] ) in serum (11.8%) than in a control group of 277 men of comparable ages and semen quality without sperm antibodies (4.3%, P less than 0.05). Frequencies of organ-specific antibodies (antigastric parietal cell, antithyroglobulin, and antithyroid microsome) in 57 men with genital tract obstructions and positive SIT were similar to those for control subjects, and there were no significant differences in the frequencies of non-organ-specific autoantibodies (antinuclear antibody, rheumatoid factor, antimitochondrial, and anti-smooth muscle) in the three groups. Because in men without genital tract obstruction antithyroid microsomal autoantibodies were more common with sperm antibodies than without, the possibility of a genetic factor in the causation of sperm autoimmunity should be considered.