Thyroid Receptor Antibodies Research Articles

Interleukin 18 and transforming growth factor β1 in the serum of patients with Graves' ophthalmopathy treated with corticosteroids

Interleukin-18 (IL-18), a novel cytokine of the IL-1 family, and TGFβ1 have been lately identified in several thyroid autoimmune diseases. The aim of this study was to estimate the influence of corticosteroids on serum IL-18 and TGFβ1 in Graves' ophthalmopathy (GO) patients and to assess their potential as a guideline of immunosuppressive therapy. The study was carried out in three groups of subjects: (1) 17 patients with clinical symptoms of ophthalmopathy (GO) that underwent corticosteroid therapy consisting of intravenous methylprednisolone (MP) infusions and subsequent treatment with oral prednisone (P); (2) 14 patients with euthyroid Graves' disease (Gd) without symptoms of ophthalmopathy; (3) 12 healthy volunteers age- and sex-matched to groups 1 and 2. The serum levels of IL-18 and TGF β1 were determined by the ELISA method. Thyroid receptor antibodies (TRAB) were estimated by the RIA method. Levels of IL-18 were significantly higher in both GO [340±109 pg/ml (p<0.02)] and Gd individuals [308±89 pg/ml (p<0.05)] as compared to the control group (238±88 pg/ml). There were no significant differences in TGFβ1 concentrations between studied groups. TRAB values were significantly increased in both GO (p<0.001) and Gd individuals (p<0.001) as compared to the controls. In coticosteroid-responsive patients we have found a significant decrease in IL-18 serum concentration as compared to the pretreatment values. We did not find any correlation between IL-18 or TGFβ1 and TRAB, duration of GO, clinical activity score (CAS) or proptosis. Our results suggest that efficient corticosteroid therapy in patients with Graves' ophthalmopathy may be related to its influence on systemic IL-18.

Relationship between thyroid autoimmunity and Yersinia enterocolitica antibodies.

It has previously been proposed that subclinical Yersinia enterocolitica infection may play a role in autoimmune thyroid disease (AITD). In this study, we investigated the relationship between the thyroid autoantibodies and the antibodies that produced against different serotypes of Y. enterocolitica. A total of 215 subjects were included into the study (65 newly diagnosed Graves' disease [GD], 57 Hashimoto's thyroiditis [HT], 53 nontoxic diffuse goiter [NTDG], and 40 subjects for control group [CG]). Thyroid receptor antibodies (TRAb), thyroid and agglutinating antibodies against Y. enterocolitica serotype O:3, O:5, O:8, O:9 were measured in the blood samples. The highest incidence of Y. enterocolitica antibody positivity was measured in GD (53.8% for O:3, 29.2% for O:5, 44.6% for O:8, and 40% for O:9) and followed by HT. In patients with GD, TRAb levels were also higher than in patients with HT, NTDG, and CG. There was no difference between NTDG and CG in respect to the titer levels and the positivity of both TRAb and Y. enterocolitica antibodies. There was also a weak linear correlation between TRAb level and the titer of antibodies against Y. enterocolitica antigens. It can be concluded that Y. enterocolitica infection may play a role in etiology of GD in Turkey.

Thyroid hormones and thyroid antibodies in infertile males

Objective: To investigate the incidence of thyroid dysfunction, thyroid antibodies, and the correlation with semen and hormonal parameters in infertile men.Design: Prospective study.Setting: University-based andrology laboratory.Patient(s): Three hundred five infertile men with idiopathic infertility.Intervention(s): Medical history, clinical examination, semen analysis, measurement of free thyroxin (fT4), free triiodothyronine (fT3), basal thyroid-stimulating hormone (bTSH), LH, FSH, T, free testosterone (fT), PRL, E2, sex hormone–binding globulin (SHBG), DHEAS, and the thyroid antibodies thyreoglobulin antibody (TGA), thyroid peroxidase antibody (TPO-Ab), and thyroid receptor antibody (TRAK).Main Outcome Measure(s): Incidence of thyroid dysfunction and thyroid antibodies, as well as the correlation with hormones and the results of semen analyses.Result(s): No manifest thyroid dysfunction was observed. Latent thyroid dysfunction and latent hypothyroidism were diagnosed in 11.5% and 3% of infertile men, respectively. No correlation between thyroid dysfunction and semen parameters was detected. bTSH correlated significantly with PRL (P<.001). Thyroid antibodies were elevated in 7.5%. Elevated TPO-Ab were significantly correlated with pathozoospermia (P=.036) and asthenozoospermia (P=.049).Conclusion(s): Latent thyroid dysfunction had no impact on semen parameters. In patients with elevated TPO-Ab levels, pathozoospermia or asthenozoospermia should be considered.

Increasing incidence of childhood Graves' disease in Hong Kong: a follow-up study.

Childhood Graves' disease has been reported to be rare but preliminary epidemiological data on its incidence appeared to be high in Hong Kong Chinese children. The aim of this study is to determine the incidence of childhood Graves' disease in Hong Kong and to analyse whether there is an increasing trend of the incidence. We established a registry of childhood Graves' disease at our centre to collect cases from four districts in Hong Kong. The diagnosis of Graves' disease was based on clinical features, diffused enlargement of thyroid gland, raised free thyroxine or triiodothyronine levels, suppressed TSH levels, and the presence of thyroid receptor antibodies. Confirmed cases of Graves' disease who resided in any of the four districts were used to calculate the incidence for the study period between 1989 and 1998. One hundred and eighteen Chinese children under 15 years of age had a confirmed diagnosis of Graves' disease during the study period from January 1989 to December 1998. There were 11 boys and 107 girls giving a male to female ratio of 1 : 9.7. The overall incidence rates were 3.2/100 000/year and 6.5/100 000/year for the two periods 1989-93 and 1994-98, respectively. The incidence rates for girls have increased significantly (P < 0.001) from 3.8/100 000/year in 1989 to 14.1/100 000/year in 1998. The current incidence of childhood Graves' disease in our population is about eight times that reported in Danish children. This study confirms the high incidence of childhood Graves' disease in Hong Kong and documents an increasing trend for girls. Further studies are required to reveal possible genetic or environmental factors responsible for such epidemiology in Hong Kong Chinese children.

Postpartum thyroid dysfunction: clinical assessment and relationship to psychiatric affective morbidity.

Postpartum thyroid dysfunction (PPTD), diagnosed using biochemical criteria, is usually transient with a wide range of reported prevalence rates. The specific clinical and psychiatric morbidity associated with PPTD is still uncertain. The aims of the study were to determine the point prevalence of PPTD in Australian women at 6 months postpartum and to assess the specific clinical and psychiatric morbidity in these women. Women who were Caucasian, aged 20-45 years and 4.5-5.5 months postpartum, were randomly selected and invited into the study. The respondents were assessed for biochemical and psychiatric morbidity. PPTD for this study was defined as TSH or free T4 outside the adult reference range. A double blind clinical assessment of PPTD women and their matched controls used standardized clinical hypo- and hyperthyroid clinical indices. From the total randomly selected sample size of 1816 women, 748 participated. Biochemical measurements were serum TSH, free T4, microsomal antibody (MsAb) and thyroid peroxidase antibody (TPOAb), and thyroid receptor antibodies (only in women with low TSH). Psychiatric assessment involved screening all participants using the General Health Questionnaire 28, followed by classifying and quantifying severity of cases using DSM-III-R categories for depression and anxiety. Clinical signs and symptoms of hypo- and hyper-thyroidism were measured using weighted standardized indices. Thyroid size was assessed by palpation. Achilles tendon reflex time was measured by photomotograph. The prevalence of PPTD in the participants was 11.5% (95% CI 9.2-13. 8%), giving a minimum prevalence for the randomly selected sample of 4.7% (95% CI 3.7-5.7%). In the PPTD women, 54% had an elevated TSH, 30% had a suppressed TSH and the remainder had a low fT4 and normal TSH. Positive thyroid autoantibody titres in the PPTD group were 46. 5% for microsomal antibody (MsAb) and 63.9% for thyroid peroxidase antibody (TPOAb), and in the non-PPTD group were 1.7% and 4.9%, respectively. The 6 month point prevalence rates of depression, generalized anxiety disorder and panic disorder and/or agoraphobia were 9.4%, 1.4% and 3.1%, respectively. No relationship was found between PPTD status and the diagnosis of current depression or between thyroid antibody status and current depression. In women who were diagnosed as anxious at the time of assessment, the number of anxiety symptoms was higher in the PPTD group (P < 0.05). There was no difference in signs and symptom scores for the hypo- and hyper-thyroid clinical indices between PPTD women and their controls. This study has shown a high prevalence of postpartum thyroid dysfunction but there was no difference in the clinical and psychiatric signs and symptoms between cases and controls. In the social, psychological, physical and endocrine setting of the postpartum period, women with postpartum thyroid dysfunction are identifiable by the attending physician only by their abnormal thyroid function tests.

Multiple changes in thyroid function in patients with chronic active HCV hepatitis treated with recombinant interferon-alpha

Recombinant human interferon-alpha (r-IFN-alpha) is often successfully used in the treatment of patients with chronic viral hepatitis B and C. Thyroid dysfunction has been reported to occur with variable frequency during r-IFN-alpha therapy especially in patients with preexisting thyroid autoimmunity. We have prospectively evaluated the effect of r-IFN-alpha on various aspects of thyroid function in patients with HCV chronic hepatitis. Thirty-two patients with HCV chronic active hepatitis were studied prospectively before and during r-IFN-alpha therapy. Serum TSH, FT4, FT3, and thyroid receptor (TSR) and thyroid peroxidase (TPO) antibodies, and the iodide-perchlorate discharge test (I-C10(4)) to detect subtle defects in the thyroid organification of iodide were carried out during the study. Thyroid radioactive iodine uptakes (RAIU) were obtained in patients who developed thyrotoxicosis. All patients were clinically and biochemically euthyroid prior to r-IFN-alpha therapy with negative I-C10(4) discharge tests. Four patients became thyrotoxic, 3 secondary to destructive or inflammatory thyroiditis with a low thyroid RAIU, and 1 patient developed hypothyroidism. The I-C10(4) discharge test became positive in 7 of the 32 patients studied prospectively; 5 of these patients did not develop other evidence of thyroid dysfunction and did not have positive TPO antibodies. In these 5 patients the test became negative after r-IFN-alpha was discontinued. Appropriate therapy of the patients with thyrotoxicosis (methylprednisolone for 3 patients with destructive thyroiditis and methimazole for 1 patient with hyperthyroidism) or with hypothyroidism (L-thyroxine) was successful. Thyroid dysfunction, especially destructive or silent thyroiditis resulting in thyrotoxicosis, is not infrequently observed in patients receiving r-IFN-alpha therapy for chronic active hepatitis. Although underlying autoimmune thyroid disease appears to predispose patients to develop thyroid dysfunction, other patients become thyrotoxic or hypothyroid in the absence of baseline positive TPO-Ab. Subtle defects in the thyroidal organification of iodine as determined by the I-C10(4) discharge test, in the absence of autoimmune thyroid disease, was observed in 5 patients who remained euthyroid, suggesting that r-IFN-alpha directly reduces the intrathyroidal organification of iodine.

Ophthalmopathy in Early Thyrotoxicosis — Relationship to Thyroid Receptor Antibodies and Effects of Treatment

A prospective study of 25 newly diagnosed thyrotoxic patients was undertaken to determine the incidence and severity of ophthalmopathy in the early stages of the disease. A quantitative analysis of the ocular muscle changes was made using B scan ultrasonography, and the effects of treatment for the thyroid disease on the course of the eye changes was assessed. Although the majority (75%) of patients showed only mild clinical signs of ophthalmopathy (Werner Class 3 or less), 92% had ultrasonographic evidence of ocular muscle enlargement. Clinical involvement of the extraocular muscles was seen in 12% of the cases. There was an inverse correlation between the serum level of thyroid stimulating hormone receptor antibody (TR Ab) and the size of the extraocular muscles. Recovery of the euthyroid state with treatment was accompanied by a decrease in orbital infiltration in some cases, both clinically (reduced amplitude of intraocular pressure rise on elevation of the globe) and by ultrasonography, but the improvement was not statistically significant.

Thyroid receptor antibody (TRAb) production: evidence for polyclonality and possible influence of activated T cells and lymphocytic infiltration

Journal Article Thyroid receptor antibody (TRAb) production: evidence for polyclonality and possible influence of activated T cells and lymphocytic infiltration Get access R Schmeidl, R Schmeidl II. Medizinische Klinik und Pathologisches Institut, Klinikum Mannheim der Universität Heidelberg Search for other works by this author on: Oxford Academic Google Scholar R Paschke, R Paschke II. Medizinische Klinik und Pathologisches Institut, Klinikum Mannheim der Universität Heidelberg Search for other works by this author on: Oxford Academic Google Scholar N Brückner, N Brückner II. Medizinische Klinik und Pathologisches Institut, Klinikum Mannheim der Universität Heidelberg Search for other works by this author on: Oxford Academic Google Scholar P Pfiester, P Pfiester II. Medizinische Klinik und Pathologisches Institut, Klinikum Mannheim der Universität Heidelberg Search for other works by this author on: Oxford Academic Google Scholar J Teuber, J Teuber II. Medizinische Klinik und Pathologisches Institut, Klinikum Mannheim der Universität Heidelberg Search for other works by this author on: Oxford Academic Google Scholar U Schwedes, U Schwedes II. Medizinische Klinik und Pathologisches Institut, Klinikum Mannheim der Universität Heidelberg Search for other works by this author on: Oxford Academic Google Scholar K H Usadel K H Usadel II. Medizinische Klinik und Pathologisches Institut, Klinikum Mannheim der Universität Heidelberg Search for other works by this author on: Oxford Academic Google Scholar Acta Endocrinologica (Norway), Volume 120, Issue 3_Supplement, Jun 1989, Pages S30–S31, https://doi.org/10.1530/acta.0.120S030 Published: 01 June 1989

Is remission of Graves' disease regulated by anti-idiotypic antibodies?

Our results show evidence for regulation of Graves' disease remission by anti-idiotypic antibodies in a biologic assay. The polyclonality and functional heterogeneity of thyroid receptor antibodies is most likely the reason why evidence for idiotypic-anti-idiotypic regulation can be demonstrated in the autologous but not consistently in the homologous system.

Consistency and variability in the character of thyrotrophin receptor antibodies in Graves' disease.

At diagnosis there was no correlation between the uptake of pertechnetate by the thyroid and thyrotrophin receptor antibodies (TRAb) measured as TSH binding inhibitory immunoglobulins in a series of 27 patients with Graves' disease. TRAb were detectable initially in 19 patients, in 11 of these there was a significant positive correlation (P less than 0.05) between serial measurements of pertechnetate uptake and TRAb made during 2 years following diagnosis. In five patients pertechnetate uptake fell with time whilst TRAb levels were maintained or fluctuated. In the remaining three of the 19 patients both measurements were low and did not change during treatment. We conclude that TRAb in any individual patient are a mixture of immunoglobulins of variable effectiveness as thyroid stimulators. In a majority of patients the composition of this mixture remains constant during the course of the illness and the clinical state reflects the levels of TRAb in the blood. In a minority, however, the character of these antibodies may alter with time or there is a change in the responsiveness of the thyroid gland. The general lack of correlation between measurements of thyroid stimulating activity and TSH binding inhibitory immunoglobulins in groups of patients is due to differences between patients in the composition of TRAb.