Hoermann R, Schumm-Draeger P M, Rehbach K, Mann K
Medical Department II, University of Munich, Federal Republic of Germany.
J Clin Invest. 1991 Dec;88(6):1947-54. doi: 10.1172/JCI115519.
The concept of using thyroid-stimulating hormone (TSH) receptor antagonists in the management of Graves' disease is intriguing. Therefore, we investigated a TSH receptor antagonist derived from human chorionic gonadotropin (hCG) with respect to TSH receptor binding, adenylate cyclase activity, thyroid hormone release, and HLA class II antigen expression in vitro and in an in vivo model. A variant of hCG, asialoagalacto-hCG, like asialo-hCG and unlike hCG itself, inhibited both 125I-bTSH binding and cAMP response to bTSH in human thyroid membranes. However, like intact or deglycosylated hCG and unlike asialo-hCG, asialoagalacto-hCG displayed a limited affinity for hepatic asialoglycoprotein receptors, a likely marker for its in vivo turnover rate. It proved capable of inhibiting bTSH-stimulated thyroid hormone release in human thyroid slices as well as in the nude mouse bearing human thyroid transplants. It also prevented bTSH induced hypertrophy of transplanted thyrocytes. Further, HLA-DR expression induced by bTSH in the presence of gamma-interferon on human thyrocytes was inhibited. In conclusion, we present evidence that asialogalacto-hCG antagonizes bTSH actions on thyroid function and HLA-DR expression in human thyroid in vitro and, more importantly, in an in vivo model. Hence, the hCG variant described here or similar agents should warrant further exploration in the study and treatment of Graves' disease.
使用促甲状腺激素(TSH)受体拮抗剂治疗格雷夫斯病的概念很吸引人。因此,我们在体外和体内模型中研究了一种源自人绒毛膜促性腺激素(hCG)的TSH受体拮抗剂在TSH受体结合、腺苷酸环化酶活性、甲状腺激素释放以及HLA II类抗原表达方面的作用。hCG的一种变体,去唾液酸半乳糖基-hCG,与去唾液酸hCG一样,与hCG本身不同,它能抑制人甲状腺膜中125I-bTSH的结合以及对bTSH的cAMP反应。然而,与完整或去糖基化的hCG一样,与去唾液酸hCG不同,去唾液酸半乳糖基-hCG对肝去唾液酸糖蛋白受体的亲和力有限,这可能是其体内周转率的一个标志。事实证明,它能够抑制人甲状腺切片以及携带人甲状腺移植体的裸鼠中bTSH刺激的甲状腺激素释放。它还能防止bTSH诱导的移植甲状腺细胞肥大。此外,bTSH在γ干扰素存在下诱导人甲状腺细胞的HLA-DR表达也受到抑制。总之,我们提供的证据表明,去唾液酸半乳糖基-hCG在体外,更重要的是在体内模型中,能拮抗bTSH对人甲状腺功能和HLA-DR表达的作用。因此,本文所述的hCG变体或类似药物在格雷夫斯病的研究和治疗中值得进一步探索。