Medical and Radiometabolic Therapy Unit, Department of Internal Medicine, University of Genoa, 16132 Genoa, Italy.
J Endocrinol Invest. 2010 Mar;33(3):197-201. doi: 10.1007/BF03346581.
TSH receptor antibodies (TRAb) play a crucial role in the pathogenesis of Graves' disease (GD). The use of human recombinant TSH-receptor far improved the analytical performance of TRAb assays (2nd-generation assays). The 3rd-generation assay is based on the inhibition of binding of a human biotin-labeled monoclonal thyroid- stimulating antibody (M22) to TSH-receptor by the autoantibodies present in the serum.
We aimed to assess the ability of the 2nd- and 3rd-generation assays to detect serum TRAb following radioiodine therapy for hyperthyroidism.
Sera from 47 hyperthyroid (25 autoimmune, 22 non-autoimmune) patients were tested using the two different assays before and at different time intervals after radioiodine therapy. The modifications of TRAb were evaluated, as well as the correlation between the two methods.
The results obtained by the two methods proved to be closely correlated. A rise in TRAb was invariably observed in GD patients following radioiodine, with a median peak at 6 months, irrespective of their initial clinical status, presence of ophthalmopathy, smoking habits or other variables. Such a rise was nearly superimposable using both methods. No TRAb appearance was observed in patients with non-autoimmune hyperthyroidism.
The use of methods of higher sensitivity with respect to that formerly used indicate that nearly all GD patients develop TRAb following radioiodine, and that this phenomenon is transient and not related to baseline conditions and clinical outcome/efficacy of treatment.
促甲状腺激素受体抗体（TRAb）在格雷夫斯病（GD）的发病机制中起着至关重要的作用。人重组 TSH 受体的使用极大地提高了 TRAb 检测的分析性能（第二代检测）。第三代检测基于存在于血清中的自身抗体抑制人生物素标记的单克隆甲状腺刺激抗体（M22）与 TSH 受体的结合。
我们旨在评估第二代和第三代检测在放射性碘治疗甲状腺功能亢进后检测血清 TRAb 的能力。
使用两种不同的检测方法，在放射性碘治疗前和治疗后不同时间间隔，检测来自 47 例甲状腺功能亢进（25 例自身免疫性，22 例非自身免疫性）患者的血清。评估了 TRAb 的变化，并比较了两种方法之间的相关性。
两种方法的结果证明密切相关。无论其初始临床状态、眼病的存在、吸烟习惯或其他变量如何，GD 患者在放射性碘治疗后 TRAb 始终升高，中位数峰值出现在 6 个月。使用这两种方法几乎都可以观察到这种升高。非自身免疫性甲状腺功能亢进患者中未观察到 TRAb 出现。
与以前使用的方法相比，使用更高灵敏度的方法表明，几乎所有 GD 患者在放射性碘治疗后都会产生 TRAb，并且这种现象是短暂的，与基线状况和临床结果/治疗效果无关。
