Schleusener H, Kotulla P, Finke R, Sörje H, Meinhold H, Adlkofer F, Wenzel K W
J Clin Endocrinol Metab. 1978 Aug;47(2):379-84. doi: 10.1210/jcem-47-2-379.
The prevalence of TSI in Graves' disease was investigated with a radioligand receptor assay using human thyroid membranes and highly purified labeled porcine TSH or bovine TSH in 110 patients before treatment and in 39 patients after successful treatment with antithyroid drugs. In 11 patients, the assay was performed before, during, and after therapy. The results in the radioligand receptor assay were compared to thyroid function tests (TRH test, free T4 index, serum %3 level, and thyroid suppression test). Normal IgG inhibits nonspecifically, but dose dependently, the binding of [125I]TSH to thyroid membranes. IgG samples from patients were only considered to be positive if they reduced the binding of the labeled hormone below the mean value minus 2 SD of the controls. TSI activity was found in 50% of the patients with untreated diffuse toxic goiter, in 3 out of 27 cases who regained suppressible thyroid function, and in 5 out of 12 cases who were off therapy for more than 6 weeks and showed normal TRH tests and normal hormone levels but in whom the suppression test was not performed. Our data cannot prove the hypothesis that only humoral antibodies are responsible for the thyroid stimulation in Graves' disease, but of course they cannot exclude it; furthermore, they suggest the existence of antibodies which bind to the human thyroid cell membrane without necessarily stimulating thyroid cellular activity.
采用放射性配体受体分析法，利用人甲状腺膜以及高度纯化的标记猪促甲状腺激素（TSH）或牛促甲状腺激素，对110例未经治疗的格雷夫斯病患者和39例抗甲状腺药物治疗成功后的患者进行TSI（促甲状腺素受体刺激性抗体）患病率调查。对11例患者在治疗前、治疗期间和治疗后均进行了该检测。将放射性配体受体分析的结果与甲状腺功能检查（促甲状腺激素释放激素试验、游离甲状腺素指数、血清甲状腺素水平及甲状腺抑制试验）进行比较。正常IgG可非特异性但呈剂量依赖性地抑制[125I]TSH与甲状腺膜的结合。仅当患者的IgG样本使标记激素的结合降低至对照组平均值减2个标准差以下时，才被视为阳性。在50%未经治疗的弥漫性毒性甲状腺肿患者、27例恢复可抑制甲状腺功能的患者中的3例以及12例停药超过6周且促甲状腺激素释放激素试验和激素水平正常但未进行抑制试验的患者中的5例中发现了TSI活性。我们的数据无法证实仅体液抗体是格雷夫斯病中甲状腺刺激原因的假说，但当然也不能排除该假说；此外，数据提示存在能与人甲状腺细胞膜结合但不一定刺激甲状腺细胞活性的抗体。
