Kasagi K, Konishi J, Arai K, Misaki T, Iida Y, Endo K, Torizuka K
J Clin Endocrinol Metab. 1986 May;62(5):855-62. doi: 10.1210/jcem-62-5-855.
A simple, sensitive, and practical assay for thyroid-stimulating autoantibodies (TSAb) was developed in which cryopreserved porcine thyroid cells were incubated with crude immunoglobulin fractions sedimented from serum with polyethylene glycol. In the assay, 1.4- to 2.0-fold and 6- to 12-fold increases in cAMP released into Hank's medium without NaCl were found at 1 and 10 microU/ml bovine TSH, respectively. TSAb were detected in 41 (97.6%) of 42 patients with untreated hyperthyroid Graves' disease, 29 (55.8%) of 52 patients with hyperthyroid Graves' disease who were euthyroid while taking antithyroid drugs, 22 (78.6%) of 28 patients with euthyroid Graves' disease, and none of the patients with simple goiter, adenomatous goiter, thyroid adenoma, or thyroid cancer tested. TSAb activities measured using porcine thyroid cells significantly correlated with those measured using human thyroid adenoma cells (r = 0.908; n = 46; P less than 0.001). Thyroid-stimulating activity was also detected in 11 (28.9%) of 38 patients with Hashimoto's thyroiditis. However, the activity was considered to be due to TSH in the patients' sera, because it was completely abolished by pretreatment with anti-TSH antibodies. Serum TSH concentrations lower than 50 microU/ml did not affect the assay result. In Graves' disease after cessation of antithyroid drugs, 85.7% (12 of 14) of TSAb-positive patients relapsed, while 77.8% (14 of 18) of TSAb-negative patients remained in remission. Thus, the assessment of TSAb was useful as an index to predict prognosis.
开发了一种简单、灵敏且实用的促甲状腺素自身抗体（TSAb）检测方法，该方法将冷冻保存的猪甲状腺细胞与用聚乙二醇从血清中沉淀出的粗免疫球蛋白组分一起孵育。在该检测中，在不含氯化钠的汉克氏培养基中，分别在1和10微单位/毫升的牛促甲状腺素作用下，发现释放到培养基中的环磷酸腺苷（cAMP）增加了1.4至2.0倍和6至12倍。在42例未经治疗的甲状腺功能亢进型格雷夫斯病患者中，41例（97.6%）检测到TSAb；在52例服用抗甲状腺药物时甲状腺功能正常的甲状腺功能亢进型格雷夫斯病患者中，29例（55.8%）检测到TSAb；在28例甲状腺功能正常的格雷夫斯病患者中，22例（78.6%）检测到TSAb；而在接受检测的单纯性甲状腺肿、腺瘤性甲状腺肿、甲状腺腺瘤或甲状腺癌患者中均未检测到TSAb。使用猪甲状腺细胞测量的TSAb活性与使用人甲状腺腺癌细胞测量的TSAb活性显著相关（r = 0.908；n = 46；P < 0.001）。在38例桥本甲状腺炎患者中，11例（28.9%）也检测到促甲状腺活性。然而，该活性被认为是由于患者血清中的促甲状腺素所致，因为用抗促甲状腺素抗体预处理后该活性完全消失。血清促甲状腺素浓度低于50微单位/毫升不影响检测结果。在停用抗甲状腺药物后的格雷夫斯病患者中，TSAb阳性患者的复发率为85.7%（14例中的12例），而TSAb阴性患者的缓解率为77.8%（18例中的14例）。因此，TSAb的评估作为预测预后的指标很有用。
