Department of Molecular Diagnostics & Endocrinology, The Core Laboratory in Medical Center of Clinical Research, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University School of Medicine, 200011, Shanghai, China.
Department of Endocrinology, Linyi People's Hospital, Linyi, China.
BMC Endocr Disord. 2021 Nov 30;21(1):238. doi: 10.1186/s12902-021-00905-4.
Graves' disease (GD) is one of the most common autoimmune thyroid diseases (AITDs) in humans, and thyrotropin receptor antibody (TRAb) is a characterized autoantibody in GD. The use of radioactive iodine therapy (RAI) for GD treatment is increasing.
We studied the biological properties of TRAb and evaluated the effect of RAI therapy on TRAb in GD patients.
In total, 225 patients (22 onset GD patients without I therapy, 203 GD patients treated with I therapy) and 20 healthy individuals as normal controls were included in this study. Clinical assessments were performed, and we examined in vitro the biological properties of TRAb in the 22 onset GD patients and 20 controls as well as 84 GD patients with I therapy.
Serum TRAb and thyroid peroxidase antibody (TPOAb) levels increased in the initial year of RAI treatment, and both antibodies decreased gradually after one year. After 5 years from radioiodine treatment, TRAb and TPOAb levels decreased in 88% and 65% of GD patients, respectively. The proportion of patients positive for thyroid-stimulatory antibody (TSAb) was significantly higher in the 7-12-month group, and thyroid-blocking antibody (TBAb) levels were elevated after one year in half of the patients who received I treatment.
Treatment of GD patients with radioiodine increased TPOAb and TRAb (their main biological properties were TSAbs) within the first year after therapy, and the main biological properties of elevated TRAb were TBAbs after 1 year.
格雷夫斯病（GD）是人类最常见的自身免疫性甲状腺疾病（AITD）之一，促甲状腺素受体抗体（TRAb）是 GD 的特征性自身抗体。放射性碘治疗（RAI）在 GD 治疗中的应用越来越多。
我们研究了 TRAb 的生物学特性，并评估了 RAI 治疗对 GD 患者 TRAb 的影响。
共纳入 225 例患者（未经 I 治疗的 22 例初发 GD 患者，203 例接受 I 治疗的 GD 患者）和 20 名健康对照者。进行临床评估，我们检测了 22 例初发 GD 患者和 20 名对照者以及 84 例接受 I 治疗的 GD 患者的 TRAb 的体外生物学特性。
RAI 治疗初始 1 年内血清 TRAb 和甲状腺过氧化物酶抗体（TPOAb）水平升高，治疗 1 年后两种抗体逐渐下降。接受放射性碘治疗 5 年后，GD 患者中分别有 88%和 65%的 TRAb 和 TPOAb 水平降低。在 7-12 个月组中，促甲状腺刺激抗体（TSAb）阳性患者的比例显著更高，接受 I 治疗的患者中有一半在治疗 1 年后 TBAb 水平升高。
放射性碘治疗 GD 患者会在治疗后 1 年内增加 TPOAb 和 TRAb（其主要生物学特性为 TSAb），而 TRAb 升高的主要生物学特性为 TBAb 则在 1 年后出现。
