Stoynova M, Shinkov A, Kirilov G, Kovatcheva R
Medical University of Sofia, University Hospital of Endocrinology, Sofia, Bulgaria.
Acta Endocrinol (Buchar). 2021 Apr-Jun;17(2):194-199. doi: 10.4183/aeb.2021.194.
Thyrotropin-receptor antibodies (TRAb) are biomarkers of Graves' disease (GD) and Graves' orbitopathy (GO). Elevated immunoglobulin E (IgE) and antinuclear antibodies (ANA) were also found in GD patients.
We aimed to assess TRAb, IgE and ANA in GD and GO patients and to evaluate the relationship between the immunological markers and smoking.
This was a comparative cross-sectional study carried out in a single tertiary care center from June 2018 to January 2020.
A total of 103 GD patients (mean age 51.2, 84 females) were divided into three subgroups: moderate-to-severe GO (n=36), mild GO (n=32) and "only GD" subgroup (n=35). Forty healthy controls (HC) (mean age 51.2, 36 females) were also included. TRAb were measured by a thyrotropin-binding inhibitory immunoglobulin (TBII) assay in GD patients; IgE and ANA - by an enzyme-linked immunosorbent assay in all subjects.
GD patients had higher IgE-positivity rate (p=0.04) and similar ANA-positivity compared to HC. Moderate-to-severe GO subgroup had the highest TBII (p<0.01), the lowest TBII-negativity rate (p<0.01) and the highest ANA-positivity rate (p=0.03) and was the only subgroup whose IgE-positivity rate was significantly higher than HC (25% 7.5%). Mild GO and "only GD" patients had comparable TBII, TBII-negativity rate, IgE and ANA.Both GO subgroups had significantly higher smoking rate than "only GD" patients. Smoking was positively associated with IgE positivity (φ=0.22, p=0.03), and negatively with TBII negativity rate (φ=-0.24, p=0.02).
GD patients exhibit different immunological patterns depending on the presence and severity of GO. Smoking might be just one of the factors responsible for the clinical and immunological variety of GD. Further studies are needed.
促甲状腺素受体抗体（TRAb）是格雷夫斯病（GD）和格雷夫斯眼眶病（GO）的生物标志物。在GD患者中还发现免疫球蛋白E（IgE）和抗核抗体（ANA）升高。
我们旨在评估GD和GO患者的TRAb、IgE和ANA，并评估这些免疫标志物与吸烟之间的关系。
这是一项于2018年6月至2020年1月在一家三级医疗中心进行的比较性横断面研究。
共103例GD患者（平均年龄51.2岁，女性84例）分为三个亚组：中重度GO（n = 36）、轻度GO（n = 32）和“仅GD”亚组（n = 35）。还纳入了40名健康对照者（HC）（平均年龄51.2岁，女性36例）。通过促甲状腺素结合抑制性免疫球蛋白（TBII）测定法检测GD患者的TRAb；通过酶联免疫吸附测定法检测所有受试者的IgE和ANA。
与HC相比，GD患者的IgE阳性率更高（p = 0.04），ANA阳性率相似。中重度GO亚组的TBII最高（p < 0.01），TBII阴性率最低（p < 0.01），ANA阳性率最高（p = 0.03），并且是唯一IgE阳性率显著高于HC的亚组（25% 对7.5%）。轻度GO和“仅GD”患者的TBII、TBII阴性率、IgE和ANA相当。两个GO亚组的吸烟率均显著高于“仅GD”患者。吸烟与IgE阳性呈正相关（φ = 0.22，p = 0
