Mori T, Akamizu T, Kosugi S, Sugawa H, Inoue D, Okuda J, Ueda Y
Department of Laboratory Medicine, Kyoto University School of Medicine, Japan.
Endocr J. 1994 Feb;41(1):1-11. doi: 10.1507/endocrj.41.1.
Recent progress in the studies of epitope analysis of the TSH-R against TSH-R Ab was reviewed extensively. Using both site-directed mutagenesis and synthetic TSH-R peptide, binding and/or action sites of TSH-R Ab have been known to be multiple and discontinuous, but the significance of two unique and TSH-R specific regions has been implicated. Further, the possible existence of heterogeneity among stimulatory TSH-R Ab has also been indicated. As for immunogenetic factors related to autoimmune thyroid diseases, studies on HLA analysis, TSH-R specific T lymphocyte analysis and VH analysis of TSH-R Ab were discussed. Of note was the negative association of HLA-DP w2 antigen in Japanese patients with Graves' disease and hypothyroidism due to blocking TSH-R Ab, and we proposed a new concept of autoimmune TSH receptor disease within autoimmune thyroid disease and emphasized possible critical roles of HLA-DP. Recent evidence of restricted usage of the Ig VH gene in cloned B lymphocytes from Graves' patients producing TSH-R Ab has also been presented.
广泛综述了促甲状腺激素受体（TSH-R）针对促甲状腺激素受体抗体（TSH-R Ab）的表位分析研究的最新进展。利用定点诱变和合成TSH-R肽，已知TSH-R Ab的结合和/或作用位点是多个且不连续的，但两个独特的TSH-R特异性区域的意义已被提及。此外，还指出了刺激性TSH-R Ab之间可能存在异质性。关于自身免疫性甲状腺疾病相关的免疫遗传因素，讨论了HLA分析、TSH-R特异性T淋巴细胞分析以及TSH-R Ab的VH分析。值得注意的是，在日本格雷夫斯病患者和因阻断TSH-R Ab导致的甲状腺功能减退患者中，HLA-DP w2抗原呈负相关，我们提出了自身免疫性甲状腺疾病中自身免疫性促甲状腺激素受体疾病的新概念，并强调了HLA-DP可能的关键作用。还展示了来自产生TSH-R Ab的格雷夫斯病患者的克隆B淋巴细胞中Ig VH基因限制性使用的最新证据。
