So you thought you have just about understood antibodies in hypothyroidism?
Sorry, but back into class again.
Don't worry if you don't understand. The authors of the paper have simply reported their observations and made a suggestion that these antibodies might be relevant. It clearly requires more research to get to the meaning.
Open Access Published online by De Gruyter May 5, 2022
TSH-receptor autoantibodies in patients with chronic thyroiditis and hypothyroidism
Mariella Giannone, Miriam Dalla Costa, Chiara Sabbadin, Silvia Garelli, Monica Salvà, Stefano Masiero, Mario Plebani
, Diego Faggian, Nicoletta Gallo, Fabio Presotto, Loris Bertazza, Davide Nacamulli, Simona Censi, Caterina Mianand Corrado Betterle
From the journal Clinical Chemistry and Laboratory Medicine (CCLM)
doi.org/10.1515/cclm-2022-0162
Abstract
Objectives
The reported prevalence of TSH-receptor (TSHR) autoantibodies (TRAb) in patients with chronic thyroiditis (CT) range from 0 to 48%. The objective was to study the prevalence of TRAb in patients with CT and hypothyroidism and to correlate it with gender, age, thyroid dimensions, TSH levels, and autoimmune diseases.
Methods
The study comprised 245 patients with CT and hypothyroidism (median age 42 years, 193 females, 52 males) and 123 Italian healthy subjects matched for sex and age as controls. TRAb were tested with ELISA using a >2.5 IU/L cut off for positivity. TSHR blocking (TBAb) and TSHR stimulating autoantibodies (TSAb) were measured in 12 TRAb-positive patients using bioassays with Chinese hamster ovary (CHO) cells expressing wild-type or R255D-mutated TSHR.
Results
TRAb positivity was found in 32/245 (13.1%) patients and significantly correlated (p<0.05) with TSH levels. TRAb positivity was significantly higher in males vs. females (p=0.034), in females 16–45 years of age vs. >45 years of age (p<0.05) and in patients with reduced vs. normal/increased thyroid dimensions (p<0.05). Linear regression analysis showed a correlation between TRAb concentrations with age (p<0.05) and TRAb concentrations with TSH (p<0.01). In bioassay with TSHR-R255D all 12 patients tested were TBAb-positive while 33% were also TSAb-positive suggesting the presence of a mixture of TRAbs with different biological activities in some patients.
Conclusions
TRAb have been found in patients with CT and hypothyroidism. A mixture of TBAb and TSAb was found in some patients and this may contribute to the pathogenesis of thyroid dysfunction during the course of the disease.
Keywords: autoimmune thyroid diseases; chronic thyroiditis; hypothyroidism; TSH-receptor autoantibodies; TSH-receptor blocking antibodies; TSH-receptor stimulating antibodies
Open Access to full paper here: