TSH 수용체 항체 측정의 임상적 의미
Clinical Implication of TSH Receptor Antibody Measurement
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Autoantibodies directed against the thyrotropin receptor have been well known to be an important pathogenesis of Graves’ disease. However, the diagnosis and management of Graves’ disease are still mainly dependent on thyroid function itself and clinical manifestation of thyrotoxic patients. That is mainly due to the low sensitivity of early generation of thyrotropin receptor assay methods. The development of sensitive thyrotropin receptor measuring tools through third generation immunometric assay made the diagnosis of Graves’ disease with mild hyperthyroidism accurate and convenient for patients. Bioassay to detect thyroid stimulating immunoglobulin is also commercially available nowadays, which theoretically discriminate thyroid stimulating antibodies from thyrotropin receptor-blocking antibodies. Although the use of these serologic markers plays an informative role in accurately diagnosing Graves’ disease and predicting the prognosis of disease, consideration of the heterogeneous nature of autoimmunity of Graves’ disease and the limitation of indirect antibody assay is also required for proper management of Graves’ disease patients. In this review, the clinical usefulness of thyrotropin receptor antibody in various clinical situations of Graves’ disease was overviewed.
Abstract
Autoantibodies directed against the thyrotropin receptor have been well known to be an important pathogenesis of Graves’ disease. However, the diagnosis and management of Graves’ disease are still mainly dependent on thyroid function itself and clinical manifestation of thyrotoxic patients. That is mainly due to the low sensitivity of early generation of thyrotropin receptor assay methods. The development of sensitive thyrotropin receptor measuring tools through third generation immunometric assay made the diagnosis of Graves’ disease with mild hyperthyroidism accurate and convenient for patients. Bioassay to detect thyroid stimulating immunoglobulin is also commercially available nowadays, which theoretically discriminate thyroid stimulating antibodies from thyrotropin receptor-blocking antibodies. Although the use of these serologic markers plays an informative role in accurately diagnosing Graves’ disease and predicting the prognosis of disease, consideration of the heterogeneous nature of autoimmunity of Graves’ disease and the limitation of indirect antibody assay is also required for proper management of Graves’ disease patients. In this review, the clinical usefulness of thyrotropin receptor antibody in various clinical situations of Graves’ disease was overviewed.
참고문헌 (21)
- Bahn Chair RS, "Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists", Thyroid, 21(6), pp.593~646 (2011)
- Costagliola S, "Second generation assay for thyrotropin receptor antibodies has superior diagnostic sensitivity for Graves' disease", J Clin Endocrinol Metab, 84(1), pp.90~97 (1999)
- Paunkovic J, "Does autoantibody-negative Graves' disease exist? A second evaluation of the clinical diagnosis", Horm Metab Res, 38(1), pp.53~56 (2006)
- Lytton SD, "Bioassays for TSH-receptor autoantibodies: an update", Autoimmun Rev, 10(2), pp.116~122 (2010)
- Michalek K, "TSH receptor autoantibodies", Autoimmun Rev, 9(2), pp.113~116 (2009)
- Morshed SA, "Neutral antibodies to the TSH receptor are present in Graves' disease and regulate selective signaling cascades", Endocrinology, 151(11), pp.5537~5549 (2010)
- Zophel K, "Clinical review about TRAb assay's history", Autoimmun Rev, 9(10), pp.695~700 (2010)
- Tozzoli R, "TSH receptor autoantibody immunoassay in patients with Graves' disease: improvement of diagnostic accuracy over different generations of methods. Systematic review and meta-analysis", Autoimmun Rev, 12(2), pp.107~113 (2012)
- Kamijo K, "Similar clinical performance of a novel chimeric thyroid-stimulating hormone receptor bioassay and an automated thyroid-stimulating hormone receptor binding assay in Graves' disease", Thyroid, 21(12), pp.1295~1299 (2011)
- Mukuta T, "Immunological findings and thyroid function of untreated Graves' disease patients with undetectable TSHbinding inhibitor immunoglobulin", Clin Endocrinol (Oxf), 40(2), pp.215~219 (1994)
- Torring O, "Graves' hyperthyroidism: treatment with antithyroid drugs, surgery, or radioiodine--a prospective, randomized study. Thyroid Study Group", J Clin Endocrinol Metab, 81(8), pp.2986~2993 (1996)
- Carella C, "Serum thyrotropin receptor antibodies concentrations in patients with Graves' disease before, at the end of methimazole treatment, and after drug withdrawal: evidence that the activity of thyrotropin receptor antibody and", or thyroid response modify during the observation period, 2006, pp.16(3), 295~302
- Giuliani C, "A TSHR-LH", CGR chimera that measures functional thyroid-stimulating autoantibodies (TSAb) can predict remission or recurrence in Graves' patients undergoing antithyroid drug (ATD) treatment, 2012, pp.97(7), E1080~E1087
- Hwang S, "High cut-off value of a chimeric TSH receptor (Mc4)-based bioassay may improve prediction of relapse in Graves' disease for 12 months", Endocrine, 48(1), pp.89~95 (2015)
- Zimmerman D, "Fetal and neonatal hyperthyroidism", Thyroid, 9(7), pp.727~733 (1999)
- Stagnaro-Green A, "Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum", Thyroid, 21(10), pp.1081~1125 (2011)
- Eckstein A, "Clinical value of TSH receptor antibodies measurement in patients with Graves' orbitopathy", Pediatr Endocrinol Rev, 7(Suppl 2), pp.198~203 (2010)
- Vos XG, "Frequency and characteristics of TBII-seronegative patients in a population with untreated Graves' hyperthyroidism: a prospective study", Clin Endocrinol (Oxf), 69(2), pp.311~317 (2008)
- Ponto KA, "Clinical relevance of thyroid-stimulating immunoglobulins in graves' ophthalmopathy", Ophthalmology, 118(11), pp.2279~2285 (2011)
- 장선영, "Correlation between TSH Receptor Antibody Assays and Clinical Manifestations of Graves’ Orbitopathy", Yonsei Medical Journal, 54(4), pp.1033~1039 (2013), 연세대학교의과대학[DOI]
- Jang SY, "Clinical characteristics of Graves' orbitopathy in patients showing discrepancy between levels from TBII assays and TSI bioassay", Clin Endocrinol (Oxf), 80(4), pp.591~597 (2014)