Correlation between TSH Receptor Antibody Assays and Clinical Manifestations of Graves’ Orbitopathy
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Purpose: To investigate an association between the levels of serum thyroid-stimulating hormone (TSH)-receptor autoantibodies (TRAbs) and Graves’ orbitopathy (GO) activity/severity scores, and compare the performance of three different TRAb assays in assessing the clinical manifestations of GO. Materials and Methods: Cross-sectional study. Medical records of 155 patients diagnosed with GO between January 2008 and December 2010 were reviewed. GO activity was assessed by clinical activity score (CAS) and severity graded with the modified NOSPECS score by a single observer. Serum TRAb was measured by three different methods: 1st generation thyrotropin-binding inhibitor immunoglobulin (TBII) assay (TRAb1st); 3rd generation TBII assay (TRAb3rd); and biological quantitative assay of thyroid-stimulating immunoglobulin (TSI) using Mc4-CHO cells (Mc4-CHO TSI assay). Results were correlated with scores of activity/severity of thyroid eye disease. Results: All three assays (TRAb1st, TRAb3rd, and Mc4-CHO TSI) yielded results that were significantly positively correlated with CAS (β=0.21, 0.21, and 0.46, respectively; p<0.05) and proptosis (β=0.38, 0.34, and 0.33, respectively;p<0.05). Mc4-CHO TSI bioassay results were significantly positively correlated with all GO severity indices (soft tissue involvement, proptosis, extraocular muscle involvement, and total eye score; β=0.31, 0.33, 0.25, and 0.39, respectively;p<0.05). Conclusion: Mc4-CHO TSI bioassay was superior over the two TBIIs in assessing active inflammation and muscle restriction due to GO, whereas TBII assay would be sufficient for evaluation of patients with proptosis.
Abstract
Purpose: To investigate an association between the levels of serum thyroid-stimulating hormone (TSH)-receptor autoantibodies (TRAbs) and Graves’ orbitopathy (GO) activity/severity scores, and compare the performance of three different TRAb assays in assessing the clinical manifestations of GO. Materials and Methods: Cross-sectional study. Medical records of 155 patients diagnosed with GO between January 2008 and December 2010 were reviewed. GO activity was assessed by clinical activity score (CAS) and severity graded with the modified NOSPECS score by a single observer. Serum TRAb was measured by three different methods: 1st generation thyrotropin-binding inhibitor immunoglobulin (TBII) assay (TRAb1st); 3rd generation TBII assay (TRAb3rd); and biological quantitative assay of thyroid-stimulating immunoglobulin (TSI) using Mc4-CHO cells (Mc4-CHO TSI assay). Results were correlated with scores of activity/severity of thyroid eye disease. Results: All three assays (TRAb1st, TRAb3rd, and Mc4-CHO TSI) yielded results that were significantly positively correlated with CAS (β=0.21, 0.21, and 0.46, respectively; p<0.05) and proptosis (β=0.38, 0.34, and 0.33, respectively;p<0.05). Mc4-CHO TSI bioassay results were significantly positively correlated with all GO severity indices (soft tissue involvement, proptosis, extraocular muscle involvement, and total eye score; β=0.31, 0.33, 0.25, and 0.39, respectively;p<0.05). Conclusion: Mc4-CHO TSI bioassay was superior over the two TBIIs in assessing active inflammation and muscle restriction due to GO, whereas TBII assay would be sufficient for evaluation of patients with proptosis.
참고문헌 (25)
- Khoo TK, "Pathogenesis of Graves’ ophthalmopathy: the role of autoantibodies", Thyroid, 17, pp.1013~1018 (2007)
- Kamath C, "The role of thyrotrophin receptor antibody assays in graves’ disease", J Thyroid Res, 2012, pp.525936~ (2012)
- Michalek K, "TSH receptor autoantibodies", Autoimmun Rev, 9, pp.113~116 (2009)
- Massart C, "Intermethod variability in TSH-receptor antibody measurement: implication for the diagnosis of Graves disease and for the follow-up of Graves ophthalmopathy", Clin Chem, 55, pp.183~186 (2009)
- Costagliola S, "Second generation assay for thyrotropin receptor antibodies has superior diagnostic sensitivity for Graves’ disease", J Clin Endocrinol Metab, 84, pp.90~97 (1999)
- Maugendre D, "Clinical value of a new TSH binding inihibitory activity assay using human TSH receptors in the follow-up of antithyroid drug treated Graves’ disease. Comparison with thyroid stimulating antibody bioassay", Clin Endocrinol, 54, pp.89~96 (2001)
- Vos XG, "Frequency and characteristics of TBII-seronegative patients in a population with untreated Graves’ hyperthyroidism: a prospective study", Clin Endocrinol, 69, pp.311~317 (2008)
- Tada H, "Blocking-type anti-TSH receptor antibodies and relation to responsiveness to antithyroid drug therapy and remission in Graves’ disease", Clin Endocrinol, 58, pp.403~408 (2003)
- Kamijo K, "A novel bioreporter assay for thyrotropin receptor antibodies using a chimeric thyrotropin receptor (mc4) is more useful in differentiation of Graves’ disease from painless thyroiditis than conventional thyrotropin-stimulating antibody assay using porcine thyroid cells", Thyroid, 20, pp.851~856 (2010)
- Saravanan P, "Thyroid autoantibodies", Endocrinol Metab Clin North Am, 30, pp.315~337 (2001)
- Goh SY, "Thyroid autoantibody profiles in ophthalmic dominant and thyroid dominant Graves’ disease differ and suggest ophthalmopathy is a multiantigenic disease", Clin Endocrinol, 60, pp.600~607 (2004)
- Eckstein AK, "Thyrotropin receptor autoantibodies are independent risk factors for Graves’ ophthalmopathy and help to predict severity and outcome of the disease", J Clin Endocrinol Metab, 91, pp.3464~3470 (2006)
- Lytton SD, "A novel thyroid stimulating immunoglobulin bioassay is a functional indicator of activity and severity of Graves’ orbitopathy", J Clin Endocrinol Metab, 95, pp.2123~2131 (2010)
- Gerding MN, "Association of thyrotrophin receptor antibodies with the clinical features of Graves’ ophthalmopathy", Clin Endocrinol, 52, pp.267~271 (2000)
- Dragan LR, "Longitudinal correlation of thyroid-stimulating immunoglobulin with clinical activity of disease in thyroid-associated orbitopathy", Ophthal Plast Reconstr Surg, 22, pp.13~19 (2006)
- Kamijo K, "Clinical evaluation of 3rd generation assay for thyrotropin receptor antibodies: the M22-biotin-based ELISA initiated by Smith", Endocr J, 52, pp.525~529 (2005)
- Lytton SD, "Bioassays for TSH-receptor autoantibodies: an update", Autoimmun Rev, 10, pp.116~122 (2010)
- Mourits MP, "Clinical activity score as a guide in the management of patients with Graves’ ophthalmopathy", Clin Endocrinol, 47, pp.9~14 (1997)
- Ponto KA, "Clinical relevance of thyroid-stimulating immunoglobulins in graves’ ophthalmopathy", Ophthalmology, 118, pp.2279~2285 (2011)
- Lytton SD, "Novel chimeric thyroid-stimulating hormone-receptor bioassay for thyroid-stimulating immunoglobulins", Clin Exp Immunol, 162, pp.438~446 (2010)
- Regensburg NI, "Do subtypes of graves’ orbitopathy exist?", Ophthalmology, 118, pp.191~196 (2011)
- Eckstein AK, "Current insights into the pathogenesis of Graves’ orbitopathy", Horm Metab Res, 41, pp.456~464 (2009)
- Peyster RG, "Exophthalmos caused by excessive fat: CT volumetric analysis and differential diagnosis", AJR Am J Roentgenol, 146, pp.459~464 (1986)
- Noh JY, "Thyroid-stimulating antibody is related to Graves’ ophthalmopathy, but thyrotropin-binding inhibitor immunoglobulin is related to hyperthyroidism in patients with Graves’ disease", Thyroid, 10, pp.809~813 (2000)
- Eckstein AK, "Euthyroid and primarily hypothyroid patients develop milder and significantly more asymmetrical Graves ophthalmopathy", Br J Ophthalmol, 93, pp.1052~1056 (2009)