We tested sera and purified immunoglobulin (Ig) fractions from patients with autoimmune thyroid disorders (AITD), with and without ophthalmopathy, and normal subjects, for the presence of antibodies reactive with eye muscle membrane antigens in an optimized enzyme-linked immunosorbent assay (ELISA). We found no correlation between ELISA results and the presence or severity of ophthalmopathy in patients with AITD for either serum or Ig, and there were no significant differences between the mean values (+/- SE) for the three groups (AITD with ophthalmopathy, AITD without ophthalmopathy and normals) for either serum or Ig. In contrast Ig from 8 of 19 (45%) patients with thyroid-associated ophthalmopathy reacted with a 64 kDa eye muscle membrane antigen in SDS-polyacrylamide gel electrophoresis and Western blotting, while tests were positive in only one of the 8 patients with AITD without eye disease and in none of the 8 normal subjects. The presence of antibodies to a 64 kDa antigen in immunoblotting did not correlate with the levels of antibodies measured in ELISA. We conclude that the ELISA, incorporating a crude membrane fractions as antigen, is not useful as a clinical test for eye muscle autoantibodies.

The meuse adrenal is more responsive to ACTH than the rat adrenal.The meuse adrenal does not differentiate between concentrations of ACTH in solution, only between total amounts. ACKNOWLEDGEMENTS

We have developed an enzyme-linked immunosorbent assay (ELISA) for the measurement of antibodies reactive with a 98 amino acid fragment, called D1, of a recombinant thyroid and eye muscle membrane protein corresponding to a MW of 64 kDa (called 1D) in the serum of patients with thyroid autoimmunity with and without ophthalmopathy. Antibodies against the D1 fragment expressed as a fusion protein with beta galactosidase, were detected in 29% of patients with thyroid-associated ophthalmopathy (TAO) of < 1 yr duration, in 33% of those with disease of > 3 yr duration, in 40% of patients with Graves' hyperthyroidism (GH) without evident eye disease, in 31% of patients with lid lag and retraction but no other signs of progressive ophthalmopathy, in 25% of patients with euthyroid Graves' disease and in 43% of patients with untreated Hashimoto's thyroiditis (HT), but in none of 14 patients with other (non-immunological) thyroid disorders. Although tests were positive in 6 out of the 15 patients with ophthalmopathy and no overt thyroid autoimmunity overall there was no close association of the antibodies with clinical features of the eye disease or its course. In those sera in which Western blotting for antibodies reactive with a 64 kDa eye muscle membrane protein and ELISA were both carried out there was no close correlation between the two tests.(ABSTRACT TRUNCATED AT 250 WORDS)

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