Clinical Courses and Thyroid Conditions in Three Infants Born to a Mother with Thyroid Stimulating-Blocking Antibodies.

Notsu, Kazumi; Ito, Yasuo; Hasegawa, Akihiro; Iwanari, Osamu; Katamura, Kenji; Kikuchi, Kiyoshi; Ohguni, Satoshi; Furuya, Hiroshi; Sohmiya, Motoi; Kato, Yuzuru

doi:10.1507/endocrj.44.233

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…[8,10,11,[18][19][20][21][22][23]. Other investigations have focused on the role of TBAb in congenital and neonatal hypothyroidism associated with mothers with autoimmune thyroid disease [19,[24][25][26][27][28][29][30][31][32]. The importance of TBAb in congenital hypothyroidism, however, has been questioned [28].…”

Section: Discussionmentioning

confidence: 99%

A novel bioassay for anti-thyrotrophin receptor autoantibodies detects both thyroid-blocking and stimulating activity

Li¹,

Kim²,

Diana

et al. 2013

Clinical and Experimental Immunology

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SummaryAutoantibodies to the thyrotrophin (TSH) receptor (anti-TSHR) are unique, in that they are involved directly in the pathophysiology of certain autoimmune thyroid diseases (AITD). Thyroid-stimulating antibodies (TSAb) act as agonists that activate the thyroid gland and cause Graves' disease. Other anti-TSHR antibodies block TSH and can cause hypothyroidism. Thyroidblocking antibodies (TBAb) have not been studied as extensively as TSAb. We developed a TBAb bioassay based on a cell line that expresses a chimeric TSHR. The 50% inhibitory concentration of the chimeric Chinese hamster ovary (CHO)-Luc cells was more than five-fold lower compared with the wild-type CHO-Luc cells. We tested the performance of this bioassay using a thyroid-blocking monoclonal antibody K1-70, established an assay cut-off and detected TBAb in 15 of 50 (30%) patients with AITD. Interestingly, the assay detects both TSAb and TBAb and measures the net activity of a mixture of both types of antibodies. There was a high correlation (R 2 0·9, P < 0·0001) between the results of the TSAb assay and the negative percentage inhibition of the TBAb assay. The TBAb bioassay was approximately 20-fold more sensitive than a commercially available TSHR binding assay (TRAb). In contrast to TRAb, sera with high levels of TBAb activity were able to be diluted several hundred-fold and still exhibit blocking activity above the cut-off level. Thus, this TBAb bioassay provides a useful tool for measuring the activity of anti-TSHR antibodies and may help clinicians to characterize the diverse clinical presentations of patients with AITD.

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