Clinical value of M22-based assays for TSH-receptor antibody (TRAb) in the follow-up of antithyroid drug treated Graves' disease: Comparison with the second generation human TRAb assay

Massart, Catherine; Gibassier, J; d’Herbomez, Michèle

doi:10.1016/j.cca.2009.06.033

Cited by 21 publications

(13 citation statements)

References 23 publications

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“…Consequently, all patients with hyperthyroidism are supposed to reexamine the TRAb level during monthly or quarterly regular follow-up. The persistent elevation of TRAb indicates that hyperthyroidism is in the active stage, while the remission phase is normally accompanied by the decline of TRAb [32, 33]. Roberto et al found that patients who experienced recurrence(s) had 1.7-fold higher levels of TRAb at onset.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, when our body lacks sufficient compensatory effect for ADM deficiency, the resistance of pulmonary circulation increases, which might be one of the important aetiological factors for pulmonary hypertension. (6) Urotensin II is able to directly act on receptors, thereby bringing about the contraction and proliferation of vessel smooth muscle cells, all of which cause reduction in pulmonary vascular compliance and increase in vascular resistance and eventually pulmonary hypertension [32, 40].…”

Section: Discussionmentioning

confidence: 99%

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The Association of Autoantibodies in Hyperthyroid Heart Disease Combined with Pulmonary Hypertension

Zhang

Chen

Sheng³

et al. 2019

International Journal of Endocrinology

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Hyperthyroidism is a clinical state that results from increased thyroid hormone levels which has a significant impact on cardiac function and structure. Graves' disease is the most common cause of hyperthyroidism in iodine-replete areas. Hyperthyroid heart disease may be associated with pulmonary hypertension in patients who have overt hyperthyroidism. To investigate the association of pulmonary hypertension induced by hyperthyroid heart disease and autoantibody, one hundred and one cases with hyperthyroid heart disease who were consecutively admitted to the inpatient department of endocrinology and metabolism of the Shandong Provincial Hospital between November 2014 and April 2018 were collected and analyzed statistically. According to the Independent samples T-test, variance analysis, chi-square test, Pearson linear correlation analysis, and logistic regression, there was a good correlation between pulmonary artery systolic pressure and thyroid stimulating hormone (TSH) and receptor antibodies (TRAb) (r = 0.264, P=0.025) (OR = 1.037, P=0.029), but there was no significant correlation between the pulmonary artery systolic pressure and other thyroid-related parameters (FT3, FT4, TSH, anti-TPO, and anti-TG). Based on variance analysis, PASP rose as the level of TRAb gets higher. What is more, patients with HHD combined with PH showed a significantly higher serum level of TRAb; moreover, serum TRAb concentration was remarkably correlated with the PASP level. Therefore, TRAb participates in the process of pulmonary hypertension caused by hyperthyroid heart disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Association of Autoantibodies in Hyperthyroid Heart Disease Combined with Pulmonary Hypertension

Zhang

Chen

Sheng³

et al. 2019

International Journal of Endocrinology

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“…TRAb binds to the TSH receptors and chronically stimulates them resulting in an abnormally high production of thyroid hormones. Therefore, almost all patients with Graves’ hyperthyroidism have detectable TRAb that has a major pathogenic role in Graves’ disease; persistent elevation correlates with disease activity, while remission is usually accompanied by a decrease in their activity [ 24 , 25 ]. The discrepancy between the 2 studies is probably due to the lower incidence of autoimmune hyperthyroidism in Merces’ study (54 % for antiperoxidase antibody and 35 % for antithyroglobulin antibody) compared to our study (100 % for TRAb).…”

Section: Discussionmentioning

confidence: 99%

Autoimmunity and pulmonary hypertension in patients with Graves’ disease

et al. 2014

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A link between hyperthyroidism and pulmonary hypertension has been reported, but the underlying mechanisms of these two conditions have not been clearly identified. The aim of this study was to determine the clinical correlates of pulmonary hypertension in patients with Graves’ disease. Among 50 consecutive patients with Graves’ disease referred for echocardiography, 18 patients (36 %) had pulmonary hypertension measured by continuous-wave Doppler echocardiography (pulmonary artery systolic pressure >35 mmHg). The patients with pulmonary hypertension had significantly higher pulmonary vascular resistance (PVR), cardiac output and thyroid-stimulating hormone receptor antibody (TRAb) compared to those without (p < 0.001, p = 0.028 and p < 0.001, respectively). Pulmonary artery systolic pressure had a good correlation with TRAb (r = 0.74, p < 0.001), but was not related to free T4 (r = 0.12, p = 0.419) and free T3 (r = 0.22, p = 0.126). To determine the important variables present in patients with Graves’ disease that may be related to pulmonary artery systolic pressure, 4 variables (PVR, cardiac output, TRAb and free T3) were used in the multivariate analysis. In addition to PVR (standard regression coefficient = 0.831, p < 0.001) and cardiac output (standard regression coefficient = 0.592, p < 0.001), TRAb (standard regression coefficient = 0.178, p < 0.001) emerged as a significant variable related to pulmonary artery systolic pressure. Thus, in addition to the effect of thyroid hormone on the cardiovascular system, autoimmune-mediated pulmonary vascular remodeling may play a role in Graves’ disease-linked elevated pulmonary artery systolic pressure.

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“…Despite the variability, the performance of second‐ and third‐generation TRAb assays was similar in predicting relapse of GD. A higher prevalence of TRAb positivity was noted in patients who relapsed following withdrawal of methimazole …”

Section: What Are the Assays Available To Measure Trab?mentioning

confidence: 95%

Measuring TSH receptor antibody to influence treatment choices in Graves’ disease

Shyamasunder

Abraham

2017

Clinical Endocrinology

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TSH receptor antibody (TRAb) plays a key role in the pathogenesis of Graves' disease (GD), and its levels correlate with the clinical course. The second- and third-generation TRAb assays have >95% sensitivity and specificity for the diagnosis of GD and have improved the utility of TRAb to predict relapse. TRAb levels decline with antithyroid drug (ATD) therapy and after thyroidectomy. Its level increases for a year following radioactive iodine (RAI) therapy, with a gradual fall thereafter. TRAb level >12 IU/l at diagnosis of GD is associated with 60% risk of relapse at 2 years and 84% at 4 years. The prediction of risk of relapse improves further to >90% with TRAb >7·5 IU/l at 12 months or >3·85 IU/l at cessation of ATD therapy. TRAb tests are not expensive, and hence, TRAb measurements at presentation, after 12 months and/or 18 months (at cessation) of ATD therapy, could potentially guide treatment choices in GD. Elevated TRAb favours definitive treatment in the form of RAI or thyroidectomy, depending on the presence or absence of moderate-to-severe Graves' ophthalmopathy (GO) and the ability to comply with radiation protection requirements. Use of ATDs in early pregnancy is associated with increased risk of congenital anomalies; early ablative treatment (RAI/surgery) should be considered in women of childbearing age at higher risk of relapse of GD. TRAb ≥5 IU/l in pregnant women with current or previously treated GD is associated with increased risk of foetal and neonatal thyrotoxicosis, and hence needs close monitoring. TRAb levels parallel the course of GO, and elevated TRAb is an indication for steroid prophylaxis to prevent progression of GO with RAI therapy.

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Clinical value of M22-based assays for TSH-receptor antibody (TRAb) in the follow-up of antithyroid drug treated Graves' disease: Comparison with the second generation human TRAb assay

Cited by 21 publications

References 23 publications

The Association of Autoantibodies in Hyperthyroid Heart Disease Combined with Pulmonary Hypertension

The Association of Autoantibodies in Hyperthyroid Heart Disease Combined with Pulmonary Hypertension

Autoimmunity and pulmonary hypertension in patients with Graves’ disease

Measuring TSH receptor antibody to influence treatment choices in Graves’ disease

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