Prediction of Relapse in Hyperthyroid Graves' Disease

McGregor, A.M.; Smith, Bernard Rees; Hall, R.; Petersen, Meryl M.; Miller, Margaret A.; Dewar, Paxton

doi:10.1016/s0140-6736(80)91551-2

Cited by 153 publications

(55 citation statements)

References 10 publications

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“…This led to the conclusion that only elevated end-treatment TSAb levels have predictive value. A similar conclusion was reached by others [6,7,10,11,15,16]. It should be remembered that the significance of low or undetectable levels of any parame ter is dependent on the sensitivity of the determination of this parameter.…”

Section: Trab Levels During Atd Treatmentsupporting

confidence: 78%

“…Abun dant experimental work from several groups, but mainly from McGregor et al [15], has suggested that ATDs have immunomodula tory effects on antibody production by lym phocytes residing within the thyroid gland. Thionamides could impair the activity of monocytes involved in the processing and presentation of thyroid antigens to helper T cells through inhibition of oxidation reac tions and scavenging of free oxygen radicals [4,5].…”

Section: Trab Levels During Atd Treatmentmentioning

confidence: 99%

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Immunological Parameters in Graves’ Disease: Are They Useful for Indication and Monitoring of Antithyroid Drug Treatment?

Orgiazzi¹,

Madec²,

Genetet³

et al. 1987

Horm Res

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This paper reviews the available published data on studies of a correlation between the presence or intensity of measurable immunological abnormalities or markers in Graves’ disease and the outcome after a course of antithyroid drug. The following parameters are discussed: circulating anti-thyroid-stimulating hormone receptor antibodies; antitubulin antibodies; human lymphocyte antigens, and repartition of T-lymphocyte subsets. At the present time no single parameter has any real practical value for individual patients either to indicate or monitor antithyroid drug therapy. The more useful information remains the anti-thyroid-stimulating hormone receptor level at the end of treatment which, if elevated, is predictive of relapse. Several areas of research, however, appear promising.

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Section: Trab Levels During Atd Treatmentsupporting

confidence: 78%

Section: Trab Levels During Atd Treatmentmentioning

confidence: 99%

Immunological Parameters in Graves’ Disease: Are They Useful for Indication and Monitoring of Antithyroid Drug Treatment?

Orgiazzi¹,

Madec²,

Genetet³

et al. 1987

Horm Res

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show abstract

“…It may prove helpful in predicting the likelihood of relapse in Graves' disease or could aide in the diagnosis of autoimmune thyroid disease either in the routine case of thyrotoxicosis or in the more unusual case of a patient with euthyroid ophthalmopathy (7,9,(41)(42)(43). Indeed, in contrast to previously reported assays (42), this ELISA appears to meet the requirements of simplicity, rapidity, and sensitivity which are essential for extensive clinical application. However, it should be emphasized that this assay measures only binding immunoglobulins and that it is not known, at present, what relation these immunoglobulins have to the stimulation or inhibition of thyroidal synthesis and/or secretion.…”

Section: Discussionmentioning

confidence: 99%

Partial characterization and clinical correlation of circulating human immunoglobulins directed against thyrotrophin binding sites in guinea pig fat cell membranes. Development of a direct enzyme immunoassay.

Baker¹,

Lukes²,

Smallridge³

et al. 1983

J. Clin. Invest.

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A B S T R A C T To obviate several problems inherent in indirect thyroid-stimulating hormone (TSH) receptor antibody assays, we developed an enzyme-linked immunosorbent assay (ELISA) that measures antibodies binding to guinea pig fat cell membrane, which contain high concentrations of TSH receptors. Solubilized guinea pig fat cell membranes were adsorbed to plastic microtiter plates and served as the solidphase antigen. Test sera and affinity-purified alkaline phosphatase-conjugated anti-human IgG were co-incubated with membranes, after which p-nitrophenyl phosphate was added. Results were read when a positive control reached a standard color change (OD405nm). Received for publication 16 March 1983 and in revised form 17 June 1983. untreated Graves' patients had OD values at least 2 SD above the normal mean (Grave's mean±SD; 0.46±0.33, P < 0.001) and in each case 10-6 M TSH inhibited the binding by at least 60%, suggesting that the immunoglobulins were directed at the TSH receptor. Seven of 25 serum samples from patients with Hashimoto's disease, seven of 23 serum samples from patients with transient hyperthyroidism (subacute thyroiditis or painless thyrotoxic thyroiditis), and two of 10 samples from patients with thyroid carcinoma had significant elevations in the titers of membrane-directed immunoglobulins. Graves' patients who were treated with ablative therapy at least 6 mo earlier and who were euthyroid when restudied continued to have abnormally elevated membrane-directed immunoglobulins in six of eight samples studied. Further studies involved the substitution of affinity-purified alkaline phosphatase anti-IgM antisera for the anti-IgG antisera routinely used. Seven of 12 serum samples from patients with Graves' disease had significant elevations in binding which in every instance was inhibited by >60% by 10-6 M TSH.In sum, the present results indicate that (a) we have developed a sensitive, specific, reproducible, convenient ELISA for the measurement both of the total amount of circulating membrane-directed antibodies and of TSH-displaceable membrane-directed immunoglobulins. (b) This ELISA detected significant elevations in TSH-displaceable guinea pig membrane binding in 23 of 25 untreated Graves' patients as well as in -30% of patients with Hashimoto's thyroiditis

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“…There are at least 3 kinds of autoimmune disorders, Graves' disease, Hashimoto thyroiditis and idiopathic myxedema, involving the thyroid gland. In Caucasian patients with Graves' disease, the close association of HLA-B8 and -DR3 or -DR5 is known [42][43][44][45][46]. There have been many reports on HLA association in Japanese patients with Graves' disease and/or Hashimoto thyroiditis.…”

Section: Hla Analysesmentioning

confidence: 99%

Recent Progress in TSH Receptor Studies with a New Concept of "Autoimmune TSH Receptor Disease".

et al. 1994

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Prediction of Relapse in Hyperthyroid Graves' Disease

Cited by 153 publications

References 10 publications

Immunological Parameters in Graves’ Disease: Are They Useful for Indication and Monitoring of Antithyroid Drug Treatment?

Immunological Parameters in Graves’ Disease: Are They Useful for Indication and Monitoring of Antithyroid Drug Treatment?

Partial characterization and clinical correlation of circulating human immunoglobulins directed against thyrotrophin binding sites in guinea pig fat cell membranes. Development of a direct enzyme immunoassay.

Recent Progress in TSH Receptor Studies with a New Concept of "Autoimmune TSH Receptor Disease".

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Prediction of Relapse in Hyperthyroid Graves' Disease

Cited by 153 publications

References 10 publications

Immunological Parameters in Graves&rsquo; Disease: Are They Useful for Indication and Monitoring of Antithyroid Drug Treatment?

Immunological Parameters in Graves&rsquo; Disease: Are They Useful for Indication and Monitoring of Antithyroid Drug Treatment?

Partial characterization and clinical correlation of circulating human immunoglobulins directed against thyrotrophin binding sites in guinea pig fat cell membranes. Development of a direct enzyme immunoassay.

Recent Progress in TSH Receptor Studies with a New Concept of "Autoimmune TSH Receptor Disease".

Contact Info

Product

Resources

About

Immunological Parameters in Graves’ Disease: Are They Useful for Indication and Monitoring of Antithyroid Drug Treatment?

Immunological Parameters in Graves’ Disease: Are They Useful for Indication and Monitoring of Antithyroid Drug Treatment?