Similar Clinical Performance of a Novel Chimeric Thyroid-Stimulating Hormone Receptor Bioassay and an Automated Thyroid-Stimulating Hormone Receptor Binding Assay in Graves' Disease

Kamijo, Keita; Murayama, Hiroshi; Uzu, Takahiro; Togashi, Kazuyoshi; Olivo, Paul D.; Kahaly, George J.

doi:10.1089/thy.2011.0056

Cited by 30 publications

(20 citation statements)

References 14 publications

(18 reference statements)

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“…In contrast, it amounted to about 26% (31% minus about 5% assumed cases of yet undiagnosed heart failure) in the peptide-based assay. Thus, the percentage of false-positives obtained with the novel cell-based competition ELISA compares quite well to what is found with even the most advanced assays for anti-TSH antibodies in Graves disease, 23 whereas it seems to be rather too high for the peptide-based assay.…”

Section: Discussionsupporting

confidence: 63%

Detection of Anti–β1-AR Autoantibodies in Heart Failure by a Cell-Based Competition ELISA

Holthoff

Zeibig

Jahns-Boivin

et al. 2012

Circulation Research

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Rationale: Autoantibodies directed against the second extracellular loop of the cardiac ␤1-adrenergic receptor (␤1-AR) are thought to contribute to the pathogenesis of dilated cardiomyopathy (DCM) and Chagas heart disease. Various approaches have been used to detect such autoantibodies; however, the reported prevalence varies largely, depending on the detection method used.Objective: We analyzed sera from 167 DCM patients (ejection fraction <45%) and from 110 age-matched volunteers who did not report any heart disease themselves, with an often used simple peptide-ELISA approach, and compared it with a novel whole cell-based ELISA, using cells expressing the full transgene for the human ␤1-AR. Additionally, 35 patients with hypertensive heart disease with preserved ejection fraction were investigated. Methods and Results:The novel assay was designed according to the currently most reliable anti-TSH receptor antibody-ELISA used to diagnose Graves disease ("third-generation assay") and also detects the target antibodies by competition with a specific monoclonal anti-␤1-AR antibody (␤1-AR MAb) directed against the functionally relevant ␤1-AR epitope. Anti-␤1-AR antibodies were detected in Ϸ60% of DCM patients and in Ϸ8% of healthy volunteers using the same cutoff values. The prevalence of these antibodies was 17% in patients with hypertensive heart disease. Anti-␤1-AR antibody titers (defined as inhibition of ␤1-AR MAb-binding) were no longer detected after depleting sera from IgG antibodies by protein G adsorption. In contrast, a previously used ELISA conducted with a linear 26-meric peptide derived from the second extracellular ␤1-AR loop yielded a high number of false-positive results precluding any specific identification of DCM patients. Conclusions:We established a simple and efficient screening assay detecting disease-relevant ␤1-AR autoantibodies in patient sera yielding a high reproducibility also in high throughput screening. The assay was validated according to "good laboratory practice" and can serve as a companion biodiagnostic assay for the development and evaluation of antibody-directed therapies in antibody-positive heart failure. (Circ Res. 2012;111:675-684.)

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Section: Discussionsupporting

confidence: 63%

Detection of Anti–β1-AR Autoantibodies in Heart Failure by a Cell-Based Competition ELISA

Holthoff

Zeibig

Jahns-Boivin

et al. 2012

Circulation Research

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“…The clinical sensitivity of the TSI method was absolute (100%), slightly higher than those previously reported for current IMAs and BAs with a similar diagnostic specificity [8,9,[28][29][30][31] (Tables 1 and 3).…”

Section: Discussionmentioning

confidence: 47%

“…We did not compare TSI Immulite with BAs, and, consequently, cannot clarify whether positive TSI in our non-GD patients were due to the presence of B-TRAb binding the N-terminal domain of the chimeric receptor or to the presence of S-TRAb. It is worth noting that a new BA is commercially available for S-TRAb [Thyretain™] [30]. Though based on chimeric receptor similar to the one used in Immulite assay, it detects only the stimulating activity (not immunoreactivity) via cAMP measurement, hence not detecting B-TRAb.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the first fully automated immunoassay method for the measurement of stimulating TSH receptor autoantibodies in Graves’ disease

Tozzoli

D’Aurizio

Villalta

et al. 2016

Clinical Chemistry and Laboratory Medicine (CCLM)

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The diagnostic performance of fully automated Immulite TSI assay in GD patients is at least comparable to that of current TRAb immunoassays (IMAs) suggesting the possibility of including such assay in rapid and cost-saving diagnostic and monitoring algorithms. However, our results do not provide full evidence that this assay is specific for S-TRAb only, and future studies comparing Immulite TSI assay to stimulating activity are required.

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“…Many clinicians in Europe, advocate the use of TRAb as a cost-effective primary test in the initial workup of hyperthyroidism, as it is useful in distinguishing GD from subacute painless thyroiditis 7. Our patient had the high M22-TRAb assay done in our hospital laboratory, which has been shown to have similar and excellent performance in diagnosing patients with GD as compared with the Mc4-TSAB assay 8. Functionally, TRAb may be divided into stimulatory antibodies that stimulate the thyroid (TSAb) and inhibitory antibodies that block the action of TSH (TBAb) and neutral antibody.…”

Section: Discussionmentioning

confidence: 97%

Unexpected cause of fever in a patient with untreated HIV

et al. 2018

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We report a case of a 27-year-old man with a history of untreated HIV who presented with fever, rash and leg cramps. Initial suspicion was high for an infectious process; however, after an exhaustive evaluation, thyrotoxicosis was revealed as the aetiology of his symptoms. Recent intravenous contrast administration complicated his workup to determine the exact cause of hyperthyroidism. Differentiation between spontaneously resolving thyroiditis and autonomous hyperfunction was paramount in the setting of existing neutropenia and the need for judicious use of antithyroid therapy. The inability to enlist a nuclear scan in the setting of recent iodinated contrast administration prompted alternative testing, including thyroid antibodies and thyroid ultrasound. In this case, we will discuss the diagnostic challenges of thyrotoxicosis in a complex patient, the sequelae of iodine contrast administration, effects of iodine on the thyroid and the predictive value of other available tests.

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Similar Clinical Performance of a Novel Chimeric Thyroid-Stimulating Hormone Receptor Bioassay and an Automated Thyroid-Stimulating Hormone Receptor Binding Assay in Graves' Disease

Cited by 30 publications

References 14 publications

Detection of Anti–β1-AR Autoantibodies in Heart Failure by a Cell-Based Competition ELISA

Detection of Anti–β1-AR Autoantibodies in Heart Failure by a Cell-Based Competition ELISA

Evaluation of the first fully automated immunoassay method for the measurement of stimulating TSH receptor autoantibodies in Graves’ disease

Unexpected cause of fever in a patient with untreated HIV

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