TY - JOUR
T1 - Endocrine ophthalmopathy
T2 - A re-evaluation of the association with thyroid autoantibodies
AU - Mclachlan, Sandra M.
AU - Bahn, Rebecca
AU - Rapoport, Basil
N1 - Funding Information:
We thank Shirley Middleton and Marian Atherton for their invaluable technical assistance. We also wish to thank Dr Bernard Rees Smith, Endocrine Immunology Unit. Department of Medicine, University of Wales College of Medicine, Wales, UK, for generously providing us with human thyroglobulin and thyroid microsomes and for assaying sera for TSH-receptor antibodies. Supported by NIH grant EY-09498 (B.R.). the Newcastle Health Authority (S.M.M.) and NIH EY-08810-01 (R.B.).
PY - 1992
Y1 - 1992
N2 - Autoantibodies to the three major thyroid autoantigens, the TSH-receptor (TSH-R), thyroid peroxidase (TPO) and thyroglobulin (TG), have been investigated in 63 Graves' patients with severe endocrine ophthalmopa-thy. In agreement with other studies. TSH-R antibodies were detectable in 88% of patients and dominated the autoantibody spectrum. TPO antibodies were detectable in 60% of patients and TG antibodies in only 25% of patients. The prevalences. as well as the amounts, of all three thyroid autoantibodies were not significantly different from the values in 51 Graves' patients without clinically significant ophthalmopathy. However, in the subgroup of patients with TG antibodies, the ophthalmopathy patients displayed a shift towards IgG4 TG antibodies. Furthermore, in the same TG antibody positive subgroup, the amount of TSH-R antibody was significantly higher in the ophthalmopathy patients than in Graves' patients without ophthalmopathy. These qualitative differences in thyroid autoantibodies in patients with and without ophthalmopathy raise the possibility that further qualitative differences, such as thyroid autoantibody epitopes. may exist in patients with ophthalmopathy. Our observations. combined with recent evidence for the presence of TSH-R specific mRNA in retro-orbital tissue, suggest that it may be premature to dismiss the potential pathogenetic or diagnostic value of thyroid autoantibodies, particularly TSH-R antibodies. in Graves' ophthalmopathy.
AB - Autoantibodies to the three major thyroid autoantigens, the TSH-receptor (TSH-R), thyroid peroxidase (TPO) and thyroglobulin (TG), have been investigated in 63 Graves' patients with severe endocrine ophthalmopa-thy. In agreement with other studies. TSH-R antibodies were detectable in 88% of patients and dominated the autoantibody spectrum. TPO antibodies were detectable in 60% of patients and TG antibodies in only 25% of patients. The prevalences. as well as the amounts, of all three thyroid autoantibodies were not significantly different from the values in 51 Graves' patients without clinically significant ophthalmopathy. However, in the subgroup of patients with TG antibodies, the ophthalmopathy patients displayed a shift towards IgG4 TG antibodies. Furthermore, in the same TG antibody positive subgroup, the amount of TSH-R antibody was significantly higher in the ophthalmopathy patients than in Graves' patients without ophthalmopathy. These qualitative differences in thyroid autoantibodies in patients with and without ophthalmopathy raise the possibility that further qualitative differences, such as thyroid autoantibody epitopes. may exist in patients with ophthalmopathy. Our observations. combined with recent evidence for the presence of TSH-R specific mRNA in retro-orbital tissue, suggest that it may be premature to dismiss the potential pathogenetic or diagnostic value of thyroid autoantibodies, particularly TSH-R antibodies. in Graves' ophthalmopathy.
KW - Graves' ophthalmopathy
KW - IgG subclass distribution
KW - TG antibody
KW - TPO antibody
KW - TSH-R antibody
KW - Thyroid autoantibodies
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U2 - 10.3109/08916939209083133
DO - 10.3109/08916939209083133
M3 - Article
C2 - 1363894
AN - SCOPUS:0027481658
SN - 0891-6934
VL - 14
SP - 143
EP - 148
JO - Autoimmunity
JF - Autoimmunity
IS - 2
ER -