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Correlation between TSH Receptor Antibody Assays and Clinical Manifestations of Graves' Orbitopathy

 Sun Young Jang  ;  Dong Yeob Shin  ;  Eun Jig Lee  ;  Young Joon Choi  ;  Sang Yeul Lee  ;  Jin Sook Yoon 
 YONSEI MEDICAL JOURNAL, Vol.54(4) : 1033-1039, 2013 
Journal Title
Issue Date
Adult ; Animals ; Autoantibodies/blood* ; CHO Cells ; Cricetulus ; Cross-Sectional Studies ; Female ; Graves Ophthalmopathy/blood ; Graves Ophthalmopathy/etiology* ; Graves Ophthalmopathy/immunology* ; Humans ; Immunoassay/methods* ; Male ; Middle Aged ; Receptors, Thyrotropin/blood ; Receptors, Thyrotropin/immunology*
Graves’ orbitopathy ; TSH-receptor autoantibody ; disease activity ; severity
PURPOSE: To investigate an association between the levels of serum thyroid-stimulating hormone (TSH)-receptor autoantibodies (TRAbs) and Graves' orbitopathy (GO) activity/severity scores, and compare the performance of three different TRAb assays in assessing the clinical manifestations of GO. MATERIALS AND METHODS: Cross-sectional study. Medical records of 155 patients diagnosed with GO between January 2008 and December 2010 were reviewed. GO activity was assessed by clinical activity score (CAS) and severity graded with the modified NOSPECS score by a single observer. Serum TRAb was measured by three different methods: 1st generation thyrotropin-binding inhibitor immunoglobulin (TBII) assay (TRAb1st); 3rd generation TBII assay (TRAb3rd); and biological quantitative assay of thyroid-stimulating immunoglobulin (TSI) using Mc4-CHO cells (Mc4-CHO TSI assay). Results were correlated with scores of activity/severity of thyroid eye disease. RESULTS: All three assays (TRAb1st, TRAb3rd, and Mc4-CHO TSI) yielded results that were significantly positively correlated with CAS (β=0.21, 0.21, and 0.46, respectively; p<0.05) and proptosis (β=0.38, 0.34, and 0.33, respectively; p<0.05). Mc4-CHO TSI bioassay results were significantly positively correlated with all GO severity indices (soft tissue involvement, proptosis, extraocular muscle involvement, and total eye score; β=0.31, 0.33, 0.25, and 0.39, respectively; p<0.05). CONCLUSION: Mc4-CHO TSI bioassay was superior over the two TBIIs in assessing active inflammation and muscle restriction due to GO, whereas TBII assay would be sufficient for evaluation of patients with proptosis.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Shin, Dong Yeob(신동엽) ORCID logo https://orcid.org/0000-0003-1048-7978
Yoon, Jin Sook(윤진숙) ORCID logo https://orcid.org/0000-0002-8751-9467
Lee, Sang Yeul(이상열)
Lee, Eun Jig(이은직) ORCID logo https://orcid.org/0000-0002-9876-8370
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