据报道,慢性甲状腺炎(CT)患者中TSH受体(TSHR)自身抗体(TRAb)的患病率为0%至48%。目的是研究CT和甲状腺功能减退症患者TRAb的患病率及其与性别的相关性。年龄,甲状腺尺寸,TSH水平,和自身免疫性疾病。
该研究包括245例CT和甲状腺功能减退症患者(中位年龄42岁,193名女性,52名男性)和123名性别和年龄相匹配的意大利健康受试者作为对照。用ELISA测试TRAb,使用>2.5IU/L的阳性截止值。使用表达野生型或R255D突变的TSHR的中国仓鼠卵巢(CHO)细胞的生物测定法在12名TRAb阳性患者中测量了TSHR阻断(TBAb)和TSHR刺激自身抗体(TSAb)。
在32/245(13.1%)患者中发现TRAb阳性,并且与TSH水平显着相关(p<0.05)。TRAb阳性在男性明显高于男性。女性(p=0.034),在女性16-45岁与>45岁(p<0.05),在患者中减少vs.正常/增加的甲状腺尺寸(p<0.05)。线性回归分析显示TRAb浓度与年龄(p<0.05)和TRAb浓度与TSH(p<0.01)之间存在相关性。在使用TSHR-R255D的生物测定中,所有12名接受测试的患者均为TBAb阳性,而33%的患者也为TSAb阳性,表明在某些患者中存在具有不同生物学活性的TRAb混合物。
在CT和甲状腺功能减退症患者中发现TRAb。在一些患者中发现了TBAb和TSAb的混合物,这可能有助于疾病过程中甲状腺功能障碍的发病机理。
The reported prevalence of TSH-receptor (TSHR) autoantibodies (TRAb) in patients with chronic thyroiditis (CT) range from 0 to 48%. The objective was to study the prevalence of TRAb in patients with CT and hypothyroidism and to correlate it with gender, age, thyroid dimensions, TSH levels, and autoimmune diseases.
The study comprised 245 patients with CT and hypothyroidism (median age 42 years, 193 females, 52 males) and 123 Italian healthy subjects matched for sex and age as controls. TRAb were tested with ELISA using a >2.5 IU/L cut off for positivity. TSHR blocking (TBAb) and TSHR stimulating autoantibodies (TSAb) were measured in 12 TRAb-positive patients using bioassays with Chinese hamster ovary (CHO) cells expressing wild-type or R255D-mutated TSHR.
TRAb positivity was found in 32/245 (13.1%) patients and significantly correlated (p<0.05) with TSH levels. TRAb positivity was significantly higher in males vs. females (p=0.034), in females 16-45 years of age vs. >45 years of age (p<0.05) and in patients with reduced vs. normal/increased thyroid dimensions (p<0.05). Linear regression analysis showed a correlation between TRAb concentrations with age (p<0.05) and TRAb concentrations with TSH (p<0.01). In bioassay with TSHR-R255D all 12 patients tested were TBAb-positive while 33% were also TSAb-positive suggesting the presence of a mixture of TRAbs with different biological activities in some patients.
TRAb have been found in patients with CT and hypothyroidism. A mixture of TBAb and TSAb was found in some patients and this may contribute to the pathogenesis of thyroid dysfunction during the course of the disease.