Interpretation of Sensitive Thyroid Autoantibody Assay
Bo Hyun Kim, MD and In Ju Kim, MD, PhD
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.- Abstract
- Autoimmune thyroid diseases share common immunologic evidences including lymphocytic infiltration of the thyroid, circulating thyroid autoantibodies, and T cell immunity. In clinical practice, measurements of thyroid-directed antibodies can be clinically useful in the evaluation of some patients with chronic autoimmune thyroiditis or Graves' disease. Thyroid peroxidase antibody (TPOAb) is the most sensitive test for detecting autoimmune thyroid disease. The types of methods developed for TSHR Ab measurements are classified relative to their functional activity. TSH binding inhibitory immunoglobulins (TBII) measurement has simplicity, precision, and cost-effectiveness, along with its commercial availability, have made it the most widely used test in clinical laboratories. A recently developed second-generation assay for TBII uses recombinant human TSHR, expressed in eukaryotic cells, this assay showed better diagnostic sensitivity and specificity than the conventional TBII assay. More recently, a human monoclonal antibody to TSHR (M22) with the characteristics of patient thyroid- stimulating autoantibodies are developed. Further evaluations are warranted in application of more sensitive and specific assays for measuring TSHR Ab in routine clinical practice.
- Keywords : Autoantibody, Thyroglobulin, Thyroid peroxidase, Thyrotropin receptor antibody
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