Non-Conventional Clinical Uses of TSH Receptor Antibodies: The Case of Chronic Autoimmune Thyroiditis
Anti TSH receptor antibodies (TSHrAb) are a family of antibodies with different activity, some of them stimulating thyroid function (TSAb), others with blocking properties (TBAb), it is a common finding that antibodies with different function might coexist in the same patient and can modulate the fu...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2021.769084/full |
| _version_ | 1818999190421766144 |
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| author | Giorgio Napolitano Giorgio Napolitano Ines Bucci Ines Bucci Giulia Di Dalmazi Giulia Di Dalmazi Cesidio Giuliani Cesidio Giuliani |
| author_facet | Giorgio Napolitano Giorgio Napolitano Ines Bucci Ines Bucci Giulia Di Dalmazi Giulia Di Dalmazi Cesidio Giuliani Cesidio Giuliani |
| author_sort | Giorgio Napolitano |
| collection | DOAJ |
| description | Anti TSH receptor antibodies (TSHrAb) are a family of antibodies with different activity, some of them stimulating thyroid function (TSAb), others with blocking properties (TBAb), it is a common finding that antibodies with different function might coexist in the same patient and can modulate the function of the thyroid. However, most of the labs routinely detect all antibodies binding to the TSH receptor (TRAb, i.e. TSH-receptor antibodies detected by binding assay without definition of functional property). Classical use of TSHr-Ab assay is in Graves’ disease where they are tested for diagnostic and prognostic issues; however, they can be used in specific settings of chronic autoimmune thyroiditis (CAT) as well. Aim of the present paper is to highlight these conditions where detection of TSHr-Ab can be of clinical relevance. Prevalence of TSHrAb is different in in the 2 main form of CAT, i.e. classical Hashimoto’s thyroiditis and in atrophic thyroiditis, where TBAb play a major role. Simultaneous presence of both TSAb and TBAb in the serum of the same patient might have clinical implication and cause the shift from hyperthyroidism to hypothyroidism and vice versa. Evaluation of TRAb is recommended in case of patients with Thyroid Associated Orbitopathy not associated with hyperthyroidism. At present, however, the most relevant recommendation for the use of TRAb assay is in patients with CAT secondary to a known agent; in particular, after treatment with alemtuzumab for multiple sclerosis. In conclusion, the routine use of anti-TSH receptor antibodies (either TRAb or TSAb/TBAb) assay cannot be suggested at the present for diagnosis/follow up of patients affected by CAT; there are, however, several conditions where their detection can be clinically relevant. |
| first_indexed | 2024-12-20T22:13:29Z |
| format | Article |
| id | doaj.art-9f094abb784648ea91ff0d1aad92746d |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-20T22:13:29Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-9f094abb784648ea91ff0d1aad92746d2022-12-21T19:25:06ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922021-11-011210.3389/fendo.2021.769084769084Non-Conventional Clinical Uses of TSH Receptor Antibodies: The Case of Chronic Autoimmune ThyroiditisGiorgio Napolitano0Giorgio Napolitano1Ines Bucci2Ines Bucci3Giulia Di Dalmazi4Giulia Di Dalmazi5Cesidio Giuliani6Cesidio Giuliani7Department of Medicine and Sciences of Aging, Unit of Endocrinology, University “G. d’Annunzio” of Chieti-Pescara, Chieti, ItalyCenter for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti‐Pescara, Chieti, ItalyDepartment of Medicine and Sciences of Aging, Unit of Endocrinology, University “G. d’Annunzio” of Chieti-Pescara, Chieti, ItalyCenter for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti‐Pescara, Chieti, ItalyDepartment of Medicine and Sciences of Aging, Unit of Endocrinology, University “G. d’Annunzio” of Chieti-Pescara, Chieti, ItalyCenter for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti‐Pescara, Chieti, ItalyDepartment of Medicine and Sciences of Aging, Unit of Endocrinology, University “G. d’Annunzio” of Chieti-Pescara, Chieti, ItalyCenter for Advanced Studies and Technology (CAST), University “G. d’Annunzio” of Chieti‐Pescara, Chieti, ItalyAnti TSH receptor antibodies (TSHrAb) are a family of antibodies with different activity, some of them stimulating thyroid function (TSAb), others with blocking properties (TBAb), it is a common finding that antibodies with different function might coexist in the same patient and can modulate the function of the thyroid. However, most of the labs routinely detect all antibodies binding to the TSH receptor (TRAb, i.e. TSH-receptor antibodies detected by binding assay without definition of functional property). Classical use of TSHr-Ab assay is in Graves’ disease where they are tested for diagnostic and prognostic issues; however, they can be used in specific settings of chronic autoimmune thyroiditis (CAT) as well. Aim of the present paper is to highlight these conditions where detection of TSHr-Ab can be of clinical relevance. Prevalence of TSHrAb is different in in the 2 main form of CAT, i.e. classical Hashimoto’s thyroiditis and in atrophic thyroiditis, where TBAb play a major role. Simultaneous presence of both TSAb and TBAb in the serum of the same patient might have clinical implication and cause the shift from hyperthyroidism to hypothyroidism and vice versa. Evaluation of TRAb is recommended in case of patients with Thyroid Associated Orbitopathy not associated with hyperthyroidism. At present, however, the most relevant recommendation for the use of TRAb assay is in patients with CAT secondary to a known agent; in particular, after treatment with alemtuzumab for multiple sclerosis. In conclusion, the routine use of anti-TSH receptor antibodies (either TRAb or TSAb/TBAb) assay cannot be suggested at the present for diagnosis/follow up of patients affected by CAT; there are, however, several conditions where their detection can be clinically relevant.https://www.frontiersin.org/articles/10.3389/fendo.2021.769084/fullchronic autoimmune thyroiditisTSH-receptor blocking antibodiesTSH-receptor stimulating antibodiesHashimoto’s thyroiditis (HT)atrophic thyroiditis |
| spellingShingle | Giorgio Napolitano Giorgio Napolitano Ines Bucci Ines Bucci Giulia Di Dalmazi Giulia Di Dalmazi Cesidio Giuliani Cesidio Giuliani Non-Conventional Clinical Uses of TSH Receptor Antibodies: The Case of Chronic Autoimmune Thyroiditis Frontiers in Endocrinology chronic autoimmune thyroiditis TSH-receptor blocking antibodies TSH-receptor stimulating antibodies Hashimoto’s thyroiditis (HT) atrophic thyroiditis |
| title | Non-Conventional Clinical Uses of TSH Receptor Antibodies: The Case of Chronic Autoimmune Thyroiditis |
| title_full | Non-Conventional Clinical Uses of TSH Receptor Antibodies: The Case of Chronic Autoimmune Thyroiditis |
| title_fullStr | Non-Conventional Clinical Uses of TSH Receptor Antibodies: The Case of Chronic Autoimmune Thyroiditis |
| title_full_unstemmed | Non-Conventional Clinical Uses of TSH Receptor Antibodies: The Case of Chronic Autoimmune Thyroiditis |
| title_short | Non-Conventional Clinical Uses of TSH Receptor Antibodies: The Case of Chronic Autoimmune Thyroiditis |
| title_sort | non conventional clinical uses of tsh receptor antibodies the case of chronic autoimmune thyroiditis |
| topic | chronic autoimmune thyroiditis TSH-receptor blocking antibodies TSH-receptor stimulating antibodies Hashimoto’s thyroiditis (HT) atrophic thyroiditis |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2021.769084/full |
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