Download PDF
Exp Clin Endocrinol Diabetes 2008; 116: S59-S63
DOI: 10.1055/s-2008-1081491
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Comparison of a Solid Phase Human- versus Porcine- Thyrotropin Receptor-based Immunoassay for the Measurement of Thyrotropin Receptor Antibodies in Patients with Thyroid Diseases

D. Hermsen 1 [*] , C. Liu 2 , 3 [*] , J. Domberg 3 , C. Graeber 3 , J. Feldkamp 4 , Y. Duan 1 , K. Xu 2 , C. Liu 2 , X. Mao 2 , W. A. Scherbaum 3 , M. Schott 3
  • 1Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Duesseldorf, Duesseldorf, Germany
  • 2Department of Endocrinology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
  • 3Department of Endocrinology, Diabetes and Rheumatology, University Hospital Duesseldorf, Duesseldorf, Germany
  • 4Department of Internal Medicine, Municipal Hospital Bielefeld, Germany
Further Information

Publication History

received 13.03.2008

accepted 11.04.2008

Publication Date:
05 September 2008 (online)

Also available at
    Permissions and Reprints

Abstract

Thyrotropin receptor (TSHR) antibody (TRAb) assays based on human or porcine TSHR which are coated to a solid phase are the most commonly used detection methods in clinical practice for patients with thyroid diseases. Yet the difference of the diagnostic values of the two TRAb assays is largely unclear. The aim of our present study was to evaluate the clinical perfomance of a solid phase porcine TRAb assay based on an ELISA technique (TRAb-porcine) and a human TRAb assay based on a chemiluminescence signal detection procedure (TRAb-human). Of 158 patients enrolled in the study, 84 suffered from Graves’ disease (GD), 34 had Hashimoto's thyroiditis (HT) and 40 had euthyroid nodular thyroid disease (NTD) without signs of autoimmunity. TRAb measurements were performed according to the manufacturer's instructions. The mean values of TRAb titers detected by the TRAb-human and TRAb-porcine assays in patients with GD were 12.14±10.80 IU/L and 15.27±13.65 IU/L, respectively. TRAb were detected in 80 and 78 out of 84 GD patients by the TRAb-human and TRAb-porcine assay, respectively. The diagnostic sensitivity of the TRAb-human and TRAb-porcine immunoassay was 95.2 and 92.9% respectively, by 100% specificity of both methods. TRAb values in GD patients detected by the TRAb-human and TRAb-porcine assays were significantly correlated (r=0.929, p<0.0001). Our results indicate that the second generation TRAb-porcine assay based on solid phase technology had a slightly lower diagnostic sensitivity compared to the TRAb-human assay.

Key words

thyrotropin receptor antibody - second generation TRAb assay - Graves’ disease - ELISA

References

  • 1 Weetman AP. Cellular immune responses in autoimmune thyroid disease.  Clin Endocrinol. 2004;  61 405-413
    Search in Google Scholar
  • 2 Guarneri F, Benvenga S. Environmental factors and genetic background that interact to cause autoimmune thyroid disease.  Cur Opin Endocrinol Diab Obes. 2007;  14 398-409
    PubMedSearch in Google Scholar
  • 3 Rapoport B, MacLachlan SM. The thyrotropin receptor in Graves’ disease.  Thyroid. 2007;  17 911-922
    CrossrefPubMedSearch in Google Scholar
  • 4 Rees Smith B, Sanders J, Furmaniak J. TSH receptor antibodies.  Thyroid. 2007;  17 928-938
    PubMedSearch in Google Scholar
  • 5 Schott M, Scherbaum WA, Morgenthaler NG. Thyrotropin receptor autoantibodies in Graves’ disease.  Trends Endocrinol Metab. 2005;  16 243-248
    CrossrefPubMedSearch in Google Scholar
  • 6 Pedersen IB, Knudsen N, Perrild H, Ovesen L, Laurberg P. TSH-receptor antibody measurement for differentiation of hyperthyroidism into Graves’ disease and multinodular toxic goitre: a comparison of two competitive binding assays.  Clin Endocrinol (Oxf). 2001;  55 ((3)) 381-390
    CrossrefPubMedSearch in Google Scholar
  • 7 Paunkovic N, Paunkovic J. The diagnostic criteria of Graves’ disease and especially the thyrotropin receptor antibody: our own experience.  Hell J Nucl Med. 2007;  10 89-94
    PubMedSearch in Google Scholar
  • 8 Izumi Y, Takeoka K, Amino N. Usefulness of the 2nd generation assay for anti-TSH receptor antibodies to differentiated relapse of Graves’ thyrotoxicosis from development of painless thyroiditis after antithyroid drug treatment for Graves’ disease.  Endocr J. 2005;  52 493-497
    CrossrefPubMedSearch in Google Scholar
  • 9 Eckstein AK, Plicht M, Lax H, Mann K, Lederbogen S, Heckmann C, Esser J, Morgenthaler NG. Thyrotropin receptor autoantibodies are independent risk factors for Graves’ ophthalmopathy and help to predict severity and outcome of the disease.  J Clin Endocrinol Metab. 2006;  91 3464-3470
    Search in Google Scholar
  • 10 Abraham P, Avenell A, Park CM, Watson WA, Bevan JS. A systematic review of drug therapy for Graves’ hyperthyroidism.  Eur J Endocrinol. 2005;  153 489-498
    Search in Google Scholar
  • 11 Schott M, Feldkamp J, Bathan C, Fritzen R, Scherbaum WA, Seissler J. Detecting TSH-receptor antibodies with the recombinant TBII assay: technical and clinical evaluation.  Horm Metab Res. 2000;  32 ((10)) 429-435
    Thieme ConnectPubMedSearch in Google Scholar
  • 12 Carella C, Mazziotti G, Sorvillo F, Piscopo M, Cioffi M, Pilla P, Nersita R, Iorio S, Amato G, Braverman LE, Roti E. Serum thyrotropin receptor antibodies concentrations in patients with Graves’ disease before, at the end of methimazole treatment, and after drug withdrawal: evidence that the activity of thyrotropin receptor antibody and/or thyroid response modify during the observation period.  Thyroid. 2006;  16 295-302
    CrossrefPubMedSearch in Google Scholar
  • 13 Schott M, Morgenthaler NG, Fritzen R, Feldkamp J, Willenberg HS, Scherbaum WA, Seiissler J. Levels of autoantibodies against human TSH receptor predict relapse of hyperthyroidism in Graves’ disease.  Horm Metab Res. 2004;  36 92-96
    Thieme ConnectPubMedSearch in Google Scholar
  • 14 Hoermann R, Quadbeck B, Roggenbuck U, Szabolcs I, Pfeilschifter J, Meng W, Reschke K, Hackenberg K, Dettmann J, Prehn B, Hirche H, Mann K. Relapse of Graves’ disease after successful outcome of antithyroid drug therapy: Results of a prospective randomized study on the use of levothyroxine.  Thyroid. 2002;  12 1119-1128
    CrossrefPubMedSearch in Google Scholar
  • 15 Cappelli C, Gandossi E, Castellano M, Pizzocaro C, Agosti B, Delbarba A, Pirola I, Martino ED, Rosei EA. Prognostic value of thyrotropin receptor antibodies (TRAb) in Graves’ disease: a 120 months prospective study.  Endocr J. 2007;  54 ((5)) 713-720
    CrossrefPubMedSearch in Google Scholar
  • 16 Schott M, Eckstein A, Willenberg HS, Nguyen T-B-T, Morgenthaler NG, Scherbaum WA. Improved prediction of relapse of Graves’ thyrotoxicosis by combined determination of TSH receptor and thyroperoxidase antibodies.  Horm Metab Res. 2007;  39 56-61
    Thieme ConnectPubMedSearch in Google Scholar
  • 17 Morgenthaler NG. New assay systems for thyroid receptor antibodies.  Current Opin Endocrinol Diabetes. 1999;  6 251-260
    CrossrefPubMedSearch in Google Scholar
  • 18 Zoephel K, Wunderlich G. Predictive value of TSH receprot antibody measurement in Graves’ disease is independent on the TSH receptor (human or porcine) but depends on the generation of the assay used.  Endocr J. 2006;  53 869-870
    CrossrefPubMedSearch in Google Scholar
  • 19 Okamoto Y, Tanigawa SI, Ishikawa K, Hamada N. Ths receptor antibody measurements and prediction of remission in Graves’ disease patients treated with minimum maintenance doses of antithyroid drugs.  Endocr J. 2006;  53 467-472
    CrossrefPubMedSearch in Google Scholar
  • 20 Cardia MS, Lima N, Knobel M, Medeiros-Neto G. Evaluvation of a coated-tube assay for antithyrotropin receptor antibodies in patients with Graves’ disease and other thyroid disorders.  Thyroid. 2004;  14 295-300
    CrossrefPubMedSearch in Google Scholar
  • 21 Feldt-Rasmussen U, Schleusner H, Carayon P. Meta-analysis evaluation of the impact of thyrotropin receptor antibodies on long-term remission after medical therapy of Graves’ disease.  J Clin Endocrinol Metab. 1994;  78 98-102
    CrossrefPubMedSearch in Google Scholar
  • 22 Costagliola S, Morgenthaler NG, Hoermann R, Badenhoop K, Struck J, Freitag D, Poertl S, Weglohner W, Hollidt JM, Quadbeck B, Dumont JE, Schumm-Draeger P-M, Bergmann A, Mann K, Vassart G, Usadel K-H. Second generation assay for thyrotropin receptor antibodies has superior diagnostic sensitivity for Graves’ disease.  J Clin Endocrinol Metab. 1999;  84 90-97
    CrossrefPubMedSearch in Google Scholar
  • 23 Kamijo K. TSH-receptor antibody measurement in patients with various thyrotoxicosis and Hashimoto's thyroiditis: a comparison of two two-step assays, coated plate ELISA using porcine TSH-receptor and coated tube radioassay using human recombinant TSH-receptor.  Endocr J. 2003;  50 ((1)) 113-116
    CrossrefPubMedSearch in Google Scholar
  • 24 Rees Smith B, Bolton J, Young S, Collyer A, Weeden A, Bradburg J, Weightman D, Perros P, Sanders J, Furmaniak J. A new assay for thyrotropin receptor autoantibodies.  Thyroid. 2004;  14 830-835
    Search in Google Scholar
  • 25 Abalovich M, Amino N, Barbour LA, Cobin RH, Groot LJ, Glinoer D, Mandel SJ, Stagnaro-Green Al. Management of thyroid dysfunction during pregnancy and postpartum: an endocrine society clinical practice guideline.  J Clin Endocrinol Metab. 2007;  92 S1-S47
    CrossrefPubMedSearch in Google Scholar
  • 26 Luton D, Le Gac I, Vuillard E, Castanet M, Guibourdenche J, Noel M, Toubert ME, Léger J, Boissinot C, Schlageter MH, Garel C, Tébeka B, Oury JF, Czernichow P, Polak M. Management of Graves’ disease during pregnancy: the key role of fetal thyroid gland monitoring.  J Clin Endocrinol Metab. 2005;  90 ((11)) 6093-6098
    CrossrefPubMedSearch in Google Scholar
  • 27 Chan GW, Mandel SJ. Therapy insight: management of Graves’ disease during pregnancy.  Nat Clin Pract Endocrinol Metab. 2007;  3 ((6)) 470-478
    CrossrefPubMedSearch in Google Scholar
  • 28 Quadbeck B, Hoermann R, Roggenbuck U, Hahn S, Mann K, Janssen OE. Sensitive thyrotropin and thyrotropin-receptor antibody determinations one month after discontinuation of antithyroid drug treatment as predictors of relapse in Graves’ disease.  Thyroid. 2005;  15 ((9)) 1047-1054
    CrossrefPubMedSearch in Google Scholar

1 Both authors contributed equally

Correspondence

M. SchottMD 

Department of Endocrinology

Diabetes and Rheumatology

University Hospital Duesseldorf

Moorenstr.5

40225 Duesseldorf

Germany

Phone: 49/211/811 78 10

Fax: 49/211/811 78 60

Email: matthias.schott@med.uni-duesseldorf.de