Clinical validity of intercellular adhesion molecule-1 (ICAM-1) and TSH receptor antibodies in sera from patients with Graves' disease.
We compared the concentrations of soluble intercellular adhesion molecule-1 (sICAM-1) and the activities of thyroid-stimulating antibodies (TSAb) and thyrotropin-receptor antibodies (TBIAb) as measured with a commercial kit (TRAK). Sera were obtained from patients with Graves' disease (GD) before, during and after therapy with carbimazole (1-methyl-2-thio-3-carbethoxyimidazole). In all the situations, TSAb method was more sensitive than TBIAb. These two parameters dropped during therapy and were not correlated at any stage of measurement. sICAM-1 levels increased in 56.4% of patients before treatment, remained elevated at the beginning of treatment and decreased after twelve months of therapy. TSAb levels were significantly different between patients in relapse (78%) and those in remission (18%) (Z = -2.250, P = 0.025), with a relapse rate depending on the TSAb positivity (chi 2 = 7.103, P = 0.0077). Positive sICAM-1 values were found in 3 of the 9 (33.3%) patients who relapsed after discontinuing the drug but were negative in all the patients remaining in remission with a significant difference (Z = -1.982, P = 0.0475). The relapse rate was also dependent on positive sICAM-1 values (chi 2 = 3.958, P = 0.0466). No correlation was found between sICAM-1 levels and anti-TSH receptor antibodies TSAb or TBIAb. We conclude that the TBIAb technique is too insensitive to explore GD. TSAb and sICAM-1 assays in patients with GD are good markers of immune process after treatment withdrawal. Because of its rapid implementation, the sICAM-1 assay may advantageously replace TSAb measurement for forming a prognosis of GD.
Massart
C
C
Laboratoire de Génétique Moléculaire et Hormonologie, CHU de Pontchaillou, Rennes, France.
Sonnet
E
E
Gibassier
J
J
Maugendre
D
D
Genetet
B
B
D000906:Antibodies / Q000097:blood*; D006111:Graves Disease / Q000097:blood* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood / Q000276:immunology*; D011379:Prognosis; D011989:Receptors, Thyrotropin / Q000276:immunology*; D015203:Reproducibility of Results; D013972:Thyrotropin / Q000037:antagonists & inhibitors / Q000378:metabolism
D000906:Antibodies; D007136:Immunoglobulins; D011989:Receptors, Thyrotropin; D018799:Intercellular Adhesion Molecule-1; D013972:Thyrotropin