Antithyrotropin receptor antibody: an update.
Numerous studies have reported the characteristics and significance concerning antithyrotropin receptor antibodies (TSHR-Abs), which cause Graves' disease and in some cases primary hypothyroidism. However, many unsolved questions concerning those antibodies remain. Here, recent developments in the study of TSHR-Abs are reviewed based on three aspects: mechanisms of TSHR-Ab production, antibody binding epitopes, and clinical TSHR-Ab assays. Mechanisms of TSHR-Ab production are discussed from five points of view: aberrant expression of the major histocompatibility complex, dysregulation of T cells, molecular mimicry, bystander effect, and expansion of autoreactive B cells. Regarding epitopes, unique TSHR-Abs have been reported that may explain the complicated pathophysiology of patients with TSHR-Ab diseases. Finally, recent efforts to improve TSHR-Ab measurements are introduced. Such efforts will contribute to clinical examinations and treatments for thyroid diseases as well as experimental methods of thyroidology.
Department of Medicine & Clinical Science, Kyoto University Graduate School of Medicine, Japan. akataka@kuhp.kyoto-u.ac.jp
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D000818:Animals; D001323:Autoantibodies / Q000096:biosynthesis; D001402:B-Lymphocytes / Q000276:immunology; D000939:Epitopes / Q000276:immunology; D015870:Gene Expression; D006111:Graves Disease / Q000276:immunology; D006801:Humans; D007037:Hypothyroidism / Q000276:immunology; D018828:Immunoglobulins, Thyroid-Stimulating; D008285:Major Histocompatibility Complex / Q000235:genetics; D018716:Molecular Mimicry; D011989:Receptors, Thyrotropin / Q000096:biosynthesis; D013601:T-Lymphocytes / Q000276:immunology
D001323:Autoantibodies; D000939:Epitopes; D018828:Immunoglobulins, Thyroid-Stimulating; D011989:Receptors, Thyrotropin; C094372:thyrotropin-binding inhibitory immunoglobulin