Anti-thyroid autoantibodies
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Anti-thyroid autoantibodies
Anti-thyroid autoantibodies (or simply anti-thyroid antibodies) are autoantibodies targeted against one or more components of the thyroid. The main types of anti-thyroid autoantibodies are anti-thyroid peroxidase antibodies (also called anti-TPO antibodies) and stimulating autoantibodies that are associated with Grave's disease.
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Subtypes
Anti-TPO antibodies
Anti-thyroid peroxidase antibodies (anti-TPO antibodies) are most commonly associated with Hashimoto's thyroiditis. Thus, an antibody titer can be used to assess disease activity in patients that have developed such antibodies.[1][2]
TSH receptor antibodies
TSH receptor antibodies come in two forms: an activating antibody (associated with hyperthyroidism) and a blocking antibody (associated with thyroiditis).
TSH receptor activating antibodies (TSHRAb) are characteristic of Graves Disease (autoimmune hyperthyroidism). Thyroid peroxidase (TPO) antibody is measured more easily than the TSH receptor antibody, and so is often used as a surrogate in the diagnosis of Graves disease. TSH receptor antibodies, however, may be useful in the diagnosis of Graves Ophthalmopathy.
TSH receptor blocking antibodies (also known as Thyrotropin Binding Inhibitory Immunoglobulins (TBII)) may be found in thyroiditis. These competitively inhibit the binding of TSH to its receptor. TBII can be measured using a radio receptor assay
Thyroglobulin antibodies
Thyroglobulin antibodies are sometimes used in the diagnosis of hyperthyroidism or for monitoring thyroid cancer.
Effect on human reproduction
The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility (odds ratio 1.5 and 95% confidence interval 1.1–2.0), miscarriage (odds ratio 3.73, 95% confidence interval 1.8–7.6), recurrent miscarriage (odds ratio 2.3, 95% confidence interval 1.5–3.5), preterm birth (odds ratio 1.9, 95% confidence interval 1.1–3.5) and maternal Postpartum thyroiditis (odds ratio 11.5, 95% confidence interval 5.6–24).[3]
References
- ^ McLachlan SM, Rapoport B (2000). "Autoimmune response to the thyroid in humans: thyroid peroxidase--the common autoantigenic denominator". Int. Rev. Immunol. 19 (6): 587–618. doi:10.3109/08830180009088514. PMID 11129117.
- ^ Chardès T, Chapal N, Bresson D, Bès C, Giudicelli V, Lefranc MP, Péraldi-Roux S (June 2002). "The human anti-thyroid peroxidase autoantibody repertoire in Graves' and Hashimoto's autoimmune thyroid diseases". Immunogenetics 54 (3): 141–57. doi:10.1007/s00251-002-0453-9. PMID 12073143.
- ^ Van Den Boogaard, E.; Vissenberg, R.; Land, J. A.; Van Wely, M.; Van Der Post, J. A. M.; Goddijn, M.; Bisschop, P. H. (2011). "Significance of (sub)clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy: A systematic review". Human Reproduction Update 17 (5): 605–619. doi:10.1093/humupd/dmr024. PMID 21622978.
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