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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Autores principales:	Giorgio Napolitano, Ines Bucci, Giulia Di Dalmazi, Cesidio Giuliani
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	chronic autoimmune thyroiditis TSH-receptor blocking antibodies TSH-receptor stimulating antibodies Hashimoto’s thyroiditis (HT) atrophic thyroiditis Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/9f094abb784648ea91ff0d1aad92746d
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spelling	oai:doaj.org-article:9f094abb784648ea91ff0d1aad92746d2021-11-05T12:32:59ZNon-Conventional Clinical Uses of TSH Receptor Antibodies: The Case of Chronic Autoimmune Thyroiditis1664-239210.3389/fendo.2021.769084https://doaj.org/article/9f094abb784648ea91ff0d1aad92746d2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fendo.2021.769084/fullhttps://doaj.org/toc/1664-2392Anti 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.Giorgio NapolitanoGiorgio NapolitanoInes BucciInes BucciGiulia Di DalmaziGiulia Di DalmaziCesidio GiulianiCesidio GiulianiFrontiers Media S.A.articlechronic autoimmune thyroiditisTSH-receptor blocking antibodiesTSH-receptor stimulating antibodiesHashimoto’s thyroiditis (HT)atrophic thyroiditisDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENFrontiers in Endocrinology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	chronic autoimmune thyroiditis TSH-receptor blocking antibodies TSH-receptor stimulating antibodies Hashimoto’s thyroiditis (HT) atrophic thyroiditis Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	chronic autoimmune thyroiditis TSH-receptor blocking antibodies TSH-receptor stimulating antibodies Hashimoto’s thyroiditis (HT) atrophic thyroiditis Diseases of the endocrine glands. Clinical endocrinology RC648-665 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
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.
format	article
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
title	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_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_sort	non-conventional clinical uses of tsh receptor antibodies: the case of chronic autoimmune thyroiditis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/9f094abb784648ea91ff0d1aad92746d
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Non-Conventional Clinical Uses of TSH Receptor Antibodies: The Case of Chronic Autoimmune Thyroiditis

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