Antibodies Against Thyroid Hormones - Hormone Restoration



Antibodies Against Thyroid Hormones

Mizuno E, Sugenoya A, Haniuda M, Sakai R, Kameko M, Kato M, Iida F. [Triiodothyronine(T3) autoantibodies in a woman with nonthyroidal disorder: a study on preparation of serum IgG fraction employing protein A column chromatography] Nihon Naibunpi Gakkai Zasshi. 1988 Aug 20;64(8):677-86. [Article in Japanese]

A 48-year-old non-goitrous woman, who had undergone cardiac surgery for mitral stenosis under the extracorporeal circulation, showed high levels of serum T3 and free T3 in a recent follow-up study, employing antibody coated-bead RIA for T3 and -Amerlex M particle RIA for free T3. However, other thyroid function tests (T4, free T4, TSH and TBG) were normal. We suspected that thyroid hormone autoantibodies (THAA) in her serum interfered with T3 and free T3 analyses. The presence of THAA was demonstrated by the use of various procedures as follows. Firstly, the patient's serum was directly incubated with 125I-T3 or -T4 analog which did not bind to TBG, followed by B/F separation with polyethyleneglycol, counting the precipitates. Secondly, after the serum was treated with an acid-charcoal solution to remove circulating thyroid hormone, the measurement of THAA was made as stated above. Normal sera were used as controls. Both the non- and acid-charcoal-treated sera showed much higher percentages of 125I-T3 analog precipitation as compared with controls. In the case of 125I-T4 analog, there was no difference between them. In the third study, the presence of IgG antibodies that bound T3 but not T4 was investigated. The IgG fraction of the patient's serum was separated employing a Protein A-Sepharose CL-4B column chromatography. Then, the prepared IgG fraction was purified by a technique of gel filtration chromatography (Sephacryl S 200). Non-purified and purified-IgG fractions both revealed higher binding percentages of 125I-T3 analog than the control IgG fraction and non-IgG fraction of the patient. Furthermore, a good dose response was observed between the binding percentage of 125I-T3 analog and each dose of the patient's serum or IgG fraction. From these observations, it was clarified that this woman had anti-T3 IgG autoantibodies using a Protein A column chromatography with confirmation of gel filtration chromatography. PMID: 3224724

Gogas J, Kouskos E, Tseleni-Balafouta S, Markopoulos C, Revenas K, Gogas G, Kostakis A. Autoimmune thyroid disease in women with breast carcinoma. Eur J Surg Oncol. 2001 Nov;27(7):626-30.

AIMS: Estimation of prevalence of autoimmune thyroid disorders in Greek breast cancer patients (prospective study). METHODS: The prevalence of autoimmune thyroiditis was estimated in 310 Greek breast cancer patients, in 100 women with benign breast disease and in 190 women without any breast disease, by submitting them to clinical examination, ultrasound thyroid evaluation, serum thyroid antibody determination and fine needle aspiration (FNA) of the thyroid gland. RESULTS: Autoimmune thyroiditis was found in 136/310 (43.9%) breast cancer women: 95 were diagnosed by positive autoantibodies, 19 had positive FNA findings and 22 had both positive autoantibodies and positive FNA findings. In 117 cases, thyroid autoantibodies were positive (37.7% whereas the control groups had respective rates of 19% and 18.4% autoantibody positivity). CONCLUSIONS: There is evidence of high incidence of autoimmune thyroiditis in Greek breast cancer patients, increasing in relation to cancer stage. PMID: 11669589 (Insufficient cortisol is a predisposing factor for autoimmune disease in general, including Hashimoto’s thyroiditis. Cortisol has anti-estrogenic--anti-proliferative--effects in the uterus and it seems in the breast also. I find that most Hashimoto’s patients have borderline or low cortisol levels/effects.—HHL)

Vyas SK, Wilkin TJ. Thyroid hormone autoantibodies and their implications for free thyroid hormone measurement. J Endocrinol Invest. 1994 Jan;17(1):15-21.

Thyroid hormone autoantibodies (THAA) disrupt the equilibrium between thyroid hormones and their binding proteins. This may lead to spurious estimations of free thyroxine (FT4) and triiodothyronine (FT3) by radioimmunoassay (RIA). In the present study we highlight the importance of THAA by examining the frequency of THAA in consecutive sera sent to a routine district hospital laboratory. Over a period of six months, sera were collected from 200 consecutive hypothyroid, 200 hyperthyroid and seven patients whose clinical and biochemical thyroid status were contradictory. A further 200 patients with non-thyroid autoimmune conditions, 20 patients with insulin autoantibodies and 100 healthy blood transfusion donors were studied. In all sera, both effects of antigen removal on THAA detection and where THAA were found, the effect of their removal on FT4, were examined. The frequencies of THAA amongst hypothyroid, hyperthyroid and non-thyroid autoimmune conditions were 7%, 1.5% and 7.5% respectively, whilst no THAA were found in insulin autoantibody positive patients and 100 blood transfusion donors. However, THAA frequency was highest in those patients whose biochemical thyroid status was widely inappropriate to clinical state (5/7 = 64%). Sera stripped of thyroid hormones prior to THAA detection had significantly higher antibody activity than unstripped sera (p = 0.0027 and p = 0.0123 for T3 and T4 binding respectively). Free thyroxine levels measured by the Amerlex-M RIA kit after antibody removal fell in all 21 THAA positive sera tested. The correlation coefficient between antibody activity in serum with percentage fall in FT4 was 0.79 (Spearman's Rank Correlation Test).(ABSTRACT TRUNCATED AT 250 WORDS) PMID: 8006324

Sapin R, Gasser F, Boehn A, Rondeau M. Spuriously high concentration of serum free thyroxine due to anti-triiodothyronine antibodies. Clin Chem. 1995 Jan;41(1):117-8.

Free thyroxine (Fr4) is now frequently measured in serum by one-step labeled antibody assays based on a Solid-Phase Antigen-Linked Technique (SPALT) (1). In this assay the serum sample is incubated with a large excess of triiodothyronine (T3)-coupled solid phase and with a limited amount of labeled anti-T4 antibody. Because the solid phase acts as a ligand of low affinity for the anti-T4 antibody, interference from circulating anti-thyroid hormone (anti-T4 or anti-T3) autoantibodies (THAA) is theoretically possible. However, until now, to our knowledge, this assay was considered to be only slightly affected by THAA (2-4).The highest measured FT4 values (up to 35 pmol/L) could be related to therapy with T4 (4). Nevertheless, recently we observed a very high FT4 value (131 pmol/L) measured by a SPALT assay (Amerlex- MAB; Kodak Clinical Diagnostics, Amersham, UK) in the serum of a hospitalized patient with Crohn disease. This 33-year-old man was euthyroid by clinical evaluation and by his normal thyrotropin serum concentration (0.59 mIUIL, normal range 0.15-4.5 mIUfL) determined with BeriLux kit (Behring, Marburg, Germany). The biological evaluation showed a moderate hypergammaglobulinemia (17 g/L, normal range ................
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