Evidence of a correlation between thyrotrophin receptor binding inhibition and thyroid adenylate cyclase activation by immunoglobulins in Graves' disease before and during long-term antithyroid treatment

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Abstract
This study measured in parallel TSH binding inhibiting Ig (TBII) and thyroid adenylate cylase stimulating Ig (TACSI) in patients with Graves'' disease (GD) before and during long-term antithyroid treatment [carbimazole or propylthiouracil]. A statistical model based on the calculation of the differences (TACSI-TBII) is presented, comparing the changes in this parameter to the analytical variation. The correlaton between TBII and TACSI in 52 patients with GD before treatmetn was r = 0.58, P < 0.0001. During long-term antithyroid treatment of GD the 2 activities changed in parallel in 39 of 45 patients followed. In a few patients discrepancies were observed, and 1 patient, initially TACSI positive, developed adenylate cyclase inhibiting IgG during treatment but without detectable TBII. TBII and TACSI are significantly correlated in patients with GD before and during long-term antithyroid treatment; in some patients discrepancies between TBII and TACSI suggest that these IgG are heterogeneous with varying capacity for stimulaton of the adenylate cyclase and receptor binding; and adenylate cyclase inhibitory IgG without TBII activity was demonstrated in GD.

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