The thyroid "microsomal" antibody revisited. Its paradoxical binding in vivo to the apical surface of the follicular epithelium.

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Abstract
Thyroid monolayers derived from the glands of patients with autoimmune thyroid disease have Ig bound to their surface. This appears to have been deposited in vivo rather than during preparation of the monolayers, a view supported by a finding of such deposits on the apical margin of follicular cells in sections cut from these glands and stained with conjugated anti-Ig. It is likely that these deposits represent specific binding of so-called microsomal autoantibodies to the surface of the thyroid cells in vivo since staining of partially disrupted follicles (half-melons) with Hashimoto serum containing microsomal autoantibodies in the indirect immunofluorescence test, localized the antigen on the apical surface of the cells lining the follicular cavity. Paradoxically, although the antigen is relatively inaccessible, autoantibodies do reach and combine with the thyroid surface in vivo and may therefore play a role in pathogenesis.