Clinical Review 3 The Clinical Use of Thyrotropin Receptor Antibody Measurements*

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Abstract
IN 1956 Adams and Purves made the pivotal observation that led to recognition of what came to be known as the long-acting thyroid stimulator (1). Since then many procedures have been developed to measure the entity that is now termed the thyroid stimulating antibody (TSAb) of Graves’ disease; some of these methods are listed in Table 1. As shown, there are two main categories of assays, namely those dependent for an end point on some index of thyroid stimulation and others that assess the ability of TSAb to inhibit the binding of radiolabeled TSH to its receptor. As will be discussed below, failure to recognize that TSH-binding inhibition (TBI) does not necessarily reflect a thyroid-stimulating activity is one of the factors confusing agreement on the clinical application of these assays; in addition there is an inevitable variability in sensitivity and, to some degree, specificity that may limit its use. Review of assay techniques Thyroid stimulation.

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