Studies with recombinant autoepitopes of thyroid peroxidase: evidence suggesting an epitope shared between the...

In a previous work we characterized a major epitope of thyroid peroxidase (TPO), which was recognised by 66% of 157 patients with autoimmune thyroid disease (AITD) and 9 out of 50 patients with non-thyroidal autoimmune disease (NTAID) 6 of whom had antibodies to the gastric parietal cell antigen (PCA). In the present study we have affinity purified C2 antibodies and demonstrated that they bind to the native TPO enzyme in a radioimmunoassay (RIA). We have measured antibodies to the C2 peptide and a second TPO peptide, C21, in enzyme-linked immunosorbent assays (ELISA) in 30 patients with NTAID all of whom have antibodies to the gastric PCA, having first determined the incidence of antibodies to C21 in 98 patients with AITD who do not have antibodies to the gastric PCA. 58% of patients with AITD have antibodies to C21, a peptide of TPO which overlaps C2 by 21 amino acids in the region containing an 11 residue fragment which is very similar to a fragment of the H+ K+ ATPase, which has recently been shown to be a major component of the gastric PCA. In patients having NTAID and antibodies to the gastric PCA, 60% are positive for C2 Ab and 100% for C21 Ab, which is suggestive of an epitope shared by TPO and H+ K+ ATPase, corresponding to TPO 659----669 and H+ K+ ATPase 177----187. We conclude that C2 antibodies are heterogenous and comprise activities which bind to the intact enzyme and activities binding to an epitope which may be common to TPO and H+ K+ ATPase.