Comparison between thyroid stimulating and tsh-binding inhibiting immunoglobulins of Graves' disease

In the sera of patients with Graves' disease abnormal thyroid 'stimulating' immunoglobulins have been demonstrated by in vivo and in vitro assay systems. Conflicting results have been reported when thyroid stimulating and thyrotrophin (TSH)-binding inhibiting activities have been compared. The present study was performed in forty-nine hyperthyroid Graves' patients to ascertain the relationships among TsH-binding inhibiting immunoglobulins (TBII), measured by a radio-receptor assay, thyroid stimulating antibody(TSAb), assayed by stimulation of adenylate cyclase-cAMP system in human thyroid plasma membranes, and LATS, measured by McKenzie's mouse bioassay.TBII was detected in twenty-one of forty-nine (42.9%), TSAb in thirty-five of forty-nine (71.4%) and LATS in nineteen of forty-nine (38.8%).TBII was also present in four of sixteen (25%) patients with other thyroid autoimmune disorders. When the results obtained with the different techniques were compared, correlation was found between LATS response and TSAb activity ( =0.53, P less than 0.001), while there was no correlation between TSAb and TBII activities and between LATS response and TBII activity. These data conform that TSAb is specific and sensitive marker of Graves' disease and suggest that TBII activity is not necessarily synonymous with thyroid stimulation, and could reflect a different phenomenon concomitantly produced.