自身免疫性甲状腺病TSH受体抗体异质性研究

Study on the Heterogeneity of TSH Receptor Antibodiesin the Pathogenesis of Autoimmune Thyroid Disease

目的研究自身免疫性甲状腺病（ＡＩＴＤ患者ＴＳＨ受体抗体（ＴＲＡｂ的异质性。方法选择异质性ＴＲＡｂ患者６例，用ＥＢ病毒转染其外周血Ｂ淋巴细胞并筛选能产生单克隆ＴＲＡｂ的阳性细胞孔。结果６例患者的ＴＳＨ结合抑制免疫球蛋白（ＴＢＩＩ）测定值为５１％～８９％，患者１、２、４、５、６存在甲状腺兴奋性抗体（ＴＳＡ），而患者１、２、３可测得甲状腺阻断性抗体（ＴＳＢＡｂ）。以ＥＢ病毒转染外周血Ｂ淋巴细胞后，患者３有５个细胞孔能产生ＴＢＩＩ，患者６有４个细胞孔能产生ＴＳＡｂ。ＴＲＡｂ的测定值存在量效关系。结论ＡＩＴＤ患者可产生兴奋性或抑制性ＴＳＨ受体抗体，ＴＲＡｂ存在异质性。

Objective To investigate the heterogeneity of TSH receptor antibodies inpatients with autoimmune thyroid disease(AITD). Methods Six patients with the presenceof heterogeneous TSH receptor antibodies were selected. The EBV - transformed B cellclones producing monoclonal antithyrotropin receptor antibodies were then established fromthe selected patients. Results Total 6 patients with heterogeneous TSH receptor antibody(TRAb) were chosen, with 125I - TSH binding inhibiting immunoglobulin(TBII) values rangingfrom 51% to 89%. Patients No. 1,2,4,5,6 had thyroid stimulating antibody(TSBAb) andpatients No.1,2,3 thyroid stimulating-blocking antibody(TSBAb). After EBV - transformationof those patients' peripheral B lymphocyte, we isolated and characterized five B cell clonesproducing TBII from patient No.3 and four B cell clones producing TSAb from patients No.6.A does - dependent relationship was found between TRAb titers and concentrations of thesupernatant collected from the EBV-- transformed B lymphocytes. Conclusion Autoantibodyof the TSH receptor is a polyclonal one populations heterogeneous with stimulatory andinhibitory effects.