Abstract
The purpose of this study was to reveal some possible factors for the differences between the pattern of disappearance of thyroglobulin autoantibodies (anti-Tg) and thyroid peroxidase autoantibodies (anti-TPO) in patients with differentiated thyroid carcinoma following thyroidectomy and iodine-131 ablation. Patients with a history of follicular cell derived cancer (papillary, follicular, both papillary and follicular, Hürthle cell) and high pre-operative titers of anti-TPO and/or anti-Tg autoantibodies were retrospectively studied. Thyroglobulin (Tg) levels were measured using radio-immunometric assay (RIA). Anti-Tg and anti-TPO levels during the first 6 yr’ follow-up were measured by passive agglutination, during the following 10 yr by ELISA method and during the last 2 yr by chemiluminescence assay. A statistically significant difference was observed between median time (72 months) of disappearance of anti-TPO and median time (39 months) of disappearance of anti-Tg in patients with complete ablation of thyroid tissue, following iodine-131 administration (p=0.0395, Logrank statistic=4.24, Kaplan-Meier method). A statistically significant difference was observed between median time (106 months) of disappearance of anti-TPO and median time (33 months) of disappearance of anti-Tg in patients >45 yr of age (p=0.034) and between median time (111 months) of disappearance of anti-TPO and median time (41 months) of disappearance of anti-Tg in patients with tumor size <2 cm (p=0.0175). We concluded that patients with differentiated thyroid carcinoma and pre-surgical elevated titers of both Tg and anti-TPO tend to become earlier anti-Tg seronegative. Although tumor size and age may influence the pattern of thyroid autoantibody reduction, the exact reasons for the different rhythm of autoantibodies decrease must further be evaluated.
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Torrens J, Burch H. Serum Tg measurement. Utility in clinical practice. Endocrinol Metab Clin North Am 2001, 30: 429–67.
Chung JK, Park YJ, Kim TY, et al. Clinical significance of elevated level of serum Anti Tg in patients with DTC after thyroid ablation. Clin Endocrinol (Oxf) 2002, 57: 21 5–21.
Rodien P, Madec AM, Ruf J, et al. Antibody-dependent cell-mediated cytotoxicity in autoimmune thyroid disease: relationship to antithyroperoxidase antibodies. J Clin Endocrinol Metab 1996, 81: 2595–600.
Baker J, Fosso CK. Immunological aspects of cancers arising from thyroid follicular cells. Endocr Rev 1993, 14: 729–46.
Spencer CA, Takeuchi M, Kazarosyan M, et al. Serum thyroglobulin autoantibodies: prevalence, influence on serum thyroglobulin measurement, and prognostic significance in patients with differentiated thyroid carcinoma. J Clin Endocrinol Metab 1998, 83: 1121–7.
Hocevar M, Auersperg M, Stanovnik L. The dynamics of serum thyroglobulin elimination from the body after thyroid surgery. Eur J Surg Oncol 1997, 23: 280–10.
Chiovato L, Latrofa F, Braverman LA, et al. Disappearance of humoral thyroid autoimmunity after complete removal of thyroid antigens. Ann Intern Med 2003, 139: 346–51.
Sheils OM, O’Eary J, Uhlmann V, Lattich K, Sweeny EC. Ret/ PTC-1 activation in Hashimoto thyroiditis. Int J Surg Pathol 2000,8:185–92.
Powel DJ, Eisenlohr LC, Rothstein JL. A thyroid tumor-specific antigen formed by the fusion of two self-proteins. J Immunol 2003, 170: 861–9.
Tomer Y, Davies TF. Infection, thyroid disease and autoimmunity. Endocr Rev 1993, 14: 107–20.
Fountoulakis S, Tsatsoulis A. On the pathogenesis of autoimmune thyroid disease: a unifying hypothesis. Clin Endocrinol (Oxf) 2004, 60: 397–409.
Tsatsoulis A. The role of apoptosis in thyroid disease. Minerva Med 2002, 93: 169–80.
Armengol MP, Juan M, Lucas-Martin A, et al. Demonstration of thyroid antigen-specific B cells and recombination-activating gene expression in cheomokine-containing active intrathyroidal germinal centers. Hum Pathol 2001, 159: 861–73.
Ringel MD, Ladenson PW, Levine MA. Molecular diagnosis of residual and recurrent thyroid cancer by amplification of thyroglobulin messenger ribonucleic acid in peripheral blood. J Clin Endocrinol Metab 1998, 83: 4435–42.
Oliviery A, Marzullo A, Salbe GB, Gilardi E, Faccini C, Carta S. Isoelectric focusing and immunoblotting analysis of thyroglobulin from different thyroid disease. Thyroidol 1991, 3: 13–6.
Fugazzola L, Michalich A, Persani L, et al. High sensitive serum thyroglobulin and circulating thyroglobulin mRNA evaluations in the management of patients with differentiated thyroid cancer in apparent remission. J Clin Endocrinol Metab 2002, 87: 3201–8.
Bugalho MJ, Domingues RS, Pinto AC, et al. Detection of thyroglobulin mRNAs transcripts in peripheral blood of individuals with and without thyroid glands: evidence for thyroglobulin expression by blood cells. Eur J Endocrinol 2001, 145: 409–13.
Macsween KF, Crawford DH. Epstein-Barr virus recent advances. Lancet Infect Dis 2002, 3: 131–40.
Nakamura M, Burastero SE, Ueki Y, Larrick JW, Notkins AL, Casali P. Probing the normal and autoimmune B cell repertoire with Epstein-Barr virus. Frequency of B cells producing monoreactive high affinity autoanibodies in patients with Hashimoto’s disease and systemic lupus erythematosus. J Immunol 1998, 141: 4165–72.
MacLahlan SM, Rapaport B. Evidence for a potential common T cell epitope between human thyroid peroxidase and human thyroglobulin with implications for the pathogenesis of autoimmune thyroid disease. Autoimmunity 1989, 5: 101–6.
Vojdani A, Rahimian P, Kahlor H, Mordechai E. Immunological cross reactivity between Candida albicans and human tissue. J Clin Lab Immunol 1996, 48: 1–15.
Bertalot G, Montresor G, Tampieri M, et al. Decrease in thyroid autoantibodies after eradication of Helicobacter pylori infection. Clin Endocrinol (Oxf) 2004, 61: 650–2.
Villiers MB, Marche PN, Villiers CL. Improvement of long-lasting response and antibody affinity by the complexation of antigen with complement C3b. Inter Immunol 2003, 15: 91–5.
Nakra P, Manivel V, Vishwakarma RA, Rao KVS. B cell responses to a peptide epitope. X. Epiotope selection in a primary response is thermodynamically regulated. J Immunol 2000, 164: 5615–25.
Inaoki M, Sato S, Weitraub BC, Goodnow CC, Tedder TF. CD-19 regulated thresholds control peripheral tolerance and autoantibody production in B lymphocytes. J Exp Med 2000, 186: 1923–31.
Fecteau JF, Neron S. CD40 stimulation of human peripheral B lymphocytes: distinct responses of naïve and memory B lymphocytes. J Immunol 2003, 171: 4621–9.
Barzon L, Boscaro M, Pacenti M, Taccaliti A, Palu G. Evaluation of circulating thyroid-specific transcripts as markers of thyroid cancer. Int J Cancer 2004, 110: 914–20.
Ma C, Kuang J, Xie J, Ma T. Possible explanations for patients with discordant findings of serum thyroglobulin and 131I whole body scanning. J Nucl Med 2005, 46: 1473–80.
Hobby P, Gardas A, Radomski R, McGregor AM, Banga JB, Sutton BJ. Identification of an immunodominant region recognized by human autoantibodies in a three-dimensional model of thyroid peroxidase. Endocrinology 2000, 141: 2018–26.
Bresson D, Cerutti M, Devauchelle G, et al. Localization of the discontinuous immunodominant region recognized by human anti-thyroperoxidase autoantibodies in autoimmune thyroid diseases. J Biol Chem 2003, 278: 9560–9.
Hammer J, Belunis C, Bolin D, et al. High-affinity binding of short peptides to major histocompatibility complex class II molecules by anchor combinations. Proc Natl Acad Sci 1994, 91: 4456–62.
Garcia KC, Teyton L, Wilson IA. Structural basis of T cell recognition. Ann Rev Immunol 1999, 17: 369–97.
Schneider F, Mariotti S, Ikekubo K, Kuma K. Iodine content of serum thyroglobulin in normal individuals and patients with thyroid cancer. J Clin Endocrinol Metab 1985, 57: 1251–6.
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Thomas, D., Liakos, V., Vassiliou, E. et al. Possible reasons for different pattern disappearance of thyroglobulin and thyroid peroxidase autoantibodies in patients with differentiated thyroid carcinoma following total thyroidectomy and iodine-131 ablation. J Endocrinol Invest 30, 173–180 (2007). https://doi.org/10.1007/BF03347421
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DOI: https://doi.org/10.1007/BF03347421