Thyrotrophin receptor antibody in Graves disease V.1
Research type
Research Study
Full title
Thyrotrophin Receptor Antibody (TRAb) modulation in Graves’ Disease – a longitudinal study of TRAb properties and concentration during and after treatment V.1
IRAS ID
142675
Contact name
Lakdasa Premawardhana
Contact email
Sponsor organisation
Aneurin Bevan University Health Board
Research summary
In patients with Graves' disease (GD), antibodies called thyrotrophin receptor antibodies (TRAb) bind to receptors on the cells of the thyroid gland, stimulating it to produce thyroid hormones in excess. This results in the clinical symptoms and signs of “thyrotoxicosis” in GD. However, TRAb in the blood are not all of the stimulatory variety. Some may have “inhibitory” properties reducing thyroid hormone production - producing hypothyroidism. The clinical presentation in individual subjects depends on which form is predominant – the stimulatory form being predominant in GD.
Some studies have shown a reduction in TRAb concentration in the blood when GD patients are treated with medication, surgery or radioiodine – reducing receptor stimulation and therefore reducing hormone production significantly. This may partially explain the disappearance of symptoms and signs of thyrotoxicosis.
However, in addition to this “quantitative” effect on TRAb (causing a reduction in TRAb concentration), treatment may also produce a “qualitative” effect on the biochemical and immunological properties of TRAb – e.g. converting stimulating type of TRAb to inhibiting type of TRAb and thereby contributing to disease control. Anecdotal evidence exists for transformation of these antibodies from one form to the other.
No good quality, well designed studies exist proving this conversion takes place in GD patients or that it is clinically relevant in GD. State of the art immunological techniques available to us, give us the opportunity to test the hypothesis that there may be a change to the biochemical and immunological properties of TRAb in treated GD subjects and contribute to its control.
We aim to recruit a group of GD subjects at diagnosis, treat them as clinically appropriate, and measure their TRAb concentrations, and also biochemical and immunological properties of TRAb over an adequate length of follow up during and after treatment.REC name
HSC REC B
REC reference
14/NI/1042
Date of REC Opinion
5 Aug 2014
REC opinion
Further Information Favourable Opinion