1994 Fiscal Year Final Research Report Summary
Distinctive measurements of thyroid stimulating activities in early pregnancy in patients with Graves' disease and their application for prediction of postpartum Graves' thyrotoxicosis.
| Project/Area Number |
05671924
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Laboratory medicine
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| Research Institution | OSAKA UNIVERSITY |
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Principal Investigator |
TAMAKI Haruo Department of Laboratory Medicine, Associate Professor, 医学部・臨床検査診断学, 助教授 (20221400)
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| Co-Investigator(Kenkyū-buntansha) |
HIDAKA Yoh Department of Laboratory Medicine, Assistant Professor, 医学部・臨床検査診断学, 助手 (30243231)
MITSUDA Nobuaki Department of Obstetrics and Gynecology, Assistant Professor, 医学部・産婦人科学, 助手 (50209805)
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| Project Period (FY) |
1993 – 1994
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| Keywords | thyroid stimulating activity (TSA) / human chorionic gonadotropin (hCG) / thyroid stimulating antibody (TSAb) / distinctive measurement / autoimmune thyroid disease / Graves' disease |
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| Research Abstract |
Thyrotoxicosis in Graves' disease is often aggravated in early pregnancy and this is closely associated with postpartum recurrence of stimulative thyrotosicosis. To examine whether thyroid-stimulating TSH receptor antibody (TSAb) or human chorionic gonadotropin (hCG), which also has thyroid-stimulating activity (TSA), was responsible for this early aggravation, the respective TSA due to TSAb or hCG was measured for the first time by a highly sensitive cAMP accumulation assay using FRTL-5 cells. In five patients with postpartum stimulative thyrotoxicosis, serial changes in TSAb and hCG-induced TSA were measured during pregnancy and the latter TSA increased associated with the increase in free thyroxine while the former TSA(TSAb) did not show striking change in early pregnancy, indicating hCG plays a crucial role in the early aggravation of Graves' thyroxicosis. Then we followed up the pregnant women with positive thyroid microsomal antibody (MCHA) in early pregnany, and analyzed the relation of respective TSA to postpartum Graves' thyrotoxicosis. Seventy-one women with positive MCHA in early pregnancy could be followed for more than six months postpartum (of total 262 MCHA positive subjects in early pregnancy). Distinctive TSAs were measured in these 71 women, 7 showed positive TSAb in early pregnancy, and all 7 developed thyroid dysfunction in the post-partum period. Five of them (72%) developed Graves' disease, two showing persistently and three transiently. None of 64 TSAb-negative subjects developed Graves' thyrotoxicosis. These data suggest that (1) respective TSA due to TSAb or hCG can be measured distinctively by a highly sensitive cAMP accumulation assay using FRTL-5 cells, (2) hCG plays a crucial role in the aggravation of Graves' thyrotoxicosis, and (3) the high risk of postpartum onset of Graves' thyrotoxicosis can be predicted by TSAb in early pregnancy.
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