The Detection of Serum IgMs to Thyroglobulin in Subacute Thyroiditis Suggests a Protective Role of IgMs in Thyroid Autoimmunity

Abstract Context The role of serum immunoglobulin (Ig)Ms in autoimmune thyroid diseases is uncertain. Objective We looked for IgMs to thyroglobulin (Tg) in patients with subacute thyroiditis (SAT), which is characterized by high serum Tg levels, the possible de novo appearance of IgGs to Tg (TgAb-Ig...

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Published in:The journal of clinical endocrinology and metabolism 2020-06, Vol.105 (6), p.e2261-e2270
Main Authors: Ricci, Debora, Brancatella, Alessandro, Marinò, Michele, Rotondi, Mario, Chiovato, Luca, Vitti, Paolo, Latrofa, Francesco
Format: Article
Language:English
Subjects:
Adult
Autoantibodies - blood
Autoantibodies - immunology
Autoimmunity
Autoimmunity - immunology
Biomarkers - blood
Bovine serum albumin
Case-Control Studies
Complications
Enzyme-linked immunosorbent assay
Female
Follow-Up Studies
Glucagon
Graves Disease - blood
Graves Disease - epidemiology
Graves Disease - immunology
Graves' disease
Hashimoto Disease - blood
Hashimoto Disease - epidemiology
Hashimoto Disease - immunology
Humans
Immunoglobulin G
Immunoglobulin M
Immunoglobulin M - blood
Immunoglobulin M - immunology
Italy - epidemiology
Male
Middle Aged
Prognosis
Thyroglobulin
Thyroglobulin - immunology
Thyroid diseases
Thyroid gland
Thyroiditis
Thyroiditis, Subacute - blood
Thyroiditis, Subacute - epidemiology
Thyroiditis, Subacute - immunology
Young Adult
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Summary:Abstract Context The role of serum immunoglobulin (Ig)Ms in autoimmune thyroid diseases is uncertain. Objective We looked for IgMs to thyroglobulin (Tg) in patients with subacute thyroiditis (SAT), which is characterized by high serum Tg levels, the possible de novo appearance of IgGs to Tg (TgAb-IgGs), and no autoimmune sequelae. Main Outcome Measures TgAb-IgMs and TgAb-IgGs were detected by binding to Tg using the enzyme-linked immunosorbent assay (ELISA). The upper reference limit of TgAb-IgMs and TgAb-IgGs was established in 40 normal subjects. We looked for TgAb-IgMs in 16 patients with SAT, 11 with Hashimoto’s thyroiditis (HT), and 8 with Graves’ disease (GD) who were all positive for TgAb-IgGs. IgM binding to bovine serum albumin (BSA), keyhole limpet hemocyanin (KLH), and glucagon in ELISA was measured. Inhibition of TgAb-IgMs binding to coated Tg was evaluated by preincubating serum samples or IgG-depleted samples with soluble Tg. Results TgAb-IgMs were positive in 10/16 patients with SAT, 2/11 with HT, and 1/8 with GD. TgAb-IgMs were higher in SAT (0.95; 0.42–1.13) (median; 25th–75th percentiles) than in HT (0.47; 0.45–0.51) and GD patients (0.35; 0.33–0.40) (P < .005 for both). IgM binding of SAT sera to BSA, KLH, and glucagon was significantly lower than Tg. Preincubation with soluble Tg reduced the binding of IgMs to coated Tg by 18.2% for serum samples and by 35.0% and 42.1% for 2 IgG-depleted samples. TgAb-IgM levels were inversely, although nonsignificantly, correlated with Tg concentrations. Conclusions Tg leak associated with thyroid injury induces the production of specific TgAb-IgMs, which, in turn, increases the clearance of Tg and might prevent the establishment of a persistent thyroid autoimmune response.
ISSN:0021-972X
1945-7197
DOI:10.1210/clinem/dgaa038