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The Interaction of TSH Receptor Autoantibodies with ¹²⁵I-Labelled TSH Receptor

FIRS Laboratories, RSR Ltd. (J.S., Y.O., S.R., A.K., T.R., J.B., V.M., S.W., J.F., B.R.S.), Parc Ty Glas, Llanishen, Cardiff CF4 5DU, Wales, United Kingdom; Department of Surgery (D.J.), Railway District Hospital, Puszczykówko, 62-041 Pozna, Poland; Department of Medicine (Y.O., S.R., J.F., B.R.S.), University of Wales College of Medicine, Heath Park, Cardiff CF4 4XN, Wales, United Kingdom

Address correspondence and requests for reprints to: Dr. B. Rees Smith, FIRS Laboratories, RSR Ltd., Parc Ty Glas, Llanishen, Cardiff CF4 5DU, Wales, United Kingdom.

Detergent-solubilized porcine TSH receptor (TSHR) has been labeled with ¹²⁵I using a monoclonal antibody to the C-terminal domain of the receptor. The ability of sera containing TSHR autoantibody to immunoprecipitate the labeled receptor was then investigated. Sera negative for TSHR autoantibody (as judged by assays based on inhibition of labeled TSH binding to detergent-solubilized porcine TSHR) immunoprecipitated about 4% of the labeled receptor, whereas sera with high levels of receptor autoantibody immunoprecipitated more than 25% of the labeled receptor. The ability to immunoprecipitate labeled TSHR correlated well with ability of the sera to inhibit labeled TSH binding to the receptor (r = 0.92; n = 63), and this is consistent with TSHR autoantibodies in these samples being directed principally to a region of the receptor closely related to the TSH binding site. Preincubation of labeled TSHR with unlabeled TSH before reaction with test sera inhibited the immunoprecipitation reaction, providing further evidence for a close relationship between the TSHR autoantibody binding site(s) and the TSH binding site. This was the case whether the sera had TSH agonist (i.e., thyroid stimulating) or TSH antagonist (i.e., blocking) activities, thus, providing no clear evidence for different regions of the TSHR being involved in forming the binding site(s) for TSHR autoantibodies with stimulating and with blocking activities. The ability of TSHR autoantibodies to stimulate cyclic AMP production in isolated porcine thyroid cells was compared with their ability to immunoprecipitate labeled porcine TSHR. A significant correlation was observed (r = 0.58; n = 50; P < 0.001) and the correlation was improved when stimulation of cyclic AMP production was compared with inhibition of labeled TSH binding to porcine TSHR (r = 0.76). Overall, our results indicate that TSHR autoantibodies bind principally to a region on the TSHR closely related to the TSH binding site, and this seems to be the case whether the autoantibodies act as TSH agonists or antagonists.

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