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Original Studies |
Autoimmune Disease Unit, Cedars-Sinai Research Institute and the School of Medicine, University of California (G.D.C., J.G., Y.W., S.M.M., B.R.), Los Angeles, California 90048; Nichols Institute Diagnostics (J.S.H., D.S.), San Juan Capistrano, California 92690; Veterans Administration Medical Center and University of California (J.C.J.), San Francisco, California 94121
Address all correspondence and requests for reprints to: Basil Rapoport, M.B., Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite B-131, Los Angeles, California 90048.
We used the secreted TSH receptor (TSHR) ectodomain variant TSHR-289
(truncated at amino acid residue 289 with a 6-histidine tail) to
investigate properties of TSHR autoantibodies in Graves disease.
Sequential concanavalin A and Ni-chelate chromatography extracted
milligram quantities of TSHR-289 (
2040% purity) from the culture
medium. Nanogram quantities of this material neutralized the TSH
binding inhibitory activity in all 15 Graves sera studied. We
generated a mouse monoclonal antibody (mAb), 3BD10, to partially
purified TSHR-289. Screening of a TSHR complementary DNA fragment
expression library localized the 3BD10 epitope to 27 amino acids at the
N-terminus of the TSHR, a cysteine-rich segment predicted to be highly
conformational. 3BD10 preferentially recognized native, as opposed to
reduced and denatured, TSHR-289, but did not interact with the TSH
holoreceptor on the cell surface. Moreover, mAb 3BD10 could extract
from culture medium TSHR-289 nonreactive with autoantibodies, but not
the lesser amount (
25%) of TSHR-289 molecules capable of
neutralizing autoantibodies. Although the active form of TSHR-289 in
culture medium was stable at ambient temperature, stability was reduced
at 37 C, explaining the mixture of active and inactive molecules in
medium harvested from cell cultures.
In conclusion, studies involving a TSHR ectodomain variant indicate the exquisite conformational requirements of TSHR autoantibodies. Even under "native" conditions, only a minority of molecules in highly potent TSHR-289 preparations neutralize patients autoantibodies. Therefore, Graves disease is likely to be caused by even lower concentrations of autoantibodies than previously thought. Finally, reciprocally exclusive binding to TSHR-289 by human autoantibodies and a mouse mAb with a defined epitope suggests that the extreme N-terminus of the TSHR is important for autoantibody recognition.
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