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Auto-immunity in the Endocrine System by Robert Volpé M.D., F.R.C.P.(C), F.A.C.P. (auth.)

By Robert Volpé M.D., F.R.C.P.(C), F.A.C.P. (auth.)

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J:J 0~ 175 150 125 100 75 50 -t:- r-iJ 0 0 0 I • 8 • --- -W~- • • 1if • • • :I • • •• •• •• • • 8• • • • 0 . 4- Results using the same IgG samples as were depicted in Fig. 3, but with an assay measuring cyclic AMP in thyroid slices as the end point. Thus this is a stimulatory assay, rather than a binding assay. Note that the yield of positive values was greater in active, untreated Graves' disease than with the radioligand assay (about 84%). Note also that those samples from patients with Hashimoto's thyroiditis or subacute thyroiditis that were positive in the radioligand assay were now negative in the TSAb assay.

Recently, a double antibody radio-immuno-assay technique has been developed for determination ofthese antibodies (Peake et al. 1974). 2 Antimicrosomal Antibodies The thyroid microsomal antigen has been localized by immunofluorescence in the apical cytoplasm of follicular cells (Pinchera et al. 1979). Roitt et al. (1964) have provided evidence that this antigen is an inherent part of the smooth endoplasmic reticulum and is apparently composed of a lipoprotein of the membrane of exocytotic vesicles supporting newly synthesized thyroglobulin from the Golgi apparatus to the colloid.

There was an excellent correlation between the presence of cells making antithyroglobulin antibodies in the thyroid gland and the appearance of lesions. Thus, the available evidence suggests that auto-immune thyroiditis is an antibody-mediated rather than a cell-mediated immunopathological process (Allison 1976). This of course does not obviate the need for sensitized helper T -lymphocytes, and thus cell-mediated immunity. However, the effector mechanism appears to be mediated by antibody. 2 Spontaneous Auto-immune Thyroiditis in Animals Since the experimentally induced animal model is not considered closely analogous to the human disorder, spontaneous models have been sought and found.

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