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. 2021 Nov 30;21(1):238.
doi: 10.1186/s12902-021-00905-4.

The effect of radioiodine treatment on the characteristics of TRAb in Graves' disease

Ya Fang #  1 , Wen-Hua Du #  2 , Cao-Xu Zhang  1 , Shuang-Xia Zhao  1 , Huai-Dong Song  3 , Guan-Qi Gao  4 , Mei Dong  5
Affiliations

The effect of radioiodine treatment on the characteristics of TRAb in Graves' disease

Ya Fang et al. BMC Endocr Disord. .

Abstract

Background: Graves' disease (GD) is one of the most common autoimmune thyroid diseases (AITDs) in humans, and thyrotropin receptor antibody (TRAb) is a characterized autoantibody in GD. The use of radioactive iodine therapy (RAI) for GD treatment is increasing.

Objectives: We studied the biological properties of TRAb and evaluated the effect of RAI therapy on TRAb in GD patients.

Methods: In total, 225 patients (22 onset GD patients without 131I therapy, 203 GD patients treated with 131I therapy) and 20 healthy individuals as normal controls were included in this study. Clinical assessments were performed, and we examined in vitro the biological properties of TRAb in the 22 onset GD patients and 20 controls as well as 84 GD patients with 131I therapy.

Results: Serum TRAb and thyroid peroxidase antibody (TPOAb) levels increased in the initial year of RAI treatment, and both antibodies decreased gradually after one year. After 5 years from radioiodine treatment, TRAb and TPOAb levels decreased in 88% and 65% of GD patients, respectively. The proportion of patients positive for thyroid-stimulatory antibody (TSAb) was significantly higher in the 7-12-month group, and thyroid-blocking antibody (TBAb) levels were elevated after one year in half of the patients who received 131I treatment.

Conclusions: Treatment of GD patients with radioiodine increased TPOAb and TRAb (their main biological properties were TSAbs) within the first year after therapy, and the main biological properties of elevated TRAb were TBAbs after 1 year.

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Conflict of interest statement

These authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Time course changes in antibodies after 131I therapy. A and B Show time course changes in TRAb and TPOAb in Graves’ disease patients before and after 131I therapy. *denotes p < 0.05, ***denotes p < 0.001, ###p < 0.001 represents the 1–6 months group versus 13–60 months group and >60 months group, &&&p < 0.001 represents the 7–12 months group versus 13–60 months group and >60 months group, $$p < 0.01 represents the 13–60 months group versus >60 months group
Fig. 2
Fig. 2
Changes in TRAb and TPOAb at different times after 131I treatment. This picture shows the time course discrepancy of the GD patient ratio with different TRAb changes (A) and TPOAb changes (B) after RAI therapy. The p value was obtained by the Trend Test
Fig. 3
Fig. 3
Bioactivity of TRAb in GD patients treated with 131I therapy. TRAb bioactivity was measured in 22 onset Graves’ disease patients without radioiodine therapy and 84 Graves’ disease patients treated with radioiodine therapy (1–6 months group [n = 20], 7–12 months group [n = 19], 13–60 months group [n = 29], >60 months group [n = 16]). A and B Show TSAb and TBAb activities in these patients, respectively. The gray circle represents patients with normal levels of TSAb and TBAb; the yellow circle represents patients with high TSAb; the red circle represents patients with high TBAb; the blue circle represents patients with high TSAb and TBAb simultaneously
Fig. 4
Fig. 4
Proportion of TSAb- or TBAb-positive patients among GD patients with different thyroid functions after 131I therapy. A and B Show ratios of TSAb-positive and TBAb-positive patients with Graves’ disease with different thyroid functions after 131I therapy. *denotes p < 0.01, **denotes p < 0.001
See this image and copyright information in PMC

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