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A novel bioreporter assay for thyrotropin receptor antibodies using a chimeric thyrotropin receptor (mc4) is more useful in differentiation of Graves' disease from painless thyroiditis than conventional thyrotropin-stimulating antibody assay using porcine thyroid cells.
使用嵌合促甲状腺激素受体 (mc4) 的促甲状腺激素受体抗体的新型生物转运蛋白测定在区分 graves 病和无痛甲状腺炎方面比使用猪甲状腺细胞的传统促甲状腺激素刺激抗体测定更有用。

摘要

BACKGROUND:Graves' disease (GD) is caused by thyrotropin (TSH) receptor antibodies (TSHRAbs) that bind to TSHR and activate thyrocytes. The measurement of TSHRAbs therefore has been used to assist in the diagnosis and management of GD.
METHODS:In this study, we evaluated the clinical significance of a newly developed bioreporter assay for the detection of TSHRAbs (Thyretain). The Thyretain bioreporter assay utilizes a chimeric receptor (Mc4), in which residues 262-335 of TSHR are replaced with a rat lutropin-choriogonadtropin receptor segment. This bioreporter is designed to specifically detect stimulating TSHRAbs (Mc4-TSHRAbs).
RESULTS:The Mc4-TSHRAb level of sera obtained from 110 normal healthy controls, 103, 99, and 50 patients with untreated GD, painless Hashimoto's thyroiditis (PT), and subacute thyroiditis (SAT) were 27.3% +/- 11.3%, 327.8% +/- 105.9%, 48.9% +/- 48.5%, and 24.9% +/- 13.4%, respectively. Compared with the Mc4-TSHRAb levels of patients with PT and SAT, and normal healthy controls, the Mc4-TSHRAb levels of untreated GD patients were significantly higher (p < 0.01). The sensitivity and specificity of the Thyretain bioreporter assay for GD and PT were 95.1% and 96.0%, respectively, at the optimal cut-off value of 128%. Measurement of TSHRAbs with a bioassay that uses porcine thyroid cells (TSH-stimulating antibody [TSAb]) showed a positive correlation (r = 0.472, p < 0.001) with the Thyretain assay for untreated GD, and strong positive correlation (r = 0.821, p < 0.001) for the entire untreated GD, PT, and SAT population. The positive rate of Mc4-TSHRAbs for GD was significantly higher than that of TSAb (95.1% vs. 89.3%, p < 0.05) and the negative rate of PT by Mc4-TSHRAbs was also significantly higher than that of TSAb (96.0% vs. 86.9%, p < 0.01). As a result, Mc4-TSHRAbs showed statistically better (p < 0.01) diagnostic accuracy in differentiating GD from PT than TSAb.
CONCLUSIONS:These data suggest that the Thyretain bioreporter assay with a chimeric TSHR (Mc4) is more useful in the differential diagnosis of GD from PT than the bioassay with wild-type TSHR on porcine thyroid cells.

译文

背景: graves 病 (GD) 是由与 TSHR 结合并激活甲状腺细胞的促甲状腺激素 (TSH) 受体抗体 (TSHRAbs) 引起的。因此,TSHRAbs 的测量已被用于协助 GD 的诊断和管理。
方法: 在本研究中,我们评估了一种新开发的生物转运蛋白检测技术 (Thyretain) 的临床意义。Thyretain 生物转运蛋白测定利用嵌合受体 (Mc4),其中 262-335 的 TSHR 残基被大鼠路普霉素-绒毛膜促总蛋白受体段取代。这种生物转运蛋白被设计用来专门检测刺激的 TSHRAbs (Mc4-TSHRAbs)。
结果: 从 110 例正常健康对照组、 103 例、 99 例和 50 例未经治疗的 GD 、无痛性桥本甲状腺炎 (PT) 和亚急性甲状腺炎 (SAT) 患者中获得的 Mc4-TSHRAb 血清水平分别为 27.3%/-11.3% 、 327.8%/-105.9% 、 48.9%/-48.5% 和 24.9%/-13.4%。与 PT 和 SAT 患者的 Mc4-TSHRAb 水平和正常健康对照组相比,未治疗的 GD 患者的 Mc4-TSHRAb 水平明显更高 (p & lt; 0.01)。在最佳临界值为 95.1% 的情况下,对于 GD 和 PT 的 Thyretain 生物转运蛋白测定的灵敏度和特异性分别为 96.0% 和 128%。使用猪甲状腺细胞 (TSH 刺激抗体 [TSAb]) 的生物测定测定 TSHRAbs 显示出正相关 (r = 0.472,p <0.001) 对于未处理的 GD,用胸腺保留试验,对于整个未处理的 GD,PT,强正相关 (r = 0.821,p & lt; 0.001)和 SAT 人口。GD 的 Mc4-TSHRAbs 阳性率明显高于 TSAb (95.1% vs.89.3%,p <0.05) mc4-TSHRAbs 的 PT 阴性率也明显高于 TSAb (96.0% vs.86.9%,p <0.01)。结果,Mc4-TSHRAbs 在鉴别 GD 和 PT 方面显示出比 TSAb 更好的统计学 (p <0.01) 诊断准确性。
结论: 这些数据表明带有嵌合 TSHR (Mc4) 的 Thyretain 生物转运蛋白试验在鉴别诊断 GD 和 PT 方面比用野生型 TSHR 对猪甲状腺细胞进行生物测定更有用。

Painless thyroiditis

内分泌 甲状腺疾病 临床研究术语
概述  :  

无痛性甲状腺炎是一种自身免疫性疾病,由于人体免疫系统攻击甲状腺细胞而引起。甲状腺炎是指甲状腺发炎,通常很痛苦,在无症状甲状腺炎中,不会对甲状腺造成疼痛。因此,它被称为“沉默或无痛性甲状腺炎”。无症状性甲状腺炎的标志性特征是没有甲状腺疼痛或压痛,并且放射性吸收明显降低。无痛性甲状腺炎的其他同义词是淋巴细胞性甲状腺炎,亚急性淋巴细胞性甲状腺炎。病理原因无痛性甲状腺炎的病因是甲状腺的炎症,破坏了甲状腺的结构。通常,甲状腺会储存大量的甲状腺激素,并会在一段时间内少量释放。由于无痛性甲状腺炎引起的腺体

Painless   英 /ˈpeɪnləs/   美 /ˈpeɪnləs/

释    义   adj. 无痛的;不痛的

例    句   The scan is safe, quick and painless. 扫描过程是安全、快速和无痛的。

 

Thyroiditis   英 /,θaɪrɒɪ'daɪtɪs/   美 /,θaɪrɔɪ'daɪtɪs/

释    义   n. [内科] 甲状腺炎

例    句   Conclusion Ultrasonograhy is an effective way for the diagnosis and observation of subacute thyroiditis. 结论:超声检查是诊断和观察亚急性甲状腺炎的一种有效的方法。

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