Eye Muscle Membrane Reactive Antibodies are not Detected in the Serum or Immunoglobulin Fraction of Patients with Thyroid-Associated Ophthalmopathy Using an Elisa and Crude Membranes

Thyroid-associated ophthalmopathy is thought to be an autoimmune disease affecting the orbit. The precise pathogenetic mechanisms are not known, but extraocular muscle and/or orbital fibroblasts are the likely targets of the autoimmune attack. Sera from 41 normal controls, 79 patients with thyroid-associated ophthalmopathy and 72 patients with other autoimmune diseases were examined for antibodies to cultured orbital fibroblasts and extraocular muscle by enzyme-linked immunosorbent assay. Orbital fibroblast antibody levels varied widely in all subject groups studied, and failed to distinguish patients with thyroid-associated ophthalmopathy from patients with other autoimmune diseases or controls. Eye-muscle binding antibody levels were higher amongst patients with ophthalmopathy compared to normal controls and patients with Graves' hyperthyroidism without clinical evidence of ophthalmopathy. Furthermore, eye-muscle binding antibody levels were found to be particularly high in patients with ophthalmopathy and concurrent dermopathy, and in patients with ophthalmic (euthyroid) Graves' disease.

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Re-evaluation of eye muscle autoantibody determination in Graves' ophthalmopathy: failure to detect a specific antigen by use of enzyme-linked immunosorbent assay, indirect immunofluorescence, and immunoblotting techniques

Acta Endocrinologica ◽

10.1530/acta.0.1210643 ◽

1989 ◽

Vol 121 (5) ◽

pp. 643-650 ◽

Cited By ~ 20

Author(s):

E. Schifferdecker ◽

U. Ketzler-Sasse ◽

B. O. Boehm ◽

H. B. Ronsheimer ◽

W. A. Scherbaum ◽

...

Keyword(s):

Skeletal Muscle ◽

Indirect Immunofluorescence ◽

Specific Antigen ◽

Antigenic Structure ◽

Muscle Membrane ◽

Enzyme Linked Immunosorbent Assay ◽

Eye Muscle ◽

Human Eye ◽

Graves Ophthalmopathy ◽

Indirect Immunofluorescence Technique

Abstract. Sera from 41 patients with Graves' ophthalmopathy were investigated for presence of autoantibodies directed against eye muscle preparations using different methods: 1. ELISA with pork eye muscle membrane preparations; 2. Immunoblotting with glycoprotein preparations from human eye muscle; 3. Indirect immunofluorescence with human eye muscle sections. The ELISA was not suitable for detection of specific immunoglobulin binding with sera from patients suffering from endocrine ophthalmopathy. Immunoblotting exhibited only nonspecific binding to some muscle proteins; it could be prevented by pre-adsorption procedures and was not different from the pattern observed with skeletal muscle as antigen. The indirect immunofluorescence technique revealed no binding of Graves' sera to human muscle sections, whereas sera containing antibodies against skeletal muscle bound to eye muscle as well. Thus far, an antigenic structure of eye muscle specific for Graves' ophthalmopathy is not detectable with the methodology used here. The possibility that retroorbital connective tissue may be the main target of the autoimmune process must be considered.

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