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Autoantibodies to the self-antigen thyroglobulin (Tg) are usually not found in sera of normal individuals, but are often present in sera of patients with autoimmune thyroid diseases. To determine if the presence of such autoantibodies could be due to the abnormal appearance of self-reactive B cells, which are otherwise absent in normal subjects, or to an alteration in the mechanisms regulating such B cells, peripheral blood lymphocytes (PBL) from normal individuals and patients with autoimmune thyroid diseases were cultured and stimulated in vitro with the polyclonal stimulant pokeweed mitogen (PWM). A modified plaque assay was used to enumerate cells secreting protein A-binding immunoglobulins (Igs) and specific antibodies against Tg. PBL from all individuals tested, including normal subjects (n = 26), could be induced by PWM to produce antibodies against Tg in vitro and these antibodies were of IgG isotypes. PBL from patients with detectable serum anti-Tg had more inducible cells secreting anti-Tg [27,000 +/- 10,700 (+/- SD)/10(6) PBL] than those from patients with autoimmune thyroid diseases, who had no detectable serum anti-Tg (8,000 +/- 5,000), and those from normal individuals (7,200 +/- 4,200). The demonstration of inducible mature (IgG) anti-Tg-producing cells in normal individuals suggests that subclinical autoimmunity against certain self-antigens may be a normal phenomenon in man and that its escalation into clinical autoimmune conditions is prevented through regulation of the specific self-reactive cells.

A radiometric two-site assay for soluble thyroglobulin-antithyroglobulin immune complex (TgA) applicable to human serum has been developed. Rabbit anti-(human)IgG globulin and anti-(human)thyroglobulin (anti-Tg) were purified by affinity chromatography. When these antibodies were labeled with 125I, 45% and 62% could be bound to their corresponding antigens, IgG globulin and thyroglobulin, respectively. TgA was prepared by dissolving the immune precipitate (formed with human thyroglobulin [Tg] and human anti-Tg) in excess Tg and chromatographing the mixture on Sepharose 4B. On immunoelectrophoresis TgA migrated between IgG and Tg and formed precipitin lines against anti-IgG and anti-Tg. Serum unknowns were chromatographed on Sepharose 4B to separate TgA from free IgG; the heavy TgA eluated in the first fraction. Standard TgA or prepared unknown was first incubated in plastic cups precoated with anti-IgG. After washing cups (free Tg was removed at this step), bound TgA was identified by binding to cups of added 125I-anti-Tg, the bound radioactivity being directly proportional to the amount of TgA present. Minimal detectable TgA was 0.4 ng/cup corresponding to a serum concentration of 16 ng/ml. The response curves of serial dilutions of serum eluate paralleled the standard curve. Coefficients of within assay variation ranged from 3.7 to 4.9%; coefficients for between assay variation ranged from 20 to 28%. Preliminary data indicated that TgA was not detected in the sera of 10 normal subjects, but was detectable in 7 of 29 subjects (24%) with Graves' disease. The clinical significance of serum TgA levels remains to be determined by more extensive testing. The results indicate that a soluble immune complex, TgA, can be detected in serum with a high degree of sensitivity and reliability.

Thyroid disorders can be associated with elevated concentrations of serum antithyroglobulin antibodies (anti-Tg) and/or thyroglobulin (Tg), but none of the available anti-Tg assays deals with anti-Tg measurements in the presence of abnormally high Tg levels. The competitive binding radioassay produces falsely elevated values for anti-Tg if serum Tg is elevated and either falsely elevated or depressed values if both Tg and anti-Tg are abnormally high. The falsely elevated anti-Tg values can be identified by measuring the formation of Tg[125I]anti-Tg complexes in the supernatant of the anti-Tg assay (supernatant assay). For screening purposes, we modified the original anti-Tg RIA into a solid phase, sandwich-type RIA. Anti-Tg in serum or standard is first bound to plastic cups coated with Tg and then quantitated by binding of [125I]Tg. This assay has a detection limit of 2 U/ml serum, intra- and interassay coefficients of variation of 9--15%, and a normal range of less than 2 U/ml. When sera with normal Tg concentrations were analyzed, the results for anti-Tg obtained by the competitive binding RIA and the new sandwich RIA were comparable as far as positives and negatives were concerned, and the numerical values for positive sera correlated moderately well (r = 0.79); the sandwich assay, in general, gave lower values for anti-Tg. The major advantages of the sandwich anti-Tg RIA are the elimination of false positive results and its applicability to sera containing high levels of both Tg and anti-Tg. In the latter case, the results indicate the level of free anti-Tg present, as opposed to antibody present in the form of Tg-anti-Tg complexes.

We studied the regulatory activities of T cells on specific antithyroglobulin (anti-Tg) and nonspecific immunoglobulin secretion in cultures of peripheral blood lymphocytes (PBL) of five patients with autoimmune thyroid diseases and high levels of serum anti-Tg. PBL were separated into a non-T population, including B-cells and monocytes, and a T-cell population by rosetting with sheep red cells. T-Cells were further separated into T helper (Th) and T suppressor (Ts) subsets by a panning technique using the monoclonal antibodies anti-Leu 3a and anti-Leu 2a, respectively. The three sets of cells, i.e. B, Th, and Ts, from patients and from normal individuals were cocultured in various combinations and stimulated with the polyclonal stimulant pokeweed mitogen. A sensitive plaque assay was used to enumerate cells producing anti-Tg and protein A-binding immunoglobulins. The PBL of both patients and normal individuals had Tg-specific suppressor cells. Ts-cells from patients in syngeneic or allogeneic combinations with B- and Th-cells at a ratio of 1:1:1 suppressed the pokeweed mitogen-induced anti-Tg response to 41 +/- 8% (+/-SE) and 50 +/- 20% of the control value, respectively, while Ts from normal individuals suppressed the response to 7 +/- 3% of the control value. The suppressive effect of the Ts-cells from patients and normal individuals on nonspecific immunoglobulin secretion was similar (reduced to 10-15% of control). Thus, there appeared to be a deficiency in Tg-specific suppressor activity in PBL of patients. On the other hand, Th-cells from patients (syngeneic or allogeneic) cocultured with patient B-cells produced a greater anti-Tg response than Th-cells from normal individuals. The helper activities of Th-cells of patients and normal individuals on nonspecific immunoglobulin secretion were similar. Thus, there appeared to be an increase in Tg-specific helper activity in PBL of patients.

A mouse hybridoma clone secreting an immunoglobulin M monoclonal antibody (K-5-4), which reacted with human thyroglobulin (Tg), was obtained from spleen cells of mice immunized with crude membranes of human eye muscle tissues (Em). Its binding to Tg could be inhibited by another monoclonal anti-Tg (F1-11-1) derived from spleen cells of mice immunized with human thyroid cell membranes, but K-5-4 did not inhibit the binding of F1-11-1 to Tg. This finding suggests that K-5-4 may react with a site on the Tg molecule which is susceptible to conformational changes, such as that induced by binding of another anti-Tg antibody at another site on Tg. K-5-4 reacted with human, mouse, rat, guinea pig, bovine, and porcine Tg. Binding and immunohistological staining experiments failed to detect binding of K-5-4 to Em tissue. The very low frequency of one Tg-reacting hybridoma from 6 X 10(8) spleen cells fused after Em immunization contrasts with the relative ease with which monoclonal anti-Tgs were generated from spleen cells of mice immunized with crude human thyroid membranes. In the latter case, 1 anti-Tg hybridoma was generated for every 100,000 spleen cells fused, and an extensive library of monoclonal anti-Tgs was collected. Some of these antibodies were specific for human Tg only, while others cross-reacted with Tg of other animal species. None had the species reativity pattern of K-5-4. The anti-Tgs were used to affinity purify human Tg directly from supernatant of thyroid homogenate; the purified Tg was, in turn, used to affinity purify human polyclonal but monospecific anti-Tg directly from serum of patients in a simple and rapid procedure. We conclude that the monoclonal anti-Tgs are useful reagents in isolating and purifying Tg and anti-Tg.

To test the hypothesis that Graves' dermopathy is due to cross-reactivity of thyroid autoantibody(ies) with a cellular target in pretibial skin, we tested the serum and serum immunoglobulin fraction of 20 such patients for their effects on the metabolic activities of cultured thyrocytes (rat FRTL cells), human pretibial skin fibroblasts, and human fibroblasts of other origins. The incorporation of 3H-labeled thymidine, amino acids, and glucosamine into DNA, protein, and glycosaminoglycans, respectively, was measured. TSH and the serum of each of the 20 patients with Graves' dermopathy markedly stimulated the synthesis of DNA, protein, and glycosaminoglycans by FRTL cells, but not by fibroblasts, whereas assays of serum from 38 of 40 patients with Graves' disease without dermopathy did not stimulate these processes in FRTL cells more than normal serum. Stimulatory activity was associated with immunoglobulins. Serum dermopathy-associated antibodies disappeared with the disappearance of the skin lesions. These results suggest that the serum of patients with dermopathy contains antibodies that recognize a component of the TSH receptor different from that recognized by serum of Graves' patients without dermopathy, the former acting in some manner to induce lesions in pretibial skin. The skin target remains unidentified.

Abnormally high levels of activity (BA) of immunoglobulins (Igs) to membranes containing TSH receptors were observed in patients with Graves' disease. The assay to detect such BA used guinea pig fat as the membrane source. [125I]Protein A was used to develop the binding antibodies (in serum or IgG). The assay was able to detect specific BA in microgram quantities or less of IgG in about 50% of the sera of patients with Graves' disease. The presence or amount of serum BA did not correlate consistently with either the presence in serum of TSH binding inhibitory Ig or the clinical estimate of thyrotoxicity in Graves' disease. High levels of BA were frequently found in sera of patients with other autoimmune diseases, such as Hashimoto's thyroiditis, rheumatoid arthritis, mixed connective tissue disease, and systemic lupus erythematosus. However, BA found in the latter disorders frequently was positive not only when using fat cell membranes but also when using liver kidney, or skeletal muscle membranes. The assay may detect a heterogeneous population of Igs binding specifically to membranes and may reflect a general state of autoimmunity.