Graves' IgG stimulation of iodide uptake in FRTL-5 rat thyroid cells: a clinical assay complementing FRTL-5 assays measuring adenylate cyclase and growth-stimulating antibodies in autoimmune thyroid disease.

With optimal conditions and cells maintained in the absence of thyrotropin (TSH) for 7-10 days, IgG preparations from approximately 90% of patients with active Graves' disease can exhibit statistically significant stimulation of cAMP levels in rat FRTL-5 thyroid cells as compared to normal controls. FRTL-5 cells maintained in the absence of TSH for 7-10 days lose their ability to take up iodide. Iodide uptake returns upon readdition of TSH over a 60-hour period via a cAMP-mediated process; thus TSH can be replaced by dibutyryl cAMP or other agents which increase cAMP levels, for example, thyroid-stimulating autoantibodies (TSAbs) from Graves' sera. TSAb stimulation of iodide uptake requires the continued presence of TSAb over at least the first 24 hours of a 48-hour reversal period; TSH, in contrast, can be withdrawn after 5 hours and will still achieve maximal effects at 36-48 hours. Iodide uptake, measured as a 30-minute pulse at 48 hours, appears, however, to be faster with TSAb than TSH. With optimized conditions (cells depleted of TSH greater than 7-10 days; 3-isobytyl-1-methyl xanthine, 0.005 mM; TSAb addition for the entire 48-hour assay period; and a 30-minute pulse of 10 microM 125I-sodium iodide at 37 C), TSAb stimulation is concentration-dependent with a half-maximal activity at approximately 10-fold lower concentrations than in the cAMP stimulation assay. In a series of 24 patients with Graves' disease, IgGs with positive values in the cAMP assay were positive in the iodide uptake assay.(ABSTRACT TRUNCATED AT 250 WORDS)