{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:26:30Z","timestamp":1783488390126,"version":"3.55.0"},"reference-count":38,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Exp Clin Endocrinol Diabetes"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective To determine the association between autoantibodies to\n                        G-protein-coupled receptors with effect on the cardiovascular system and the\n                        cardiac biomarker N-terminal pro-brain natriuretic peptide reflecting heart\n                        function in Graves\u02bc disease.<\/jats:p><jats:p>\n          Design and Methods Sixty premenopausal women with Graves\u2019\n                        disease were analyzed for IgG autoantibodies against\n                        \u03b21-adrenergic, muscarinic acetylcholine type 2 and\n                        angiotensin II type 1 receptors using enzyme-linked immunosorbent assays\n                        based on cell membranes overexpressing receptors in their native\n                        conformations. N-terminal pro-brain natriuretic peptide and heart symptoms\n                        were analyzed in hyperthyroidism and after 7.5 months of antithyroid\n                        treatment. Matched thyroid healthy controls were also assessed.<\/jats:p><jats:p>\n          Results Serum levels of antibodies against the\n                        \u03b21-adrenergic and the muscarinic acetylcholine type 2\n                        receptors were higher in hyperthyroid patients than in controls (median\n                            \u03b21-adrenergic receptor antibodies 1.9 [IQR\n                        1.3\u20132.7] vs. 1.1 [0.8\u20131.7] \u03bcg\/mL,\n                            P&lt;0.0001; muscarinic acetylcholine type 2 receptor 20.5\n                        [14.0\u201338.3] vs. 6.0 [3.2\u20139.9] U\/mL,\n                        P&lt;0.0001). These antibodies decreased in euthyroidism\n                            (P&lt;0.01), but were still higher than in controls\n                            (P&lt;0.01). Angiotensin II type 1 receptor levels did not\n                        differ. N-terminal pro-brain natriuretic peptide was higher in\n                        hyperthyroidism (240 [134\u2013372] vs. &lt;35\n                        [&lt;35\u201367] ng\/L, P&lt;0.0001), normalized\n                        after treatment and did not correlate with autoantibodies.<\/jats:p><jats:p>\n          Conclusion Autoantibodies against the \u03b21-adrenergic\n                        and the muscarinic acetylcholine type 2 receptors were increased in\n                        Graves\u2019 patients, decreased with treatment, but did not correlate\n                        with cardiac function. However, an autoimmune effect on the heart cannot be\n                        excluded in subpopulations, as the functional properties of the analyzed\n                        antibodies remain to be determined.<\/jats:p>","DOI":"10.1055\/a-1342-2853","type":"journal-article","created":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T23:45:48Z","timestamp":1610495148000},"page":"783-790","source":"Crossref","is-referenced-by-count":3,"title":["\u03b21-adrenergic and Muscarinic Acetylcholine Type 2\n                    Receptor Antibodies are Increased in Graves\u2019 Hyperthyroidism and\n                    Decrease During Antithyroid Therapy"],"prefix":"10.1055","volume":"129","author":[{"given":"Karin","family":"Tammelin","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,\n                    Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Lundgren","sequence":"additional","affiliation":[{"name":"Clinical Immunology and Transfusion Medicine, Sahlgrenska University\n                    Hospital, Gothenburg, Sweden"},{"name":"Institute of Biomedicine, Sahlgrenska Academy, Department of\n                    Microbiology and Immunology, University of Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Holmberg","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,\n                    Sweden"},{"name":"ANOVA, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bengt","family":"Andersson","sequence":"additional","affiliation":[{"name":"Clinical Immunology and Transfusion Medicine, Sahlgrenska University\n                    Hospital, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena Filipsson","family":"Nystr\u00f6m","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Sahlgrenska Academy, University of Gothenburg,\n                    Sweden"},{"name":"Department of Endocrinology, Sahlgrenska University Hospital,\n                    Gothenburg, Sweden"},{"name":"Wallenberg Center for Molecular and Translational Medicine, Gothenburg,\n                    Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,1,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1089\/thy.2016.0229","article-title":"2016 American Thyroid Association Guidelines for Diagnosis and\n                    Management of Hyperthyroidism and Other Causes of\n                    Thyrotoxicosis","volume":"26","author":"D S Ross","year":"2016","journal-title":"Thyroid : Official Journal of the American\n                    Thyroid\n                    Association"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1055\/s-0034-1370920","article-title":"Relationship between autoantibody to the angiotensin II-1 receptor\n                    and cardiovascular manifestations of Graves'\n                    disease","volume":"122","author":"J Xu","year":"2014","journal-title":"Experimental and clinical endocrinology &\n                    diabetes : Official Journal, German Society of Endocrinology [and] German\n                    Diabetes\n                    Association"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1007\/s00268-015-3352-6","article-title":"A prospective study on cardiovascular dysfunction in patients with\n                    hyperthyroidism and its reversal after surgical cure","volume":"40","author":"S Muthukumar","year":"2016","journal-title":"World\n                    Journal of\n                    Surgery"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1002\/ejhf.592","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and\n                    chronic heart failure: The Task Force for the diagnosis and treatment of acute\n                    and chronic heart failure of the European Society of Cardiology (ESC). 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