{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T23:36:28Z","timestamp":1773272188852,"version":"3.50.1"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T00:00:00Z","timestamp":1636070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>Anti TSH receptor antibodies (TSHrAb) are a family of antibodies with different activity, some of them stimulating thyroid function (TSAb), others with blocking properties (TBAb), it is a common finding that antibodies with different function might coexist in the same patient and can modulate the function of the thyroid. However, most of the labs routinely detect all antibodies binding to the TSH receptor (TRAb, i.e. TSH-receptor antibodies detected by binding assay without definition of functional property). Classical use of TSHr-Ab assay is in Graves\u2019 disease where they are tested for diagnostic and prognostic issues; however, they can be used in specific settings of chronic autoimmune thyroiditis (CAT) as well. Aim of the present paper is to highlight these conditions where detection of TSHr-Ab can be of clinical relevance. Prevalence of TSHrAb is different in in the 2 main form of CAT, i.e. classical Hashimoto\u2019s thyroiditis and in atrophic thyroiditis, where TBAb play a major role. Simultaneous presence of both TSAb and TBAb in the serum of the same patient might have clinical implication and cause the shift from hyperthyroidism to hypothyroidism and vice versa. Evaluation of TRAb is recommended in case of patients with Thyroid Associated Orbitopathy not associated with hyperthyroidism. At present, however, the most relevant recommendation for the use of TRAb assay is in patients with CAT secondary to a known agent; in particular, after treatment with alemtuzumab for multiple sclerosis. In conclusion, the routine use of anti-TSH receptor antibodies (either TRAb or TSAb\/TBAb) assay cannot be suggested at the present for diagnosis\/follow up of patients affected by CAT; there are, however, several conditions where their detection can be clinically relevant.<\/jats:p>","DOI":"10.3389\/fendo.2021.769084","type":"journal-article","created":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T12:33:07Z","timestamp":1636115587000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Non-Conventional Clinical Uses of TSH Receptor Antibodies: The Case of Chronic Autoimmune Thyroiditis"],"prefix":"10.3389","volume":"12","author":[{"given":"Giorgio","family":"Napolitano","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ines","family":"Bucci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Di Dalmazi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesidio","family":"Giuliani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,5]]},"reference":[{"key":"B1","article-title":"Zur Kenntniss Der Lymphomatosen Veranderung Der Schilddruse (Struma Lymphomatosa)","volume":"97","author":"Hashimoto","year":"1912","journal-title":"Arch Klin Chir"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.01.007","article-title":"Hashimoto Thyroiditis: Clinical and Diagnostic Criteria","volume":"13","author":"Caturegli","year":"2014","journal-title":"Autoimmun Rev"},{"key":"B3","article-title":"On a Cretinoid State Supervening in Adult Life in Women","volume":"7","author":"Gull","year":"1874","journal-title":"Trans Clin Soc London"},{"key":"B4","first-page":"34","volume-title":"Abnormal Responses in the Assay of Thyrotropin","author":"Adams","year":"1956"},{"key":"B5","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1152\/physrev.1968.48.1.252","article-title":"Humoral Factors in the Pathogenesis of Graves\u2019 Disease","volume":"48","author":"McKenzie","year":"1968","journal-title":"Physiol Rev"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0229","article-title":"2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis","volume":"26","author":"Ross","year":"2016","journal-title":"Thyroid"},{"key":"B7","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1089\/thy.2010.0417","article-title":"Hyperthyroidism and Other Causes of Thyrotoxicosis: Management Guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists","volume":"21","author":"Bahn Chair","year":"2011","journal-title":"Thyroid"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1159\/000500881","article-title":"2019 European Thyroid Association Guidelines on the Management of Thyroid Dysfunction Following Immune Reconstitution Therapy","volume":"8","author":"Muller","year":"2019","journal-title":"Eur Thyroid J"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1126\/science.2556796","article-title":"Molecular Cloning of the Thyrotropin Receptor","volume":"246","author":"Parmentier","year":"1989","journal-title":"Science"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/0006-291x(89)92727-7","article-title":"Molecular Cloning, Sequence and Functional Expression of the cDNA for the Human Thyrotropin Receptor","volume":"165","author":"Nagayama","year":"1989","journal-title":"Biochem Biophys Res Commun"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.87.15.5677","article-title":"Cloning, Chromosomal Assignment, and Regulation of the Rat Thyrotropin Receptor: Expression of the Gene is Regulated by Thyrotropin, Agents That Increase cAMP Levels, and Thyroid Autoantibodies","volume":"87","author":"Akamizu","year":"1990","journal-title":"Proc Natl Acad Sci USA"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2016.00103","article-title":"Bioassays for TSH Receptor Autoantibodies, From FRTL-5 Cells to TSH Receptor-LH\/CG Receptor Chimeras: The Contribution of Leonard D. 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