{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:17:48Z","timestamp":1787026668600,"version":"build-2736575974"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"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. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Endometriosis can cause gastrointestinal symptoms that sometimes lead to incorrect diagnosis of irritable bowel syndrome (IBS). Receptors of thyroid-stimulating hormone (TSH) are found in the endometrium and are overexpressed in ectopic endometrium. The role of TSH receptors and thyroid hormones in the pathophysiology of endometriosis has therefore been discussed. No biomarker is available for endometriosis diagnosis, but the findings of TSH receptor antibodies (TRAb) have been found by two different methods. The present study aimed to confirm that TRAb IgG levels are elevated in patients with endometriosis compared with IBS and healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 121 patients with a diagnosis of endometriosis and two cohorts with 50 IBS patients and 50 healthy controls were recruited for the study. All subjects had to fulfill study questionnaires regarding sociodemographic factors, lifestyle, medical history, and gastrointestinal symptoms. Blood samples were drawn, and TRAb IgG was analyzed in serum samples at the Departments of Clinical Chemistry at Sahlgrenska University Hospital using the BRAHMS TRAK Human assay from Thermo Fisher Scientific and at Sk\u00e5ne University Hospital using the Elecsys Anti-TSHR assay from Roche Diagnostics. Both methods were developed and used clinically to diagnose Graves\u2019 disease with high specificity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with endometriosis had the highest BMI (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001) and prevalence of hypothyroidism (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.005). Endometriosis and IBS patients had many gastrointestinal symptoms, in contrast to the healthy controls. There was no significant difference in the number of patients with detectable serum TRAb between endometriosis patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f10, 8.3%) and controls (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f2, 4%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.512) or between endometriosis patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f10, 8.3%) and IBS patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f3, 6%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.758) in Gothenburg. Similar results were found when TRAb was analyzed in serum samples in Malm\u00f6, with the same prevalence of TRAb in endometriosis patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f4, 4.9%) as in controls (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f4, 8.0%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.710) and IBS patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f4, 8.0%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.710).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The available tests in clinical routine could not reveal elevated levels of TRAb in the current exploratory study. Thus, TRAb cannot yet be used clinically as a biomarker of endometriosis. Still, other variants of antibody tests may be used in a laboratory experimental setting. The role of TSH receptors and TRAb in the pathophysiology of endometriosis deserves further research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1612079","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T05:28:39Z","timestamp":1758518919000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Elevated levels of TRAb IgG autoantibodies are not recognized in endometriosis by the current clinical methods"],"prefix":"10.3389","volume":"12","author":[{"given":"Agnes","family":"Petersson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bodil","family":"Roth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Becker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bodil","family":"Ohlsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1016\/S0140-6736(04)17403-5","article-title":"Endometriosis","volume":"364","author":"Giudice","year":"2004","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2713","DOI":"10.1111\/jog.14837","article-title":"Risk factors for recurrence of deep infiltrating endometriosis after surgical treatment","volume":"47","author":"Yela","year":"2021","journal-title":"J Obstet Gynaecol Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"61","DOI":"10.5603\/FHC.a2018.0013","article-title":"Endometriosis - insights into a multifaceted entity","volume":"1","author":"Amalinei","year":"2018","journal-title":"Folia Histochem Cytobiol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1210\/er.2009-0041","article-title":"Thyroid function and human reproductive health","volume":"31","author":"Krassas","year":"2010","journal-title":"Endocr Rev"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1016\/S1472-6483(10)60091-0","article-title":"Receptors for thyroid-stimulating hormone and thyroid hormones in human ovarian tissue","volume":"18","author":"Aghajanova","year":"2009","journal-title":"Reprod Biomed Online"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"237.e1-2","DOI":"10.1016\/j.fertnstert.2010.06.079","article-title":"Thyroid-stimulating hormone receptor and thyroid hormone receptors are involved in human endometrial physiology","volume":"95","author":"Aghajanova","year":"2011","journal-title":"Fertil Steril"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"11894","DOI":"10.1073\/pnas.1820469116","article-title":"Role of thyroid dysimmunity and thyroid hormones in endometriosis","volume":"116","author":"Peyneau","year":"2019","journal-title":"Proc Natl Acad Sci USA"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1159\/000539265","article-title":"Coexistence of endometriosis and thyroid autoimmunity in infertile women: impact on in vitro fertilization and reproductive outcomes","volume":"89","author":"Koro\u0161ec","year":"2024","journal-title":"Gynecol Obstet Investig"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e2975","DOI":"10.1097\/MD.0000000000002975","article-title":"Graves disease is associated with endometriosis: a 3-year population-based cross-sectional study","volume":"95","author":"Yuk","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.ejogrb.2018.09.034","article-title":"Characteristics of endometriosis: a case-cohort study showing elevated IgG titers against the TSH receptor (TRAb) and mental comorbidity","volume":"231","author":"Ek","year":"2018","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.ejogrb.2022.09.013","article-title":"TSH receptor antibodies (TRAb) - a potential new biomarker for endometriosis","volume":"278","author":"Svensson","year":"2022","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"10497323251328538","DOI":"10.1177\/10497323251328538","article-title":"Endometriosis, polycystic ovary syndrome, and the thyroid: a review. Endocr","volume":"13","author":"Kirkegaard","year":"2024","journal-title":"Connect"},{"key":"ref13","first-page":"e20221679","article-title":"Is there an association between endometriosis and thyroid autoimmunity?","volume-title":"Rev Assoc Med Bras","author":"\u015eerifo\u011flu","year":"1992"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1089\/105072502320908330","article-title":"Thyroid dysfunction and autoimmunity in infertile women","volume":"12","author":"Poppe","year":"2002","journal-title":"Thyroid"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"3412","DOI":"10.1093\/humrep\/des316","article-title":"Diagnostic delay for endometriosis in Austria and Germany: causes and possible consequences","volume":"27","author":"Hudelist","year":"2012","journal-title":"Hum Reprod"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"914356","DOI":"10.3389\/fmed.2022.914356","article-title":"Endometriosis and irritable bowel syndrome: a systematic review and meta-analyses","volume":"9","author":"Nabi","year":"2022","journal-title":"Front Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.ejogrb.2020.01.031","article-title":"A systematic review and meta-analysis of the associations between endometriosis and irritable bowel syndrome","volume":"246","author":"Saidi","year":"2020","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref18","year":"2022"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"39","DOI":"10.3390\/nu16173039","article-title":"A starch-and sucrose-reduced diet has similar efficiency as low FODMAP in IBS-A randomized non-inferiority study","volume":"16","author":"Roth","year":"2024","journal-title":"Nutrients"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1053\/j.gastro.2016.02.031","article-title":"Bowel Disorders","volume":"150","author":"Mearin","year":"2016","journal-title":"Gastroenterology"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1046\/j.1365-2036.1997.142318000.x","article-title":"The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress","volume":"11","author":"Francis","year":"1997","journal-title":"Aliment Pharmacol Ther"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1342351","DOI":"10.3389\/fphys.2024.1342351","article-title":"Gastrointestinal symptoms in patients with postural orthostatic tachycardia syndrome in relation to hemodynamic findings and immunological factors","volume":"15","author":"Tufvesson","year":"2024","journal-title":"Front Physiol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/1471-230X-7-16","article-title":"Development and psychometric testing of the visual analogue scale for irritable bowel syndrome (VAS-IBS)","volume":"7","author":"Bengtsson","year":"2007","journal-title":"BMC Gastroenterol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1097\/SGA.0b013e3182945881","article-title":"Further validation of the visual analogue scale for irritable bowel syndrome after use in clinical practice","volume":"36","author":"Bengtsson","year":"2013","journal-title":"Gastroenterol Nurs"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1481","DOI":"10.1053\/j.gastro.2016.02.014","article-title":"Rome IV diagnostic questionnaires and tables for investigators and clinicians","volume":"150","author":"Palsson","year":"2016","journal-title":"Gastroenterology"},{"key":"ref26","year":"2024"},{"key":"ref27","year":"2024"},{"key":"ref28","article-title":"Assay of thyroid hormones and related substances","volume-title":"Endotext","author":"Spencer","year":"2000"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"E328","DOI":"10.1152\/ajpendo.00123.2024","article-title":"Identification and functionalization of thyrotropin receptor antibodies with different antigenic epitopes","volume":"327","author":"Zheng","year":"2024","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1007\/s12020-020-02264-x","article-title":"Identification of novel HLA-A0201-restricted T-cell epitopes against thyroid antigens in autoimmune thyroid diseases","volume":"69","author":"Cai","year":"2020","journal-title":"Endocrine"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3126\/jucms.v4i2.19082","article-title":"Prevalence of thyroid dysfunction in irritable bowel syndrome","volume":"4","author":"Khadka","year":"2018","journal-title":"J Univ Coll Med Sci"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1093\/humupd\/dmz014","article-title":"The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis","volume":"25","author":"Shigesi","year":"2019","journal-title":"Hum Reprod Update"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1612079\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T05:28:40Z","timestamp":1758518920000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1612079\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,22]]},"references-count":32,"alternative-id":["10.3389\/fmed.2025.1612079"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1612079","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,22]]},"article-number":"1612079"}}