have previously demonstrated that radioiodine treatment increases TRAb titers already 1 month after treatment and with a maximal response after 3 months [8]. GO after 12 months and relationship to the genetic background (HLA, CTLA-4, and CYR61). Results Three months of radioiodine TRAb titers increased in two thirds of patients (value(HLA-DR-DQQ was analysed as previously explained [16]. Table 2 SRPKIN-1 Characteristics of genotyped patients (%) unless normally stated DNA was collected for genotyping using buccal swabs, then extracted using QiAamp UCP DNA Micro Kit (Qiagen, Sweden) and amplified using Repli-g Screening Kit (Qiagen, Sweden). SNPs were genotyped by TaqMan Allelic Discrimination Assay using the Quantstudio 7 Flex system (Applied Biosystems by Life Technologies, Sweden). The minor SRPKIN-1 allele frequency (MAF) for all those SNPs was > 0.05. One SNP (rs12756618 in CYR61) failed the HardyCWeinberg equilibrium and was excluded from your analysis. The standard statistical analysis approach was used to find the association of TRAb < median/TRAb > median and GO/no GO association. A linear regression model was used with smoking and gender as covariates. The data are offered as odds ratios (ORs) with 95% confidence intervals (CIs). The p-values are based on additive models for the genetic variants. All genetic analyses were performed using PLINK version 1.0 (http://pngu.mgh.harvard.edu/~purcell/plink/index.shtml). Assays for antibodies TRAb was measured with a competitive Electro Chem Luminiscens Immunoassay (ECLI) according to the produces instructions (Roche). The limit of detection was 0.3 IU/L, CV 5% at 16 IU/L. The cut-off for any positive value of TRAb was >1 kIU/L. Anti-TPO titer was measured with a competitive sandwich ELISA (Roche) according to the produces instructions (detection limit 5 kIU/L, CV 11% at 34 kIU/L. The cut-off for any positive value of anti-TPO was >34 kIU/L. Anti-TG was measured Rabbit Polyclonal to ENDOGL1 with a competitive sandwich ELISA (Roche) according to the produces instructions (detection limit 10 kIU/L, CV 10% at 73 kIU/L). The cut-off for any positive value of anti-TG was >115 kIU/L. Samples were analysed in routine clinical laboratory at the Department of Clinical Chemistry in Malm? and Lund. Statistics The fold changes of thyroid antibodies were calculated. A change of 1.1 or more was judged as an increase and if lower than 1.1 the change was judged as unchanged or decreased. The t-test (continuous variables), chi-square test (categorical variables), and bi-nomial test were used to assess the statistical significance of differences between the groups. Linear regression analysis was used to study the correlations between the parameters fold switch of TRAb, anti, TPO, and anti-TG. All statistical analyses were carried out using the SPSS 22.0 statistical software (SPSS, Chicago, IL, USA) or Graph Pad prism 8.0 The significance levels were *p?0.05; **p?0.01; ***p?0.001, ****p?0.0001. Results At the start of treatment with radioiodine 204 patients were registered and thyroid antibodies; TRAb, anti-TPO, anti TG were analysed before treatment with radioiodine, and 3 months after radioiodine the antibody analysis was repeated for detection of patients that showed an increase of 1 1.1 or more. The cut-off was set based on the knowledge of the variance coefficient for the antibody assays. We found two groups according to antibody response 3 months after radioiodine; one group increased in titers of TRAb anti-TPO and anti-TG (70% of patients). Another group showed a decrease in titers of antibodies or were unchanged (30% of patients) (Fig. ?(Fig.1).1). There was not only a significant increase or decrease in fold switch of antibody titers 3 months after radioiodine, but also a significant increase or decrease in median values of all three antibodies (Fig. ?(Fig.1).1). Three months after treatment, a correlation with radioiodine was found for titers of TRAb and anti-TPO (Fig. ?(Fig.2)2) but not for anti-TG (data not shown). Open in a separate windows Fig. 1 Fold change and proportion of TRAb (A, D), anti-TPO (B, E), and anti-TG (C, F) 3 months after treatment of Graves disease with radioiodine. The median values of TRAb, anti-TPO and anti TG before and after radioiodine in the group with fold switch 1.1 and in the group with fold switch >/=?1.1 were all significant with p-values 0.0001 (t-test). Differences in proportion was calculated with a binomial test and differences in median values with a t-test SRPKIN-1 Open in a separate windows Fig. 2 Correlation of fold switch in TRAb and anti-TPO 3 months after treatment with RI (R?=?0.362, p?0.0001) All 204 patients were followed for at least 1 year after treatment with radioiodine to identify the development of GO and correlate GO to the antibody response. We found an overrepresentation of GO in the group with increased titers of TRAb and anti-TPO with a proportion of GO patients at follow-up after 1 year of 70% versus 30% in the group with no increase in antibody titers.