What is Graves disease?

Graves’ disease is an autoimmune thyroid disorder typically characterized by low thyroid stimulating hormone (TSH) levels and elevated T3 and T4 values, which lead to hypothyroidism. The causative agent is thyroid stimulating immunoglobulin (TSI).What are the causes?

What are the symptoms?

Early signs and symptoms of Graves’ disease include

  • Tachycardia
  • Palpitations
  • Chest pain
  • Anxiety
  • Depression
  • Weight loss
  • Fatigue

More serious signs and symptoms include

  • Goiter
  • ”Orange-peel" skin
  • Lid-lag
  • Exophthalmos/Graves’ opthalmopathy
  • Atrial fibrillation
  • Tremor
  • Osteoporosis
  • Pretibial myxedema

What are the treatment options?

Medical Therapy: Antithyroid drugs (ATD) and thyrostatics are suppressive drugs meant to inhibit the production of thyroid hormones T3 and T4 to treat the symptoms of Graves’ disease.

Radiodine Ablation Therapy: Iodine-131 (Radioiodine) is given orally on a one-time basis to destroy the function of a hyperactive gland. The radioactive iodine is picked up by the active cells in the thyroid, which use iodine to produce T4, and destroys these cells. A common outcome following radioiodine treatment is hypothyroidism.

Surgery: For patients who cannot tolerate medicines or are allergic to or decline iodine-131. Full or partial thyroidectomy is used only in rare cases in the US and is not considered a primary option for Graves’ disease treatment, due to the risks from anesthesia and surgery.

Who gets Graves’ disease?

  • Population Prevalence: 1-2%
  • Onset: Typically Late 20’s to 40’s
  • Female to Male Ratio: 8:1

What is Thyretain?

Thyretain is a TSI assay based on a genetically engineered cell line that specifically responds to TSI in patient serum. Unlike the current methodology of nonspecific TRAB assays, which cannot differentiate between blocking or stimulating antibodies, the genetically engineered cell line in Thyretain differentiates immediately between blocking and stimulating immunoglobulins.

How does it work?

The genetically engineered cell line in Thyretain expresses a modified version of the TSH receptor on the thyroid gland. This receptor receives TSI from a patient sample and produces firefly luciferase under the control of a cyclic AMP-responsive promoter. The luciferase can then be detected and quantified to provide a TSI value for the patient.