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*Substance via MeSH
Endocrine Reviews 19 (6): 673-716
Copyright © 1998 by The Endocrine Society

The Thyrotropin (TSH)-Releasing Hormone Receptor: Interaction with TSH and Autoantibodies1

Basil Rapoport, Gregorio D. Chazenbalk, Juan Carlos Jaume2 and Sandra M. McLachlan

Autoimmune Disease Unit, Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, and the University of California, Los Angeles, California 90048

I. Introduction
II. TSHR Ectodomain Structure
A. Primary amino acid structure
B. Subunit structure
C. Disulfide bonds in the TSHR ectodomain
D. Carbohydrate moieties in the TSHR ectodomain
E. TSHR dimerization
III. Recombinant TSHR Expression
A. Approaches to TSHR expression
B. TSHR expression in prokaryotes
C. TSHR expression as cell-free translates or as synthetic peptides
D. TSHR expression in eukaryotic insect cells
E. TSHR expression in mammalian cells
IV. TSH and Autoantibody Binding to the TSHR Ectodomain
A. Holoreceptor vs. ectodomain
B. Conformational nature of binding sites
C. TSHR carbohydrate: part of the binding site?
D. TSHR amino acid residues in TSH-binding site
E. Autoantibody epitopes
V. TSHR Autoantibody Assays
A. Historical background
B. In vivo and in vitro bioassays
C. Indirect TBI assays
D. Direct assays for TSHR autoantibodies
E. Confusion on the terminology and types of TSHR autoantibodies
VI. Monoclonal Autoantibodies to the TSHR Ectodomain
A. Introduction
B. Mouse TSHR mAb
C. Human monoclonal TSHR autoantibodies
D. Interpretation of the data on human TSHR-specific mAbs
E. Why is the subject of TSHR mAbs controversial?
F. Source of B cells used to obtain human TSHR monoclonal antibodies
VII. T Cell Epitopes
A. Background
B. Approaches to studying T cell responses
C. TSHR synthetic peptides
D. Endogenous antigen processing
E. TSHR-specific T cell receptor genes and cytokine production
F. Summary
VIII. Molecular Mimicry
IX. Animal Models of Graves’ Disease
A. Immunization with soluble TSHR antigen and adjuvant
B. Genetic immunization
C. Severe combined immunodeficiency (SCID) mouse model of Graves’ disease
D. Immunization with live syngeneic fibroblasts expressing the TSHR and class II molecules
X. Ectodomain Mutations and Polymorphisms
A. Spontaneous ectodomain mutations leading to enhanced TSHR function
B. Spontaneous ectodomain mutations leading to decreased TSHR function
C. Nonfunctional polymorphisms in the TSHR ectodomain
D. TSHR ectodomain splice variants
XI. Extrathyroidal Manifestations of Graves’ Disease




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J. Immunol.Home page
Y. Nagayama, H. Mizuguchi, T. Hayakawa, M. Niwa, S. M. McLachlan, and B. Rapoport
Prevention of Autoantibody-Mediated Graves'-Like Hyperthyroidism in Mice with IL-4, a Th2 Cytokine
J. Immunol., April 1, 2003; 170(7): 3522 - 3527.
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CMAJHome page
J. Ginsberg
Diagnosis and management of Graves' disease
Can. Med. Assoc. J., March 4, 2003; 168(5): 575 - 585.
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J. Clin. Endocrinol. Metab.Home page
T. Y. Kim, Y. J. Park, D. J. Park, H.-K. Chung, W. B. Kim, L. D. Kohn, and B. Y. Cho
Epitope Heterogeneity of Thyroid-Stimulating Antibodies Predicts Long-Term Outcome in Graves' Patients Treated with Antithyroid Drugs
J. Clin. Endocrinol. Metab., January 1, 2003; 88(1): 117 - 124.
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EndocrinologyHome page
P. V. Rao, P. F. Watson, A. P. Weetman, G. Carayanniotis, and J. P. Banga
Contrasting Activities of Thyrotropin Receptor Antibodies in Experimental Models of Graves' Disease Induced by Injection of Transfected Fibroblasts or Deoxyribonucleic Acid Vaccination
Endocrinology, January 1, 2003; 144(1): 260 - 266.
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J. Biol. Chem.Home page
R. Latif, P. Graves, and T. F. Davies
Ligand-dependent Inhibition of Oligomerization at the Human Thyrotropin Receptor
J. Biol. Chem., November 15, 2002; 277(47): 45059 - 45067.
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Endocr. Rev.Home page
M. Ascoli, F. Fanelli, and D. L. Segaloff
The Lutropin/Choriogonadotropin Receptor, A 2002 Perspective
Endocr. Rev., April 1, 2002; 23(2): 141 - 174.
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Mol. Endocrinol.Home page
G. Smits, C. Govaerts, I. Nubourgh, L. Pardo, G. Vassart, and S. Costagliola
Lysine 183 and Glutamic Acid 157 of the TSH Receptor: Two Interacting Residues with a Key Role in Determining Specificity toward TSH and Human CG
Mol. Endocrinol., April 1, 2002; 16(4): 722 - 735.
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Mol. Endocrinol.Home page
V. Vlaeminck-Guillem, S.-C. Ho, P. Rodien, G. Vassart, and S. Costagliola
Activation of the cAMP Pathway by the TSH Receptor Involves Switching of the Ectodomain from a Tethered Inverse Agonist to an Agonist
Mol. Endocrinol., April 1, 2002; 16(4): 736 - 746.
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Physiol. Rev.Home page
M. W. Szkudlinski, V. Fremont, C. Ronin, and B. D. Weintraub
Thyroid-Stimulating Hormone and Thyroid-Stimulating Hormone Receptor Structure-Function Relationships
Physiol Rev, April 1, 2002; 82(2): 473 - 502.
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J. Immunol.Home page
Y. Nagayama, M. Kita-Furuyama, T. Ando, K. Nakao, H. Mizuguchi, T. Hayakawa, K. Eguchi, and M. Niwa
A Novel Murine Model of Graves' Hyperthyroidism with Intramuscular Injection of Adenovirus Expressing the Thyrotropin Receptor
J. Immunol., March 15, 2002; 168(6): 2789 - 2794.
[Abstract] [Full Text] [PDF]


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Am. J. Pathol.Home page
M. P. Armengol, M. Juan, A. Lucas-Martin, M. T. Fernandez-Figueras, D. Jaraquemada, T. Gallart, and R. Pujol-Borrell
Thyroid Autoimmune Disease : Demonstration of Thyroid Antigen-Specific B Cells and Recombination-Activating Gene Expression in Chemokine-Containing Active Intrathyroidal Germinal Centers
Am. J. Pathol., September 1, 2001; 159(3): 861 - 873.
[Abstract] [Full Text] [PDF]


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EndocrinologyHome page
P. Pichurin, X.-M. Yan, L. Farilla, J. Guo, G. D. Chazenbalk, B. Rapoport, and S. M. McLachlan
Naked TSH Receptor DNA Vaccination: A TH1 T Cell Response in Which Interferon-{gamma} Production, Rather than Antibody, Dominates the Immune Response in Mice
Endocrinology, August 1, 2001; 142(8): 3530 - 3536.
[Abstract] [Full Text] [PDF]


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J. Clin. Endocrinol. Metab.Home page
G. D. Chazenbalk, S. M. McLachlan, P. Pichurin, X.-M. Yan, and B. Rapoport
A Prion-Like Shift between Two Conformational Forms of a Recombinant Thyrotropin Receptor A-Subunit Module: Purification and Stabilization Using Chemical Chaperones of the Form Reactive with Graves' Autoantibodies
J. Clin. Endocrinol. Metab., March 1, 2001; 86(3): 1287 - 1293.
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J. Clin. Endocrinol. Metab.Home page
D. Russo, C. Betterle, F. Arturi, E. Chiefari, M. E. Girelli, and S. Filetti
A Novel Mutation in the Thyrotropin (TSH) Receptor Gene Causing Loss of TSH Binding But Constitutive Receptor Activation in a Family with Resistance to TSH
J. Clin. Endocrinol. Metab., November 1, 2000; 85(11): 4238 - 4242.
[Abstract] [Full Text]


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NEJMHome page
A. P. Weetman
Graves' Disease
N. Engl. J. Med., October 26, 2000; 343(17): 1236 - 1248.
[Full Text] [PDF]


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J. Pharmacol. Exp. Ther.Home page
Y. Nagayama, E. Nishihara, H. Namba, S. Yamashita, and M. Niwa
Identification of the Sites of Asparagine-Linked Glycosylation on the Human Thyrotropin Receptor and Studies on Their Role in Receptor Function and Expression
J. Pharmacol. Exp. Ther., October 1, 2000; 295(1): 404 - 409.
[Abstract] [Full Text]


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EndocrinologyHome page
K. Tanaka, G. D. Chazenbalk, S. M. McLachlan, and B. Rapoport
Evidence that Cleavage of the Thyrotropin Receptor Involves a "Molecular Ruler" Mechanism: Deletion of Amino Acid Residues 305-320 Causes a Spatial Shift in Cleavage Site 1 Independent of Amino Acid Motif
Endocrinology, October 1, 2000; 141(10): 3573 - 3577.
[Abstract] [Full Text] [PDF]


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Mol. Endocrinol.Home page
Y.-X. Tao, A. N. Abell, X. Liu, K. Nakamura, and D. L. Segaloff
Constitutive Activation of G Protein-Coupled Receptors as a Result of Selective Substitution of a Conserved Leucine Residue in Transmembrane Helix III
Mol. Endocrinol., August 1, 2000; 14(8): 1272 - 1282.
[Abstract] [Full Text]


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J. Clin. Endocrinol. Metab.Home page
T. Akamizu, L. D. Kohn, H. Hiratani, M. Saijo, K. Tahara, and K. Nakao
Hashimoto's Thyroiditis with Heterogeneous Antithyrotropin Receptor Antibodies: Unique Epitopes May Contribute to the Regulation of Thyroid Function by the Antibodies
J. Clin. Endocrinol. Metab., June 1, 2000; 85(6): 2116 - 2121.
[Abstract] [Full Text]


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EndocrinologyHome page
J. Chung, E. S. Park, D. Kim, J. M. Suh, H. K. Chung, J. Kim, H. Kim, S. J. Park, O-Y. Kwon, H. K. Ro, et al.
Thyrotropin Modulates Interferon-{gamma}-Mediated Intercellular Adhesion Molecule-1 Gene Expression by Inhibiting Janus Kinase-1 and Signal Transducer and Activator of Transcription-1 Activation in Thyroid Cells
Endocrinology, June 1, 2000; 141(6): 2090 - 2097.
[Abstract] [Full Text] [PDF]


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Mol. Endocrinol.Home page
E. S. Park, H. Kim, J. M. Suh, S. J. Park, S. H. You, H. K. Chung, K. W. Lee, O-Y. Kwon, B. Y. Cho, Y. K. Kim, et al.
Involvement of JAK/STAT (Janus Kinase/Signal Transducer and Activator of Transcription) in the Thyrotropin Signaling Pathway
Mol. Endocrinol., May 1, 2000; 14(5): 662 - 670.
[Abstract] [Full Text]


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Clin. Chem.Home page
J. Bolton, J. Sanders, Y. Oda, C. Chapman, R. Konno, J. Furmaniak, and B. Rees Smith
Measurement of Thyroid-stimulating Hormone Receptor Autoantibodies by ELISA
Clin. Chem., December 1, 1999; 45(12): 2285 - 2287.
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J. Biol. Chem.Home page
K. Tanaka, G. D. Chazenbalk, S. M. McLachlan, and B. Rapoport
Subunit Structure of Thyrotropin Receptors Expressed on the Cell Surface
J. Biol. Chem., November 26, 1999; 274(48): 33979 - 33984.
[Abstract] [Full Text] [PDF]


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J. Clin. Endocrinol. Metab.Home page
J. Sanders, Y. Oda, S. Roberts, A. Kiddie, T. Richards, J. Bolton, V. McGrath, S. Walters, D. Jaskolski, J. Furmaniak, et al.
The Interaction of TSH Receptor Autoantibodies with 125I-Labelled TSH Receptor
J. Clin. Endocrinol. Metab., October 1, 1999; 84(10): 3797 - 3802.
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J. Clin. Endocrinol. Metab.Home page
H. Devos, C. Rodd, N. Gagné, R. Laframboise, and G. Van Vliet
A Search for the Possible Molecular Mechanisms of Thyroid Dysgenesis: Sex Ratios and Associated Malformations
J. Clin. Endocrinol. Metab., July 1, 1999; 84(7): 2502 - 2506.
[Abstract] [Full Text]


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J. Clin. Endocrinol. Metab.Home page
J. C. Jaume, J. Guo, Y. Wang, B. Rapoport, and S. M. McLachlan
Cellular Thyroid Peroxidase (TPO), Unlike Purified TPO and Adjuvant, Induces Antibodies in Mice That Resemble Autoantibodies in Human Autoimmune Thyroid Disease
J. Clin. Endocrinol. Metab., May 1, 1999; 84(5): 1651 - 1657.
[Abstract] [Full Text]


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J. Clin. Endocrinol. Metab.Home page
J. C. Jaume, J. Guo, D. L. Pauls, M. Zakarija, J. M. McKenzie, J. A. Egeland, C. L. Burek, N. R. Rose, W. H. Hoffman, B. Rapoport, et al.
Evidence for Genetic Transmission of Thyroid Peroxidase Autoantibody Epitopic "Fingerprints"
J. Clin. Endocrinol. Metab., April 1, 1999; 84(4): 1424 - 1431.
[Abstract] [Full Text]


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J. Clin. Endocrinol. Metab.Home page
G. D. Chazenbalk, Y. Wang, J. Guo, J. S. Hutchison, D. Segal, J. C. Jaume, S. M. McLachlan, and B. Rapoport
A Mouse Monoclonal Antibody to a Thyrotropin Receptor Ectodomain Variant Provides Insight into the Exquisite Antigenic Conformational Requirement, Epitopes and in Vivo Concentration of Human Autoantibodies
J. Clin. Endocrinol. Metab., February 1, 1999; 84(2): 702 - 710.
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J. Biol. Chem.Home page
K. Tanaka, G. D. Chazenbalk, S. M. McLachlan, and B. Rapoport
Thyrotropin Receptor Cleavage at Site 1 Involves Two Discontinuous Segments at Each End of the Unique 50-Amino Acid Insertion
J. Biol. Chem., January 22, 1999; 274(4): 2093 - 2096.
[Abstract] [Full Text] [PDF]


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J. Biol. Chem.Home page
H. Kishi and M. Ascoli
Multiple Distant Amino Acid Residues Present in the Serpentine Region of the Follitropin Receptor Modulate the Rate of Agonist-induced Internalization
J. Biol. Chem., September 29, 2000; 275(40): 31030 - 31037.
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J. Biol. Chem.Home page
K. Nakabayashi, M. Kudo, B. Kobilka, and A. J. W. Hsueh
Activation of the Luteinizing Hormone Receptor Following Substitution of Ser-277 with Selective Hydrophobic Residues in the Ectodomain Hinge Region
J. Biol. Chem., September 22, 2000; 275(39): 30264 - 30271.
[Abstract] [Full Text] [PDF]


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J. Biol. Chem.Home page
C.-R. Chen, K. Tanaka, G. D. Chazenbalk, S. M. McLachlan, and B. Rapoport
A Full Biological Response to Autoantibodies in Graves' Disease Requires a Disulfide-bonded Loop in the Thyrotropin Receptor N Terminus Homologous to a Laminin Epidermal Growth Factor-like Domain
J. Biol. Chem., April 27, 2001; 276(18): 14767 - 14772.
[Abstract] [Full Text] [PDF]


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J. Biol. Chem.Home page
S. Li, X. Liu, L. Min, and M. Ascoli
Mutations of the Second Extracellular Loop of the Human Lutropin Receptor Emphasize the Importance of Receptor Activation and De-emphasize the Importance of Receptor Phosphorylation in Agonist-induced Internalization
J. Biol. Chem., March 9, 2001; 276(11): 7968 - 7973.
[Abstract] [Full Text] [PDF]


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J. Biol. Chem.Home page
R. Latif, P. Graves, and T. F. Davies
Oligomerization of the Human Thyrotropin Receptor. FLUORESCENT PROTEIN-TAGGED hTSHR REVEALS POST-TRANSLATIONAL COMPLEXES
J. Biol. Chem., November 21, 2001; 276(48): 45217 - 45224.
[Abstract] [Full Text] [PDF]




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