Thyroglobulinthyroglobulin antibodies, thyroglobulin levels
Tg is used by the thyroid gland to produce the thyroid hormones thyroxine T4 and triiodothyronine T3 The active form of triiodothyronine, 3, 5, 3' triiodothyronine, is produced both within the thyroid gland and in the periphery by 5'-deiodinase which has been referred to as tetraiodothyronine 5' deiodinase It is presumed that Tg and thyroid are also an important storage of iodine for all body needs, in particular, for many iodine-concentrating organs such as breast, stomach, salivary glands, thymus, choroid plexus and cerebrospinal fluid, etc see iodine in biology
Tg is produced by the thyroid epithelial cells, called thyrocytes, which form spherical follicles Tg is secreted and stored in the follicular lumen
Via a reaction with the enzyme thyroperoxidase, iodine is covalently bound to tyrosine residues in thyroglobulin molecules, forming monoiodotyrosine MIT and diiodotyrosine DIT
Small globules of the follicular colloid Tg are endocytosed hormone TSH-mediated and proteases in lysosomes digest iodinated thyroglobulin, releasing T3 and T4 within the thyrocyte cytoplasm The T3 and T4 are then transported across TSH-mediated the basolateral thyrocyte membrane, into the bloodstream, by an unknown mechanism, while the lysosome is recycled back to the follicular lumen
Half-life and clinical elevation
Metabolism of thyroglobulin occurs in the liver and via thyroid gland recycling of the protein Circulating thyroglobulin has a half-life of 65 hours Following thyroidectomy, it may take many weeks before thyroglobulin levels become undetectable After thyroglobulin levels become undetectable following thyroidectomy, levels can be serially monitored
A subsequent elevation of the thyroglobulin level is an indication of recurrence of papillary or follicular thyroid carcinoma Hence, thyroglobulin levels in the blood are mainly used as a tumor marker for certain kinds of thyroid cancer particularly papillary or follicular thyroid cancer Thyroglobulin is not produced by medullary or anaplastic thyroid carcinoma
In the clinical laboratory, thyroglobulin testing can be complicated by the presence of anti-thyroglobulin antibodies ATAs, alternatively referred to as TgAb Anti-thyroglobulin antibodies are present in 1 in 10 normal individuals, and a greater percentage of patients with thyroid carcinoma The presence of these antibodies can result in falsely low or rarely falsely high levels of reported thyroglobulin, a problem that can be somewhat circumvented by concomitant testing for the presence of ATAs The ideal strategy for a clinician's interpretation and management of patient care in the event of confounding detection of ATAs is testing to follow serial quantitative measurements rather than a single laboratory measurement
ATAs are often found in patients with Hashimoto's thyroiditis or Graves' disease Their presence is of limited use in the diagnosis of these diseases, since they may also be present in healthy euthyroid individuals ATAs are also found in patients with Hashimoto's encephalopathy, a neuroendocrine disorder related to—but not caused by—Hashimoto's thyroiditis
Thyroglobulin has been shown to interact with Binding immunoglobulin protein
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