TSI as a biomarker in thyroid eye disease (oogziekte)

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TSI as a biomarker in thyroid eye disease

Dion Paridaens, MD PhD

Oculoplastic & Orbital Surgeon at Rotterdam Eye Hospital & Erasmus Medical Center

"Over the past few years, our TED research group in Rotterdam has been investigating whether biomarkers can improve clinical decision-making in thyroid eye disease (TED/Graves’ orbitopathy).

One recurring finding is the importance of thyroid-stimulating immunoglobulins (TSI).

In our cohort, higher TSI levels were associated with active disease, and high TSI also predicted a poorer response to intravenous methylprednisolone. In multivariable analysis, TSI remained an independent predictor of treatment response. 

We subsequently evaluated the rapid functional Turbo TSI bioassay. It showed high sensitivity for Graves’ orbitopathy and correlated more strongly with clinical activity than conventional TBII measurements. However, its ability to predict steroid response remained moderate, indicating that TSI alone is unlikely to provide the complete answer. 

Taken together, these studies support TSI as more than a diagnostic antibody: TSI reflects biologically relevant disease activity and may contribute to predicting treatment response in TED.

The next step is likely not a single biomarker, but a combination of biomarkers that allows us to select the right treatment for the right patient.

We gratefully acknowledge the financial support for this research from ZonMw, Stichting Wetenschappelijk Onderzoek Oogziekenhuis (SWOO-Flieringa), Rotterdamse Stichting voor Blindenbelangen (RSB), Stichting Ooglijders, Oogfonds (UitZicht) and Foundation Combined Ophthalmic Research Rotterdam (CORR)." 

References

Hötte GJ et al. Front Endocrinol. 2024;15:1340415
🔗 https://lnkd.in/gmzRn9Cs

Hötte GJ et al. Front Endocrinol. 2024;15:1469179
🔗 https://lnkd.in/gmkBp8rv