Thyroid markers for diseases in endocrinology

B·R·A·H·M·S thyroid markers help evaluate the effectiveness of treatment

thyroid-diseases-biomarkersThyroid diseases rank among the most frequent medical conditions. As a result, they do not only affect the quality of life of the individual patient but also impose considerable cost on society as a whole. Depending on iodine supply, or lack thereof, up to 50% of the total population experience an enlargement of the thyroid gland, also known as goiter. Nodular alterations are found in 5 to 25% of the population, with the frequency increasing in line with age.

For thyroid diseases, measurement of in-vitro parameters is key to diagnosis, differential diagnosis and clinical decisions to be made in the course of the condition. Thermo Scientific B·R·A·H·M·S Biomarkers is a market leader for a variety of tests, such as the TSH receptor antibody test (TRAK).

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Hyperactivity of the thyroid gland (hyperthyroidism) and thyroid insufficiency (hypothyroidism)

Hyperactivity of the thyroid gland (hyperthyroidism) occurs with a prevalence of approx. 0.5 to 2%. In regions with iodine shortage, thyroid autonomy is the dominant condition while Graves’ disease (exophthalmic goiter) is more frequent in areas with normal or abundant iodine supply. Thyroid insufficiency (hypothyroidism) is found in approx. 0.25 to 1.1% of the population. In many cases, this condition is caused by an autoimmune process. (Autoimmune [Hashimoto’s] thyroiditis).

For the assessment of the activity of the thyroid gland B·R·A·H·M·S Biomarkers offers the most common assays such as Total T3 and Total T4 as well as free T3 (fT3) and free T4 (fT4). In addition to that we are also able to provide special assays, for example TBG. With these assays we offer our complete portfolio of radioimmunoassays in thyroid indications.


Confidence in the follow-up of thyroid cancer patients with B·R·A·H·M·S hTg sensitive

Carcinomas of the thyroid occur in 10 to 30 per million people, accounting for 0.5 to 1.5% of all cancerous diseases. In 80% of all cases, these are differentiated thyroid carcinomas with a relatively good prognosis, provided the disease is diagnosed at an early stage and carefully followed up. For follow-up of thyroid cancer B·R·A·H·M·S Biomarkers offers a variety of assays formats of hTg and anti-Tg both manual assays as well as automated .

Differential thyroid carcinoma (DTC) is the most common endocrine cancer worldwide with an ever increasing prevalence. The initial treatment consists of total thyoidectomy usually followed by ablation of thyroid remnant mit radioiodine. For a reliable and effective monitoring of patients for recurrent or persistent disease, circulating thyroglobulin (hTg) is used as a biochemical marker. As thyroid cells are the only source of hTg, it is highly specific for DTC and recommended for use as biomarker by internatinoal clinical practice guideline.

Due to the outstanding design the quality of our B·R·A·H·M·S hTg sensitive KRYPTOR assay enables laboratories to measure extremely low concentrations: it offers highest sensitivity (0,1ng/ml) that drastically reduces the need for rhTSH stimulation of patients. Unlike other thyroglobulin assays the B·R·A·H·M·S hTg sensitive does not over-estimate patients' hTg levels, it provides results that are comparable to those measured by mass spectrometry.

The unique mini-recovery concept for our hTg sensitive KRYPTOR assay guarantees the most efficient and effective classification of "valid" and "invalid" Tg results in therapy follow-up of differentiated thyroid carcinoma by showing all possible interferences.


B·R·A·H·M·S TRAK human is the diagnostic gold standard in Graves' disease

Graves' disease is an autoimmune thyroid disease that is characterized by the clinical symptoms of goiter, tachycardia and exophthalmus (abnormal protrusion of the eyeballs). From a differential diagnosis point of view, Graves' disease must be distinguished from the functional autonomy of the thyroid since the former can initially be treated by the application of drugs while the latter should be treated by surgery or radioiodine therapy. The measurement of the TSH receptor antibody concentration (TRAK) is key to detecting and adequately treating Graves' disease.

With the introduction of the highly sensitive Thermo Scientific B·R·A·H·M·S TRAK human assay in 1999, using immobalized recombinant human TSH receptors, a definite improvement for differential diagnosis of Graves' disease was achieved. This assay ensures that a greater number of patients can be adequately treated at an early stage and that the treatment success can be controlled.

The differences in TRAK human serum levels between patients with mild and severe course of Graves' Ophthalmopathy (GO) were substantial enough to define cut off levels over the entire course of the disease. Values below or higher certain cut offs were associated with either a mild or severe course of GO (specificity 90%).

trak-human-serum-levelsDifferences in TRAK human serum levels between patients with mild and severe course of Graves' Ophthalmopathy (GO)


Hashimoto’s thyroiditis

Hashimoto's thyroiditis is another autoimmune disease of the thyroid gland. The destruction of thyroid tissue ultimately causes hypothyroidism characterized by a multitude of metabolic symptoms. Characteristically for Hashimoto's thyroiditis is the presence of autoantibodies against thyroid proteins, most prominent targets are TPO and - to a lesser extent - also Tg. The severity of thyroiditis can be assessed with help of B·R·A·H·M·S anti-TPOn and B·R·A·H·M·S Tgn assays. Due to the use of native assay components both assays achieve improved assay sensitivity and specificity.

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