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The 64-Kilodalton Eye Muscle Protein Is the Flavoprotein Subunit of Mitochondrial Succinate Dehydrogenase: The Corresponding Serum Antibodies Are Good Markers of an Immune-Mediated Damage to the Eye Muscle in Patients with Graves’ Hyperthyroidism1
Ist Teil von
The journal of clinical endocrinology and metabolism, 1998-02, Vol.83 (2), p.443-447
Ort / Verlag
Endocrine Society
Erscheinungsjahr
1998
Quelle
Oxford Journals 2020 Medicine
Beschreibungen/Notizen
Thyroid-associated ophthalmopathy (TAO) is a progressive eye disorder
associated with thyroid autoimmunity, particularly Graves’
hyperthyroidism, which is generally considered to have an autoimmune
etiology. Eye muscle membrane proteins reportedly of 55 and 64 kDa are
the best markers of the ophthalmopathy. The main focus of our recent
studies has been to purify the pertinent proteins from porcine eye
muscle membranes and characterize them. The 64-kDa protein is now shown
from a partial sequence and by Western blotting using specific antibody
probes to be the flavoprotein (Fp) subunit of succinate dehydrogenase
and to have a correct molecular mass of 67 kDa. The protein was
purified and cleaved with cyanogen bromide, and the N-terminal region
of an immunoreactive partial peptide was determined. The 20-amino acid
porcine sequence so obtained matched one within the Fp subunits of
human and bovine succinate dehydrogenases in 20 and 18 of these
positions, respectively. Succinate dehydrogenase is both a citric acid
cycle enzyme and a component (complex II) of the mitochondrial
respiratory chain. It is thus essential for aerobic energy production
and is highly conserved. The mature human and bovine Fp subunits are
92% homologous and have a molecular mass of ∼67 kDa, the same as our
redetermined value for the 64-kDa marker protein. Sera from patients
with TAO and from those with Graves’ hyperthyroidism without evident
ophthalmopathy highlighted the 64-kDa marker protein in crude porcine
eye muscle membranes and the Fp subunit of highly purified bovine
succinate dehydrogenase at the identical position on Western blots.
Anti-beef Fp antibodies were detected in sera from 67% of patients
with active TAO of more than 1-yr duration, in 30% with stable TAO of
more than 3-yr duration, and in 30% of patients with Graves’
hyperthyroidism without ophthalmopathy, but in only 7% of age- and
sex-matched normal subjects. As succinate dehydrogenase is bound to the
matrix (inside) surface of the mitochondrial inner membrane, it is
unlikely to be accessible to circulating autoantibodies. We would
postulate that eye muscle damage in ophthalmopathy is probably caused
by cytotoxic antibodies or CD+ T lymphocytes targeting a
cell membrane antigen, such as the thyroid and eye muscle shared
protein G2s, and that presentation of succinate dehydrogenase is
secondary. On the other hand, an autoantibody response to succinate
dehydrogenase may be a good marker of immune-mediated damage to the eye
muscle fiber and may support the idea that the extraocular muscles are
targets of the autoimmune reactions of TAO.