Secretor Status and Infection in Patients with Graves' Disease

Abstract

We have demonstrated that the inability to secrete the water soluble glycoprotein form of the ABO blood group antigens into saliva is significantly more common in patients with Graves' disease than control subjects (40% vs 27%; P < 0.025) but not among those with Hashimoto's thyroiditis or spontaneous primary atrophic hypothyroidism. Non-secretion is associated with increased susceptibility to infection and to asymptomatic carriage of some microorganisms.

Although Yersinia entrocolitica has been found to express antigen cross reactive with the TSH receptor, we did not find an increased prevalence of Yersinia species in the faeces of 107 patients with Graves' disease. The isolation rate (< 1%) was similar to that observed in the local population with diarrhoeal illness. Salivary IgA levels determined by whole cell ELlSA with Y. enterocolitica 03 were not elevated in the majority of specimens examined. The results suggest that. in contrast to reports from Scandinavia. there is no strong evidence that yersiniae play a role in the pathogenesis of Graves' disease among patients in South east Scotland.

Non-secretors are significantly over represented among patients with several other autoimmune diseases; however, with the exception of antitubulin antibodies, non-secretors with Graves' disease did not have more antibodies to other human antigens than secretor patients.

Key Words:

• Graves' disease
• non-secretors
• Yersinia enterocolitica
• Salivary IgG