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Las enfermedades tiroideas son un importante problema de salud que afecta a un gran porcentaje de la población. Las pruebas bioquímicas constituyen el pilar fundamental para su diagnóstico y seguimiento. El desarrollo de ensayos de segunda y tercera generación ha supuesto un gran avance en el diagnóstico de estas enfermedades. El texto incluye los ensayos utilizados para diagnosticar y tratar las diferentes enfermedades tiroideas, provee información bioquímica y clínica actualizada contenida en secciones referidas a la utilidad clínica de las determinaciones de hormonas tiroideas totales y libres, anticuerpos antitiroideos, tirotropina humana y tiroglobulina, de manera que pueda ofrecer, tanto al laboratorio como al médico, un panorama general de la utilidad y la capacidad actual de estas pruebas.Thyroid diseases are a significant health problem affecting a high percentage of the population. The biochemical tests are the fundamental pillar for diagnosis and follow-up. The development of second and third-generation assays has represented a great advance in diagnosing these diseases. The text covers the tests to diagnose and treat a number of thyroid diseases, and provides the reader with updated biochemical and clinical information in sections about the clinical usefulness of total and free thyroid hormone determinations, antithyroid antibodies, human thyrotropin and thyroglobulin. In this way, it can offer both the lab and the physician a general overview of the usefulness and the current capability of these tests.

Solid-phase bioluminescent immunoassay of thyroid hormones, human thyrotropin (hTSH) and two forms of thyroxine (T4), whose determinations are vitally important for diagnostics of thyroid diseases and the efficiency of treatment, is described. The recombinant obelin, a Ca2+-regulated photoprotein originally derived from the luminous marine hydroid Obelia longissima, is employed as a bioluminescent label. To produce obelin conjugates with anti-hTSH, anti-T4 immunoglobulins (IgG), and T4, additional SH groups are introduced into the obelin molecule using Traut’s reagent (2-iminothiolane) and then obelin possessing extra SH groups is conjugated with succinimidyl 4-(N-maleimidomethyl)-cyclohexane-1-carboxylate-activated IgGs or T4. The total yield of obelin conjugates determined by luminescent activity is 60–65% after all chemical and purification procedures. The obtained conjugates are stable to lyophilization and in solution for at least 9 months at 4 °C, with loss of activity not exceeding 10%. The application of obelin conjugates for determination of the hTSH, total T4, and free T4 in standard, control, and patient sera displays high sensitivity and reproducibility of results. The results of bioluminescent immunoassays are closely comparable to those obtained by the radioimmunoassay method (R=0.95–0.99). [Copyright &y& Elsevier]

The glycoprotein hormones are all structurally related heterodimers consisting of an α-subunit and a ligand-specific β-subunit that confers their unique biological activity. Crystal structures showed how the β-subunit surrounds a part of the α-subunit, and we showed the existence of the two mechanisms responsible for that assembly. In human choriogonadotropin, the β-subunit is folded before the subunits dock, and the α-subunit becomes incorporated into the dimer by a mechanism we termed "threading," passing between parts of the preassembled β-subunit. Here, we show that the human lutropin β-subunit is not folded completely prior to its interaction with the α-subunit and show that docking of the subunits enables the α-subunit to serve as a chaperone to the β-subunit. Based on data described here, we propose that the α-subunit facilitates formation of the human lutropin β-subunit by two mechanisms. First, the cystine knot of the α-subunit potentiates formation of the β-subunit cystine knot, and second, contacts between α-subunit loop 2 and a hydrophobic tail in the β-subunit facilitate formation of the seatbelt latch disulfide, which stabilizes the heterodimer. The primary influence of the α-subunit was seen when the hydrophobic tail was present or absent, but the secondary mechanism was required only when the hydrophobic tail of the β-subunit was present. During the evolution of human choriogonadotropin, neither of these α-subunit roles was necessary for folding of the β-subunit. The complex mechanism for lutropin assembly may be required to provide an additional control on its positive feedback function in vertebrate reproduction., (© 2014 by The American Society for Biochemistry and Molecular Biology, Inc.)