Putative protective role of autoantibodies against the insulin-like growth factor-1 receptor in Graves’ Disease: results of a pilot study



The insulin-like growth factor-1 receptor (IGF-1R) is a key element in the pathogenesis of Graves’ Orbitopathy (GO), but the role of IGF-1R autoantibodies (IGF-1RAbs) has not been established.


We designed a cross-sectional investigation to measure IGF-1RAbs in patients with Graves’ disease (GD), with or without GO, who underwent radioiodine therapy followed by glucocorticoids (GC). Twenty-nine patients were included, 15 of which with GO. Patients were evaluated at baseline and three and 6 months after radioiodine. The primary objective was the prevalence of positive tests for IGF-1RAbs. The secondary objectives were: (1) IGF-1RAbs concentrations and their variations; (2) relationship between IGF-1RAbs and the features of GO; (3) relationship between IGF-1RAbs and anti-thyroid autoantibodies.


IGF-1RAbs above the cut-off value were found only in one patient with GD without GO. IGF-1RAb levels were greater in patients with GD without GO, at baseline (P < 0.0001), and after three (P < 0.0001) and six (P = 0.0001) months. No correlations were observed between IGF-1RAbs and the features of GO, nor between IGF-1RAbs and anti-thyroglobulin or anti-thyroperoxidase autoantibodies. There was an inverse correlation between anti-TSH receptor autoantibodies (TRAbs) and IGF-1RAb levels in GD patients with GO at 6 months (P = 0.03).


IGF-1RAbs appear to be greater in patients with GD without GO compared with those with GO, suggesting a putative protective role of IGF-1RAbs on the development of GO, in line with the beneficial effects of Teprotumumab on GO. The inverse correlation between IGF-1RAbs and TRAbs 6 months after radioiodine may reflect antigen spreading and/or GC treatment.

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The study was funded by the University of Pisa (Fondi di Ateneo, to MM).

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Correspondence to M. Marinò.

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Lanzolla, G., Ricci, D., Nicolì, F. et al. Putative protective role of autoantibodies against the insulin-like growth factor-1 receptor in Graves’ Disease: results of a pilot study. J Endocrinol Invest (2020). https://doi.org/10.1007/s40618-020-01341-2

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  • Thyroid
  • Graves’ disease
  • Graves’ orbitopathy
  • Graves’ ophthalmopathy
  • Thyroid eye disease
  • Thyroid autoimmunity
  • Autoimmune thyroiditis
  • Insulin-like growth factor-1 receptor