HYROID STIMULATING HORMONE (TSH) ENZYME IMMUNOASSY
The determination of serum or plasma levels of thyroid stimulating hormone (TSH) is recognized as a sensitive method in the diagnosis of primary and secondary hypothyroidism. TSH is secreted by the anterior lobe of the pituitary gland and induces the production and release of thyroxine and triiodothyronine from the thyroid gland. It is a glycoprotein with a molecular weight of approximately 28,000 daltons, consisting of two chemically different subunits, alpha and beta. Although the concentration of TSH in the blood is extremely low, it is essential for the maintenance of normal thyroid function. The release of TSH is regulated by a TSH-releasing hormone (TRH) produced by the hypothalamus. The levels of TSH and TRH are inversely related to the level of thyroid hormone. When there is a high level of thyroid hormone in the blood, less TRH is released by the hypothalamus, so less TSH is secreted by the pituitary. The opposite action will occur when there is decreased thyroid hormone in the blood. This process is known as a negative feedback mechanism and is responsible for maintaining the proper blood levels of these hormones. TSH and the pituitary glycoproteins: luteinizing hormonee (LH), follicle-stimulating hormone (FSH), and human chorionic gonadotropin (hCG), have identical alpha chains. The beta chain is distinct but does contain identical amino acid sequences, which can cause considerable cross-reactivity with some polyclonal TSH antisera. The use of a monoclonal antibody in this TSH EIA test eliminates this interference, which could result in falsely elevated TSH values in either menopausal or pregnant females--a population whose evaluation of thyroid status is clinically significant.
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