Which receptor is implicated in the autoimmune process of Thyroid Eye Disease?

Which receptor is implicated in the autoimmune process of Thyroid Eye Disease?

• A. Acetylcholine receptor
• B. NMDA receptor
• C. GABA receptor
• D. TSH receptor

Answer: (D)

Thyroid Eye Disease is driven by an autoimmune attack on the thyroid-stimulating hormone receptor expressed in orbital tissue. Antibodies against this receptor bind to TSH receptors on orbital fibroblasts and related cells, activating signaling that increases glycosaminoglycan production and drives adipogenesis and inflammation. The result is edema, expansion of orbital contents, and inflammatory remodeling of the extraocular muscles, which manifest as proptosis, eyelid retraction, and diplopia. This TSH receptor–mediated pathway explains the link between thyroid autoimmunity and the orbital manifestations. Other receptors listed are associated with different conditions (for example, acetylcholine receptors with myasthenia gravis; NMDA and GABA receptors with neural signaling) and are not the targets driving Thyroid Eye Disease.