Thyroid peroxidase (TPO) is an enzyme normally found in the thyroid gland which plays an important role in the production of thyroid hormones, converting the thyroid hormone T4 to T3. It is one of the most important thyroid gland antigens and along with thyroglobulin (Tg), it is targeted by the immune system in several autoimmune thyroid diseases.
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Thyroid Peroxidase (TPO)
As an enzyme, the role of TPO is to catalyze the oxidation of iodide on tyrosine residues in thyroglobulin for the synthesis of triiodothyronine (T3) and thyroxine (T4). Diseases associated with TPO are usually autoimmune related and thyroid peroxidase is a frequent epitope of autoantibodies which generates anti-thyroid peroxidase antibodies (anti-TPO antibodies). Consequently, anti-TPO antibodies are detectable in most autoimmune disorders including Hashimoto thyroiditis and Grave’s disease and may also be found in patients with non-thyroid autoimmune diseases such as pernicious anemia, type I diabetes, or other disorders that activate the immune system.
The TPO antibody assay is the most sensitive test for autoimmune thyroid disease, and it is useful in differentiating thyroid autoimmune disorders from non-autoimmune goiter or hypothyroidism. It employs both non-competitive and competitive assay formats using TPO antigen. Traditionally, human native TPO purified from thyroid glands was used; however, studies have shown that the soluble extracellular domain of recombinant human thyroid peroxidase (rTPO) produced in insect cells has immunochemical properties similar to native human thyroid peroxidase (Haubruck et al. 1993).
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