TSHR and autoimmune thyroid disease: Researchers found that Btx and thyroid autoantigens share amino acid sequence homology and may play a role in cross-reactive complication of autoimmune thyroid disease [12]. Borrelia burgdorferi has been shown to have protein homology with TSH receptor and therefore plays a role as an antigenic trigger for autoimmune thyroid disease [13]. Coxsackie virus antibodies have also demonstrated cross-reactivity with the thyroid and have been reported to be a contributing factor to the pathogenesis of autoimmune thyroid disorder [14].