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Shu X, Shao Y, Chen Y, Zeng C, Huang X, Wei R. Immune checkpoints: new insights into the pathogenesis of thyroid eye disease. Front Immunol 2024; 15:1392956. [PMID: 38817600 PMCID: PMC11137266 DOI: 10.3389/fimmu.2024.1392956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/01/2024] [Indexed: 06/01/2024] Open
Abstract
Thyroid eye disease (TED) is a disfiguring autoimmune disease characterized by changes in the orbital tissues and is caused by abnormal thyroid function or thyroid-related antibodies. It is the ocular manifestation of Graves' disease. The expression of thyroid-stimulating hormone receptor (TSHR) and the insulin-like growth factor-1 receptor (IGF-1 R) on the cell membrane of orbital fibroblasts (OFs) is responsible for TED pathology. Excessive inflammation is caused when these receptors in the orbit are stimulated by autoantibodies. CD34+ fibrocytes, found in the peripheral blood and orbital tissues of patients with TED, express immune checkpoints (ICs) like MHC II, B7, and PD-L1, indicating their potential role in presenting antigens and regulating the immune response in TED pathogenesis. Immune checkpoint inhibitors (ICIs) have significantly transformed cancer treatment. However, it can also lead to the occurrence of TED in some instances, suggesting the abnormality of ICs in TED. This review will examine the overall pathogenic mechanism linked to the immune cells of TED and then discuss the latest research findings on the immunomodulatory role of ICs in the development and pathogenesis of TED. This will offer fresh perspectives on the study of pathogenesis and the identification of potential therapeutic targets.
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Affiliation(s)
| | | | | | | | | | - Ruili Wei
- Department of Ophthalmology, Changzheng Hospital of Naval Medicine University, Shanghai, China
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Abstract
PURPOSE Our understanding of thyroid-associated ophthalmopathy (TAO, A.K.A Graves' orbitopathy, thyroid eye disease) has advanced substantially, since one of us (TJS) wrote the 2010 update on TAO, appearing in this journal. METHODS PubMed was searched for relevant articles. RESULTS Recent insights have resulted from important studies conducted by many different laboratory groups around the World. A clearer understanding of autoimmune diseases in general and TAO specifically emerged from the use of improved research methodologies. Several key concepts have matured over the past decade. Among them, those arising from the refinement of mouse models of TAO, early stage investigation into restoring immune tolerance in Graves' disease, and a hard-won acknowledgement that the insulin-like growth factor-I receptor (IGF-IR) might play a critical role in the development of TAO, stand out as important. The therapeutic inhibition of IGF-IR has blossomed into an effective and safe medical treatment. Teprotumumab, a β-arrestin biased agonist monoclonal antibody inhibitor of IGF-IR has been studied in two multicenter, double-masked, placebo-controlled clinical trials demonstrated both effectiveness and a promising safety profile in moderate-to-severe, active TAO. Those studies led to the approval by the US FDA of teprotumumab, currently marketed as Tepezza for TAO. We have also learned far more about the putative role that CD34+ fibrocytes and their derivatives, CD34+ orbital fibroblasts, play in TAO. CONCLUSION The past decade has been filled with substantial scientific advances that should provide the necessary springboard for continually accelerating discovery over the next 10 years and beyond.
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Affiliation(s)
- E J Neag
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, Brehm Tower, 1000 Wall Street, Ann Arbor, MI, 48105, USA
- Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan Medical School, Ann Arbor, MI, 48105, USA
- Michigan State University College of Osteopathic Medicine, East Lansing, MI, USA
| | - T J Smith
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, Brehm Tower, 1000 Wall Street, Ann Arbor, MI, 48105, USA.
- Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan Medical School, Ann Arbor, MI, 48105, USA.
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Kim BY, Jang SY, Choi DH, Jung CH, Mok JO, Kim CH. Anti-inflammatory and Antioxidant Effects of Selenium on Orbital Fibroblasts of Patients With Graves Ophthalmopathy. Ophthalmic Plast Reconstr Surg 2021; 37:476-481. [PMID: 33782320 DOI: 10.1097/iop.0000000000001931] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE In the present study, the authors investigated the effects of selenium on inflammation, hyaluronan production, and oxidative stress in primary cultured orbital fibroblasts of patients with Graves ophthalmopathy (GO). METHODS Orbital adipose/connective tissue specimens were obtained during the course of orbital surgery for patients with GO (n = 7) and other noninflammatory problems (n = 5). After incubation with various concentrations of sodium selenite for 48 hours, supernatants from primary cultures were collected. Hyaluronan and cytokine levels were measured using commercially available enzyme-linked immunosorbent assay kits. To determine the effect of selenium on reactive oxygen species (ROS) production stimulated by H2O2 (100 μM) for 30 minutes, the cells were pretreated with various concentrations of sodium selenite for 60 minutes. RESULTS Interleukin (IL)-6 and tumor necrosis factor-alpha levels were significantly higher in orbital fibroblasts of patients with GO than in orbital fibroblasts of control patients. Hyaluronan production was suppressed by selenium in cultured orbital fibroblasts of patients with GO. Inflammatory cytokines such as IL-1α, IL-8, and tumor necrosis factor-alpha were suppressed by selenium in cultured orbital fibroblasts of patients with GO. IL-1β and IL-6 were not suppressed by selenium in cultured orbital fibroblasts of patients with GO. Selenium pretreatment reduced intracellular ROS generation stimulated by H2O2 in cultured orbital fibroblasts of patients with GO. CONCLUSIONS In conclusion, hyaluronan production, inflammatory cytokines, and intracellular ROS generation were suppressed by selenium in cultured orbital fibroblasts of patients with GO. Several inflammatory cytokines may be suppressed by selenium in cultured orbital fibroblasts of patients with GO. This study provide the basis for use of selenium in the treatment of GO.
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Affiliation(s)
- Bo-Yeon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine
| | - Sun-Young Jang
- Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Dug-Hyun Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine
| | - Chan-Hee Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine
| | - Ji-Oh Mok
- Division of Endocrinology and Metabolism, Department of Internal Medicine
| | - Chul-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine
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Wang N, Hou SY, Qi X, Deng M, Cao JM, Tong BD, Xiong W. LncRNA LPAL2/miR-1287-5p/EGFR Axis Modulates TED-Derived Orbital Fibroblast Activation Through Cell Adhesion Factors. J Clin Endocrinol Metab 2021; 106:e2866-e2886. [PMID: 33877318 DOI: 10.1210/clinem/dgab256] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Indexed: 12/19/2022]
Abstract
CONTEXT The activation of orbital fibroblasts, the prime targets in thyroid eye disease (TED), is central to its underlying pathogenesis. OBJECTIVE We aimed to investigate the mechanism of TED orbital fibroblast activation from the perspective of noncoding RNA regulation. METHODS Immunofluorescence (IF) staining was applied to evaluate the fibrotic changes in target cells. Cell proliferation was evaluated by 5-ethoxy 2-deoxyuridine and colony-formation assays. Collagen I concentration was determined by enzyme-linked immunosorbent assay. Human microarray analysis was performed on 3 TED and 3 healthy control orbital tissue samples. RESULTS Bioinformatics analysis showed that cell adhesion signaling factors were differentially expressed in TED tissues, including intercellular adhesion molecule (ICAM)-1, ICAM-4, vascular cell adhesion molecule, and CD44, which were all upregulated in diseased orbital tissues. Long noncoding RNA LPAL2 level was also upregulated in orbital tissues and positively correlated with ICAM-1 and ICAM-4 expression. Stimulation of the TED orbital fibroblasts by transforming growth factor-β1 (TGF-β1) significantly increased the expression of ICAM-1, ICAM-4, and LPAL2. Knockdown of LPAL2 in orbital fibroblasts inhibited TGF-β1-induced increases in cell adhesion factor levels and orbital fibroblast activation. Microarray profiling was performed on TED and normal orbital tissues to identify differentially expressed microRNAs, and miR-1287-5p was remarkably reduced within diseased orbital samples. miR-1287-5p was directly bound to the epidermal growth factor receptor (EGFR) 3' untranslated region and LPAL2, and LPAL2 modulated EGFR/protein kinase B (AKT) signaling through targeting miR-1287-5p. CONCLUSION The LPAL2/miR-1287-5p axis modulated TGF-β1-induced increases in cell adhesion factor levels and TED orbital fibroblast activation through EGFR/AKT signaling.
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Affiliation(s)
- Nuo Wang
- Department of Ophthalmology, The Third Xiangya Hospital, Central South University, Changsha, Hunan,China
| | - Shi-Ying Hou
- Department of Ophthalmology, Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan,China
| | - Xin Qi
- Department of Ophthalmology, Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan,China
| | - Mi Deng
- Department of Ophthalmology, Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan,China
| | - Jia-Min Cao
- Department of Ophthalmology, The Third Xiangya Hospital, Central South University, Changsha, Hunan,China
| | - Bo-Ding Tong
- Department of Ophthalmology, Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital, Central South University, Changsha, Hunan,China
| | - Wei Xiong
- Department of Ophthalmology, The Third Xiangya Hospital, Central South University, Changsha, Hunan,China
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Kang J, Li Y, Zhao Z, Zhang H. Differentiation between thyroid-associated orbitopathy and Graves' disease by iTRAQ-based quantitative proteomic analysis. FEBS Open Bio 2021; 11:1930-1940. [PMID: 33934566 PMCID: PMC8255837 DOI: 10.1002/2211-5463.13172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/17/2021] [Indexed: 11/12/2022] Open
Abstract
Graves' ophthalmopathy, also known as thyroid-associated orbitopathy (TAO), is the most common inflammatory eye disease in adults. The most common etiology for TAO is Graves' disease (GD); however, proteomic research focusing on differences between GD and TAO is limited. This study aimed to identify differentially expressed proteins between thyroid-associated orbitopathy (TAO) and GD. Furthermore, we sought to explore the pathogenesis of TAO and elucidate the differentiation process via specific markers. Serum samples of three patients with TAO, GD, and healthy controls, respectively, were collected. These samples were measured using the iTRAQ technique coupled with mass spectrometry. Differentially expressed proteins in TAO and GD were identified by proteomics; 3172 quantified proteins were identified. Compared with TAO, we identified 110 differential proteins (27 proteins were upregulated and 83 were downregulated). In addition, these differentially expressed proteins were closely associated with cellular processes, metabolic processes, macromolecular complexes, signal transduction, and the immune system. The corresponding functions were protein, calcium ion, and nucleic acid binding. Among the differential proteins, MYH11, P4HB, and C4A were markedly upregulated in TAO patients and have been reported to participate in apoptosis, autophagy, the inflammatory response, and the immune system. A protein-protein interaction network analysis was performed. Proteomics demonstrated valuable large-scale protein-related information for expounding the pathogenic mechanism underlying TAO. This research provides new insights and potential targets for studying GD with TAO.
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Affiliation(s)
- Jianshu Kang
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, The Fourth Affiliated Hospital of Kunming Medical University, China.,Yunnan Eye Institute, Kunming, China.,Key Laboratory of Yunnan Province for the Prevention and Treatment of Ophthalmologya, Kunming, China.,Yunnan Eye Disease Clinical Medical Center, Kunming, China.,Yunnan Eye Disease Clinical Medical Research Center, Kunming, China
| | - Yunqin Li
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, The Fourth Affiliated Hospital of Kunming Medical University, China.,Yunnan Eye Institute, Kunming, China.,Key Laboratory of Yunnan Province for the Prevention and Treatment of Ophthalmologya, Kunming, China.,Yunnan Eye Disease Clinical Medical Center, Kunming, China.,Yunnan Eye Disease Clinical Medical Research Center, Kunming, China
| | - Zhijian Zhao
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, The Fourth Affiliated Hospital of Kunming Medical University, China.,Yunnan Eye Institute, Kunming, China.,Key Laboratory of Yunnan Province for the Prevention and Treatment of Ophthalmologya, Kunming, China.,Yunnan Eye Disease Clinical Medical Center, Kunming, China.,Yunnan Eye Disease Clinical Medical Research Center, Kunming, China
| | - Hong Zhang
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, The Fourth Affiliated Hospital of Kunming Medical University, China.,Yunnan Eye Institute, Kunming, China.,Key Laboratory of Yunnan Province for the Prevention and Treatment of Ophthalmologya, Kunming, China.,Yunnan Eye Disease Clinical Medical Center, Kunming, China.,Yunnan Eye Disease Clinical Medical Research Center, Kunming, China
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Zou H, Xu W, Wang Y, Wang Z. A data-driven approach for the discovery of biomarkers associated with thyroid eye disease. BMC Ophthalmol 2021; 21:166. [PMID: 33832456 PMCID: PMC8034124 DOI: 10.1186/s12886-021-01903-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/02/2021] [Indexed: 12/03/2022] Open
Abstract
Background Thyroid eye disease (TED) is the most common autoimmune disease and usually occurs in patients with hyperthyroidism. In this disease, eye-related tissue, such as eye muscles, eyelids, tear glands, etc., become inflated, which causes the eyes and eyelids to become red, swollen, and uncomfortable. The pathophysiology of this disease is still poorly known. Aim This study aims to discover potential biomarkers and regulatory pathways of TED which will not only help to diagnose the disease and understand orbital involvement in thyroid dysfunction but also provide an insight for better therapeutics. Methods We applied a data-driven approach by combining gene biomarkers both from published literature and computationally predicted from microarray gene expression data. Further, the DAVID tool is used for Gene Ontology-based enrichment analysis. Results We obtained a total of 22 gene biomarkers, including 18 semi-automatically curated from the literature and 4 predicted using data-driven approaches, involved in the pathogenesis of TED that can be used as potential information for therapeutic targets. Further, we constructed a regulatory pathway of TED biomarkers comprises of 310 connected components, and 1134 interactions using four prominent interaction databases. Conclusion This constructed pathway can be further utilized for disease dynamics and simulation studies. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-01903-9.
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Affiliation(s)
- Huihui Zou
- Department of Ophthalmology, Dezhou People's Hospital, Dezhou, 253000, China
| | - Weiwei Xu
- Department of Ophthalmology, Dezhou People's Hospital, Dezhou, 253000, China
| | - Ying Wang
- Department of Ophthalmology, Dezhou Women's and Children's Hospital, Shandong, China
| | - Zhihong Wang
- Department of Ophthalmology, Dezhou People's Hospital, Dezhou, 253000, China.
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Ahmad SS, Anwar R, Khan MA, Usmani N, Jahan S. Evaluation of Proptosis: A Primer. Ophthalmology 2021. [DOI: 10.17925/opht.2021.15.1.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Gontarz-Nowak K, Szychlińska M, Matuszewski W, Stefanowicz-Rutkowska M, Bandurska-Stankiewicz E. Current Knowledge on Graves' Orbitopathy. J Clin Med 2020; 10:E16. [PMID: 33374706 PMCID: PMC7793490 DOI: 10.3390/jcm10010016] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/14/2020] [Accepted: 12/19/2020] [Indexed: 12/12/2022] Open
Abstract
(1) Background: Graves' orbitopathy (GO) is an autoimmune inflammation of the orbital tissues and the most common extra-thyroid symptom of Graves' disease (GD). Mild cases of GO are often misdiagnosed, which prolongs the diagnostic and therapeutic process, leading to exacerbation of the disease. A severe course of GO may cause permanent vision loss. (2) Methods: The article presents an analysis of GO-its etiopathogenesis, diagnostics, current treatment and potential future therapeutic options based on a review of the currently available literature of the subject. (3) Results: Current treatment of the active GO consists predominantly in intravenous glucocorticoids (GCs) administration in combination with orbital radiotherapy. The growing knowledge on the pathogenesis of the disease has contributed to multiple trials of the use of immunosuppressive drugs and monoclonal antibodies which may be potentially effective in the treatment of GO. Immunosuppressive treatment is not effective in patients in whom a chronic inflammatory process has caused fibrous changes in the orbits. In such cases surgical treatment is performed-including orbital decompression, adipose tissue removal, oculomotor muscle surgery, eyelid alignment and blepharoplasty. (4) Conclusions: Management of GO is difficult and requires interdisciplinary cooperation in endocrinology; ophthalmology, radiation oncology and surgery. The possibilities of undertaking a reliable assessment and comparison of the efficacy and safety of the therapeutic strategies are limited due to the heterogeneity of the available studies conducted mostly on small group of patients, with no comparison with classic systemic steroid therapy. The registration by FDA of Teprotumumab, an IGF1-R antagonist, in January 2020 may be a milestone in future management of active GO. However, many clinical questions require to be investigated first.
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Affiliation(s)
- Katarzyna Gontarz-Nowak
- Clinic of Endocrinology, Diabetology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-957 Olsztyn, Poland; (M.S.); (W.M.); (M.S.-R.); (E.B.-S.)
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Abstract
OBJECTIVE To examine risk factors that might be associated with thyroid eye disease (TED) in patients with Graves' disease (GD), which may guide physicians in the prevention and management of TED. METHODS Medline and Embase were searched for articles discussing risk factors of TED. Comparisons were made between GD patients with and without TED, and between active and inactive TED GD patients. Weighted mean differences (WMDs) and odds ratios (ORs) were determined for continuous and dichotomous outcomes, respectively. Results were pooled with random effects using the DerSimonian and Laird model. RESULTS Fifty-six articles were included in the analysis. Smoking, inclusive of current and previous smoking status, was a significant risk factor for TED (OR: 2.401; CI: 1.958-2.945; P < .001). Statistical significance was found upon meta-regression between male sex and the odds of smoking and TED (β = 1.195; SE = 0.436; P = .013). Other risk factors were also examined, and patients with TED were significantly older than those without TED (WMD: 1.350; CI: 0.328-2.372; P = .010). While both age (WMD: 5.546; CI: 3.075-8.017; P < .001) and male sex (OR: 1.819; CI: 1.178-2.808; P = .007) were found to be significant risk factors for active TED patients compared to inactive TED patients, no statistical significance was found for family history, thyroid status, cholesterol levels, or body mass index. CONCLUSION Factors such as smoking, sex, and age predispose GD patients to TED, and TED patients to active TED. A targeted approach in the management of GD and TED is required to reduce the modifiable risk factor of smoking.
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Zhu L, Li S, He S, Tong Q, Wang L, Li X, Wu X, Meng Q, Jin E, Zhang C, Li T, Xu N, Huang L, Wang Y, Zhao M. The critical role of m 6A methylation in the pathogenesis of Graves' ophthalmopathy. EYE AND VISION 2020; 7:55. [PMID: 33292635 PMCID: PMC7708247 DOI: 10.1186/s40662-020-00221-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 11/03/2020] [Indexed: 02/14/2023]
Abstract
PURPOSE To investigate the role of N6-methyladenosine (m6A) RNA modification in the pathogenesis of Graves' ophthalmopathy (GO). METHODS Surgically excised extraocular muscles from 7 patients with GO and 5 subjects without GO were used. The global m6A levels in the specimens were determined using an m6A RNA methylation quantification kit. RNA sequencing (RNA-seq) was used to analyze the molecules involved in the regulation of m6A RNA methylation and the differential expression of mRNAs between the two groups (4 eyes, respectively). The expression of m6A RNA modification genes was evaluated by real-time PCR. The functional implications of the gene alterations between the GO and control specimens were determined by Gene Ontology analysis. RESULTS The m6A level was significantly increased in the specimens of GO patients compared to the control specimens (P < 0.05). The expression of m6A methylation regulators, such as WT1 associated protein (WTAP), alkylation repair homolog protein 5 (ALKBH5), E74 like ETS transcription factor 3 (ELF3), YTH N6-methyladenosine RNA binding protein 2 (YTHDF2), YTHDF3 and YTH domain containing 2 (YTHDC2), was significantly upregulated (P < 0.05). Gene Ontology enrichment analysis showed that the most highly upregulated genes and biological pathways were related to the immune response and inflammatory processes such as lymphocyte activation, leukocyte differentiation, cytokine production and cytokine-mediated signaling pathways. CONCLUSIONS Our results suggest that m6A methylation may play a critical role in the pathogenesis of GO and that targeting genes that regulate m6A methylation may provide a new therapeutic approach for GO.
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Affiliation(s)
- Li Zhu
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Xizhimen South Street 11, Xi Cheng District, Beijing, 100044, China
| | - Siyan Li
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Xizhimen South Street 11, Xi Cheng District, Beijing, 100044, China
| | - Shikun He
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Xizhimen South Street 11, Xi Cheng District, Beijing, 100044, China
| | - Qizhe Tong
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Xizhimen South Street 11, Xi Cheng District, Beijing, 100044, China
| | - Lejin Wang
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Xizhimen South Street 11, Xi Cheng District, Beijing, 100044, China
| | - Xiaohua Li
- Henan Provincial People's Hospital and Henan Eye Hospital, Zhengzhou, China
| | - Xi Wu
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Xizhimen South Street 11, Xi Cheng District, Beijing, 100044, China
| | - Qingyu Meng
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Xizhimen South Street 11, Xi Cheng District, Beijing, 100044, China
| | - Enzhong Jin
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Xizhimen South Street 11, Xi Cheng District, Beijing, 100044, China
| | - Chuan Zhang
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Xizhimen South Street 11, Xi Cheng District, Beijing, 100044, China
| | - Tianyuan Li
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Xizhimen South Street 11, Xi Cheng District, Beijing, 100044, China
| | - Ningda Xu
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Xizhimen South Street 11, Xi Cheng District, Beijing, 100044, China
| | - Lvzhen Huang
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Xizhimen South Street 11, Xi Cheng District, Beijing, 100044, China
| | - Yi Wang
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Xizhimen South Street 11, Xi Cheng District, Beijing, 100044, China.
| | - Mingwei Zhao
- Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Xizhimen South Street 11, Xi Cheng District, Beijing, 100044, China.
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Huang X, Liu G, Mei S, Cai J, Rao J, Tang M, Zhu T, Chen W, Peng S, Wang Y, Ye Y, Zhang T, Deng Z, Zhao J. Human leucocyte antigen alleles confer susceptibility and progression to Graves' ophthalmopathy in a Southern Chinese population. Br J Ophthalmol 2020; 105:1462-1468. [PMID: 33221730 PMCID: PMC8479741 DOI: 10.1136/bjophthalmol-2020-317091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 10/12/2020] [Accepted: 10/26/2020] [Indexed: 12/02/2022]
Abstract
Purpose To evaluate the contributions of human leucocyte antigen (HLA) class I and II genes in the development of Graves’ ophthalmopathy (GO) in a Southern Chinese population. Methods Eight HLA loci were genotyped and analysed in 272 unrelated patients with Graves’ disease (GD) or the proptosis and myogenic phenotypes of GO, and 411 ethnically matched control subjects. Results The allele frequencies of HLA-DRB1*16:02 and -DQB1*05:02 in the GD, proptosis and myogenic groups, HLA-B*38:02 and -DQA1*01:02 in the myogenic group were significantly higher than those in the control group, respectively (all corrected p values <0.05, OR >2.5). The haplotype frequencies of HLA-DRB1*16:02-DQA1*01:02-DQB1*05:02 and HLA-DRB1*16:02-DQA1*01:02-DQB1*05:02-DPA1*02:02-DPB1*05:01 in the proptosis and myogenic groups, and HLA-A*02:03-B*38:02-C*07:02 and HLA-A*02:03-B*38:02-C*07:02-DRB1*16:02-DQA1*01:02-DQB1*05:02-DPA1*02:02-DPB1*05:01 in the myogenic group were significantly higher than those in the control group respectively (all corrected p values <0.05, OR >2.5). The potential epitopes (‘FLGIFNTGL’ of TSHR, ‘IRHSHALVS’, ‘ILYIRTNAS’ and ‘FVFARTMPA’ of IGF-1R) were fitted exactly in the peptide-binding groove between HLA-DRA1-DRB1*16:02 heterodimer, and the epitopes (‘ILEITDNPY’ of THSR, ‘NYALVIFEM’ and ‘NYSFYVLDN’ of IGF-1R) were also fitted exactly in the peptide-binding groove between HLA-DQA1*01:02-DQB1*05:02 heterodimer. Conclusions The HLA-DRB1*16:02 and -DQB1*01:02 alleles might be risk factors for GD including the proptosis and myogenic phenotypes of GO. The alleles HLA-B*38:02, -DQA1*01:02, the HLA haplotypes consisting of HLA-B*38:02, -DRB1*16:02, -DQA1*01:02 and -DQB1*05:02 might be susceptibility risk factors for GO. Simultaneously, some epitopes of TSHR and IGF-1R tightly binding to groove of HLA-DRA1-DRB1*16:02 or HLA-DQA1*01:02-DQB1*05:02 heterodimers might provide some hints on presenting the pathological antigen in GO.
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Affiliation(s)
- Xiaosheng Huang
- Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, Guangdong, China.,School of Ophthalmology & Optometry, Shenzhen University, Shenzhen, Guangdong, China
| | - Guiqin Liu
- Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, Guangdong, China.,School of Ophthalmology & Optometry, Shenzhen University, Shenzhen, Guangdong, China
| | - Shaoyi Mei
- Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, Guangdong, China.,School of Ophthalmology & Optometry, Shenzhen University, Shenzhen, Guangdong, China
| | - Jiamin Cai
- School of Ophthalmology & Optometry, Shenzhen University, Shenzhen, Guangdong, China
| | - Jing Rao
- Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, Guangdong, China
| | - Minzhong Tang
- Cancer Center, Wuzhou Red Cross Hospital, Wuzhou, Guangxi, China
| | - Tianhui Zhu
- Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, Guangdong, China.,School of Ophthalmology & Optometry, Shenzhen University, Shenzhen, Guangdong, China
| | - Wenchiew Chen
- Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, Guangdong, China
| | - Shiming Peng
- Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, Guangdong, China.,School of Ophthalmology & Optometry, Shenzhen University, Shenzhen, Guangdong, China
| | - Yan Wang
- Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, Guangdong, China
| | - Ye Ye
- School of Ophthalmology & Optometry, Shenzhen University, Shenzhen, Guangdong, China
| | - Tong Zhang
- Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, Guangdong, China
| | - Zhihui Deng
- Immunogenetics Laboratory, Shenzhen Blood Center, Shenzhen, Guangdong, China .,Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
| | - Jun Zhao
- Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, Guangdong, China .,School of Ophthalmology & Optometry, Shenzhen University, Shenzhen, Guangdong, China
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12
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Proteomics in thyroid cancer and other thyroid-related diseases: A review of the literature. BIOCHIMICA ET BIOPHYSICA ACTA-PROTEINS AND PROTEOMICS 2020; 1868:140510. [DOI: 10.1016/j.bbapap.2020.140510] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/26/2020] [Accepted: 07/19/2020] [Indexed: 12/21/2022]
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13
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Sviridenko NY, Bessmertnaya EG, Belovalova IM, Mikheenkov AA, Sheremeta MS, Nikankina LV, Malysheva NM. [Autoantibodies, immunoglobulins and cytokine profile in patients with graves' disease and Graves' orbitopathy]. ACTA ACUST UNITED AC 2020; 66:15-23. [PMID: 33369369 DOI: 10.14341/probl12544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/20/2020] [Accepted: 10/01/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Graves' Orbitopathy (GO) - also known as Thyroid Eye Disease (TED) - is an autoimmune condition in the modern sense. It is closely associated with autoimmune thyroid diseases. Cytokine-mediated mechanisms play a critical part in immunopathogenesis of autoimmune thyroid diseases including GO. Investigating cytokine profiles as well as antibodies to tissue-specific antigens is essential for explaining GO pathogenesis and developing future therapeutic strategies. AIMS The study examines serum levels of cytokines, autoantibodies and immunoglobulins IgG and IgG4 as mediators of autoimmune inflammation in patients with GO and Graves' Disease (GD). MATERIALS AND METHODS The study included 52 patients (104 orbits) aged 25-70 years (mean age 48,8±12,3) in the active phase of GO and GD verified with the international diagnostic standards. These patients did not get any treatment for GO before. The control group consisted of 14 individuals (28 orbits) aged 30-68 years without known autoimmune disease.Serum levels of IgG, IgG4,TNFα, IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-17A, IL-13, sIL-6R, sTNFα- RI и TNFα- R2 IL-2R, TGFβ1, TGF β3, antibodies to TSH-receptor, free T4, free T3 and TSH were measured. A diagnostic ultrasound exam of thyroid gland, multislice computed tomography (MSCT) / magnetic resonance imaging (MRI) of orbits were performed. RESULTS Mean duration of GO prior to being admitted to the centre was 8,8±1,5 months (range: 1 - 48 months). According to the degree of thyrotoxicosis compensation: 24 patients were clinically euthyroid, TSH 3,3±0,7 mU/L, free T4 11,9±0,59 pmol/L, free T3 3,97±0,1 pmol/L; 28 patients were considered to have subclinical thyrotoxicosis: TSH 0,03±0,01 mU/L, free T4 14,2±1,0 pmol/L, free T3 5,77±0,49 pmol/L. Serum levels of sTNFα-R2 (p=0,041, p≤0,05), sIL-2R (p=0,020, p≤0,05), TGFβ1 (p=0,000, p≤0,001) were significantly higher in patients with GO compared to the control group. Serum levels of sTNFRα2 (p=0,038, p<0,05) and TGFβ1 (P=0,011, p≤0,05) were positively correlated with the duration of GO. The positive correlations between the serum level of sIL-6R (p=0,034, p≤0,05) and the severity of GO as well as between the serum level of sTNFα- R 1 (P=0,012, p≤0,05) and activity of GO were observed. 54% of patients had elevated concentration level of IgG4 in IgG ( >5%). CONCLUSION High levels of soluble cytokine receptors sTNFα-R2 and sIL-2R and cytokine TGFβ1 in patients with long-standing untreated GO and GD being euthyroid or having subclinical thyrotoxicosis indicate activation of regulatory T cells aimed at suppressing autoimmune processes. High concentration level of IgG4 in IgG and cytokine TGFβ1 can determine the development of fibrotic changes in the orbital tissues. A decrease in the concentration of cytokine TGFβ1 can indicate an unfavorable course of the disease GO.
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Chin YH, Ng CH, Lee MH, Koh JWH, Kiew J, Yang SP, Sundar G, Khoo CM. Prevalence of thyroid eye disease in Graves' disease: A meta-analysis and systematic review. Clin Endocrinol (Oxf) 2020; 93:363-374. [PMID: 32691849 DOI: 10.1111/cen.14296] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/03/2020] [Accepted: 07/13/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Thyroid eye disease (TED) is a debilitating condition that frequently manifests in patients suffering from Graves' disease (GD). This study aims to analyse the prevalence of TED among GD patients, with a focus on geographical region-specific rates. METHODS Medline and Embase were searched for articles examining TED prevalence on April 2020, and articles were retrieved and sieved. Statistical analysis was performed after Freeman-Tukey double arcsine transformation. Thereafter, results were pooled with random effects by DerSimonian and Laird model. RESULTS Fifty-seven articles involving 26,804 patients were included in the review. The overall pooled prevalence of TED was 40% (CI: 0.32 to 0.48) and by continent was 38% (CI: 0.31 to 0.46) for Europe, 44% (CI: 0.32 to 0.56) for Asia, 27% (CI: 0.06 to 0.56) for North America and 58% (CI: 0.55 to 0.61) for Oceania. The prevalence of TED in Southeast Asia was 35% (CI: 0.24 to 0.47) and Middle East 48% (CI: 0.19 to 0.78). Subgroup analysis showed regions with predominantly Caucasians (37%; CI: 0.28 to 0.46) had a lower prevalence of TED compared to Asians (45%; CI: 0.33 to 0.58). The pooled prevalence of lid retraction was 57% (CI: 0.39 to 0.74), proptosis 57% (CI: 0.48 to 0.65), diplopia 36% (CI: 0.24 to 0.48) and ocular hypertension 13% (CI: 0.06 to 0.19). CONCLUSION A substantial proportion of patients with GD have TED and often manifest as lid retraction, proptosis and diplopia. Early detection through active screening might help to mitigate the progression of TED and its associated complications.
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Affiliation(s)
- Yip Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cheng Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ming Hui Lee
- Department of Biological Science, Faculty of Science, National University of Singapore, Singapore
| | - Jeffery Wei Heng Koh
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
| | - Jolene Kiew
- Department of Medicine, National University Hospital, Singapore
| | - Samantha Peiling Yang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Medicine, National University Hospital, Singapore
| | - Gangadhara Sundar
- Department of Ophthalmology, National University Hospital, Singapore
| | - Chin Meng Khoo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Medicine, National University Hospital, Singapore
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15
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Chen L, Huang Z, Liao Y, Yang B, Zhang J. Association between tumor necrosis factor polymorphisms and rheumatoid arthritis as well as systemic lupus erythematosus: a meta-analysis. ACTA ACUST UNITED AC 2019; 52:e7927. [PMID: 30916218 PMCID: PMC6437938 DOI: 10.1590/1414-431x20187927] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 12/10/2018] [Indexed: 02/05/2023]
Abstract
Tumor necrosis factor-alpha (TNF-α) plays an important role in
autoimmune diseases. Previous studies have investigated the association of
TNF-α-238G/A (rs361525) and -308G/A
(rs1800629) polymorphisms with rheumatoid arthritis (RA) and systemic lupus
erythematosus (SLE). However, no agreed conclusion had been made. Therefore,
this meta-analysis was conducted to assess the associations of
TNF-α-238G/A and -308G/A polymorphisms
with RA and SLE risk. A systematic search was conducted in commonly used
databases. Meta-analysis was performed by STATA12.0. A total of 43 studies were
included. In the overall population, the TNF-α-238A allele was
observed to be a protective factor for RA (A vs G: OR=0.75,
95%CI=0.57–0.99, P=0.040) and the TNF-α-308A allele was found
to be a risk factor for SLE (A vs G: OR=1.78, 95%CI=1.45–2.19,
P<0.001). However, no evidence of association was found between
TNF-α-238 G/A polymorphism and SLE nor between -308G/A and
RA. In the subgroup analysis, TNF-α-308A allele played a
pathogenic role for RA in Latin Americans (A vs G: OR=1.46,
95%CI=1.15–1.84, P=0.002) and for SLE in Latin Americans (A vs
G: OR=2.12, 95%CI=1.32–3.41, P=0.002) and Europeans (A vs G:
OR=2.03, 95%CI=1.56–2.63, P<0.001), while it played a protective role for RA
in Asians (A vs G: OR=0.54, 95%CI=0.32–0.90, P=0.017). No
significant association was found between TNF-α-308G/A and SLE
susceptibility in Africans and Asians. This meta-analysis demonstrated that
TNF-α-238A was associated with decreased risk of RA rather
than SLE, while -308G/A polymorphism was associated with SLE
rather than RA. Stratification analysis indicated that different ethnicities
would have different risk alleles.
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Affiliation(s)
- Lin Chen
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Zhuochun Huang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yun Liao
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Bin Yang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Junlong Zhang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
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Yao Q, An X, Zhang J, Mu K, Li L, Song R, Sun P, Zhang JA. IRF7 Gene Variations Confer Susceptibility to Autoimmune Thyroid Diseases and Graves' Ophthalmopathy. Int J Endocrinol 2019; 2019:7429187. [PMID: 30774658 PMCID: PMC6350596 DOI: 10.1155/2019/7429187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 11/01/2018] [Indexed: 01/20/2023] Open
Abstract
The objective of this study was to investigate whether IRF7 polymorphisms are associated with autoimmune thyroid diseases (AITDs). We selected three single nucleotide polymorphisms (SNPs) of IRF7, namely, rs1061501, rs1131665, and rs1061502 for genotyping using PCR-based ligase detection reaction (LDR) method in a total of 1659 participants (592 with Graves' disease, 297 with Hashimoto's thyroiditis, and 770 healthy controls). Gene-disease and genotype-clinical phenotype associations were evaluated for the three SNPs. Our results showed that the AG genotype and the minor allele G frequency of rs1131665 and rs1061502 in AITD patients were both higher than those of the controls (rs1131665: AG genotype: P = 0.017, OR = 1.968; allele G: P = 0.018, OR = 1.946; rs1061502: AG genotype: P = 0.029, OR = 1.866; allele G: P = 0.031, OR = 1.847). Subgroup analysis also showed that the AG genotype and the minor allele G frequency of rs1131665 and rs1061502 in Graves' disease patients were both higher than those of the controls (rs1131665: AG genotype: P = 0.015, OR = 2.074; allele G: P = 0.016, OR = 2.048; rs1061502: AG genotype: P = 0.034, OR = 1.919; allele G: P = 0.035, OR = 1.898). Furthermore, the allele G frequency of rs1061501 was associated with Graves' ophthalmopathy (P = 0.035, OR = 1.396). No significant difference in IRF7 polymorphisms was found between Hashimoto's thyroiditis patients and controls. Our study has revealed for the first time that IRF7 is a susceptibility gene for AITD, especially for Graves' disease and Graves' ophthalmopathy.
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Affiliation(s)
- Qiuming Yao
- Department of Endocrinology, Jinshan Hospital of Fudan University, No. 1508 Longhang Road, Jinshan District, Shanghai 201508, China
| | - Xiaofei An
- Department of Endocrinology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210023, China
| | - Jing Zhang
- Department of Endocrinology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, No. 1500 Zhouyuan Road, Pudong District, Shanghai 201318, China
| | - Kaida Mu
- Department of Endocrinology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, No. 1500 Zhouyuan Road, Pudong District, Shanghai 201318, China
| | - Ling Li
- Department of Endocrinology, Jinshan Hospital of Fudan University, No. 1508 Longhang Road, Jinshan District, Shanghai 201508, China
| | - Ronghua Song
- Department of Endocrinology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, No. 1500 Zhouyuan Road, Pudong District, Shanghai 201318, China
| | - Peilong Sun
- Department of General Surgery, Jinshan Hospital of Fudan University, No. 1508 Longhang Road, Jinshan District, Shanghai 201508, China
| | - Jin-an Zhang
- Department of Endocrinology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, No. 1500 Zhouyuan Road, Pudong District, Shanghai 201318, China
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17
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Longo CM, Higgins PJ. Molecular biomarkers of Graves' ophthalmopathy. Exp Mol Pathol 2018; 106:1-6. [PMID: 30414981 DOI: 10.1016/j.yexmp.2018.11.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 09/15/2018] [Accepted: 11/07/2018] [Indexed: 12/25/2022]
Abstract
Graves' ophthalmopathy (GO), a complication of Graves' disease (GD), is typified by orbital inflammation, ocular tissue expansion and remodeling and, ultimately, fibrosis. Orbital fibroblasts are key effectors of GO pathogenesis exhibiting exaggerated inflammatory and fibroproliferative responses to cytokines released by infiltrating immune cells. Activated orbital fibroblasts also produce inflammatory mediators that contribute to disease progression, facilitate the orbital trafficking of monocytes and macrophages, promote differentiation of matrix-producing myofibroblasts and stimulate accumulation of a hyaluronan-rich stroma, which leads to orbital tissue edema and fibrosis. Proteomic and transcriptome profiling of the genomic response of ocular and non-ocular fibroblasts to INF-γ and TGF-β1 focused on identification of translationally-relevant therapeutic candidates. Induction of plasminogen activator inhibitor-1 (PAI-1, SERPINE1), a clade E member of the serine protease inhibitor (SERPIN) gene family and a prominent regulator of the pericellular proteolytic microenvironment, was one of the most highly up-regulated proteins in INF-γ- or TGF-β1-stimulated GO fibroblasts as well as in severe active GD compared to patients without thyroid disease. PAI-1 has multifunctional roles in inflammatory and fibrotic processes that impact tissue remodeling, immune cell trafficking and survival as well as signaling through several receptor systems. This review focuses on the pathophysiology of the GO fibroblast and possible targets for effective drug therapy.
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Affiliation(s)
- Christine M Longo
- Department of Regenerative & Cancer Cell Biology, Albany Medical College, Albany, New York 12208, United States
| | - Paul J Higgins
- Department of Regenerative & Cancer Cell Biology, Albany Medical College, Albany, New York 12208, United States.
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Ramírez-Bello J, Cadena-Sandoval D, Mendoza-Rincón JF, Barbosa-Cobos RE, Sánchez-Muñoz F, Amezcua-Guerra LM, Sierra-Martínez M, Jiménez-Morales S. Tumor necrosis factor gene polymorphisms are associated with systemic lupus erythematosus susceptibility or lupus nephritis in Mexican patients. Immunol Res 2018; 66:348-354. [DOI: 10.1007/s12026-018-8993-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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19
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Thyroid-Associated Orbitopathy and Biomarkers: Where We Are and What We Can Hope for the Future. DISEASE MARKERS 2018; 2018:7010196. [PMID: 29736194 PMCID: PMC5875031 DOI: 10.1155/2018/7010196] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 12/21/2017] [Accepted: 01/30/2018] [Indexed: 01/10/2023]
Abstract
Background Thyroid-associated orbitopathy (TAO) is the most common autoimmune disease of the orbit. It occurs more often in patients presenting with hyperthyroidism, characteristic of Graves' disease, but may be associated with hypothyroidism or euthyroidism. The diagnosis of TAO is based on clinical orbital features, radiological criteria, and the potential association with thyroid disease. To date, there is no specific marker of the orbital disease, making the early diagnosis difficult, especially if the orbital involvement precedes the thyroid dysfunction. Summary The goal of this review is to present the disease and combine the available data in the literature concerning investigation of TAO biomarkers. Conclusions Despite the progress done in the understanding of TAO disease, some important pieces are still missing. Typically, for the future, major efforts have to be done in the discovery of new biomarkers, validation of the suspected candidates on multicenter cohorts with standardized methodologies, and establishment of their clinical performances on the specific clinical application fields in order to improve not only the management of the TAO patients but also the therapeutic options and follow-up.
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20
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Wang Y, Zhou H, Fan X. The effect of orbital radiation therapy on thyroid-associated orbitopathy complicated with dysthyroid optic neuropathy. Front Med 2017; 11:359-364. [PMID: 28500433 DOI: 10.1007/s11684-017-0528-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 02/08/2017] [Indexed: 01/11/2023]
Abstract
Thyroid-associated orbitopathy (TAO) is an inflammatory autoimmune disorder. The most serious complication of TAO is dysthyroid optic neuropathy (DON), which can lead to permanent vision loss because of volume expansion in the orbital apex. Orbital radiation therapy (ORT) is an anti-inflammatory treatment used in the treatment of active TAO. Clinical studies support radiotherapy as having a modest effect on DON, and early radiotherapy may protect against disease progression to DON. Current studies suggest that radiotherapy is generally safe. However, risks still exist in some cases. The possible effects of radiotherapy on TAO, especially complicated with DON, are reviewed. The effects of radiotherapy on DON are not completely known, and evidence from standardized, prospective, and multicenter clinical trials is still lacking.
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Affiliation(s)
- Yang Wang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Huifang Zhou
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Xianqun Fan
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
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21
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Wang B, Shao X, Song R, Xu D, Zhang JA. The Emerging Role of Epigenetics in Autoimmune Thyroid Diseases. Front Immunol 2017; 8:396. [PMID: 28439272 PMCID: PMC5383710 DOI: 10.3389/fimmu.2017.00396] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/21/2017] [Indexed: 12/15/2022] Open
Abstract
Autoimmune thyroid diseases (AITD) are a group of both B cell- and T cell-mediated organ-specific autoimmune diseases. Graves’ disease and Hashimoto thyroiditis are the two main clinical presentations of AITD. Both genetic and environmental factors have important roles in the development of AITD. Epigenetics have been considered to exert key roles in integrating those genetic and environmental factors, and epigenetic modifications caused by environmental factors may drive genetically susceptibility individuals to develop AITD. Recent studies on the epigenetics of AITD have provided some novel insights into the pathogenesis of AITD. The aim of this review is to provide an overview of recent advances in the epigenetic mechanisms of AITD, such as DNA methylation, histone modifications, and non-coding RNAs. This review highlights the key roles of epigenetics in the pathogenesis of AITD and potential clinical utility. However, the epigenetic roles in AITD are still not fully elucidated, and more researches are needed to provide further deeper insights into the roles of epigenetics in AITD and to uncover new therapeutic targets. Although there are many studies assessing the epigenetic modifications in AITD patients, the clinical utility of epigenetics in AITD remains poorly defined. More studies are needed to identify the underlying epigenetic modifications that can contribute to accurate diagnosis of AITD, adequate choice of treatment approach, and precise prediction of treatment outcomes.
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Affiliation(s)
- Bin Wang
- Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China.,Department of Rheumatology and Immunology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Xiaoqing Shao
- Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China.,Department of Rheumatology and Immunology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Ronghua Song
- Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China.,Department of Rheumatology and Immunology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Donghua Xu
- Department of Rheumatology and Immunology, The Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Jin-An Zhang
- Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai, China.,Department of Rheumatology and Immunology, Jinshan Hospital of Fudan University, Shanghai, China
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22
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Fang S, Huang Y, Wang S, Zhang Y, Luo X, Liu L, Zhong S, Liu X, Li D, Liang R, Miranda P, Gu P, Zhou H, Fan X, Li B. IL-17A Exacerbates Fibrosis by Promoting the Proinflammatory and Profibrotic Function of Orbital Fibroblasts in TAO. J Clin Endocrinol Metab 2016; 101:2955-65. [PMID: 27224264 DOI: 10.1210/jc.2016-1882] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT The development of thyroid-associated ophthalmopathy (TAO) is associated with self-immune dysfunction. Recent findings in TAO and Graves' disease indicate that IL-17A may also be involved in the autoimmunity of TAO. OBJECTIVE We sought to investigate the pathogenic function of IL-17A-producing T cells in TAO. DESIGN/SETTING/PARTICIPANTS Blood samples and orbital fibroblasts (OFs) were collected from TAO patients and healthy subjects. MAIN OUTCOME MEASURES Flow cytometry, real-time PCR, cytokine-specific ELISA, and Western blotting were performed. RESULTS Here, we showed a significantly higher proportion of IL-17A-producing T cells in TAO patients and the recruitment of both CD4(+) and CD8(+) T cells in TAO orbits. TAO orbital tissues expressed more IL-17A receptor, IL-17A, and its related cytokines, with severe fibrotic change compared with normal controls. Furthermore, we validated that IL-17A could enhance the proinflammatory function of OFs and stimulate the production of extracellular matrix proteins in OFs but not eyelid fibroblasts. The mechanisms involved in this enhancement mainly relied on MAPK activation. Finally, we observed that the deubiquitinase inhibitor vialinin A could down-regulate retinoic acid receptor-related orphan receptor-γt expression and decrease IL-17A level in TAO patients. CONCLUSION Our observations illustrate the potential pathogenic role of IL-17A-producing T cells in the inflammatory response and fibrosis of TAO. The effect of vialinin A on the reduction of retinoic acid receptor-related orphan receptor-γt level implicates its potential role as a novel therapeutic agent for TAO and other autoimmune disorders in the future.
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Affiliation(s)
- Sijie Fang
- Department of Ophthalmology (S.F., Y.H., Y.Z., S.Z., X.Li., P.G., H.Z., X.F.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011; and Key Laboratory of Molecular Virology and Immunology (S.F., S.W., X.Lu., L.L., D.L., R.L., P.M., B.L.), Chinese Academy of Sciences Center for Excellence in Molecular Cell Science, Unit of Molecular Immunology, Institut Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences Medical School, Chinese Academy of Sciences, Shanghai 200031
| | - Yazhuo Huang
- Department of Ophthalmology (S.F., Y.H., Y.Z., S.Z., X.Li., P.G., H.Z., X.F.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011; and Key Laboratory of Molecular Virology and Immunology (S.F., S.W., X.Lu., L.L., D.L., R.L., P.M., B.L.), Chinese Academy of Sciences Center for Excellence in Molecular Cell Science, Unit of Molecular Immunology, Institut Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences Medical School, Chinese Academy of Sciences, Shanghai 200031
| | - Shuaiwei Wang
- Department of Ophthalmology (S.F., Y.H., Y.Z., S.Z., X.Li., P.G., H.Z., X.F.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011; and Key Laboratory of Molecular Virology and Immunology (S.F., S.W., X.Lu., L.L., D.L., R.L., P.M., B.L.), Chinese Academy of Sciences Center for Excellence in Molecular Cell Science, Unit of Molecular Immunology, Institut Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences Medical School, Chinese Academy of Sciences, Shanghai 200031
| | - Yidan Zhang
- Department of Ophthalmology (S.F., Y.H., Y.Z., S.Z., X.Li., P.G., H.Z., X.F.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011; and Key Laboratory of Molecular Virology and Immunology (S.F., S.W., X.Lu., L.L., D.L., R.L., P.M., B.L.), Chinese Academy of Sciences Center for Excellence in Molecular Cell Science, Unit of Molecular Immunology, Institut Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences Medical School, Chinese Academy of Sciences, Shanghai 200031
| | - Xuerui Luo
- Department of Ophthalmology (S.F., Y.H., Y.Z., S.Z., X.Li., P.G., H.Z., X.F.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011; and Key Laboratory of Molecular Virology and Immunology (S.F., S.W., X.Lu., L.L., D.L., R.L., P.M., B.L.), Chinese Academy of Sciences Center for Excellence in Molecular Cell Science, Unit of Molecular Immunology, Institut Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences Medical School, Chinese Academy of Sciences, Shanghai 200031
| | - Luyan Liu
- Department of Ophthalmology (S.F., Y.H., Y.Z., S.Z., X.Li., P.G., H.Z., X.F.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011; and Key Laboratory of Molecular Virology and Immunology (S.F., S.W., X.Lu., L.L., D.L., R.L., P.M., B.L.), Chinese Academy of Sciences Center for Excellence in Molecular Cell Science, Unit of Molecular Immunology, Institut Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences Medical School, Chinese Academy of Sciences, Shanghai 200031
| | - Sisi Zhong
- Department of Ophthalmology (S.F., Y.H., Y.Z., S.Z., X.Li., P.G., H.Z., X.F.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011; and Key Laboratory of Molecular Virology and Immunology (S.F., S.W., X.Lu., L.L., D.L., R.L., P.M., B.L.), Chinese Academy of Sciences Center for Excellence in Molecular Cell Science, Unit of Molecular Immunology, Institut Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences Medical School, Chinese Academy of Sciences, Shanghai 200031
| | - Xingtong Liu
- Department of Ophthalmology (S.F., Y.H., Y.Z., S.Z., X.Li., P.G., H.Z., X.F.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011; and Key Laboratory of Molecular Virology and Immunology (S.F., S.W., X.Lu., L.L., D.L., R.L., P.M., B.L.), Chinese Academy of Sciences Center for Excellence in Molecular Cell Science, Unit of Molecular Immunology, Institut Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences Medical School, Chinese Academy of Sciences, Shanghai 200031
| | - Dan Li
- Department of Ophthalmology (S.F., Y.H., Y.Z., S.Z., X.Li., P.G., H.Z., X.F.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011; and Key Laboratory of Molecular Virology and Immunology (S.F., S.W., X.Lu., L.L., D.L., R.L., P.M., B.L.), Chinese Academy of Sciences Center for Excellence in Molecular Cell Science, Unit of Molecular Immunology, Institut Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences Medical School, Chinese Academy of Sciences, Shanghai 200031
| | - Rui Liang
- Department of Ophthalmology (S.F., Y.H., Y.Z., S.Z., X.Li., P.G., H.Z., X.F.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011; and Key Laboratory of Molecular Virology and Immunology (S.F., S.W., X.Lu., L.L., D.L., R.L., P.M., B.L.), Chinese Academy of Sciences Center for Excellence in Molecular Cell Science, Unit of Molecular Immunology, Institut Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences Medical School, Chinese Academy of Sciences, Shanghai 200031
| | - Piccioni Miranda
- Department of Ophthalmology (S.F., Y.H., Y.Z., S.Z., X.Li., P.G., H.Z., X.F.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011; and Key Laboratory of Molecular Virology and Immunology (S.F., S.W., X.Lu., L.L., D.L., R.L., P.M., B.L.), Chinese Academy of Sciences Center for Excellence in Molecular Cell Science, Unit of Molecular Immunology, Institut Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences Medical School, Chinese Academy of Sciences, Shanghai 200031
| | - Ping Gu
- Department of Ophthalmology (S.F., Y.H., Y.Z., S.Z., X.Li., P.G., H.Z., X.F.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011; and Key Laboratory of Molecular Virology and Immunology (S.F., S.W., X.Lu., L.L., D.L., R.L., P.M., B.L.), Chinese Academy of Sciences Center for Excellence in Molecular Cell Science, Unit of Molecular Immunology, Institut Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences Medical School, Chinese Academy of Sciences, Shanghai 200031
| | - Huifang Zhou
- Department of Ophthalmology (S.F., Y.H., Y.Z., S.Z., X.Li., P.G., H.Z., X.F.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011; and Key Laboratory of Molecular Virology and Immunology (S.F., S.W., X.Lu., L.L., D.L., R.L., P.M., B.L.), Chinese Academy of Sciences Center for Excellence in Molecular Cell Science, Unit of Molecular Immunology, Institut Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences Medical School, Chinese Academy of Sciences, Shanghai 200031
| | - Xianqun Fan
- Department of Ophthalmology (S.F., Y.H., Y.Z., S.Z., X.Li., P.G., H.Z., X.F.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011; and Key Laboratory of Molecular Virology and Immunology (S.F., S.W., X.Lu., L.L., D.L., R.L., P.M., B.L.), Chinese Academy of Sciences Center for Excellence in Molecular Cell Science, Unit of Molecular Immunology, Institut Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences Medical School, Chinese Academy of Sciences, Shanghai 200031
| | - Bin Li
- Department of Ophthalmology (S.F., Y.H., Y.Z., S.Z., X.Li., P.G., H.Z., X.F.), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011; and Key Laboratory of Molecular Virology and Immunology (S.F., S.W., X.Lu., L.L., D.L., R.L., P.M., B.L.), Chinese Academy of Sciences Center for Excellence in Molecular Cell Science, Unit of Molecular Immunology, Institut Pasteur of Shanghai, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences Medical School, Chinese Academy of Sciences, Shanghai 200031
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Genetic associations of the thyroid stimulating hormone receptor gene with Graves diseases and Graves ophthalmopathy: A meta-analysis. Sci Rep 2016; 6:30356. [PMID: 27456991 PMCID: PMC4960547 DOI: 10.1038/srep30356] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 06/30/2016] [Indexed: 12/16/2022] Open
Abstract
Graves' disease (GD) is a common thyroid disease, and Graves ophthalmopathy(GO) is the most common extra-thyroidal manifestation of GD. Genetic associations of the thyroid stimulating hormone receptor (TSHR) gene with GD and GO have been studied in different population groups for a long time. We aimed to obtain a more precise estimation of the effects of TSHR single nucleotide polymorphisms (SNPs) on GD/GO using a meta-analysis. Publications were searched on Pub Med and EMBASE up to December 30, 2015. Eight studies involving three SNPs (rs179247, rs12101255, and rs2268458), which included 4790 cases and 5350 controls, met the selection criteria. The pooled odds ratios (OR) and the 95% confidence intervals (CI) were estimated. SNPs rs179247 (dominant model [GG + GA vs. AA]: OR = 0.66, 95%CI: 0.61-0.73, P = 0.000, I(2) = 0%) and rs12101255 (dominant model [TT + TC vs. CC]: OR = 1.67, 95%CI: 1.53-1.83, P = 0.000, I(2) = 0%) were significantly associated with GD in all of the genetic models. TSHR rs12101255 and rs2268458 polymorphisms had no association between GO and GD (GD without GO). The results indicate that rs179247 and rs12101255 are likely to be genetic biomarkers for GD. Further studies with different population groups and larger sample sizes are needed to confirm the genetic associations of the TSHR gene with GD/GO.
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Wong KH, Rong SS, Chong KKL, Young AL, Pang CP, Chen LJ. Genetic Associations of Interleukin-related Genes with Graves' Ophthalmopathy: a Systematic Review and Meta-analysis. Sci Rep 2015; 5:16672. [PMID: 26578206 PMCID: PMC4649612 DOI: 10.1038/srep16672] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/07/2015] [Indexed: 12/23/2022] Open
Abstract
Graves’ ophthalmopathy (GO) is the commonest extra-thyroidal manifestation of Graves’ disease (GD). Associations between interleukin-related (IL) gene polymorphisms and GO have been reported in different populations. We aim to confirm such associations by conducting a meta-analysis. Totally 382 publications were retrieved in MEDLINE and EMBASE up to 25/2/2015. After removing the duplicates and assessing the studies, we retrieved 16 studies that met the selection criteria for meta-analysis, involving 12 polymorphisms in 8 IL-related genes, and 1650 GO cases and 2909 GD controls. The summary odds ratio (OR) and 95% confidence intervals (CI) were estimated. We found one polymorphism in IL1A (rs1800587, c.-889C>T) showing a suggestive association with GO in the meta-analysis (allelic model [T vs. C]: OR = 1.62, 95% CI: 1.00–2.62, P = 0.050, I2 = 53.7%; recessive model [TT vs. TC + CC]: OR = 2.39, 95% CI: 1.07–5.37, P = 0.039, I2 = 23.6%; heterozygous model [TC vs. CC]: OR = 1.52, 95% CI: 1.04–2.22, P = 0.034, I2 = 37.0%). No association with GO was detected for the other 7 genes (IL1B, IL1RA, IL4, IL6, IL12B, IL13 and IL23R). Our results thus indicate that IL1A is likely to be a genetic biomarker for GO. Further studies with larger sample sizes are warranted to confirm the associations of IL1A and other IL-related genes with GO.
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Affiliation(s)
- Kah Hie Wong
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Shi Song Rong
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Kelvin K L Chong
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Alvin L Young
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
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Korkmaz H, Tabur S, Ozkaya M, Oguz E, Aksoy N, Akarsu E. Serum prolidase levels in Graves' disease without ophthalmopathy and its association with oxidative status. J Endocrinol Invest 2015; 38:1167-73. [PMID: 25900177 DOI: 10.1007/s40618-015-0278-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 03/17/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate serum prolidase levels and its association with oxidative stress in autoimmune thyroid disease (AITD). MATERIALS AND METHODS 25 with Hashimoto thyroiditis (HT) and 25 patients Graves' disease (GD), and 27 healthy controls were enrolled in the study. The patients with signs of Graves' ophthalmopathy were excluded from the study. Serum samples were obtained in euthyroid period at the third month of treatment. Serum prolidase, total antioxidant status (TAS), total oxidative stress (TOS), and total free sulfhydryl (-SH) levels were measured. RESULTS Serum prolidase levels were significantly higher in the patients with GD compared to the HT and the healthy control group. Oxidative stress index (OSI) and TOS levels of the patients with both GD and HT were significantly higher compared to those of the control group (p < 0.001, for each), while -SH levels were significantly lower (p < 0.001, for each). There was no significant difference between the patients with HT and healthy control group in terms of prolidase levels (p = 0.580). Prolidase levels were positively correlated with TOS and OSI and negatively correlated with -SH (r = 0.565, p = 0.003; r = 0.604, p = 0.001; r = -0.532, p = 0.006). CONCLUSION Serum prolidase activity is increased in GD patients without signs of ophthalmopathy, and showed a positive correlation with oxidative stress parameters.
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Affiliation(s)
- H Korkmaz
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Gaziantep University, 27100, Sahinbey, Gaziantep, Turkey.
| | - S Tabur
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Gaziantep University, 27100, Sahinbey, Gaziantep, Turkey
| | - M Ozkaya
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Gaziantep University, 27100, Sahinbey, Gaziantep, Turkey
| | - E Oguz
- Department of Medical Pharmacology, Faculty of Medicine, Harran University, 63300, Sanliurfa, Turkey
| | - N Aksoy
- Department of Clinical Biochemistry, Faculty of Medicine, Harran University, 63300, Sanliurfa, Turkey
| | - E Akarsu
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Gaziantep University, 27100, Sahinbey, Gaziantep, Turkey
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Lahooti H, Cultrone D, Edirimanne S, Walsh JP, Delbridge L, Cregan P, Champion B, Wall JR. Novel single-nucleotide polymorphisms in the calsequestrin-1 gene are associated with Graves' ophthalmopathy and Hashimoto's thyroiditis. Clin Ophthalmol 2015; 9:1731-40. [PMID: 26445519 PMCID: PMC4590686 DOI: 10.2147/opth.s87972] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The eye disorder associated with Graves' disease, called Graves' ophthalmopathy (GO), greatly reduces the quality of life in affected patients. Expression of the calsequestrin (CASQ1) protein in thyroid tissue may be the trigger for the development of eye muscle damage in patients with GO. We determined the prevalence of rs74123279, rs3747673, and rs2275703 single-nucleotide polymorphism (SNPs) in patients with autoimmune thyroid disorders, GO, Graves' hyperthyroidism (GH), or Hashimoto's thyroiditis (HT) and control subjects with no personal or family history of autoimmune thyroid disorders. Furthermore, we measured the concentration of the CASQ1 protein in normal and Graves' thyroid tissue, correlating levels with parameters of the eye signs, CASQ1 antibody levels, and the CASQ1 gene polymorphism rs74123279 and rs2275703. METHODS High-quality genomic DNA was isolated from fresh blood samples, assayed for identification of rs74123279, rs3747673, and rs2275703 SNPs in CASQ1 gene by MassARRAY SNP analysis using iPLEX technology of SEQUENOM. RESULTS DNA samples from 300 patients and 106 control subjects (100 males, 306 females) with GO (n=74), GH (n=130), HT (n=96) and control subjects (n=106) were genotyped for the SNPs rs74123279, rs3747673 (n=405), and rs2275703 (n=407). The SNP rs74123279, rs3747673, and rs2275703 were identified as 1) common homozygous or wild type, 2) heterozygote, and 3) rare homozygous. Minor allele frequency for rs74123279, rs3747763, and rs2275703 were 21%, 40%, and 44%, respectively. Multiple comparisons of genotype frequency for rs74123279, rs3747763, and rs2275703 in the GO, GH, HT, and control groups showed P=0.06, 0.641, and 0.189, respectively. These results were substantiated by multiple comparison of alleles frequency for rs74123279, rs3838216, rs3747763, and rs2275703 in the GO, GH, HT, and control groups showed, P=0.36, 0.008, 0.66, and 0.05, respectively. Pairwise analysis of alleles frequency distribution in patients with GO showed significant probability for rs2275703, P=0.008. CONCLUSION Based on their evolutionary conservation and their significant prevalence, we suggest that CASQ1 gene SNPs rs74123279, rs3838216, and rs2275703 may be considered as genetic markers for GO.
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Affiliation(s)
- Hooshang Lahooti
- Thyroid Research Laboratory, Sydney Medical School – Nepean Clinical School, The University of Sydney, Kingswood, NSW, Australia
- Nepean Blue Mountains Local Health District, Nepean Hospital, Kingswood, NSW, Australia
| | - Daniele Cultrone
- Thyroid Research Laboratory, Sydney Medical School – Nepean Clinical School, The University of Sydney, Kingswood, NSW, Australia
- Nepean Blue Mountains Local Health District, Nepean Hospital, Kingswood, NSW, Australia
| | - Senarath Edirimanne
- Thyroid Research Laboratory, Sydney Medical School – Nepean Clinical School, The University of Sydney, Kingswood, NSW, Australia
- Nepean Blue Mountains Local Health District, Nepean Hospital, Kingswood, NSW, Australia
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia
- School of Medicine and Pharmacology, The University of Western Australia, Crawley, WA, Australia
| | - Leigh Delbridge
- Department of Surgery, Royal North Shore Hospital, The University of Sydney, St Leonards, NSW, Australia
- Sydney Medical School – Northern Clinical School, The University of Sydney, St Leonards, NSW, Australia
| | - Patrick Cregan
- Thyroid Research Laboratory, Sydney Medical School – Nepean Clinical School, The University of Sydney, Kingswood, NSW, Australia
- Nepean Blue Mountains Local Health District, Nepean Hospital, Kingswood, NSW, Australia
| | - Bernard Champion
- Thyroid Research Laboratory, Sydney Medical School – Nepean Clinical School, The University of Sydney, Kingswood, NSW, Australia
- Nepean Blue Mountains Local Health District, Nepean Hospital, Kingswood, NSW, Australia
| | - Jack R Wall
- Thyroid Research Laboratory, Sydney Medical School – Nepean Clinical School, The University of Sydney, Kingswood, NSW, Australia
- Nepean Blue Mountains Local Health District, Nepean Hospital, Kingswood, NSW, Australia
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Abstract
Purpose To determine the prevalence of eye disorders in children with celiac disease (CD). Methods A total of 67 patients with CD aged from 1 to 16 years and 38 age- and sex-matched healthy children were screened for decreased visual acuity, cataract, uveitis, and diabetic retinopathy at diagnosis and during follow‐up. Results None of the patients had eye disorders at diagnosis. Only 2 of the patients had accommodative dysfunction and the others had no change in visual function during the follow-up. One of the controls had accommodative dysfunction. Conclusions No significant association was found between CD and eye disorders such as visual acuity, cataract, and uveitis among children.
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Dalsgaard S, Waltoft BL, Leckman JF, Mortensen PB. Maternal history of autoimmune disease and later development of tourette syndrome in offspring. J Am Acad Child Adolesc Psychiatry 2015; 54:495-501.e1. [PMID: 26004665 DOI: 10.1016/j.jaac.2015.03.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 02/26/2015] [Accepted: 03/13/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVE In a nationwide prospective cohort study, we examined the possible association between maternal autoimmune disease (AD) and later diagnosis of Tourette syndrome (TS) in offspring. METHOD Data from national Danish health registers identified a cohort consisting of all children born in Denmark between 1990 and 2007 (n = 1,116,255), followed prospectively from birth until 2011, date of TS diagnosis, death, or emigration/disappearance, whichever came first. The incidence rate ratio (IRR) of TS, dependent on whether or not the mother had a prior diagnosis of AD, was estimated by Poisson regression with 95% CIs and adjusted for age, calendar time, place of birth, maternal and paternal age, parental psychiatric diagnoses other than TS, and parental TS. RESULTS The cohort contributed a total of 13,000,162 person years and 2,442 participants with a diagnosis of TS (414 females and 2,028 males). Prior maternal AD was found in 110 of the 2,442 children with TS, corresponding to an increased risk of TS, with an adjusted IRR of 1.22 (95% CI = 1.01-1.48). Maternal history of a prior AD increased the risk of TS in males, with an adjusted IRR of 1.29 (95% CI = 1.05-1.58), but not in females, with an adjusted IRR of 0.89 (95% CI = 0.52-1.52). CONCLUSION Maternal AD was associated with a 29% increased incidence rate of TS in male offspring. This finding supports the hypothesis that neuroimmunological disorders may act as a component in the etiology of a subset of TS.
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Affiliation(s)
- Søren Dalsgaard
- National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark, and the Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark; Hospital of Telemark, Kragerø, Norway.
| | - Berit L Waltoft
- National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark, and the Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark; Bioinformatics Research Centre, Aarhus University
| | - James F Leckman
- Child Study Center, Yale University School of Medicine, New Haven, CT
| | - Preben Bo Mortensen
- NCRR, School of Business and Social Sciences, Aarhus University, and the Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH
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Bufalo NE, Dos Santos RB, Marcello MA, Piai RP, Secolin R, Romaldini JH, Ward LS. TSHR intronic polymorphisms (rs179247 and rs12885526) and their role in the susceptibility of the Brazilian population to Graves' disease and Graves' ophthalmopathy. J Endocrinol Invest 2015; 38:555-61. [PMID: 25543543 DOI: 10.1007/s40618-014-0228-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 12/13/2014] [Indexed: 12/21/2022]
Abstract
PURPOSE Intronic thyroid-stimulating hormone receptor polymorphisms have been associated with the risk for both Graves' disease and Graves' ophthalmopathy, but results have been inconsistent among different populations. We aimed to investigate the influence of thyroid-stimulating hormone receptor intronic polymorphisms in a large well-characterized population of GD patients. METHODS We studied 279 Graves' disease patients (231 females and 48 males, 39.80 ± 11.69 years old), including 144 with Graves' ophthalmopathy, matched to 296 healthy control individuals. Thyroid-stimulating hormone receptor genotypes of rs179247 and rs12885526 were determined by Real Time PCR TaqMan(®) SNP Genotyping. RESULTS A multivariate analysis showed that the inheritance of the thyroid-stimulating hormone receptor AA genotype for rs179247 increased the risk for Graves' disease (OR = 2.821; 95 % CI 1.595-4.990; p = 0.0004), whereas the thyroid-stimulating hormone receptor GG genotype for rs12885526 increased the risk for Graves' ophthalmopathy (OR = 2.940; 95 % CI 1.320-6.548; p = 0.0083). Individuals with Graves' ophthalmopathy also presented lower mean thyrotropin receptor antibodies levels (96.3 ± 143.9 U/L) than individuals without Graves' ophthalmopathy (98.3 ± 201.9 U/L). We did not find any association between the investigated polymorphisms and patients clinical features or outcome. CONCLUSION We demonstrate that thyroid-stimulating hormone receptor intronic polymorphisms are associated with the susceptibility to Graves' disease and Graves' ophthalmopathy in the Brazilian population, but do not appear to influence the disease course.
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Affiliation(s)
- N E Bufalo
- Laboratory of Cancer Molecular Genetics, School of Medical Sciences (FCM), University of Campinas (UNICAMP), Rua Tessalia Vieira de Camargo, 126, Cidade Universitaria Zeferino Vaz, Campinas, SP, 13083-887, Brazil.
| | - R B Dos Santos
- Division of Endocrinology, Pontifical Catholic University of Campinas (PUCCAMP), Av. John Boyd Dunlop, s/no Jardim Ipaussurama, Campinas, SP, 13060-904, Brazil
| | - M A Marcello
- Laboratory of Cancer Molecular Genetics, School of Medical Sciences (FCM), University of Campinas (UNICAMP), Rua Tessalia Vieira de Camargo, 126, Cidade Universitaria Zeferino Vaz, Campinas, SP, 13083-887, Brazil
| | - R P Piai
- Laboratory of Cancer Molecular Genetics, School of Medical Sciences (FCM), University of Campinas (UNICAMP), Rua Tessalia Vieira de Camargo, 126, Cidade Universitaria Zeferino Vaz, Campinas, SP, 13083-887, Brazil
| | - R Secolin
- Department of Medical Genetics, University of Campinas (UNICAMP), Rua Tessalia Vieira de Camargo, 126, Cidade Universitaria Zeferino Vaz, Campinas, SP, 13083-887, Brazil
| | - J H Romaldini
- Division of Endocrinology, Pontifical Catholic University of Campinas (PUCCAMP), Av. John Boyd Dunlop, s/no Jardim Ipaussurama, Campinas, SP, 13060-904, Brazil
- HSPE-IAMSPE, Av. Ibirapuera, 981, Vila Clementino, São Paulo, 04029-000, Brazil
| | - L S Ward
- Laboratory of Cancer Molecular Genetics, School of Medical Sciences (FCM), University of Campinas (UNICAMP), Rua Tessalia Vieira de Camargo, 126, Cidade Universitaria Zeferino Vaz, Campinas, SP, 13083-887, Brazil
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Wu Y, Tong B, Luo Y, Xie G, Xiong W. Effect of radiotherapy on moderate and severe thyroid associated ophthalmopathy: a double blind and self-controlled study. Int J Clin Exp Med 2015; 8:2086-2096. [PMID: 25932139 PMCID: PMC4402786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 02/06/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The effect of radiotherapy on moderate and severe Thyroid associated ophthalmopathy (TAO) was evaluated by various objective and quantitative indexes including T2 signal intensity ratios of orbital MRI inferior rectus and ipsilateral temporal muscle (T2SIR), extraocular muscles (EOM) volume, and the degree of exophthalmos using clinical research with prospective, randomized, double blind, self controlled. METHODS The patients with TAO who in the moderate and severe active period and had similar double eyes condition in the Outpatient Department of Ophthalmology of Xiangya No. 2 Hospital of Central South University from 2011.2 to 2014.2 were selected as objects in this study. The related body check was finished after the research group was built. For the object, one eye of patient having random radiotherapy was chosen as the experimental eye. The other eye in the same patient with pseudo radiotherapy (merely known by operator, doctors in department of ophthalmology and patients were double blind) was selected as the control eye. The radiotherapy plan was made by the operator according to the CT results. The T2 signal intensity ratios of orbital MRI inferior rectus and ipsilateral temporal muscle (T2SIR), extraocular muscles (EOM) volume, and the exophthalmos degree was compared by MRI check to evaluate the effect of radiotherapy. RESULTS The T2 signal intensity ratios of orbital MRI inferior rectus and ipsilateral temporal muscle (T2SIR), extraocular muscles (EOM) volume, and the exophthalmos degree between both eyes (experimental and control eyes) had significant differences and these data had statistical significance. CONCLUSIONS The treatment of radiotherapy is effective for the TAO in the moderate and severe active period.
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Affiliation(s)
- Yujie Wu
- Department of Ophthalmology and Eye Research Center, The 2nd Xiangya Hospital, Central South UniversityChangsha 410011, Hunan, China
| | - Boding Tong
- Department of Ophthalmology and Eye Research Center, The 2nd Xiangya Hospital, Central South UniversityChangsha 410011, Hunan, China
| | - Yongheng Luo
- Department of Radiology, The 2nd Xiangya Hospital, Central South UniversityChangsha 410011, Hunan, China
| | - Guiyuan Xie
- Department of Oncology, The 2nd Xiangya Hospital, Central South UniversityChangsha 410011, Hunan, China
| | - Wei Xiong
- Department of Ophthalmology and Eye Research Center, The 2nd Xiangya Hospital, Central South UniversityChangsha 410011, Hunan, China
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Wang H, Zhu LS, Cheng JW, Cai JP, Li Y, Ma XY, Wei RL. Meta-analysis of Association Between the +49A/G Polymorphism of Cytotoxic T-Lymphocyte Antigen-4 and Thyroid Associated Ophthalmopathy. Curr Eye Res 2015; 40:1195-203. [DOI: 10.3109/02713683.2014.993767] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Jurecka-Lubieniecka B, Ploski R, Kula D, Szymanski K, Bednarczuk T, Ambroziak U, Hasse-Lazar K, Hyla-Klekot L, Tukiendorf A, Kolosza Z, Jarzab B. Association between polymorphisms in the TSHR gene and Graves' orbitopathy. PLoS One 2014; 9:e102653. [PMID: 25061884 PMCID: PMC4111286 DOI: 10.1371/journal.pone.0102653] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 06/23/2014] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Graves' orbitopathy (GO) as well as Graves' disease (GD) hyperthyroidism originate from an autoimmune reaction against the common auto-antigen, thyroid-stimulating hormone receptor (TSHR). GO phenotype is associated with environmental risk factors, mainly nicotinism, as well as genetic risk factors which initiate an immunologic reaction. In some patients GO is observed before diagnosis of GD hyperthyroidism, while it can also be observed far after diagnosis. The intensity of GO symptoms varies greatly in these patients. Thus, the pathogenesis of GD and GO may correlate with different genetic backgrounds, which has been confirmed by studies of correlations between GO and polymorphisms in cytokines involved in orbit inflammation. The aim of our analysis was to assess genetic predisposition to GO in young patients (age of diagnosis ≤30 years of age), for whom environmental effects had less time to influence outcomes than in adults. METHODS 768 GD patients were included in the study. 359 of them had clinically evident orbitopathy (NOSPECS ≥2). Patients were stratified by age at diagnosis. Association analyses were performed for genes with a known influence on development of GD - TSHR, HLA-DRB1, cytotoxic T-lymphocyte antigen 4 (CTLA4) and lymphoid protein tyrosine phosphatase (PTPN22). RESULTS The rs179247 TSHR polymorphism was associated with GO in young patients only. In young GO-free patients, allele A was statistically more frequent and homozygous carriers had a considerable lower risk of disease incidence than patients with AG or GG genotypes. Those differences were not found in either elderly patients or the group analyzed as a whole. CONCLUSIONS Allele A of the rs179247 polymorphism in the TSHR gene is associated with lower risk of GO in young GD patients.
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Affiliation(s)
- Beata Jurecka-Lubieniecka
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Department of Nuclear Medicine and Endocrine Oncology, Gliwice, Poland
| | - Rafal Ploski
- Department of Medical Genetics, College of Forensic Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Dorota Kula
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Department of Nuclear Medicine and Endocrine Oncology, Gliwice, Poland
| | - Konrad Szymanski
- Department of Medical Genetics, College of Forensic Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Bednarczuk
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Urszula Ambroziak
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Kornelia Hasse-Lazar
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Department of Nuclear Medicine and Endocrine Oncology, Gliwice, Poland
| | | | - Andrzej Tukiendorf
- Department of Epidemiology, Gliwice Branch, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - Zofia Kolosza
- Department of Epidemiology, Gliwice Branch, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - Barbara Jarzab
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Department of Nuclear Medicine and Endocrine Oncology, Gliwice, Poland
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Dharmasena A. Selenium supplementation in thyroid associated ophthalmopathy: an update. Int J Ophthalmol 2014; 7:365-75. [PMID: 24790886 DOI: 10.3980/j.issn.2222-3959.2014.02.31] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 12/12/2013] [Indexed: 12/18/2022] Open
Abstract
The therapeutic effect of selenium (Se) has already been proven in thyroid disease and thyroid associated ophthalmopathy (TAO). In spite of clear scientific proof of its benefits in TAO, there appears to be no clear agreement among the clinicians regarding its optimum dose, duration of the treatment, efficacy and safety to date. In this review, the author summarises the findings of 135 English language articles published on this subject over the past four decades from 1973 to 2013. The regulation and metabolism of thyroid hormones require a steady supply of Se and recent studies have revealed several possible mechanisms by which Se improves the severity of thyroid disease and TAO. These mechanisms include 1) inhibitory effect of HLA-DR molecule expression on thyrocytes; 2) profound reductions of thyroid stimulating hormone (TSH) receptor antibodies (TSHR-Ab) and TPO antibodies (TPO-Ab); 3) prevention of dysregulation of cell-mediated immunity and B cell function; 4) neutralising reactive oxygen species (ROS) and inhibition of redox control processes required for the activation, differentiation and action of lymphocytes, macrophages, neutrophils, natural killer cells involved in both acute and chronic orbital inflammation in TAO; 5) inhibition of expression of pro-inflammatory cytokines and 6) inhibition of prostaglandin and leukotriene synthesis. An increased oxidative stress has been observed in both acute and chronic phases of thyroid disease with raised tissue concentrations of ROS. The benefits of Se supplementation in individuals with TAO appear to be proportionate to the degree of systemic activity of the thyroid disease. The maximal benefit of Se supplementation is therefore seen in the subjects who are hyperthyroid. Restoration of euthyroidism is one of the main goals in the management of TAO and when anti-thyroid drugs are combined with Se, the patients with Graves' disease (GD) and autoimmune thyroiditis (AIT) achieved euthyroidism faster than those treated with anti-thyroid drugs alone. Se status of normal adult humans can vary widely and Se supplementation may confer benefit only if serum Se levels are insufficient. The author recommends that serum Se levels of patients with TAO to be assessed prior to and during Se supplementation at regular intervals to avoid potential iatrogenic chronic Se overdose.
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Affiliation(s)
- Aruna Dharmasena
- Department of Oculoplastics, Lacrimal and Orbital Surgery, Manchester Royal Eye Hospital, Oxford Road, Manchester M13 9WH, UK
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Winsz-Szczotka K, Komosińska-Vassev K, Kuźnik-Trocha K, Olczyk K. Antioxidant activity and structural modifications of serum chondroitin sulfate in Graves' disease. Clin Biochem 2014; 47:19-24. [DOI: 10.1016/j.clinbiochem.2013.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 07/30/2013] [Accepted: 08/01/2013] [Indexed: 12/22/2022]
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