Objective: The latest studies on Graves ophthalmopathy (GO) emphasize the importance of the orbital adipose tissue and fibroblasts in the pathogenesis of the disease by secreting proinflammatory cytokines. In vitro, these cytokines were proved to have a major role in the maintenance and progress of inflammation in the orbit. The aim of this study was to investigate serum cytokine levels in patients with GO.
Materials and methods: Serum interleukins IL-1a, IL-2, IL-6, IL-8, and monocyte chemotactic protein-1 (MCP1) were determined with biochip-cytokine array (Randox) in ten patients with Graves ophthalmopathy. Thyroid function was investigated by measuring TSH, FT4+/−TT3 levels. TSH-receptor and antiTPO antibodies were also measured. Smoking status was recorded. Activity and staging of the disease were recorded following EUGOGO recommendations.
Results: There was no difference in interleukin levels between smokers and non-smokers, euthyroid vs. hyperthyroid patients or in patient with active (CAS≥4) versus inactive (CAS<4) GO. Patients with stages NOSPECS 0-III.c presented higher MCP 1 levels compared with patients stages IV.a-IV.c (P=0.045). In relation with disease duration, there was only a difference in IL-2 levels, which were lower in patients with evolution over 3 years (P=0.052, r=−0.6301). Previous corticotherapy or antithyroid therapy did not influence measured serum interleukin levels.
Conclusions: There is a high variability between individuals with GO in both clinical and paraclinical parameters. In patients with early stages there seems to be a Th1 profile cytokine dominancy (IL-2, TNFa, IFNg). MCP 1 is likely to play a protective or reparative role in less severe stages of GO. This study must be extended to a larger number of patients.
Prague, Czech Republic
24 - 28 Apr 2010
European Society of Endocrinology