Graves' ophthalmopathy: State of the art and perspectives

被引:55
作者
Bartalena, L
Wiersinga, WM
Pinchera, A
机构
[1] Univ Insubria, Dept Clin Med, Varese, Italy
[2] Univ Amsterdam, Dept Endocrinol & Metab, Amsterdam, Netherlands
[3] Univ Pisa, Dept Endocrinol, Pisa, Italy
关键词
Graves' ophthalmopathy; thyroid eye disease; Graves' orbitopathy; management of Graves' ophthalmopathy; anticytokine therapy; immunosuppression;
D O I
10.1007/BF03345280
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Graves' ophthalmopathy (GO) is an autoimmune orbital disorder most commonly associated with Graves' disease. Recent studies have underscored the role that orbital cells, particularly fibroblasts and adipocytes, play in causing the increase in orbital content responsible for clinical manifestations of the disease. GO seems to be related to autoimmune reactions triggered by autoreactive T lymphocytes of thyroid origin, which recognize antigen(s) shared by thyroid and orbit. The nature of the antigen (or antigens) involved is not fully understood, but TSH receptor is likely to be involved. Cytokines secreted by T lymphocytes, macrophages and fibroblasts play an essential role in perpetuating the disease. Animal models of GO have been developed, but results have not clarified GO pathogenesis yet. Progress in the management of the ophthalmopathy has been very limited, and glucocorticoids, orbital radiotherapy and orbital decompression remain the mainstays in GO treatment. Novel treatments, such as somatostatin analogues, antioxidants, cytokine antagonists are currently under investigation, as well as the effects of total thyroid ablation. Cessation of smoking currently represents the only form of GO (secondary and tertiary) prevention.
引用
收藏
页码:295 / 301
页数:7
相关论文
共 61 条
[41]   Oxygen free radicals in interleukin-1β-induced glycosaminoglycan production by retro-ocular fibroblasts from normal subjects and Graves' ophthalmopathy patients [J].
Lu, R ;
Wang, PH ;
Wartofsky, L ;
Sutton, BD ;
Zweier, JL ;
Bahn, RS ;
Garrity, J ;
Burman, KD .
THYROID, 1999, 9 (03) :297-303
[42]   Inducing Graves' ophthalmopathy [J].
Ludgate, M ;
Baker, G .
JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION, 2004, 27 (03) :211-215
[43]  
Many MC, 1999, J IMMUNOL, V162, P4966
[44]   Novel aspects of immunosuppressive and radiotherapy management of Graves' ophthalmopathy [J].
Marcocci, C ;
Marinò, M ;
Rocchi, R ;
Menconi, F ;
Morabito, E ;
Pinchera, A .
JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION, 2004, 27 (03) :272-280
[45]   Comparison of the effectiveness and tolerability of intravenous or oral glucocorticoids associated with orbital radiotherapy in the management of severe Graves' ophthalmopathy: Results of a prospective, single-blind, randomized study [J].
Marcocci, C ;
Bartalena, L ;
Tanda, ML ;
Manetti, L ;
Dell'Unto, E ;
Rocchi, R ;
Barbesino, G ;
Mazzi, B ;
Bartolomei, MP ;
Lepri, P ;
Cartei, F ;
Nardi, M ;
Pinchera, A .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2001, 86 (08) :3562-3567
[46]   Role of thyroglobulin in the pathogenesis of Graves' ophthalmopathy:: The hypothesis of Kriss revisited [J].
Marinò, M ;
Chiovato, L ;
Lisi, S ;
Altea, MA ;
Marcocci, C ;
Pinchera, A .
JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION, 2004, 27 (03) :230-236
[47]   Identification of thyroglobulin in orbital tissues of patients with thyroid-associated ophthalmopathy [J].
Marinò, M ;
Lisi, S ;
Pinchera, A ;
Mazzi, B ;
Latrofa, F ;
Sellari-Franceschini, S ;
McCluskey, RT ;
Chiovato, L .
THYROID, 2001, 11 (02) :177-185
[48]   A NEW SOLID-PHASE IMMUNORADIOMETRIC ASSAY FOR ANTI-THYROGLOBULIN AUTOANTIBODY [J].
MARIOTTI, S ;
PISANI, S ;
RUSSOVA, A ;
PINCHERA, A .
JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION, 1982, 5 (04) :227-233
[49]   NEW THOUGHTS ABOUT CAUSE AND TREATMENT OF SEVERE OCULAR MANIFESTATIONS OF GRAVES-DISEASE [J].
MCDOUGALL, IR ;
KRISS, JP .
SCOTTISH MEDICAL JOURNAL, 1974, 19 (04) :165-169
[50]   CELL-MEDIATED OR HUMORAL IMMUNITY IN GRAVES OPHTHALMOPATHY - PROFILES OF T-CELL CYTOKINES AMPLIFIED BY POLYMERASE CHAIN-REACTION FROM ORBITAL TISSUE [J].
MCLACHLAN, SM ;
PRUMMEL, MF ;
RAPOPORT, B .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1994, 78 (05) :1070-1074