甲狀腺刺激素受體和細胞間素在甲狀腺上眼瞼攣縮所扮演的角色
Date Issued
2004
Date
2004
Author(s)
廖述朗
DOI
922314B002291
Abstract
Purpose: To investigate thyrotropin receptor (TSHr), the candidate autoantigen shared by
Graves’ disease and Graves’ ophthalmopathy, and cytokine profiles in the pathogenesis of
patients with thyroid lid retraction.
Methods & materials: Data from all Müllerectomy patients, with clinical characteristics
of thyroid lid retraction, were collected retrospectively. The diseased and controlled
Müller‘s muscles were collected from patients after IRB approval and given of informed
consent by patients. All muscle specimens were embedded in paraffin solution for
subsequent pathological examination including routine H&E and immunohistochemistry
(IHC). Some parts of the Müller‘s muscle were homogenized for test of local cytokine
expression. Peripheral blood from GO patients was also collected for investigating the
effects of exogenous cytokines.
Results: A total of 31 patients, 29 female and 2 male, with thyroid lid retraction were
enrolled into this study. We found a correlation between the severity of upper lid retraction
(MRD1) and age (r=0.407, p=0.0203), initial thyroid state (p=0.045), and the period of
hyperthyroidism (r=0501, p=0.004). On pathological analyses, variation of fat and fibrosis,
as well as a decrease in normal muscle volume, were noted in the thyroid Müller‘s muscle.
Neither cells stained positive of TSHr in both groups using IHC. The determination of
local cytokine expression within the Müller‘s muscle could not be performed using the
current Western blot method owing to the very low quantity of total protein. However,
there is significant difference of serum IL-4 levels between GO and control groups
(p<0.005).
Conclusion: In clinical association analyses, there was a positive correlation between the
severity of upper lid retraction and age, along with the initial thyroid state and the period
of hyperthyroidism. Although TSHr could not be detected using IHC, the existence of
TSHr involving thyroid Müller‘s muscle, using PCR or Q-PCR amplification, remains to
be studied in near future. From data of peripheral cytokine in GO patients, the serum Th2
cytokine level may correlate with clinical activity but not with the degree of severity of
GO.
Subjects
Graves’ ophthalmopathy
thyroid eye disease
Muller’s muscle
upper lid retraction
thyrotropin receptor antibody
cytokines
Publisher
臺北市：國立臺灣大學醫學院眼科
Type
journal article
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