2017-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/650753摘要：甲狀腺眼病變是最常見的眼窩疾病，有多達半數的葛雷夫氏症(Graves’ disease)患者有眼病變。許多眼病變無法以現有治療方式治癒(例如眼藥水、全身性類固醇、眼窩放射線治療、眼窩減壓手術)。甲狀腺眼病變的症狀包括結膜充血、眼球突出、動眼肌病變、視神經病變等。這些症狀是由眼窩脂肪組織增生與動眼肌肥厚引起，這些眼窩內組織的變化與纖維母細胞(fibroblast)有關。纖維母細胞可以製造glycosaminoglycans 與發炎物質，也可增生、可分化成脂肪細胞。纖維母細胞生長因子(fibroblastgrowth factor, FGF)與纖維母細胞生長因子受體(FGF receptor, FGFR)結合後，可以促進纖維母細胞的增生和分化。甲狀腺眼疾的致病機轉可能與纖維母細胞生長因子和纖維母細胞相關，但相關研究較少。本研究希望可以釐清纖維母細胞生長因子、纖維母細胞與甲狀腺眼病變之間的相關性，測試抗FGF抗體或 FGFR 抑制劑是否可能影響甲狀腺眼疾的纖維母細胞，而推測是否有治療的希望。試驗方法為收納因甲狀腺眼疾或因其他疾病接受眼窩手術的患者，培養手術取得的軟組織，觀察纖維母細胞生長分化與其受抗FGF 抗體或 FGFR 抑制劑影響的狀況。收案同時也會抽血測量受試者血中纖維母細胞生長因子、甲狀腺功能、甲促素受體抗體等指數以對照分析。希望能藉由這些觀察提出一個新的治療甲狀腺眼疾的方向。<br> Abstract: Thyroid eye disease (TED) is the most common orbital disease. TED is seen in up to 50% of thepatients with Graves’ disease. Many patients with TED cannot tolerate or be cured by current treatmentsincluding topical ophthalmic medications, systemic steroid, orbital radiotherapy, and orbital decompressionsurgery. Clinical signs of TED include conjunctival injection, proptosis, eyelid retraction, restrictiveextraocular myopathy, and compressive optic neuropathy. These signs are mainly caused by exraocularmuscle hypertrophy and expanded orbital adipose tissue. Orbital fibroblasts play a major role in thepathogenesis of TED. Orbital fibroblasts produce glycosaminoglycans and inflammatory cytokines. They canalso proliferate or differentiate into adipocytes. Fibroblast growth factors (FGFs), when binding to FGFreceptors (FGFRs) on the fibroblasts, can induce cell proliferation and differentiation. The role of FGFs inTED is unclear. In this study, we will investigate the relationship of FGF, fibroblast and TED. We willobserve the influence of anti-FGF antibodies or FGFR inhibitors on orbital fibroblasts. Orbital tissue of TEDpatients or patients receiving orbital surgery for other reasons will be obtained. We will observe theproliferation and differentiation of fibroblasts, and the effect of anti-FGF antibodies or FGFR inhibitors.Serum levels of FGFs, thyroid function, and TSH receptor antibodies will be measured and analyzed. Wehope to propose an alternative choice to treat TED by this study.甲狀腺眼病變纖維母細胞生長因子纖維母細胞葛雷夫氏症Thyroid eye diseasefibroblast growth factorfibroblastGraves’ disease