廖述朗2006-07-262018-07-122006-07-262018-07-122004http://ntur.lib.ntu.edu.tw//handle/246246/26740Purpose: 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.application/pdf71509 bytesapplication/pdfzh-TW國立臺灣大學醫學院眼科Graves’ ophthalmopathythyroid eye diseaseMuller’s muscleupper lid retractionthyrotropin receptor antibodycytokinesjournal articlehttp://ntur.lib.ntu.edu.tw/bitstream/246246/26740/1/922314B002291.pdf