| Aim: To investigate the relationships between IL-6/IL-6R system ,TRAb and the pathogenesis of Graves' ophthalmopathy, and the relationships between clinical activity score, serum IL-6, sIL-6R, HA, TRAb and the activity of GO, the clinical response to corcicosteroids therapy, we determined the above markers in 33 patients with GO, 25 patients with Graves hyperthyroidism but without ophthalmopathy(NGO) and 20 healthy controls. Methods: Serum concentrations of IL-6, HA and TRAb were measured by radioimmunoassay, serum concentration of sIL-6R was measured using ELISAS. Patients with GO were assessed using clinical activity score. The severity of GO and clinical response to corcicosteroids was evaluated by NOSPECS Grade. Each marker was compared among these three groups, the same work was done between responders to corcicosteroids and those who did not respond. Results: 1.There were significant differences amongthese three groups in serum concentrations of IL-6, sIL-6R and TRAb. There were significant differences in serum concentration of HA between the GO group and the NGO group. The same result was drawn between the GO group and healthy controls. 2.1n patients with GO and Graves hyperthroidism, serum concentration of IL-6 correlated with that of sIL-6R. Serum concentrations of IL-6 and sIL-6R correlated with that of FT3 and clinical activity score, but did not correlate with duration, severity of GO and that of HA, TRAb. Serum concentration of TRAb correlated with severity of GO. 3. The CAS and serum concentrations of IL-6, IL-6R, HA were significant higher in responders to corcicosteroids than that of those who did not respond, but there was no significant difference in serum concentration of TRAb. 4. Backward logistic regression analysis showed that serum concentrations of IL-6 and sIL-6R were able to predict a beneficial response to corcicosteroids. Conclusions: 1. CAS could reflect the activity of GO and predict therapeutic outcome to corcicosteroids. But false-positive and false-negative appeared if only using this one marker. 2.Serum concentrations of IL-6 and sIL-6R in patients of GO group were significantly higher than that in patients of NGO group and healthy controls. The change was happened in the early stage of GO(the active stage). Serum concentrations of IL-6 and sIL:-6R could reflect the activity of GO and predict the outcome ofcorcicosteroids therapy. The immune reaction introduced by Th2 derived cytokines participated in the occurrence of GO. The IL-6/IL-6R system was activated in the early stage, so we could treat GO with antagonists of such cytokines. 3. The measurement of serum concentration of HA was simple and cheap, we could use it as a adjuvant means to judge the activity of GO and choose whether or not to use immunosuppression therapy. 4.The serum titre of TRAb was significantly higher in patients of GO group than that of NGO group. It correlated with the severity of GO and could predict the episode of GO. The conclusion also stated that TSHR did act in the pathogenesis of GO. But TRAb could not reflect the activity of GO. |
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