The Relative Study Of Cell-mediated Immunity In Graves' Ophthalmopathy

Objective : By analyzing the phenotype and function of the immunocyte of the patients with recent onset ( < 2 years ) Graves'ophthalmopathy ,to explore the type and degree of the immunologic disturbance of the early GO ,and study the role of the immune mechanism in the pathogenesis of GO.Methods:(1) We detected the T cell subgroup , the CD8-/FN-γ +T lymphocyte (represent Thl-like cytokines) and the CD8-/IL-4+ T lymphocyte (represent Th2-like cytokines) in the patients with early GO ,the patients with initial Graves'disease (GD) without ophthalmopathy and normal group by flow cytometry.(2) To assay the T cell subgroup , the CD8-/IFN- γ + T lymphocyte and the CD8-/IL-4+ T lymphocyte in the patients with early GO and the patients with GD without ophthalmopathy after treatment with methimazole.(3) To detect FT3, FT4, TRAb, CAS, TMA and TGA in the patients with early GO and the patients with GD without ophthalmopathy. To analyze the relationship between aboved-mentioned indexes and the T cell subgroup , the CD8-/IFN- γ +T lymphocyte and the CD8-/IL-4+T lymphocyte by statistics software.Results:(1) Compared with the control, the percent of the CD4+ T cells and the ratio of the CD4+ T cells to the CD8+ T cells were higher, but the percent of the CD8+T cells was lower in early GO and GD without ophthalmopathy. ( P <0.05 for all) (2) The percent of the CD8-/IFN- γ + T lymphocyte and the ratio of the CD8-/IFN-γ +T lymphocyte to the CD8-/IL-4+ T lymphocyte in early GO were obviously higher than in GD without ophthalmopathy and the control. The percentof the CD8-/IL-4+T lymphocyte in GD without ophthalmopathy was higher than in early GO and the control , but the ratio of the CD87IFN- γ +T lymphocyte to the CD8-/IL-4+T lymphocyte in GD without ophthalmopathy was lower than in early GO and the control. (P <0.05 for all) (3 ) The T cell subgroup , the percent of the CD8-/IFN- γ + T lymphocyte and the CD8-/IL-4+ T lymphocyte ,and the ratio of the CD8-/IFN- γ + T lymphocyte to the CD8-/IL-4* T lymphocyte have no obvious difference between before and after treatment with methimazole in early GO and GD without ophthalmopathy. (P >0.05 for all)(4) There was a positive correlation between the CAS and the percent of the CD87IFN- γ +T lymphocyte, the ratio of the CD8-/EFN- Y + T lymphocyte to the CD87IL-4+ T lymphocyte(P < 0.05 for all), but CAS has no correlation with the T cell subgroup , the percent of the CD8-/L-4+ T lymphocyte and TRAb( P >0.05 for all). (5) There was no correlation between the T cell subgroup , the percent of the CD8-/IFN- gamma +T lymphocyte ,the percent of the CD8-/IL-4+T lymphocyte and FT3 , FT4 , TRAb , TMA , TGA in early GO and GD without ophthalmopathy. (P >0.05 for all)(6) TRAb, TMA, TGA haved no statistics difference between in early GO and in GD without ophthalmopathy (P >0.05 for all).Conslusion: 1. There was a disturbance of T cell subgroup in early GO .The balance of Th1/Th2 profile cytokine shifted to Th1, and the cell-mediated immunity mediated by the Th1-type CD4+ T cell played a predominant role in pathogenesis of early GO. 2. There was a disturbance of T cell subgroup in GD without ophthalmopathy. The balance of Th1/Th2 profile cytokine shifted to Th2, and the humoral immunity mediated by the Th2-type CD4+ T cell played a predominant role in pathogenesis of GD without ophthalmopathy. 3. Our study hinted, GO is a special type of GD, its immune type is relatively independent, and different from the GD without ophthalmopathy. The CD8-/EFN-γ +T lymphocyteand the ratio of the CD87IFN- gamma+ T lymphocyte to the CD8-/IL-4+T lymphocyte may be a clinical marker to reflect retrobulbar tissue proliferation and the activity of ophthalmopathy , and also provide a theoretical basis and observing indexes for using immuno-suppressive in clinics in GO .