Graves' Eye Disease In Patients With Serum Soluble Il-6 Receptor, Soluble Il-2 Receptor, Eye Sarcolemma Antibody Detection

Objective: Graves' ophthalmopathy (GO) is a disorder associated with autoimmune thyroid disease characterized by lymphocytes infiltrating orbital tissue. T cell and Macrophages product and release various cytokines to the tissue. The immune process in the orbit leads to proliferation of fibroblasts and stimulation of glycosaminoglycan (GAG) synthesis. Environmental factors such as smoking may account for an enhanced tendency for overt eye involvement. Increased serum cytokine levels have been reported in patients with autoimmune thyroid disease, but less is known about their levels in patients with GO. In the present study we have measured the concentrations of soluble interleukin-2 receptor (sIL-2R), soluble IL-6 receptor (sIL-6R) in the serum of patients with Graves' disease (GD). By multivariate analysis, we have evaluated the presence or absence of ophthalmopathy, the severity of symptoms (according to the NOSPECS classification), the effect of patient's smoking habits, and the relation to the circulating concentrations of TSH, free thyroid hormones (FT3 and FT4). we investigated whether cytokine levels could be used as a biological marker of Graves' ophthalmopathy, and predict the clinical development of ophthalmopathy. Subjects and Methods: We studied 62 GD patients, Thirty-seven (60%) patients with GO and 25 (40%) patients without GO; We also studied 26 normal subjects as controls. Thirty-two GD patients and 12 controls were smokers. We classified GO patients as 20 benign GO and 17 infiltrative GO patients respectively according to theNOSPECS classification devised by ATA in 1969. We measured sIL-2R and sIL-6R concentrations in the serum of normal subjects and patients with Graves' disease using highly sensitive sandwich enzyme-linked immunoassay (ELISA).Results:Serum sIL-6R concentrations were significantly higher in GD patients without ophthalmopathy (P=0.004), the latter was significantly higher than controls (P<0.001), Serum sIL-2R concentrations were significantly higher in both GD with or without ophthalmopathy (P<0.001 and P=0.002 respectively), when compared with controls, but there was no significance of sIL-2R concentrations between GO and GD without ophthalmopathy (P=0.014). no changes of serum sIL-2R and sIL-6R concentrations in the NOSPECS classification have been observed. Although difference in sIL-6R concentrations were noted between smokers and non-smokers of GO (P<0.05), cigarette smoking has no effect on serum sIL-6R concentrations both controls and GD without ophthalmopathy and no effect on serum sIL-2R concentrations even in the presence of ophthalmopathy. We found circulating concentrations of TSH,FT3 and FT4 have significant differences with sIL-2R and sIL-6R concentrations respectively, but the r value were small, so the clinical significance was not dependable.Conclusion: serum sIL-2R and sIL-6R concentrations were significantly higher in GD patients with or without ophthalmopathy compared with controls, sIL-6R concentrations was elevated in GO, which shows sIL-2R and sIL-6R concentrations have some value for predicting the development of Graves'ophthalmopathy. no changes in the NOSPECS classification have been observed. Although difference in sIL-6R concentrations were noted between smokers and non-smokers of GO, this may be explained by some factors caused by smoking...