| The incidence rate of thyroid-associated ophthalmopathy(TAO) is the highest one of orbit diseases. TAO is also a medically incurable disease. It affects the retroobital space, and is concerned of a kind of organic specific autoimmunity disease. Its pathogenesis appears to have strong etiological links with autoimmune thyroid disease. Clinically the patients may be euthyroid, hyperthyroidism or hypothyroidism. Its mechanism is not very clear.High concentrations of tyrotropin receptor (TSHR) stimulating immunoglobulins almost invariably are detectabale in their sera. Clinically, although no clear correlation has been established between the presence or severity of TSHR-directed antibodies and the presence or severity of TAO. For a long time, authors contend whether TAO and graves disease are the same one, or two closely associated or two different autoimmune ones. The major question is if the single antigen shared between the affected anatomic areas in graves ophthalmopathy and the representation of thyroid gland. Therefore, if an antigen shared between the affected anatomic areas in Graves disease(thyroid gland, retroorbital space, pretibial subcutaneous connective tissue) can be envisioned, the TSHR may appear to be a logical candidate. Thus, author are looking for more evidence that TSHR exists in tissues outside the thyroid gland, including retroorbital tissue and adipocytes by different assays and techniques, but fail to get a consistent result, and lack of systemic study on it. Since TAO importantly represents an immune-mediated inflammatory process of the extraocular muscles. In our paper, we will initially detect the presence of TSHR protein in extraocular muscles derived from patients with TAO and from normal individuals, further to demonstrate the presence of mRNA encoding the TSHR in these tissue at molecular level. This experiment looks for evidence of THSR in tissues outside the thyroid gland, in order to collect some evidences or provide some clew to highlight the pathogenesis.Part I Expression of thyrotropin receptor mRNA in extraocular muscles of thyroid-associated ophthalmopathy with RT-PCRObjective: Detect mRN A encoding TSHR in extraocular muscles with TAO and healthy subjects at transcription level, demonstrate that TSHR may present in retroorbital extraocular muscular tissue and serve as common antigen in the thyroidal and extrathydoidal manifestations of TAO.Methods: Collect twelve extraocular muscle specimens from TAO patiens during the operation of orbit decompression, ophthalmectomy owing to failed exposure keratitis and operation of strabismus. Collect ten extraocular muscle specimens from normal persons during the operation of strabismus and accidental death. The total tissue RNA were isolated by single-step method of Acid Guanidinium Thiocyanate-Phenol-Chloroform extration and determined by reverse transcription polymerase chain reaction for TSHR mRNA.Results: 11 of 12 TAO patiens and 2 of 10 normal subjects express TSHR mRNA in extraocular muscular tissues. The rate of TSHR mRNA expression in TAO extraocular muscular tissues was 91.67%, in healthy subjects was 20%. They have statistic distinction.Conclusion: There are mature TSHR mRNA present in TAO retroobital extraocular muscular tissue and highly expressed. It indicates that TSHR may be as a common antigen that responsible for thyroid gland and the retraorbital tissue, and play an important function in the pathogenesis of TAO.Part II Expression of thyrotropin receptor proteins in extraocular muscles of thyroid-associated ophthalmopathy with immunohistochemisthyObjective: We have searched for RNA encoding TSHR in TAO retroobital extraocular muscles tissue on usage of reverse trscription polymerase chain reaction(RT-PCR), but the physiological significance of the transcripts demonstrable only by RT-PCR has been questioned. Thus in this part, we will confirm if there areintact TSHR protien expressed in retroorbital extraocular muscular tissue.Methods: We have performed immunocytochemistry staining...
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