| Objective:1.In order to evaluate the activity and severity of TAO,we detected the serum levels of inflammatory cytokines IL-6,TNF-a,SICAM-1in Patients with different stage of TAO and healthy people using enzyme-linked immunosorbent assay (ELISA) method.2.To explore change rule of inflammatory cytokines in pathogenesis of TAO and seek laboratory indicators of judgment of active TAO,we detected the tear levels of inflammatory cytokines IL-6,TNF-a,SICAM-1in patients with different stage of TAO and healthy people using the same method.3.In order to find influence and change law of inflammatory cytokines causing by glucocorticoids,we detected inflammatory cytokines IL-6,TNF-a,SICAM-1in serum and tear of active TAO after glucocorticoid treatment and compared the changes of these cytokines before and after treatment.Method:1.According to CAS score,34TAO cases divided into two groups:22patients with active TAO(CAS>3),12patients with inactive TAO(CAS<3).We detected cytokines IL-6,TNF-a,sICAM-1in the serum and tear of different stage of TAO and heathy people using ELISA method. Meanwhile the values between groups were analyzed.2.Using the same method,we detected the serum and tear levels of inflammatory cytokines IL-6,TNF-a,SICAM-1in22Patients with active TAO after glucocorticoid treatment and compared the changes of these cytokines before and after treatment. Steroid hormone therapy was applied to patients with active TAO(Methylprednisolone was used for three days in the first week using daily500mg.In the second week,the same dose of methylprednisolone was used for same days),then switch to use prednisone(30mg/dx2w,20mg/dx2w,10mg/dx2w).The treatment process was eight weeks.3. Statistical analyses were conducted with SPSS17.0for windows. All data are presented as means±SD,and the normality and homogeneity of variance were analyzed.The variables of two groups were analyzed using two independent samples t test.Paired-samples t test was used to analyze the variables of TAO patients before and after treatment groups.The relationships between the variables were evaluated by Spearman’s test.P<0.05was considered to be statistically significant.Results:1. Levels of inflammatory cytokines in serum of TAO(1) Serum IL-6,TNF-a,sICAM-1were detected in all samples.(2) Compared with the control group,serum IL-6,TNF-a,sICAM-llevels of TAO patients were significantly increased,the difference was statistically significant (p<0.05).(3) The concentrations of serum IL-6and sICAM-1of active TAO group were significantly higher than the inactive TAO group,the difference was statistically significant(p<0.05),while there was no significant difference of serum TNF-a level between active TAO group and inactive TAO group(P>0.05).(4) The serum levels of IL-6,sICAM-1were decreased in patients with TAO after treated with glucocorticoids,the difference before and after treatment was statistically significant(p<0.05),while there was no significant difference of serum TNF-a before and after treatment (P>0.05).(5) There were significant positive correlations between IL-6,TNF-a levels and sICAM-1levels.2. Levels of inflammatory cytokines in tear of TAO(1) Tear IL-6and TNF-a were detected in all samples,while tear sICAM-1was detected in eight cases.(2) Compared with the control group,tear IL-6levels of TAO patients was significantly increased,the difference was statistically significant (p<0.05), while there was no significant difference of tear TNF-a between TAO group and control group (P>0.05).(3) The concentrations of tear IL-6of active TAO group were significantly higher than the inactive TAO group,the difference was statistically significant (p<0.05),while there was no significant difference of tear TNF-a level between active TAO group and the inactive TAO group (P>0.05).(4) The tear levels of IL-6was decreased in patients with TAO after treated with glucocorticoids,the difference before and after treatment was statistically significant (p<0.05),while there was no significant difference of tear TNF-a before and after treatment (P>0.05).(5) Tear IL-6level in TAO group was positively correlated with tear TNF-a level(p<0.05).3.Correlation with inflammatory cytokines in serum and tear Tear IL-6,TNF-a levels in TAO group were positively correlated with serum IL-6, TNF-a levels(p<0.05).Conclusion:1. Our results suggested that IL-6,TNF-α,sICAM-1jointly play an important in the pathogenesis of TAO.2.Some cytokines in serum and tears of TAO patients are abnormally expressed. The concentration of serum cytokines IL-6,TNF-a,sICAM-1and tear cytokines IL-6in TAO group were increased significantly than healthy peoples.3.The expression of serum cytokines and tear cytokines in different phase of TAO were significantly different. Serum IL-6,sICAM-1levels and tear IL-6level in active TAO group was significantly higher than inactive TAO group. To a certain degree, serum IL-6, sICAM-1concentration and tear IL-6concentration could be used as indicators for judgment of activity of TAO.4.There were significant positive correlations between IL-6,TNF-a levels and sICAM-1levels.Tear IL-6level in TAO group was positively correlated with tear TNF-a level.Tear IL-6,TNF-a levels in TAO group were positively correlated with serum IL-6,TNF-a levels. So combined determination of many cytokines could better monitoring and evaluate the disease.5.The serum levels of IL-6,sICAM-1were decreased in patients with TAO after treatment with glucocorticoids,the experiment demonstrated glucocorticoids exert therapeutic effect by influencing the inflammatory cytokines.Tear IL-6concentration is also decreased,so we think glucocorticoids may indirectly affects immune response in lacrimal gland on reducing IL-6release to tear by inhibiting orbital,so as to improve the symptoms of dry eye.6.Tear cytokines IL-6,TNF-a are abnormally expressed in patients with TAO. It is prompt that inflammatory cytokines play an important role in dry eye causing by TAO and provide powerful theoretical basis for cytokine inhibitors applying in dry eye. |
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