Role of the mononuclear cell infiltrate in Graves' orbitopathy (GO): results of a large cohort study.
J Endocrinol Invest
; 45(3): 563-572, 2022 Mar.
Article
in En
| MEDLINE
| ID: mdl-34671950
ABSTRACT
OBJECTIVE:
The extent to which mononuclear cells and TSH-receptor autoantibodies (TRAb) contribute to Graves' orbitopathy (GO) is not completely defined. Here we investigated the relationship between the immunohistochemical phenotype of orbital infiltrating cells and GO features in a large number of patients.METHODS:
We conducted an observational cohort study in 76 consecutive patients with GO (16 men and 60 women) who underwent orbital decompression over a period of 18 consecutive months. An ophthalmological evaluation was performed in all patients, as well as immunohistochemistry for CD3, CD4, CD8, CD56 (T-cell markers), CD25 (T and B-cell marker), CD20, CD19 (B-cell markers), and CD138 (plasmacell marker) in specimens collected at decompressive surgery.RESULTS:
Having established cutoff values for each marker, cell infiltrates were found in 60 patients (78.9%; CD3 39.4%, CD4 55.2%, CD8 50%, CD56 0%, CD25 28.9%, CD20 51.3%, CD19 25%, CD138 26.3%). Eleven (14.4%) stained exclusively for CD138 (plasmacells). Patients with CD4-positive mononuclear cells had a significantly greater GO clinical activity score (CAS) (mean difference 1.07, 95% CI - 0.33 to - 1.82, P = 0.004 by univariate, P = 0.05 by multivariate analysis). CAS as well as the remaining GO features were not affected significantly by the mononuclear cell subpopulations in multivariate analyses.CONCLUSIONS:
Mononuclear cell infiltrates are present in the majority of GO patients, with a small percentage represented exclusively by plasmacells. CD4 cells exert a major role on GO activity. These findings may represent a further advancement in the comprehension of GO pathogenesis.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Plasma Cells
/
Leukocytes, Mononuclear
/
Graves Ophthalmopathy
Type of study:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
J Endocrinol Invest
Year:
2022
Document type:
Article
Affiliation country:
Italy