Effect of systemic steroid therapy in Graves' orbitopathy on regulatory T cells and Th17/Treg ratio.
Diplopia
/ diagnosis
Drug Monitoring
/ methods
Female
Flow Cytometry
/ methods
Glucocorticoids
/ administration & dosage
Graves Ophthalmopathy
/ blood
Humans
Lymphocyte Count
/ methods
Magnetic Resonance Imaging
/ methods
Male
Methylprednisolone
/ administration & dosage
Middle Aged
Patient Acuity
Pulse Therapy, Drug
/ methods
Severity of Illness Index
T-Lymphocytes, Regulatory
/ pathology
Th17 Cells
/ pathology
Treatment Outcome
Visual Acuity
FOXP3
Glucocorticosteroids
Orbitopathy
RORγt
Th17
Treg
Journal
Journal of endocrinological investigation
ISSN: 1720-8386
Titre abrégé: J Endocrinol Invest
Pays: Italy
ID NLM: 7806594
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
28
11
2020
accepted:
29
03
2021
pubmed:
19
4
2021
medline:
8
2
2022
entrez:
18
4
2021
Statut:
ppublish
Résumé
Glucocorticoids are a mainstay treatment for Graves' orbitopathy, yet their exact mechanisms of action remain unclear. We aimed to determine whether the therapeutic effects of systemic steroid therapy in Graves' orbitopathy are mediated by changes in regulatory T lymphocytes (Tregs) and T helper 17 lymphocytes (Th17). We assessed Treg and Th17 levels in the peripheral blood of 32 patients with active, moderate-to-severe Graves' orbitopathy who received 12 weekly pulses of methylprednisolone, and determined their association with disease severity, disease activity, and treatment outcomes. The acute orbitopathy phase was confirmed based on clinical evaluation and magnetic resonance imaging, and assessed using the clinical activity score (CAS). The severity of the disease was classified according to ETA/EUGOGO guidelines, and quantified based on the total eye score. Treatment response was determined based on specific criteria (e.g., changes in CAS score, diplopia grade, visual acuity, etc.). Treg and Th17 cells were identified using flow cytometry. Methylprednisolone treatment improved the activity of the disease and altered the Th17/Treg balance (i.e., the percentage of Tregs decreased while the number of Th17 cells remained unchanged). There was no association between the Treg/Th17 ratio and the activity and severity of the disease or the treatment response. Therapeutic effects of steroid therapy in Graves' orbitopathy are not mediated by Treg and Th17 alterations in the peripheral blood. The decrease in peripheral Treg percentage is likely a consequence of the non-specific effects of steroids and does not impact clinical outcome.
Identifiants
pubmed: 33866536
doi: 10.1007/s40618-021-01565-w
pii: 10.1007/s40618-021-01565-w
doi:
Substances chimiques
Glucocorticoids
0
Methylprednisolone
X4W7ZR7023
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2475-2484Subventions
Organisme : Uniwersytet Medyczny im. Piastów Slaskich we Wroclawiu
ID : STM.C120.16.016
Informations de copyright
© 2021. Italian Society of Endocrinology (SIE).
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