[1]马超,刘薇,李凯军,等.甲状腺相关眼病免疫相关发病机制的研究现状与进展[J].眼科新进展,2019,39(8):790-794.[doi:10.13389/j.cnki.rao.2019.0180]
 MA Chao,LIU Wei,LI Kai-Jun,et al.Current status and progress of immune related pathogenesis in thyroid associated ophthalmopathy[J].Recent Advances in Ophthalmology,2019,39(8):790-794.[doi:10.13389/j.cnki.rao.2019.0180]
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
39卷
期数:
2019年8期
页码:
790-794
栏目:
文献综述
出版日期:
2019-08-05

文章信息/Info

Title:
Current status and progress of immune related pathogenesis in thyroid associated ophthalmopathy
作者:
马超刘薇李凯军何剑峰
530021 广西壮族自治区南宁市,广西医科大学附属第一医院眼科
Author(s):
MA ChaoLIU WeiLI Kai-JunHE Jian-Feng
Department of Ophthalmology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China
关键词:
甲状腺相关眼病自身免疫发病机制
Keywords:
thyroid associated ophthalmopathyautoimmunitypathogenesis
分类号:
R777.5
DOI:
10.13389/j.cnki.rao.2019.0180
文献标志码:
A
摘要:
甲状腺相关眼病(thyroid associated ophthalmopathy,TAO)是Graves病最常见的甲状腺腺外表现,主要表现为上眼睑退缩、水肿、眶周组织红斑和眼球突出,进一步发展可影响患者视力甚至导致失明。TAO的发病机制不完全清楚,由多种因素共同影响,但是目前患者自身免疫的功能异常是TAO的主要发病因素。本文将从细胞免疫、自身抗原和自噬这几个方面阐述TAO免疫相关发病机制研究的现状与进展,为临床工作和相关研究提供参考。
Abstract:
Thyroid associated ophthalmopathy(TAO) is the most common extrathyroidal manifestation of Graves’ disease,mainly manifested as upper eyelid retraction,edema,orbital tissue erythema and exophthalmos,and further development can affect the patient’s vision and even lead to blindness.The pathogenesis of TAO is not completely clear and is affected by many factors.However,the abnormal function of autoimmunity is the main pathogenic factor of TAO.The current status and progress of TAO immune-related pathogenesis are reviewed in this article from the aspects of cellular immunity,autoantigen and autophagy,which can provide references for clinical work and related research.

参考文献/References:

[1] PRABHAKAR B S,BAHN R S,SMITH T J.Current perspective on the pathogenesis of Graves’ disease and ophthalmopathy[J].Endocr Rev,2003,24(6):802-835.
[2] RAJABI M T,PAPAGEORGIOU K,TABAN M,HWANG C J,HOSSEINI S S,RAJABI M B,et al.Ultrasonographic motion analysis of lower eyelid compartments in patients with chronic thyroid associated ophthalmopathy[J].J Curr Ophthalmol,2017,29(4):310-317.
[3] SMITH T J.TSHR as a therapeutic target in Graves’ disease[J].Expert Opin Ther Targets,2017,21(4):427-432.
[4] OU Y M,LIU G Q,FAN N,YING F W.Effects of berberine on differerntiation of orbital preadipocytes of TAO patients in vitro[J].Rec Adv Ophthalmol,2016,36(1):12-14.
欧阳明,刘桂琴,樊宁,应方微.小蘖碱对甲状腺相关眼病眼眶前脂肪细胞分化的影响[J].眼科新进展,2016,36(1):12-14.
[5] LIU F,ZHU Y,ZHANG K,LI Z G.Effect of pulsed glucocorticoid combined with orbital radiotherapy for the treatment of severe active thyroid associated ophthalmopathy[J].J Xin-xiang Med Univ,2016,33(7):623-625.
刘芳,朱豫,张珂,李志刚.激素冲击联合放射治疗重度活动期甲状腺相关眼病疗效观察[J].新乡医学院学报,2016,33(7):623-625.
[6] WIERSINGA W M.Advances in treatment of active,moderate-to-severe Graves’ ophthalmopathy[J].Lanc Diab Endocrinol,2017,5(2):134-142.
[7] CHEN H H,TAO Y.Research progresses in the pathogenesis of thyroid associated ophthalmopathy[J].Chin J Pract Intern Med,2015,35(7):561-565.
陈欢欢,涛杨.甲状腺相关眼病发病机制研究进展[J].中国实用内科杂志,2015,35(7):561-565.
[8] ANTONELLI A,FERRARI S M,FRASCERRA S,RUFFILLI I,GELMINI S,MINUTO M,et al.Peroxisome proliferator-activated receptor-α agonists modulate CXCL9 and CXCL11 chemokines in Graves’ ophthalmopathy fibroblasts and preadipocytes[J].Mol Scell Endocrinol,2012,349(2):255-261.
[9] ANTONELLI A,FERRARI S M,CORRADO A,FRANCESCHINI S S,GELMINI S,FERRANNINI E,et al.Extra-ocular muscle cells from patients with Graves’ ophthalmopathy secrete alpha (CXCL10) and beta (CCL2) chemokines under the influence of cytokines that are modulated by PPARgamma[J].Autoimmun Rev,2014,13(11):1160-1166.
[10] DEL P G,ROMAGNANI S.The role of TH1 and TH2 subsets in human infectious diseases[J].Trends Microbiol,1994,2(1):4.
[11] NO B.Immunological mechanisms implicated in the pathogenesis of chronic urticaria and hashimoto thyroiditis[J].Iran J Allergy Asthma Immunol,2017,16(4):358-366.
[12] RAPOPORT B,MCLACHLAN S M.Graves’ hyperthyroidism is antibody-mediated but is predominantly a Th1-type cytokine disease[J].J Clin Endocrinol Metab,2014,99(11):4060-4061.
[13] FANG S,HUANG Y,LIU X,ZHONG S,WANG N,ZHAO B,et al.Interaction between CCR6+ Th17 cells and CD34+ fibrocytes promotes inflammation:implications in Graves’ orbitopathy in chinese population[J].Invest Ophthalmol Vis Sci,2018,59(6):2604-2614.
[14] SIOMKAJ O M,DYBKO J,DAROSZEWSKI J.Regulatory lymphocytes in thyroid orbitopathy and autoimmune thyroid diseases[J].Postepy Hig Med Dosw (Online),2016,70(0):1378-1388.
[15] BEDOYA S K,LAM B,LAU K,RD L J.Th17 cells in immunity and autoimmunity[J].Clin Dev Immunol,2013,2013(7):986789.
[16] ICHIYAMA K,GONZALEZ-MARTIN A,KIM B S,JIN H Y,JIN W,XU W,et al.The microRNA-183-96-182 cluster promotes T helper 17 cell pathogenicity by negatively regulating transcription factor Foxo1 expression[J].Immunity,2016,44(6):1284-1298.
[17] JAIN R,CHEN Y,KANNO Y,JOYCE-SHAIKH B,VAHEDI G,HIRAHARA K,et al.Interleukin-23-induced transcription factor blimp-1 promotes pathogenicity of T helper 17 cells[J].Immunity,2016,44(1):131-142.
[18] MATSUZAWA K,IZAWA S,OKURA T,FUJII S,MATSUMOTO K,SHOJI K,et al.Implications of FoxP3-positive and -negative CD4+CD25+T cells in Graves’ ophthalmopathy[J].Endocr J,2016,63(8):755-764.
[19] RAMOS-LEVI A M,MARAZUELA M.Pathogenesis of thyroid autoimmune disease:the role of cellular mechanisms[J].Endocrinol Nutr,2016,63(8):421-429.
[20] HWANG C J,AFIFIYAN N,SAND D,NAIK V,SAID J,POLLOCK S J,et al.Orbital fibroblasts from patients with thyroid-associated ophthalmopathy overexpress CD40:CD154 hyperinduces IL-6,IL-8,and MCP-1[J].Invest Ophthalmol Vis Sci,2009,50(5):2262-2268.
[21] SALVI M.Immunotherapy for Graves’ ophthalmopathy[J].Curr Opin Endocrinol Diabetes Obes,2014,21(5):409-414.
[22] NAGATA K,NAKAYAMA Y,HIGAKI K,OCHI M,KANAI K,MATSUSHITA M,et al.Reactivation of persistent Epstein-Barr virus (EBV) causes secretion of thyrotropin receptor antibodies (TRAbs) in EBV-infected B lymphocytes with TRAbs on their surface[J].Autoimmunity,2015,48(5):328-335.
[23] KAMBAYASHI T,LAUFER T M.Atypical MHC class II-expressing antigen-presenting cells:can anything replace a dendritic cell?[J].Nat Rev Immunol,2014,14(11):719-730.
[24] TANG F,CHEN X,MAO Y,WAN S,AI S,YANG H,et al.Orbital fibroblasts of Graves’ orbitopathy stimulated with proinflammatory cytokines promote B cell survival by secreting BAFF[J].Mol Cell Endocrinol,2017,446:1-11.
[25] ROSSER E C,MAURI C.Regulatory B cells:origin,phenotype,and function[J].Immunity,2015,42(4):607-612.
[26] VAN DER WEERD K,VAN HAGEN PM,SCHRIJVER B,KWEK-KEBOOM D J,DE HERDER WW,TEN BROEK M R,et al.The peripheral blood compartment in patients with Graves’ disease:activated T lymphocytes and increased transitional and pre-naive mature B lymphocytes[J].Clin Exp Immunol,2013,174(2):256-264.
[27] SAHLI E,GUNDUZ K.Thyroid-associated ophthalmopathy[J].Turkish J Ophthalmol,2017,47(2):94-105.
[28] DIK W A,VIRAKUL S,VAN STEENSEL L.Current perspectives on the role of orbital fibroblasts in the pathogenesis of Graves’ ophthalmopathy[J].Exp Eye Res,2016,142:83-91.
[29] WANG Q,SHI B M,XIE F,FU Z Y,CHEN Y J,AN J N,et al.Enhancement of CD4+T cell response and survival via coexpressed OX40/OX40L in Graves’ disease[J].Mol Cell Endocrinol,2016,430:115-124.
[30] LI B,SMITH T J.Divergent expression of IL-1 receptor antagonists in CD34+ fibrocytes and orbital fibroblasts in thyroid-associated ophthalmopathy:contribution of fibrocytes to orbital inflammation[J].J Clin Endocrinol Metab,2013,98(7):2783-2790.
[31] DOUGLAS R S,AFIFIYAN N F,HWANG C J,CHONG K,HAIDER U,RICHARDS P,et al.Increased generation of fibrocytes in thyroid-associated ophthalmopathy[J].J Clin Endocrinol Metab,2010,95(1):430-438.
[32] FERNANDO R,LU Y,ATKINS S J,MESTER T,BRANHAM K,SMITH T J.Expression of thyrotropin receptor,thyroglobulin,sodium-iodide symporter,and thyroperoxidase by fibrocytes depends on AIRE[J].J Clin Endocrinol Metab,2014,99(7):E1236-1244.
[33] FERNANDO R,ATKINS S,RAYCHAUDHURI N,LU Y,LI B,DOUGLAS R S,et al.Human fibrocytes coexpress thyroglobulin and thyrotropin receptor[J].Proc Natl Acad Sci USA,2012,109(19):7427-7432.
[34] KRISS J P,PLESHAKOV V,ROSENBLUM A L,HOLDERNESS M,SHARP G,UTIGER R.Studies on the pathogenesis of the ophthalmopathy of Graves’ disease[J].J Clin Endocrinol Metab,1967,27(4):582.
[35] SMITH T J.TSH-receptor-expressing fibrocytes and thyroid-associated ophthalmopathy[J].Nat Rev Endocrinol,2015,11(3):171-181.
[36] LYTTON S D,PONTO K A,KANITZ M,MATHEIS N,KOHN L D,KAHALY GJ.A novel thyroid stimulating immunoglobulin bioassay is a functional indicator of activity and severity of Graves’ orbitopathy[J].J Clin Endocrinol Metab,2010,95(5):2123-2131.
[37] JANG S Y,SHIN D Y,LEE E J,CHOI Y J,LEE S Y,YOON J S.Correlation between TSH receptor antibody assays and clinical manifestations of Graves’ orbitopathy[J].Yonsei Med J,2013,54(4):1033-1039.
[38] JANG S Y,SHIN D Y,LEE E J,LEE S Y,YOON J S.Relevance of TSH-receptor antibody levels in predicting disease course in Graves’ orbitopathy:comparison of the third-generation TBII assay and Mc4-TSI bioassay[J].Eye (Lond),2013,27(8):964-971.
[39] WOO Y J,JANG S Y,LIM T H,YOON J S.Clinical association of thyroid stimulating hormone receptor antibody levels with disease severity in the chronic inactive stage of Graves’ orbitopathy[J].Korean J Ophthalmol,2015,29(4):213-219.
[40] GERDING M N,VAN DER MEER J W,BROENINK M,BAKKER O,WIERSINGA W M,PRUMMEL M F.Association of thyrotrophin receptor antibodies with the clinical features of Graves’ ophthalmopathy[J].Clin Endocrinol (Oxf),2000,52(3):267-271.
[41] DOUGLAS R S,NAIK V,HWANG C J,AFIFIYAN N F,GIANOUKAKIS A G,SAND D,et al.B cells from patients with Graves’ disease aberrantly express the IGF-1 receptor:implications for disease pathogenesis[J].J Immunol,2008,181(8):5768-5774.
[42] DOUGLAS R S,GIANOUKAKIS A G,KAMAT S,SMITH T J.Aberrant expression of the insulin-like growth factor-1 receptor by T cells from patients with Graves’ disease may carry functional consequences for disease pathogenesis[J].J Immunol,2007,178(5):3281-3287.
[43] KRIEGER C C,PLACE R F,BEVILACQUA C,MARCUS-SAMUELS B,ABEL B S,SKARULIS M C,et al.TSH/IGF-1 receptor cross talk in Graves’ ophthalmopathy pathogenesis[J].J Clin Endocrinol Metab,2016,101(6):2340-2347.
[44] ZHANG L,GRENNAN-JONES F,DRAMAN M S,LANE C,MORRIS D,DAYAN C M,et al.Possible targets for nonimmunosuppressive therapy of Graves’ orbitopathy[J].J Clin Endocrinol Metab,2014,99(7):E1183-1190.
[45] KRIEGER C C,NEUMANN S,PLACE R F,MARCUS-SAMUELS B,GERSHENGORN M C.Bidirectional TSH and IGF-1 receptor cross talk mediates stimulation of hyaluronan secretion by Graves’ disease immunoglobins[J].J Clin Endocrinol Metab,2015,100(3):1071-1077.
[46] SMITH T J,HEGEDUS L,DOUGLAS R S.Role of insulin-like growth factor-1 (IGF-1) pathway in the pathogenesis of Graves’ orbitopathy[J].Best Pract Res Clin Endocrinol Metab,2012,26(3):291-302.
[47] CHEN H,MESTER T,RAYCHAUDHURI N,KAUH C Y,GUPTA S,SMITH T J,et al.Teprotumumab,an IGF-1R blocking monoclonal antibody inhibits TSH and IGF-1 action in fibrocytes[J].J Clin Endocrinol Metab,2014,99(9):E1635-1640.
[48] CHEN H,SHAN S J,MESTER T,WEI Y H,DOUGLAS R S.TSH-Mediated TNFalpha production in human fibrocytes is inhibited by teprotumumab,an IGF-1R antagonist[J].PLoS One,2015,10(6):e0130322.
[49] SANDERS J,EVANS M,PREMAWARDHANA L,DEPRAETERE H,JEFFREYS J,RICHARDS T,et al.Human monoclonal thyroid stimulating autoantibody[J].Lancet,2003,362(9378):126-128.
[50] HE X H,LIU G Q,JIANG L Q,OU Y M,MA D H,ZHU T H.Expression of AdPLA in orbital adipose tissue of normal and patients with thyroid associated ophthalmopathy[J].Rec Adv Ophthalmol,2016,36(9):841-843.
何小寒,刘桂琴,蒋丽琼,欧阳明,马大卉,祝天辉.甲状腺相关眼病患者和正常人眼眶脂肪组织中脂肪特异性磷脂酶A2的表达[J].眼科新进展,2016,36(9):841-843.
[51] LIU G Q,OU Y M,WANG Y,MA D H,ZHU T H,CHEN W J.Higher expression of AdPLA in orbital adipose tissue of patients with thyroid associated ophthalmopathy of Ⅲ level and stationary phase[J].Rec Adv Ophthalmol,2017,37(4):354-357.
刘桂琴,欧阳明,王云,马大卉,祝天辉,陈文杰.AdPLA基因在Ⅲ级静止期甲状腺相关眼病眼眶脂肪内高表达研究[J].眼科新进展,2017,37(4):354-357.
[52] WANG L,MA J M.Progression of the pathogenesis of thyroid associated ophthalmopathy[J].Chin J Ophthalmol.2017,53(6):474-480.
王蕾,马建民.甲状腺相关眼病发病机制的研究进展[J].中华眼科杂志,2017,53(6):474-480.
[53] CHENG K C,HUNG C T,CHENG K Y,CHEN K J,WU W C,SUEN J L,et al.Proteomic surveillance of putative new autoantigens in thyroid orbitopathy[J].Br J Ophthalmol,2015,99(11):1571-1576.
[54] MORI Y,MATSUI T,OMOTE D,FUKUDA M.Small GTPase Rab39A interacts with UACA and regulates the retinoic acid-induced neurite morphology of Neuro2A cells[J].Biochem Biophys Res Commun,2013,435(1):113-119.
[55] OHSUMI Y.Historical landmarks of autophagy research[J].Cell Res,2014,24(1):9-23.
[56] BAERGA R,ZHANG Y,CHEN P H,GOLDMAN S,JIN S.Targeted deletion of autophagy-related 5 (atg5) impairs adipogenesis in a cellular model and in mice[J].Autophagy,2009,5(8):1118-1130.
[57] ZHANG Y,GOLDMAN S,BAERGA R,ZHAO Y,KOMATSU M,JIN S.Adipose-specific deletion of autophagy-related gene 7 (atg7) in mice reveals a role in adipogenesis[J].Proc Natl Acad Sci USA,2009,106(47):19860-19865.
[58] YOON J S,LEE H J,CHAE M K,LEE E J.Autophagy is involved in the initiation and progression of Graves’ orbitopathy[J].Thyroid,2015,25(4):445-454.
[59] LI H,YUAN Y,ZHANG Y,ZHANG X,GAO L,XU R.Icariin inhibits AMPK-dependent autophagy and adipogenesis in adipocytes in vitro and in a model of Graves’ orbitopathy in vivo[J].Front Physiol,2017,8:45.

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备注/Memo

备注/Memo:
国家自然科学基金资助(编号:81260149)
更新日期/Last Update: 2019-07-31