Effect of systemic steroid therapy in Graves’ orbitopathy on regulatory T cells and Th17/Treg ratio
| Autor: | Łukasz Mizera, Marta Siomkajło, D Szymczak, Katarzyna Kolackov, Marek Bolanowski, Jedrzej Grzegrzolka, Jacek Daroszewski |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Visual acuity Endocrinology Diabetes and Metabolism Visual Acuity chemical and pharmacologic phenomena Disease Methylprednisolone Severity of Illness Index T-Lymphocytes Regulatory Endocrinology RAR-related orphan receptor gamma Diplopia Humans Medicine Lymphocyte Count Glucocorticoids medicine.diagnostic_test business.industry Therapeutic effect Patient Acuity FOXP3 hemic and immune systems Magnetic resonance imaging Middle Aged Flow Cytometry Magnetic Resonance Imaging Peripheral Graves Ophthalmopathy Treatment Outcome Pulse Therapy Drug Immunology Th17 Cells Female Drug Monitoring medicine.symptom business medicine.drug |
| Zdroj: | Journal of Endocrinological Investigation. 44:2475-2484 |
| ISSN: | 1720-8386 |
| DOI: | 10.1007/s40618-021-01565-w |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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