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Ciclosporin and thyroid-stimulating immunoglobulins in endocrine orbitopathy

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Research in Experimental Medicine

Summary

The study investigated whether ciclosporin (C) affected the thyroid-stimulating immunoglobulins (TSI) in serum of patients with endocrine orbitopathy (EO). The effect of C was compared with that of prednisone (P). Fifteen patients with EO classes III–V received C (n = 7) or P (n = 8). In addition to the immunosuppressants, five patients with Graves' disease in each group received methimazole (MMI). The stimulation of the cAMP levels in the medium of thyrocyte cultures was determined as a parameter of TSI.

The TSI levels were markedly lowered in both groups during and after therapy. C group: before therapy 6.2 pmol/ml ± 1.63 (100%, mean ± SEM), during treatment 4.6 pmol/ml ± 2.28 (74%), after treatment 4.1 pmol/ml ± 1.33 (66%). P group: before treatment 9.1 pmol/ml ± 3.42 (100%), during treatment 5.9 pmol/ml ± 2.90 (65%), after treatment 3.7 pmol/ml ± 1.20 (41%). There is neither a significant difference between the two groups nor between the patients who received the combined therapy (MMI + immunosuppressants) or only received immunosuppressants (P more than 0.05). The mean cAMP value of the healthy reference group (n = 19) is 0.4 pmol/ml ± 0.03. There is a significant difference between this value and the cAMP values of the patients both before and after therapy (P less than 0.01). Thus, both C and P markedly lower the TSI titers of patients with EO.

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References

  1. Weetman AP, McGregor AM, Ludgate M, Beck L, Mills PV, Lazarus JH, Hall R (1983) Ciclosporin improves Graves' ophthalmopathy. Lancet 2:486–489

    PubMed  Google Scholar 

  2. Brabant G, Peter H, Becker G, Schwarzrock R, Wonigkeit K, Hesch RD (1984) Cyclosporin in infiltrative eye disorder. Lancet 2:515–516

    Google Scholar 

  3. Howlett JA, Lawton NF, Besser GM (1984) Deterioration of severe Graves' ophthalmopathy during cyclosporin treatment. Lancet 2:1101

    Google Scholar 

  4. Witte A, Landgraf R, Markl A, Boergen KP, Hasenfratz G, Pickardt CR (1985) Treatment of Graves' ophthalmopathy with cyclosporin A. Klin Wochenschr 63:1000–1004

    PubMed  Google Scholar 

  5. Kahaly G, Schrezenmeir J, Krause U, Schweikert B, Meuer S, Müller W, Dennebaum R, Beyer J (1986) Ciclosporin and prednisone v. prednisone in treatment of Graves' ophthalmopathy. A controlled, randomized and prospective study. Eur J Clin Invest 16:415–422

    PubMed  Google Scholar 

  6. Werner SC (1977) Modification of the classification of the eye changes of Graves' disease: Recommendations of the Ad Hoc Committee of the American Thyroid Association. J Clin Endocrinol Metab 44:203–204

    PubMed  Google Scholar 

  7. Zakarija M, McKenzie JM, Banovac K (1980) Clinical significance of assay of thyroidstimulating antibody in Graves' disease. Ann Intern Med 93:28–32

    PubMed  Google Scholar 

  8. Endo K, Amir SM, Ingbar SH (1981) Development and evaluation of a method for the partial purification of immunoglobulins specific for Graves' disease. J Clin Endocrinol Metab 52:1113–1123

    PubMed  Google Scholar 

  9. Balley JL (1967) Techniques in protein chemistry. Elsevier. Amsterdam London New York, p 341

    Google Scholar 

  10. Kasagi K, Konischi J, Iida Y, Ikekubo K, Mori T, Kuma K, Torizuka K (1982) A new in vitro assay for human thyroid stimulation using cultured thyroid cells: Effects of sodium chloride on adenosine 3′5′ monophosphate increase. J Clin Endocrinol Metab 54:108–114

    PubMed  Google Scholar 

  11. McKenzie JM, Zakarija M (1976) A reconsideration of a thyroid-stimulating immunoglobulin as cause of hyperthyroidism in Graves' disease. J Clin Endocrinol Metab 42:778–781

    PubMed  Google Scholar 

  12. Rapaport B, Greenspan FS, Filetti S, Pepitone M (1984) Clinical experience with a human thyroid cell bioassay for thyroid stimulation immunoglobulin. J Clin Endocrinol Metab 58:332–338

    PubMed  Google Scholar 

  13. Herold KC, Lancki DW, Moldwin RL, Fitch FW (1986) Immunosuppressive effects of ciclosporin A on cloned T cells. J Immunol 136:1315–1321

    PubMed  Google Scholar 

  14. Reed JC, Abidi AH, Alpers JD, Hoover RJ, Nowell PC (1986) Effect of cyclosporin A and dexamethasone on interleukin 2 receptor gene expression. J Immunol 137:150–157

    PubMed  Google Scholar 

  15. Halloran P, Farkas S, Autenried P (1986) Cyclosporin depresses expression of class II MHC antigens. Transplant Proc 18:827–839

    Google Scholar 

  16. Piccinini LA, MacKenzie WA, Platzer M, Davies TF (1987) Lymphokine regulation of HLA-DR gene expression in human thyroid cell monolayers. J Clin Endocrinol Metab 64:543–548

    PubMed  Google Scholar 

  17. Kahaly G, Moncayo R, Bemetz U, Krause U, Beyer J, Pfeiffer EF (1989) Eye muscle antibodies in endocrine exophthalmos. Horm Metabol Res 21:135–139

    Google Scholar 

  18. Werner SC, Platman SR (1965) Remission of hyperthyroidism (Graves' disease) and alterned pattern of serum-thyroxine binding induced by prednisone. Lancet 2:751–755

    PubMed  Google Scholar 

  19. Pinkston P, Saltini C, Müller-Quernheim J, Crystal RG (1987) Corticosteroid therapy suppresses spontaneous interleukin 2 release and spontaneous proliferation of lung T-lymphocytes of patients with active pulmonary sarcoidoses. J Immunol 139:755–760

    PubMed  Google Scholar 

  20. Weetman AP, Holt ME, Campbell AK, Hall R, McGregor AM (1984) Methimazole inhibits oxygen radical generation by monocytes: A potential role of immunosuppression. Br Med J 288:518–522

    Google Scholar 

  21. McLachlan SM, Pegg CAS, Atherton MC, et al (1985) The effect of carbimazole on thyroid autoantibody synthesis by thyroid lymphocytes. J Clin Endocrinol Metab 60:1237–1242

    PubMed  Google Scholar 

  22. Volpe R, Karlsson A, Jansson R, Dahlberg PA (1987) Thyrostatic drugs act through modulation of thyroid cell activity to induce remission in Graves' disease. Acta Endocrinol (Copenh) 281:305–311

    Google Scholar 

  23. Tötterman TH, Karlsson FA, Bengtsson M, Mendel-Hartvig IB (1987) Induction of circulation activated suppressor-like T cells by methimazole therapy for Graves' disease. N Engl J Med 316:15–22

    PubMed  Google Scholar 

  24. Wenzel KW, Lente JR (1984) Similar effects of thionamide drugs and perchlorate on thyroid-stimulating immunoglobulins in Graves' disease: Evidence against an immunosuppressive action of thionamide drugs. J Clin Endocrinol Metab 58:62–69

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Third Medical Department, Division of Endocrinology and Metabolism, Johannes Gutenberg University Hospital, Langenbeckstr. 1, D-6500, Mainz 1, Federal Republic of Germany

    G. Kahaly, J. P. Yuan, U. Krause, K. Hülbusch & J. Beyer

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  1. G. Kahaly
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  2. J. P. Yuan
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  3. U. Krause
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  4. K. Hülbusch
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  5. J. Beyer
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Additional information

Ms. J. P. Yuan is a DAAD grant-supported postgraduate student from the People's Republic of China. The paper contains substantial parts of her dissertation

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Kahaly, G., Yuan, J.P., Krause, U. et al. Ciclosporin and thyroid-stimulating immunoglobulins in endocrine orbitopathy. Res. Exp. Med. 189, 355–362 (1989). https://doi.org/10.1007/BF01855041

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  • DOI: https://doi.org/10.1007/BF01855041

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