Markers of Inflammation and Fibrosis in the Orbital FatConnective Tissue of Patients with Graves’ Orbitopathy: Clinical Implications

الملخص EN

Purpose.

To assess FGF-β, TGF-β, and COX2 expression and immunocompetent cells in the orbital tissue of patients with severe and mild Graves’ orbitopathy.

Patients and Methods.

Orbital tissue was taken from 27 patients with GO: (1) severe GO (n=18), the mean clinical activity score (CAS) being 8.5 (SD 2.5); and (2) mild GO (n=9), the mean CAS being 2.2 (SD 0.8), and from 10 individuals undergoing blepharoplasty.

The expression of CD4+, CD8+, CD20+, and CD68 and FGF-β, TGF-β, and COX2 in the orbital tissue was evaluated by immunohistochemical methods.

Results.

We demonstrated predominant CD4+ T cells in severe GO.

CD68 expression was observed in the fibrous connective area of mild GO and was robust in severe GO, while the prominent TGF-β expression was seen in all GO.

Increased FGF-β expression was observed in the fibroblasts and adipocytes of severe GO.

No expression of COX2 was found in patients with GO.

Conclusions.

Macrophages and CD4 T lymphocytes are both engaged in the active/severe and long stage of inflammation in the orbital tissue.

FGF-β and TGF-β expression may contribute to tissue remodeling, fibrosis, and perpetuation of inflammation in the orbital tissue of GO especially in severe GO.