Thyroid Eye Disease: Pathogenic Risk Factors

Pathogenesis of Thyroid Eye Disease

“…Prolonged hypothyroidism and elevated TSH are reported the risk factors for worsening TED 9. Conversely, control of thyroid hormone levels is reported to have a more favorable outcome in TED 8,10. Thyroid ablation with RAI is associated with new-onset or worsening of TED 8,22,23.…”

“…In the later stages of disease, Th2 cytokines predominate, including IL-4, IL-5, IL-10, and IL-13 1,34,58. The dampening of the immune response may reflect shifts in the cytokine profile or cytokine environment, such as a hypoxic state 8,43,63. Interestingly, there have been few cases of elderly TED patients presenting with severe progressive fibrosis without evidence of a previously active inflammatory condition 64…”

“…14 In GD, TSI binding to TSH-R on thyroid follicular endothelial cells results in excessive production of thyroid hormone, thyrocyte growth, and goiter formation that is uncoupled from the hypothalamic-pituitary axis. 8 However, the role of endocrine dysfunction in the pathogenesis of TED remains unclear. In TED, TSI levels have been found to be the most diagnostic and predictive of the disease course and Clinical Activity Score.…”

“…In TED, TSI levels have been found to be the most diagnostic and predictive of the disease course and Clinical Activity Score. 8,15,[17][18][19][20] In addition, antibodies against thyroid peroxidase and thyroglobulin (TG) can also be detected in TED. Unstable thyroid function is hypothesized to lead to fluctuations in TSH and TSI levels and result in a proinflammatory state.…”

Research progress on the pathogenesis of Graves’ ophthalmopathy: Based on immunity, noncoding RNA and exosomes

“…IGF-1R/TSHR signaling also boosts the production of hyaluronan in GO OFs and other glycosaminoglycan components in the ECM ( 48 ) ( Figure 2 ). Increased deposition of ECM, especially high molecular weight hyaluronan, can promote enlargement, inflammation, edema and congestion of GO orbital tissue ( 49 ). Activation of the IGF-1R/TSHR protein complex also increases the secretion IL-6 and IL-8, which are involved in the autoimmune response to GO.…”