Treatment of moderate to severe orbitopathy: Current modalities and perspectives

Bouzehouane, Nadia; Borson‐Chazot, Françoise; Abeillon, J.; Caron, Philippe

doi:10.1016/j.ando.2021.02.001

Cited by 7 publications

(3 citation statements)

References 24 publications

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“…Rundle's curve showed the natural course of TAO. First, a dynamic (active) in ammatory phase, followed by an inactive phase (Bouzehouane, Borson-Chazot, Abeillon, & Caron, 2021) . This active phase usually lasts for at least 6-18 months (Dolman, 2021) .…”

Section: Discussionmentioning

confidence: 99%

Disrupted Gray Matter Structural Networks between Active and Inactive Phases of Thyroid-Associated Ophthalmopathy

Luo

Wen

Gao

et al. 2022

Preprint

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Patients with thyroid-associated opthalmopathy (TAO) reportedly exhibit widespread morphological abnormalities in attention and default mode network (DMN) areas, but alterations in coordinated patterns of brain structural networks underlying TAO are still poorly understood. This study aims to investigate the disruptions in gray matter (GM) structural networks between TAO patients in active and inactive phases. We constructed subject-wise structural networks based on GM volumetric features for 37 active and 35 inactive TAO patients, and 23 healthy controls. Graph theory analysis was conducted to assess the alterations of global and regional network topological properties for TAO patients and their correlation with clinical characteristics. Compared with inactive TAO patients and controls, active TAO patients showed significantly decreased global/local efficiency, and significant altered nodal betweenness centrality (BC) in the visual, attention, DMN and sensorimotor areas. Intriguingly, the BC of left lingual gyrus was significantly negatively correlated with bilateral intraocular pressure, and medial superior/opercular inferior frontal gyrus was significantly correlated with anxiety and depression parameters. Our results suggest that TAO patients at different clinical stages have segregated disruptions in GM network topology, which may due to the visual function and psychological changes. These findings may provide new insights into the neurobiological mechanisms of TAO.

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Section: Discussionmentioning

confidence: 99%

Disrupted Gray Matter Structural Networks between Active and Inactive Phases of Thyroid-Associated Ophthalmopathy

Luo

Wen

Gao

et al. 2022

Preprint

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“…According to the 2021 European Group on Graves Orbitopathy (EUGOGO), the annual incidence of TAO was 0.54–0.9 cases/100,000 in men and 2.67–3.3 cases/100,000 in women [ 4 , 5 ]. The current guidelines of the EUGOGO recommend local treatment and selenium for mild TAO and high-dose intravenous glucocorticoid pulses as standard treatment for active and moderate-to-severe disease [ 4 , 6 ]. However, a substantial number (20–30%) of active moderate-to-severe TAO patients may not respond to current guideline-recommended approaches.…”

Section: Introductionmentioning

confidence: 99%

Machine learning-based prediction of diagnostic markers for Graves’ orbitopathy

Cai

et al. 2023

Endocrine

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Purpose The pathogenesis of Graves’ orbitopathy/thyroid-associated orbitopathy (TAO) is still unclear, and abnormal DNA methylation in TAO has been reported. Thus, selecting and exploring TAO biomarkers associated with DNA methylation may provide a reference for new therapeutic targets. Methods The TAO-associated expression data and methylation data were downloaded from The Gene Expression Omnibus database. Firstly, weighted gene co-expression network analysis was used to obtain the TAO-related genes, which were intersected with differentially methylated genes (DMGs), and differentially expressed genes between TAO samples and normal samples to obtain TAO-associated DMGs (TA-DMGs). Thereafter, the functions of the TA-DMGs were analyzed, and diagnostic markers were screened by least absolute shrinkage and selection operator (Lasso) regression analysis and support vector machine (SVM) analysis. The expression levels and diagnostic values of the diagnostic markers were also analyzed. Furthermore, single gene pathway enrichment analysis was performed for each diagnostic marker separately using gene set enrichment analysis (GSEA) software. Next, we also performed immune infiltration analysis for each sample in the GSE58331 dataset using the single-sample GSEA algorithm, and the correlation between diagnostic markers and differential immune cells was explored. Lastly, the expressions of diagnostic markers were explored by quantitative real-time polymerase chain reaction (qRT-PCR). Results A total of 125 TA-DMGs were obtained. The enrichment analysis results indicated that these TA-DMGs were mainly involved in immune-related pathways, such as Th1 and Th2 cell differentiation and the regulation of innate immune response. Moreover, two diagnostic markers, including S100A11 and NKD2, were obtained by Lasso regression analysis and SVM analysis. Single gene pathway enrichment analysis showed that S100A11 was involved in protein polyufmylation, pancreatic-mediated proteolysis, and NKD2 was involved in innate immune response in mucosa, Wnt signaling pathway, etc. Meanwhile, immune cell infiltration analysis screened 12 immune cells, including CD56 dim natural killer cells and Neutrophil cells that significantly differed between TAO and normal samples, with the strongest positive correlation between NKD2 and CD56 dim natural killer cells. Finally, the qRT-PCR illustrated the expressions of NKD2 and S100A11 between normal and TAO. Conclusion NKD2 and S100A11 were screened as biomarkers of TAO and might be regulated by DNA methylation in TAO, providing a new reference for the diagnosis and treatment of TAO patients.

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“…It occurs in 30–50% of Graves’ disease (GD) patients. About 5% of patients are moderate-to-severe cases, which can lead to vision loss and even blindness, resulting in long-term disability [ 1 ]. The pathogenesis of GO has not been fully clarified yet.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of mycophenolate mofetil in the treatment of moderate to severe Graves’ orbitopathy: a meta-analysis

Feng

Zhang

et al. 2022

Bioengineered

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The role of mycophenolate mofetil (MMF) in the treatment of Graves’ orbitopathy (GO) has attracted much attention. This study is to evaluate the benefit and safety of MMF in moderate-to-severe GO. A meta-analysis of clinical control trials comparing MMF (with or without glucocorticoid (GC)) for the treatment of GO with GC was conducted. We searched the databases, including PubMed, EMBASE, the Cochrane Library, Web of Science, Wanfang, and China National Knowledge Infrastructure (CNKI), for articles published up to 15 June 2022. The primary outcome is referred to the improvement in overall response, and secondary outcomes included the change in clinical activity score (CAS) and adverse events (AEs). Of the 289 articles initially searched, 6 studies were finally eligible for inclusion. The results showed that MMF (with or without GC) was superior to GC in the treatment of GO (OR 3.34, 95% CI 2.17–5.14; p < 0.00001). Subgroup analyses also showed that MMF monotherapy was more effective than GC (OR 4.46, 95% CI 2.52–7.87; p < 0.00001). Compared to methylprednisolone (MP) monotherapy, a combination of MP and MMF was more effective. CAS decreased even more significantly (WMD 0.29, 95% CI 0.10–0.48; p = 0.002) and fewer AEs occurred (OR 0.2, 95% CI 0.06–0.72; p = 0.01) in patients receiving MMF. The pooled data suggested that MMF treatment in GO might be promising. Compared with GC therapy, MMF is safer and more effective. However, more large-sample and high-quality studies targeting MMF use in GO patients and long-term surveillance of prognosis are urgently needed.

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Treatment of moderate to severe orbitopathy: Current modalities and perspectives

Cited by 7 publications

References 24 publications

Disrupted Gray Matter Structural Networks between Active and Inactive Phases of Thyroid-Associated Ophthalmopathy

Disrupted Gray Matter Structural Networks between Active and Inactive Phases of Thyroid-Associated Ophthalmopathy

Machine learning-based prediction of diagnostic markers for Graves’ orbitopathy

Efficacy and safety of mycophenolate mofetil in the treatment of moderate to severe Graves’ orbitopathy: a meta-analysis

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