Relationship between Disease Duration and Predominant Orbital T Cell Subset in Graves Ophthalmopathy
Jaroslaw P. Aniszewski,
Rosanee W. Valyasevi and
Rebecca S. Bahn
Division of Endocrinology, Mayo Clinic/Foundation, Rochester,
Minnesota 55905
Address all correspondence and requests for reprints to: Rebecca S. Bahn, M.D., Mayo Clinic, Division of Endocrinology, 200 First Street SW, Rochester, Minnesota 55905. E-mail: bahn.rebecca{at}mayo.edu
We sought to determine whether the predominant orbital T helper
(TH)cell subset in orbital T cell clones established from
patientswith Graves ophthalmopathy (GO) might be related to disease
duration.A total of 117 clones were established from orbital
adipose/connectivetissues of 6 GO patients, and cytokine production
was measuredin 57 CD3+CD4+ clones.
TH1-type clones were predominant in culturesfrom patients
with recent onset (<2 yr) Graves hyperthyroidism(n = 44;
TH1/TH0/TH2 = 57/29/14%) or
GO (n = 53 clones;
TH1/TH0/TH2= 47/30/23%). In
contrast, TH2-type clones predominated in culturesfrom
patients with more remote onset (>2 yr) hyperthyroidism(n = 13;
TH1/TH0/TH2 = 0/31/69%;
P < 0.005) or GO (n = 4;
TH1/TH0/TH2= 0/25/75%;
P = 0.05). In addition, we established T cell
clonesfrom 1 TH1-dominant patient with recent-onset
thyroid and eyedisease using either IL-2 (12.5 ng/mL) alone or IL-2
plus IL-4(5 ng/mL) and found no shift toward recovery of
TH2-type clonesin the latter. In conclusion, although the
CD3+CD4+ clones characterizedwere not
necessarily tissue antigen specific, our findings suggestthat
cell-mediated (TH1-type) immune reactions may predominate
inthe orbit in early GO, whereas humoral immunity
(TH2-type) mightplay the greater role in later stages of
the disease.
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