Soluble IL-2 receptor levels in patients with Graves' ophthalmopathy.
In various autoimmune diseases circulating levels of soluble IL-2 receptor (sIL-2R) seem to be related to disease activity. Because reliable parameters of disease activity in Graves' ophthalmopathy are lacking, we measured sIL-2R levels in 47 patients with this disorder. The patients had Graves' disease, but no other immune-mediated diseases, had not yet received specific treatment for their ophthalmopathy and were euthyroid during the entire study period. Twenty-one of the 47 patients (45%) had sIL-2R values above the upper normal limit of 650 U/ml, as established in 20 healthy controls. There were no differences between patients with normal (median 469, range 280-644 U/ml) and elevated (median 946, range 678-1588 U/ml) sIL-2R levels regarding duration or severity of the eye disease (as assessed clinically from the total eye score). However, patients with severely enlarged eye muscles had higher sIL-2R values than patients with less severely enlarged eye muscles on CT scan. Patients with elevated sIL-2R tended to have a higher response rate (71%) to a 3-month course of prednisone, than those with normal levels (46%; P = 0.081). Since a successful outcome of prednisone treatment might be representative for disease activity, the elevated sIL-2R levels seem to reflect active inflammation. Although the practical relevance of this finding in individual patients is limited, it underscores the importance of cell-mediated immune responses in this thyroid-related eye disease.
Prummel
M F
MF
Department of Endocrinology, University of Amsterdam, The Netherlands.
Wiersinga
W M
WM
Van der Gaag
R
R
Mourits
M P
MP
Koornneef
L
L
D000328:Adult; D005128:Eye Diseases / Q000209:etiology* / Q000378:metabolism*; D005260:Female; D006111:Graves Disease / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011241:Prednisone / Q000494:pharmacology / Q000627:therapeutic use; D015375:Receptors, Interleukin-2 / Q000096:biosynthesis*; D013972:Thyrotropin / Q000032:analysis; D013974:Thyroxine / Q000032:analysis; D014284:Triiodothyronine / Q000032:analysis
D015375:Receptors, Interleukin-2; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine; D011241:Prednisone