Ciclosporin and thyroid-stimulating immunoglobulins in endocrine orbitopathy.
The study investigated whether ciclosporin (C) affected the thyroid-stimulating immunoglobulins (TSI) in serum of patients with endocrine orbitopathy (EO). The effect of C was compared with that of prednisone (P). Fifteen patients with EO classes III-V received C (n = 7) or P (n = 8). In addition to the immunosuppressants, five patients with Graves' disease in each group received methimazole (MMI). The stimulation of the cAMP levels in the medium of thyrocyte cultures was determined as a parameter of TSI. The TSI levels were markedly lowered in both groups during and after therapy. C group: before therapy 6.2 pmol/ml +/- 1.63 (100%, mean +/- SEM), during treatment 4.6 pmol/ml +/- 2.28 (74%), after treatment 4.1 pmol/ml +/- 1.33 (66%). P group: before treatment 9.1 pmol/ml +/- 3.42 (100%), during treatment 5.9 pmol/ml +/- 2.90 (65%), after treatment 3.7 pmol/ml +/- 1.20 (41%). There is neither a significant difference between the two groups nor between the patients who received the combined therapy (MMI + immunosuppressants) or only received immunosuppressants (P more than 0.05). The mean cAMP value of the healthy reference group (n = 19) is 0.4 pmol/ml +/- 0.03. There is a significant difference between this value and the cAMP values of the patients both before and after therapy (P less than 0.01). Thus, both C and P markedly lower the TSI titers of patients with EO.
Kahaly
G
G
Third Medical Department, Johannes Gutenberg University Hospital, Mainz, Federal Republic of Germany.
Yuan
J P
JP
Krause
U
U
Hülbusch
K
K
Beyer
J
J
D000328:Adult; D000368:Aged; D000242:Cyclic AMP / Q000097:blood; D003524:Cyclosporins / Q000627:therapeutic use*; D005094:Exophthalmos / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D006111:Graves Disease / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G; D018828:Immunoglobulins, Thyroid-Stimulating; D008297:Male; D008713:Methimazole / Q000494:pharmacology; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D013961:Thyroid Gland / Q000276:immunology*; D014284:Triiodothyronine / Q000097:blood
D003524:Cyclosporins; D007074:Immunoglobulin G; D018828:Immunoglobulins, Thyroid-Stimulating; D014284:Triiodothyronine; D008713:Methimazole; D000242:Cyclic AMP; D011241:Prednisone