Protein expression of VEGF, IGF-1 and FGF in retroocular connective tissues and clinical correlation in Graves' ophthalmopathy.
OBJECTIVE
To investigate the immunohistochemical expression (IGF-1, EGFr, EGF, c-erbB-2/HER-2/neu, PDGF-A, PDGF-B, FGF and VEGF) in patients with Graves' ophthalmopathy.


METHODS
Twenty-four samples (Graves' ophthalmopathy patients) underwent lateral rectus muscle and surrounding fibrous and adipose tissue biopsy. The control group was obtained by strabismus surgery. Correlation between clinical-ophthalmologic, endocrinological, ultrasonographic findings, and immunohistochemical expression was performed.


RESULTS
IGF-1: There were 7 positive cases (29.2%). There was a direct relation with higher CAS (clinical activity score) in all of them and if only CAS equal or higher than 5 was considered, this was 54.5%. FGF: There was expression in 5 cases (20.8%) with a direct relation in all those with higher CAS (>5) (45.4%). VEGF: There were two positive cases (8.3%) for VEGF in endothelial cells, in these cases the patients also presented CAS higher than 5. There was no expressions of all growth factors in the control group.


CONCLUSIONS
All patients, except one, with positive expression of FGF, IGF-1 and VEGF showed CAS greater than 5, suggesting in this way an important role of these growth factors in the pathogenesis and severity of Graves' ophthalmopathy. However, statistical analysis revealed only significant association between IGF-1 and male sex (P=0.034). Low ultrasound reflectivity and endocrine status may not correlate directly with disease activity or with immunoexpression of growth factors and c-erbB-2/HER-2/neu.
Matos
Kimble
K
Department of Ophtalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil. kimblematos@hotmail.com
Manso
Paulo Gois
PG
Marback
Eduardo
E
Furlanetto
Reinaldo
R
Alberti
Gustave Nosé
GN
Nosé
Vania
V
D000273:Adipose Tissue / Q000378:metabolism / Q000473:pathology; D000328:Adult; D001706:Biopsy; D016022:Case-Control Studies; D003238:Connective Tissue / Q000378:metabolism*; D003627:Data Interpretation, Statistical; D005260:Female; D005346:Fibroblast Growth Factors / Q000032:analysis*; D049970:Graves Ophthalmopathy / Q000209:etiology / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000378:metabolism* / Q000473:pathology; D013285:Strabismus / Q000378:metabolism / Q000601:surgery; D042442:Vascular Endothelial Growth Factors / Q000032:analysis*
D042442:Vascular Endothelial Growth Factors; D005346:Fibroblast Growth Factors; D007334:Insulin-Like Growth Factor I