title: Markers of inflammation and fibrosis in the orbital fat/connective tissue of patients with Graves' orbitopathy: clinical implications.
abstract: OBJECTIVE
  To assess FGF-β, TGF-β, and COX2 expression and immunocompetent cells in the orbital tissue of patients with severe and mild Graves' orbitopathy.
  
  
  METHODS
  Orbital tissue was taken from 27 patients with GO: (1) severe GO (n = 18), the mean clinical activity score (CAS) being 8.5 (SD 2.5); and (2) mild GO (n = 9), the mean CAS being 2.2 (SD 0.8), and from 10 individuals undergoing blepharoplasty. The expression of CD4+, CD8+, CD20+, and CD68 and FGF-β, TGF-β, and COX2 in the orbital tissue was evaluated by immunohistochemical methods.
  
  
  RESULTS
  We demonstrated predominant CD4+ T cells in severe GO. CD68 expression was observed in the fibrous connective area of mild GO and was robust in severe GO, while the prominent TGF-β expression was seen in all GO. Increased FGF-β expression was observed in the fibroblasts and adipocytes of severe GO. No expression of COX2 was found in patients with GO.
  
  
  CONCLUSIONS
  Macrophages and CD4 T lymphocytes are both engaged in the active/severe and long stage of inflammation in the orbital tissue. FGF-β and TGF-β expression may contribute to tissue remodeling, fibrosis, and perpetuation of inflammation in the orbital tissue of GO especially in severe GO.
authors.affiliation: Department of Medical Pathomorphology, Cathedral of Biostructure, Medical University of Białystok, 13 Waszyngtona Street, 15-269 Białystok, Poland ; Department of Pediatric Ophthalmology with Strabismus Treatment Unit, Medical University of Białystok, 17 Waszyngtona Street, 15-274 Białystok, Poland.
authors.forename: Przemyslaw
authors.initials: P
authors.lastname: Pawlowski
authors.affiliation: Department of Medical Pathomorphology, Cathedral of Biostructure, Medical University of Białystok, 13 Waszyngtona Street, 15-269 Białystok, Poland.
authors.forename: Joanna
authors.identifier: 0000-0002-0169-0897
authors.initials: J
authors.lastname: Reszec
authors.affiliation: Department of Ophthalmology, University Hospital Essen and University of Duisburg-Essen, Hufeland Straße 55, 45-122 Essen, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Eckstein
authors.affiliation: Bayer Healtcare, Kaiser-Wilhelm-Allee 10, Leverkusen, 51-373 Nordshein-Westfalen, Germany.
authors.forename: Kristian
authors.initials: K
authors.lastname: Johnson
authors.affiliation: Department of Ophthalmology, Poznań City Hospital, 3 Szwajcarska Street, 61-285 Poznań, Poland ; Department of Ophthalmology, University of Warmia and Mazury, 30 Warszawska Street, 10-082 Olsztyn, Poland.
authors.forename: Andrzej
authors.identifier: 0000-0002-3724-2391
authors.initials: A
authors.lastname: Grzybowski
authors.affiliation: Department of Medical Pathomorphology, Cathedral of Biostructure, Medical University of Białystok, 13 Waszyngtona Street, 15-269 Białystok, Poland.
authors.forename: Lech
authors.initials: L
authors.lastname: Chyczewski
authors.affiliation: Department of Nuclear Medicine, Medical University of Białystok, 24A Skłodowskiej-Curie Street, 15-276 Białystok, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Mysliwiec
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D003238:Connective Tissue / Q000378:metabolism*; D005260:Female; D005355:Fibrosis / Q000378:metabolism*; D049970:Graves Ophthalmopathy / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D066298:In Vitro Techniques; D007249:Inflammation / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000378:metabolism*
chemical_list: D015415:Biomarkers