Kahaly G, Moncayo R, Stover C, Beyer J
III. Department of Medicine, Endocrinology and Metabolism, Johannes Gutenberg-University Hospital, Mainz, Federal Republic of Germany.
Res Exp Med (Berl). 1991;191(2):137-44. doi: 10.1007/BF02576669.
The relationship between endocrine orbitopathy and Graves' hyperthyroidism is still not clarified. The purpose of this study was to elucidate the incidence of eye muscle antibodies and the relationship with HLA phenotypes and thyroid antibodies in 65 patients with endocrine orbitopathy classes 1-5. Both bovine and abdominal muscles were used as antigens in ELISA systems in which IgG and IgM antibodies were assayed. Before starting the immunosuppressant therapy, 46/65 patients (71%) showed a positive result for eye muscle antibodies. Those patients with an active disease had such antibodies more frequently. Where the ophthalmopathy was of recent onset IgM antibodies were found, whereas patients with chronic disease were mostly IgG-Ab positive. No association was found either with HLA phenotypes (B8, DR3) or with antibodies directed against thyroglobulin, thyroid microsomes, and the TSH receptor measured as thyroid-stimulating immunoglobulins. Furthermore, there was no correlation between ophthalmopathy class and optic muscle antibody-binding activity. There was no relation between the degree of exophthalmos and eye muscle, thyroid-stimulating, antithyroglobulin, or antithyroid microsomal antibodies. These results suggest that, although very closely related, endocrine orbitopathy and Graves' hyperthyroidism are separate, organ-specific autoimmune diseases.
内分泌性眼眶病与格雷夫斯甲亢之间的关系仍未阐明。本研究的目的是阐明65例1 - 5级内分泌性眼眶病患者眼肌抗体的发生率及其与HLA表型和甲状腺抗体的关系。在ELISA系统中，以牛肌肉和腹直肌作为抗原检测IgG和IgM抗体。在开始免疫抑制治疗前，46/65例患者（71%）眼肌抗体检测呈阳性。那些患有活动性疾病的患者更频繁地出现此类抗体。近期发病的眼病患者可检测到IgM抗体，而慢性病患者大多为IgG抗体阳性。未发现与HLA表型（B8、DR3）或针对甲状腺球蛋白、甲状腺微粒体以及作为甲状腺刺激免疫球蛋白检测的TSH受体的抗体存在关联。此外，眼病分级与眼肌抗体结合活性之间无相关性。眼球突出程度与眼肌、甲状腺刺激、抗甲状腺球蛋白或抗甲状腺微粒体抗体之间无关联。这些结果表明，尽管内分泌性眼眶病与格雷夫斯甲亢密切相关，但它们是独立存在的器官特异性自身免疫性疾病。
