Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston University, Boston, Massachusetts, USA.
Laryngoscope. 2011 Mar;121(3):656-60. doi: 10.1002/lary.21392. Epub 2010 Nov 18.
To compare radiographic sinus mucosal thickening in patients with Graves' orbitopathy versus controls and determine whether target autoantigens thought to underlie systemic manifestations of Graves' disease are present within paranasal sinus mucosa.
Case-control study.
Sinus computed tomography (CT) scans from patients with Graves' orbitopathy scheduled for orbital decompression surgery (n = 50) were compared with maxillofacial CT scans from control patients (n = 50). Scans were rated for sinus mucosal disease by two independent reviewers using the Lund-MacKay and Harvard staging systems. Gene expression for thyrotropin receptor and type 1 insulin-like growth factor receptor (IGF-1R) was assessed in ethmoid mucosal samples using real-time quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry (IHC).
Increased sinus mucosal thickening was found in patients with Graves' orbitopathy compared with controls for both the Lund-MacKay (6.2 vs. 2.7; P < .01) and Harvard (2.1 vs. 1.3; P < .01) systems. Compared with control scans, the Graves' orbitopathy group exhibited greater mucosal thickening in the ethmoid, frontal, and sphenoid sinuses (P < .05 for all). RT-qPCR and IHC demonstrated gene expression for both the thyrotropin receptor and the IGF-1R in ethmoid mucosa.
Patients with Graves' orbitopathy who present for orbital decompression exhibit a higher prevalence of sinus mucosal thickening on CT scan. These findings may be explained by circulating autoantibodies to target antigens, thyrotropin receptor and IGF-1R, associated with Graves' disease and found to be expressed in sinus mucosa.
比较格雷夫斯眼病（Graves' orbitopathy）患者与对照组的鼻窦黏膜增厚的放射影像学表现，并确定是否存在潜在的全身格雷夫斯病表现的靶向自身抗原。
病例对照研究。
对拟行眼眶减压术的格雷夫斯眼病患者（n=50）的鼻窦计算机断层扫描（CT）与对照组患者（n=50）的颌面 CT 进行比较。由两位独立的观察者采用 Lund-MacKay 和 Harvard 分期系统对鼻窦黏膜疾病进行评分。使用实时定量聚合酶链反应（RT-qPCR）和免疫组织化学（IHC）评估筛窦黏膜中促甲状腺激素受体（thyrotropin receptor）和 1 型胰岛素样生长因子受体（type 1 insulin-like growth factor receptor，IGF-1R）的基因表达。
与对照组相比，格雷夫斯眼病患者的鼻窦黏膜增厚更为明显，无论是 Lund-MacKay 评分（6.2 比 2.7；P<.01）还是 Harvard 评分（2.1 比 1.3；P<.01）。与对照组相比，格雷夫斯眼病组的筛窦、额窦和蝶窦黏膜均显示出更大的黏膜增厚（所有 P<.05）。RT-qPCR 和 IHC 显示筛窦黏膜中存在促甲状腺激素受体和 IGF-1R 的基因表达。
接受眼眶减压术的格雷夫斯眼病患者的 CT 扫描显示更高的鼻窦黏膜增厚发生率。这些发现可能可以用与格雷夫斯病相关的针对靶抗原（促甲状腺激素受体和 IGF-1R）的循环自身抗体来解释，这些自身抗体在鼻窦黏膜中表达。
