Endocrinology Unit I, Department of Clinical and Experimental Medicine, University Hospital of Pisa, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
Division of Immunology, Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, MD, USA.
J Endocrinol Invest. 2019 Apr;42(4):471-480. doi: 10.1007/s40618-018-0943-8. Epub 2018 Aug 21.
A role of the insulin-like growth factor-1 receptor (IGF-1R) in the pathogenesis of Graves' orbitopathy (GO) has been proposed, but the existence and function of anti-IGF-1R-antibodies (IGF-1R-Abs) are debated.
We designed a cross-sectional investigation to measure serum IGF-1R-Abs by a commercial assay in consecutive patients with Graves' disease (GD) compared with healthy subjects and patients with autoimmune thyroiditis (AT). A total of 134 subjects were screened including 27 healthy subjects, 80 GD patients (54 of whom with GO), and 27 AT patients. The main outcome measure was the prevalence of positive serum IGF-1R-Abs in GO, compared with GD without GO and with the other study groups.
Having established a cut-off value at 55.2 ng/ml for positive tests, positive IGF-1R-Abs were more frequent in GD (25%), than in AT (3.7%, P = 0.003) and healthy subjects (0%, P = 0.006). Within GD, there was no difference between patients with or without GO. Serum levels of IGF-1R-Abs differed across the study population (P < 0.0001), reflecting their higher concentrations in GD (P < 0.0001 vs both AT and healthy subjects), but with no difference between patients with or without GO. In patients with GO, there was an inverse correlation between serum IGF-1R-Abs and CAS (R = - 0.376, 95% CI: from - 0.373 to - 0.631; P = 0.005), the significance of which remains to be investigated.
Serum autoantibodies against the IFG-1R are present in one-fourth of GD patients, regardless of the presence of GO. Further functional studies are needed to investigate the significance of their inverse correlation with GO activity.
胰岛素样生长因子-1 受体 (IGF-1R) 在格雷夫斯眼病 (GO) 的发病机制中起作用，但其存在和功能存在争议。
我们设计了一项横断面研究，通过商业检测在连续的 Graves 病 (GD) 患者中测量血清 IGF-1R-Abs，与健康受试者和自身免疫性甲状腺炎 (AT) 患者进行比较。共筛选了 134 名受试者，包括 27 名健康受试者、80 名 GD 患者（其中 54 名患有 GO）和 27 名 AT 患者。主要观察指标是 GO 患者与无 GO 的 GD 患者以及其他研究组相比，血清 IGF-1R-Abs 阳性的患病率。
确定阳性检测的截断值为 55.2ng/ml 后，IGF-1R-Abs 在 GD 中（25%）比 AT 中（3.7%，P=0.003）和健康受试者中（0%，P=0.006）更为常见。在 GD 中，有无 GO 的患者之间没有差异。IGF-1R-Abs 的血清水平在研究人群中存在差异（P<0.0001），反映了其在 GD 中的浓度更高（P<0.0001 与 AT 和健康受试者相比），但有无 GO 的患者之间没有差异。在 GO 患者中，血清 IGF-1R-Abs 与 CAS 呈负相关（R=-0.376，95%CI：-0.373 至-0.631；P=0.005），其意义仍有待进一步研究。
IGF-1R 的自身抗体存在于四分之一的 GD 患者中，无论是否存在 GO。需要进一步的功能研究来研究其与 GO 活动之间的负相关的意义。
