Hutan
Senior Member
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- 1,099
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- New Zealand
Just lately it feels as if nearly everything can be fixed by rituximab.
Yesterday I posted papers suggesting rituximab is useful for Raynaud's disease and granuloma annulare.
I and my family have ME, Raynaud's and granuloma annulare. Which brings me to Graves eye disease...
My Graves eye disease started roughly 10 years before the ME. Graves eye disease is also called thyroid eye disease - it is usually associated with hyperthyroidism. For me though, tests at onset and subsequently have never found a problem with my thyroid.
So, this paper suggests that rituximab can help this condition too.
The Pathophysiology of Thyroid Eye Disease (TED): Implications for Immunotherapy
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3512192/
Curr Opin Ophthalmol. Author manuscript; available in PMC 2012 Dec 3.
Published in final edited form as: Curr Opin Ophthalmol. 2011 Sep; 22(5): 385–390.
The link (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3512192/) gives the full author's manuscript. I found much of interest in it including:
Rituximab in the Treatment of Thyroid Eye Disease: A Review
Neuroophthalmology. 2015 Jun; 39(3): 109–115.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5123122/
Yesterday I posted papers suggesting rituximab is useful for Raynaud's disease and granuloma annulare.
I and my family have ME, Raynaud's and granuloma annulare. Which brings me to Graves eye disease...
My Graves eye disease started roughly 10 years before the ME. Graves eye disease is also called thyroid eye disease - it is usually associated with hyperthyroidism. For me though, tests at onset and subsequently have never found a problem with my thyroid.
So, this paper suggests that rituximab can help this condition too.
The Pathophysiology of Thyroid Eye Disease (TED): Implications for Immunotherapy
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3512192/
Curr Opin Ophthalmol. Author manuscript; available in PMC 2012 Dec 3.
Published in final edited form as: Curr Opin Ophthalmol. 2011 Sep; 22(5): 385–390.
Purpose of Review
Thyroid eye disease (TED) is a poorly understood autoimmune manifestation most commonly associated with Graves’ disease. Current nonspecific treatment paradigms offer symptomatic improvement but fail to target the underlying pathogenic mechanisms and thus, do not significantly alter the long-term disease outcome. The purpose of this review is to provide an update of the current understanding of the immunopathogenesis of TED and explore these implications for targeted immunotherapy.
Recent Findings
Orbital fibroblasts are integral to the pathogenesis of TED and may modulate immune responses by production of cytokines and hyaluronan in response to activation of shared autoantigens including thyrotropin receptor (TSHR) and insulin-like growth factor-1 receptor (IGF-R1). Fibrocytes share many of these phenotypic and functional features, suggesting a link between systemic and site-specific disease. Use of targeted immunotherapies in TED is limited, though data from the use Rituximab (RTX), a B cell depleting agent, are encouraging. Sustained clinical response has been seen with RTX in several reports, despite return of peripheral B cell levels to pretreatment levels. Additionally, this response appears to be independent to cytokine and antibody production, suggesting possible modulation of antigen presentation as a mechanism of its effect.
Summary
Progressive advances in the understanding of the immunopathogenesis of TED continue to spur clinical trials utilizing targeted immune therapies. Continued understanding of the molecular mechanisms of disease will expand potential treatments for TED patients and obviate the need for reconstructive surgical therapies.
The link (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3512192/) gives the full author's manuscript. I found much of interest in it including:
- In thyroid eye disease, fibrocytes from bone marrow infiltrate orbital tissues. Orbital fibroblasts from people with thyroid eye disease uniquely express several potentially important inflammatory molecules, including CD34, CD40, and many cytokines.
- Selenium has been found to help in a double-blind trial
- Anti-cytokine therapies (infliximab), t-cell targeting therapies, b=cell targeting therapies (rituximab) all seem useful
- Rituximab led to improvements at one month and improvements were sustained at 1 year followup. Some possible rituximab side effects are noted.
Rituximab in the Treatment of Thyroid Eye Disease: A Review
Neuroophthalmology. 2015 Jun; 39(3): 109–115.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5123122/
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