T Cell Subsets are Associated with Clinical Activity and Efficacy of 4.5g Intravenous Glucocorticoid for Moderate-To-Severe Thyroid-Associated Ophthalmopathy

作者：H.-Y. Li, Bin Wang, Qin Li, Qing Li, Jie Qiao, Dongping Lin, Chunhua Sui, Ye Lin, Hualing Zhai, Boren Jiang, Ningjian Wang, Bing Han, Mengda Jiang, Xiaofeng Tao, Ziyang Shao, Chenfang Zhu, Yubo Ma, Ping Xiong, Jing Sun, Huifang Zhou, Yingli Lu · 发表于：Endocrine Research · 年份：2023 · DOI：10.1080/07435800.2023.2219734 · 被引用次数：17 · 研究领域：Ophthalmology and Eye Disorders、Thyroid Disorders and Treatments、Thyroid Cancer Diagnosis and Treatment

Background Intravenous glucocorticoid (IVGC) remains the main treatment for moderate-to-severe and active thyroid-associated ophthalmopathy (TAO). However, a substantial number (20–30%) of active moderate-to-severe TAO patients may not respond to IVGC. Some patients may have disease progression despite IVGC treatment or relapse after steroid withdrawal.Objectives To analyze risk factors for clinical activity and predictive factors for clinical outcomes of 4.5 g IVGC therapy in patients with moderate-to-severe TAO.Design and methods Our study was performed in two steps: step 1 involved 110 moderate-to-severe TAO patients and analyzed risk factors for TAO activity; step 2 involved 53 active moderate-to-severe TAO patients from step 1 who were treated with 4.5 g IVGC therapy and analyzed predictive factors for clinical outcomes of IVGC therapy. Multivariate logistic regression analysis was used to identify the independent predictors and establish the predictive model.Results Abnormal TRAb (OR = 4.717; P = 0.019) and the percentage of CD3+CD4+ T cell (OR = 1.092; P = 0.028) were independently associated with the activity of moderate-to-severe TAO patients. The pretreatment CAS-max in both eyes (OR = 7.221; P = 0.013) and the percentage of pretreatment CD3+T cell (OR = 0.718; P = 0.037) were independently associated with therapeutic efficacy. The pretreatment CAS-max in both eyes (OR = 156.53; P = 0.028) and the percentage of post-treatment CD3+T cell (OR = 0.554; P = 0.043) were ...