Specific immune status in patients with active thyroid-associated orbitopathy before and after methylprednisolone therapy

Abstract

Abstract Purpose:Therapy with intravenous glucocorticoids (GCs) is a safe, effective, and cost-effective first-line treatment modality used by most clinicians to treat thyroid-associated orbitopathy (TAO). The disturbing of immune function play key roles in the pathogenesis of TAO. However, the impact of GCs on immune status in TAO patients is unclear.This study aim to investigate the influence of intravenous methylprednisolone(IVMP) pulse administration on the immune status of patients with active TAO. Methods:Patients with active moderate-to-severe TAO were enrolled. All patients treated with IVMP pulses (6×0.5 g on a weekly schedule, accumulating dosage: 3.0 g) throughout the study period. Immune status was assessed using the peripheral blood of patients before and after IVMP pulse treatment by using mass cytometry for accurate immunotyping of cell populations. Patients’ clinical activities were assessed using the clinical activity score (CAS). Statistical analyses were performed using t-test. Statistical significance was set at P ≤ 0.05. Results:Six patients with active moderate-to-severe TAO were recruited. The CAS decreased significantly from a median of 4.2 (range 3.0–5.0) to 1.5 (1.0–2.0) after IVMP pulse therapy. The rate of activated T cells (expressing HLA-DR), central memory Th1 cells, central memory Th2 cells, conventional DC (cDC) cells in TAO patients have been decreased after IVMP pulse therapy, but the rate of natural killer cells increased. Conclusion:The relieved of the CAS in patients with active TAO receiving IVMP therapy, were accompany with a decrease in activated T cells, central memory T cells and cCDs.