Huixia Li, Bin Wang, Qin Li, Qing Li, Jie Qiao, Dongping Lin, Chunhua Sui, Lin Ye, 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
{"title":"T细胞亚群与静脉注射4.5g糖皮质激素治疗中重度甲状腺相关性眼病的临床活性和疗效相关","authors":"Huixia Li, Bin Wang, Qin Li, Qing Li, Jie Qiao, Dongping Lin, Chunhua Sui, Lin Ye, 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","doi":"10.1080/07435800.2023.2219734","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objectives: </strong>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.</p><p><strong>Design and methods: </strong>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.</p><p><strong>Results: </strong>Abnormal TRAb (OR = 4.717; <i>P</i> = 0.019) and the percentage of CD3+CD4+ T cell (OR = 1.092; <i>P</i> = 0.028) were independently associated with the activity of moderate-to-severe TAO patients. The pretreatment CAS-max in both eyes (OR = 7.221; <i>P</i> = 0.013) and the percentage of pretreatment CD3+T cell (OR = 0.718; <i>P</i> = 0.037) were independently associated with therapeutic efficacy. The pretreatment CAS-max in both eyes (OR = 156.53; <i>P</i> = 0.028) and the percentage of post-treatment CD3+T cell (OR = 0.554; <i>P</i> = 0.043) were independently associated with therapeutic efficacy. Besides, multivariable prediction models were established, which were better in the forecasting aspect than single-variable prediction models.</p><p><strong>Conclusions: </strong>Based on the findings of this study, we should monitor the peripheral blood T cell subsets for TAO, which could be helpful to timely judge the condition of clinical manifestation and effect of treatment for TAO patients. Multivariable prediction models have been established, which have great significance for clinical work.</p>","PeriodicalId":11601,"journal":{"name":"Endocrine Research","volume":"48 2-3","pages":"55-67"},"PeriodicalIF":1.5000,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"T Cell Subsets are Associated with Clinical Activity and Efficacy of 4.5g Intravenous Glucocorticoid for Moderate-To-Severe Thyroid-Associated Ophthalmopathy.\",\"authors\":\"Huixia Li, Bin Wang, Qin Li, Qing Li, Jie Qiao, Dongping Lin, Chunhua Sui, Lin Ye, 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\",\"doi\":\"10.1080/07435800.2023.2219734\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Objectives: </strong>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.</p><p><strong>Design and methods: </strong>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.</p><p><strong>Results: </strong>Abnormal TRAb (OR = 4.717; <i>P</i> = 0.019) and the percentage of CD3+CD4+ T cell (OR = 1.092; <i>P</i> = 0.028) were independently associated with the activity of moderate-to-severe TAO patients. The pretreatment CAS-max in both eyes (OR = 7.221; <i>P</i> = 0.013) and the percentage of pretreatment CD3+T cell (OR = 0.718; <i>P</i> = 0.037) were independently associated with therapeutic efficacy. The pretreatment CAS-max in both eyes (OR = 156.53; <i>P</i> = 0.028) and the percentage of post-treatment CD3+T cell (OR = 0.554; <i>P</i> = 0.043) were independently associated with therapeutic efficacy. Besides, multivariable prediction models were established, which were better in the forecasting aspect than single-variable prediction models.</p><p><strong>Conclusions: </strong>Based on the findings of this study, we should monitor the peripheral blood T cell subsets for TAO, which could be helpful to timely judge the condition of clinical manifestation and effect of treatment for TAO patients. Multivariable prediction models have been established, which have great significance for clinical work.</p>\",\"PeriodicalId\":11601,\"journal\":{\"name\":\"Endocrine Research\",\"volume\":\"48 2-3\",\"pages\":\"55-67\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2023-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Endocrine Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/07435800.2023.2219734\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/07435800.2023.2219734","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
T Cell Subsets are Associated with Clinical Activity and Efficacy of 4.5g Intravenous Glucocorticoid for Moderate-To-Severe Thyroid-Associated Ophthalmopathy.
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 independently associated with therapeutic efficacy. Besides, multivariable prediction models were established, which were better in the forecasting aspect than single-variable prediction models.
Conclusions: Based on the findings of this study, we should monitor the peripheral blood T cell subsets for TAO, which could be helpful to timely judge the condition of clinical manifestation and effect of treatment for TAO patients. Multivariable prediction models have been established, which have great significance for clinical work.
期刊介绍：
This journal publishes original articles relating to endocrinology in the broadest context. Subjects of interest include: receptors and mechanism of action of hormones, methodological advances in the detection and measurement of hormones; structure and chemical properties of hormones. Invitations to submit Brief Reviews are issued to specific authors by the Editors.
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