Understanding the pathogenesis of Graves' orbitopathy: A new age paradigm

Abstract

Graves' orbitopathy or thyroid associated orbitopathy (TAO) is a disquieting condition both for the patient and the clinician. While the mainstay of treatment of the orbitopathy is corticosteroids, its action is non-specific. The arguments against its use also include multiple side effects and recurrence on stopping it. While some clinicians are complacent with the drug due to our long term experience with it, many are in search for specific so called 'targeted' treatment. The autoimmune process in TAO is rather complex where multiple cytokines act at more than one level making it challenging to control the inflammation. Hence, in order to discover better treatment strategies, having a sound understanding of the pathogenesis of the disease is essential.

Keywords: Graves, Orbital fibroblasts, Autoimmunity..