CYTOKINES IN THE EVOLUTION OF GRAVES OPHTHALMOPATHY

Infiltration of the retroocular space by inflammatory cells and the ac cumulation of glycosaminoglycans are histological characteristics of G raves' ophthalmopathy, Various cytokines, released by infiltrating imm unocompetent cells and resident connective tissue cells, play a pivota l role in the evolution of this disease, The predominant cytokines sec reted by orbital T cells during the course of the disease may govern t he activity and stage of the local autoimmune process. Cytokine effect s of potential relevance to the pathogenesis of Graves' ophthalmopathy include their ability to stimulate orbital fibroblasts to proliferate and secrete excess quantities of glycosaminoglycans. The edema associ ated with these hydrophilic macromolecules is directly responsible for many of the characteristic clinical features of the disease. In addit ion, certain cytokines induce or enhance the expression on orbital fib roblasts of immunomodulatory proteins. We review current evidence supp orting the notion that cytokines are central to the development and ev olution of Graves' ophthalmopathy (149 words).