Abstract
Graves' ophthalmopathy is thought to be an autoimmune disease. Whether this disease is organ specific or one of the manifestations of the closely linked Graves' thyroid disease is still a matter of speculation. Many papers describe autoimmunity to orbital antigens, in particular to extraocular muscles, in patients with Graves' ophthalmopathy. In this paper we have tried to give an overview of the evidence for circulating antibodies against extraocular muscle antigens and to discuss their significance in relation to the immunopathogenesis of the disease.
Similar content being viewed by others
References
Gorman CA. Graves' disease: an overview. In: The eye and orbit in thyroid disease. Raven Press 1984: 1–4.
Wall JR. Autoimmunity and Graves' ophthalmopathy. In: The eye and orbit in thyroid disease. Raven Press 1984: 103–20.
Kendall-Taylor P. The pathogenesis of Graves' ophthalmopathy. Clin Endocrinol Metab 1985; 14: 331–49.
Kodama K, Sikorska H, Bandy-Dafoe P, Bayly R, Wall JR. Demonstration of a circulating autoantibody against a soluble eye-muscle antigen in Graves' ophthalmopathy. Lancet 1982; ii: 1353–6.
Ahmann A, Baker JR, Weetman AP, Wartofsky L, Nutman TB, Burman KD. Antibodies to porcine eye muscle in patients with Graves' ophthalmopathy: Identification of serum immunoglobulins directed against unique determinants by immunoblotting and enzyme-linked immunosorbent assay. J Clin Endocrinol 1987; 64: 454–60.
Kadlubowski M, Irvine WJ, Rowland AC. The lack of specificity of ophthalmic immmunoglobulins in Graves' disease. J Clin Endorinol Metab 1986; 63: 1–6.
Faryna M, Nauman J, Gardas A. Measurement of autoantibodies against human eye muscle plasma membranes in Graves' ophthalmopathy. Br Med J 1985; 290: 191–2.
Atkinson S, Holcombe M, Kendall-Taylor P. Ophthalmic immunoglobulin in patients with Graves' ophthalmopathy. Lancet 1984; ii: 374–6.
Kendall-Taylor P, Atkinson S, Holcombe M. A specific IgG in Graves' ophthalmopathy and its relation to retroorbital and thyroid autoimmunity. Br Med J 1984; 288: 1183–6.
Miller A, Sikorska H, Salvi M, Wall JR. Evaluation of an enzyme-linked immunosorbent assay for the measurement of autoantibodies against eye muscle membrane antigens in Graves' ophthalmopathy. Acta Endocrinol (Copenh) 1986; 113: 514–22.
Mengistu M, Laryea E, Miller A, Wall JR. Clinical significance of a new autoantibody against human eye muscle soluble antigen, detected by immunofluorescence. Clin Exp Immunol 1986; 65: 19–27.
Bemetz U, Moncayo R, Scherbaum W, Frisch H, Badenhoop K, Hool G, Schleussener H, Pfeiffer EF. Detection of IgG and IgM antibodies directed against eye and peripheral muscle preparations in juvenile and adult patients with Graves' disease and in patients with hypothyroidism. In: The thyroid and autoimmunity. Excerpta Medica. International congress series 1986; 711: 250–2.
Wang PW, Hiromatsu Y, Laryea E, Wosu L, How J, Wall JR. Immunologically mediated cytotoxicity against human eye muscle cells in Graves' ophthalmopathy. J Clin Endocrinol Metab 1986; 63: 316–22.
Hiromatsu Y, Fukazawa H, How J, Wall JR. Antibody-dependent cell-mediated cytotoxicity against human eye muscle cells and orbital fibroblasts in Graves' ophthalmopathy. Roles of class II MHC antigen expression and gamma-interferon action on effector and target cells. Clin exp Immunol 1987; 70: 593–603.
Mahieu P, Winand RJ. Demonstration of delayed hypersensitivity to retrobulbar and thyroid tissues in human exophthalmos. J Clin Endocrinol Metab 1972; 34: 1090–2.
Mullin BR, Levinson RE, Friedman A, Henson DE, Winand RJ, Kohn LD. Delayed hypersensitivity in Graves' disease and exophthalmos: Identification of thyroglobulin in normal human orbital muscle. Endocrinology 1977; 100: 351–66.
Blau HM, Kaplan I, Tao TW, Kriss JP. Thyroglobulin-independent, cell-mediated cytotoxicity of human eye muscle cells in tissue culture by lymphocytes of a patient with Graves' ophthalmopathy. Life Sci 1983; 32: 45–53.
Weetman AP, Panagiotidi C, Fella P, Shine B. T- and B-cell responses to human eye muscle in Graves' ophthalmopathy. Abstract book BSI, Spring meeting 1988; page 118.
Bahn RS, Gorman CA, Woloschak GE, David CS, Johnson PM, Johnson CM. Human retroocular fibroblasts in vitro: a model for the study of Graves' ophthalmopathy. J Clin Endocrinol Metab 1987; 65: 665–70.
Rotella CM, Zonefrati R, Toccafondi R, Valente WA, Kohn LD. Ability of monoclonal antibodies to the thyrotropin receptor to increase collagen synthesis in human fibroblasts: an assay which appears to measure exophthalmogenic immunoglobulins in Graves' sera. J Clin Endocrinol Metab 1986; 62: 357–67.
Kroll AJ, Kuwabara T. Dysthyroid ocular myopathie. Anatomy, Histology and electron microscopy. Arch Ophthalmol 1966; 76: 244–57.
Hufnagel TJ, Hickey WF, Cobbs WH, Jakobiec FA, Iwamoto T, Eagle R. Immunohistochemical and ultrastructural studies on the exenterated orbital tissues of a patient with Graves' disease. Ophthalmology 1984; 91: 1411–9.
Tallstedt L, Norberg R. Immunohistochemmical staining of normal and Graves' extraocular muscle. Invest Ophthalmol Vis Sci 1988; 29: 175–84.
Koornneef L. Spatial aspects of orbital musculo-fibrous tissue in man. Amsterdam: Zwets and Zeitlinger BV, 1976.
Koornneef L. Eyelid and orbital fascial attachments and their clinical significance. Eye 1988; 2:130–4.
Wegelius O, Asboe-Hansen G, Lamberg BA. Retrobulbar connective tissue changes in malignant exophthalmos. Acta Endocrinol 1957; 25: 452–6.
Sikorska H, Wall JR. Failure to detect eye muscle membrane specific autoantibodies in Graves' ophthalmopathy. Br Med J 1985; 291: 604.
Sikorska H, Miller A, Wall JR. Analysis of nonspecific reaction in enzyme linked immunosorbent assay testing for human eye muscle specific antibodies in Graves' ophthalmopathy and Hashimoto's thyroiditis. In: Autoimmunity and the thyroid. Academic Press 1985: 335–6.
Werner SC, Coleman DJ, Franzen LA. Ultrasonographic evidence of a consistent orbital involvement in Graves' disease. N Engl J Med 1974; 290: 1447–50.
Gamblin GT, Harper DG, Galentine P, Buck DR, Chernow B, Eil C. Prevalence of increased intraocular pressure in Graves' disease. Evidence of frequent subclinical ophthalmopathy. N Engl J Med 1983; 308: 420–4.
Wiersinga WM, Smit T, van der Gaag R, Koornneef L. Temporal relationship between onset of Graves' ophthalmopathy and onset of thyroidal Graves' disease. J Endocrinol Invest 1988; 11: 615–19.
Wieczorek DF, Periasamy M, Butler-Browne GS, Whalen RG, Nadal-Ginard B. Co-expression of multiple myosin heavy chain genes, in addition to a tissue-specific one, in extraocular musculature. J Cell Biol 1985; 101: 618–29.
Sartore S, Mascarello F, Rowlerson A, Gorza L, Ausoni S, Vianello M, Schiaffino S. Fibre types in extraocular muscles: a new myosin isoform in the fast fibres. J Musc Res Cell Motil 1987; 8: 161–72.
Asboe-Hansen G, Iversen K, Wichmann R. Malignant exophthalmos. Muscular changes and thyrotrophin content in serum. Acta Endocrinol 1952; 11: 376–99.
Florini JR. Hormonal control of muscle growth. Muscle & Nerve 1987; 10: 577–98.
Gonnering RS, Dortzbach RK, Erikson KA, Kaufman PL. The cynomolgus monkey as a model for orbital research. I. Normal anatomy. Curr Eye Res 1984; 3: 529–40.
Ringel SP, Wilson B, Barden MT, Kaiser KK. Histochemistry of the human extraocular muscle. Arch Ophthalmol 1978; 96: 1067–72.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
van der Gaag, R., Vernimmen, R., Fiebelkorn, N. et al. Graves' ophthalmopathy: What is the evidence for extraocular muscle specific autoantibodies. Int Ophthalmol 14, 25–30 (1990). https://doi.org/10.1007/BF00131165
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00131165