The Evolving Role of Selenium in the Treatment of Graves' Disease and Ophthalmopathy
Figure 1
(a) Schematic presentation of the cascade of events in the pathogenesis of Graves’ ophthalmopathy. Secretion of cytokines, such as IFN-γ and IL-2, by activated helper cells result in activation of B cells and secretion of TSH receptor antibodies. These bind to the TSH receptor in the orbital fibroblast and on the thyroid follicular cells, thereby, extending muscle enlargement resulting in oedema. (b) Selenium by suppressing cytokines production considerably attenuates the inflammation leading to alleviation of symptoms and signs. Abbreviations: HLA: human leukocyte antigen; APC: antigen presenting cell; IFN-γ: interferon-γ; IL-1: interleukin-1; TRAB: TSH-receptor antibodies; GAG: glycosaminoglycans.
