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Mediators of Inflammation
Volume 2014, Article ID 412158, 9 pages
Research Article

Markers of Inflammation and Fibrosis in the Orbital Fat/Connective Tissue of Patients with Graves’ Orbitopathy: Clinical Implications

1Department of Medical Pathomorphology, Cathedral of Biostructure, Medical University of Białystok, 13 Waszyngtona Street, 15-269 Białystok, Poland
2Department of Pediatric Ophthalmology with Strabismus Treatment Unit, Medical University of Białystok, 17 Waszyngtona Street, 15-274 Białystok, Poland
3Department of Ophthalmology, University Hospital Essen and University of Duisburg-Essen, Hufeland Straße 55, 45-122 Essen, Germany
4Bayer Healtcare, Kaiser-Wilhelm-Allee 10, Leverkusen, 51-373 Nordshein-Westfalen, Germany
5Department of Ophthalmology, Poznań City Hospital, 3 Szwajcarska Street, 61-285 Poznań, Poland
6Department of Ophthalmology, University of Warmia and Mazury, 30 Warszawska Street, 10-082 Olsztyn, Poland
7Department of Nuclear Medicine, Medical University of Białystok, 24A Skłodowskiej-Curie Street, 15-276 Białystok, Poland

Received 16 May 2014; Revised 6 August 2014; Accepted 9 August 2014; Published 17 September 2014

Academic Editor: Valentin Huerva

Copyright © 2014 Przemyslaw Pawlowski et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To assess FGF-, TGF-, and COX2 expression and immunocompetent cells in the orbital tissue of patients with severe and mild Graves’ orbitopathy. Patients and Methods. Orbital tissue was taken from 27 patients with GO: (1) severe GO (), the mean clinical activity score (CAS) being 8.5 (SD 2.5); and (2) mild GO (), the mean CAS being 2.2 (SD 0.8), and from 10 individuals undergoing blepharoplasty. The expression of CD4+, CD8+, CD20+, and CD68 and FGF-, TGF-, and COX2 in the orbital tissue was evaluated by immunohistochemical methods. Results. We demonstrated predominant CD4+ T cells in severe GO. CD68 expression was observed in the fibrous connective area of mild GO and was robust in severe GO, while the prominent TGF- expression was seen in all GO. Increased FGF- expression was observed in the fibroblasts and adipocytes of severe GO. No expression of COX2 was found in patients with GO. Conclusions. Macrophages and CD4 T lymphocytes are both engaged in the active/severe and long stage of inflammation in the orbital tissue. FGF- and TGF- expression may contribute to tissue remodeling, fibrosis, and perpetuation of inflammation in the orbital tissue of GO especially in severe GO.