Роль растворимой формы межклеточной молекулы адгезии ICAM-1 в ранней диагностике и оценке эффективности терапии аутоиммунной офтальмопатии у больных диффузным токсическим зобом

Abstract

sIСАМ-1 was measured in the sera of 156 patients with diffuse toxic goiter (DTG). The majority (105) of these patients presented with clinical signs of autoimmune ophthalmopathy (AO), and the above parameter was measured in order to assess the probability of using it as a criterion of preclinical diagnosis of AO and assessment of the efficacy of its therapy. Five groups of patients were distinguished in the course of study: 1) DTG without AO (n = 27); 2) zero stage of AO (no clinical manifestations) (n = 24); 3) stage I AO (n — 22); 4) stage II AO (n = 60); and 5) stage III AO (n = 23). All patients were in a state of drug-induced euthyrosis; AO of the first-third stages wasttreated traditionally (nonsteroid antiinflammatory drugs, glucocorticoids, radiotherapy of the orbits). Significant changes in sICAM-1 concentration were recorded in DTG patients as early as during the zero stage of AO without apparent clinical signs and confirmed only by computer- aided tomography of the orbits; this result recommends this parameter as an early marker of AO. Serum sICAM-1 content was notably increased in DTG patients with AO, the increase depending on the severity of AO. Changes of si CAM-1 correlated with the clinical picture of the condition (time course of the orbital and muscle index and size of the orbit) and can be used as an additional criterion for assessing the efficacy of treatment of AO.