muramidase and Graves-Disease

Graves' orbitopathy (GO) is an autoimmune inflammatory ocular complication and one of the most frequent manifestations of Graves' disease (GD). Clinical judgment of GO is subjective sometimes leading to clinical and therapeutic challenges. Better tools to diagnose this severe complication are warranted.. The aim of the present study was to evaluate tear levels of LYZ, LACRT and AZGP1 in GD patients with or without GO, as possible biomarkers for GO. Tear samples were collected from GD patients with moderate-to-severe GO (n = 21) and no clinical signs of GO (n = 21). Additionally, 18 GD patients with mild GO and 9 patients without GO were included in a further part of the study.. Tear levels of LYZ (p < 0.001), LACRT (p = 0.004) and AZGP1 (p = 0.001) were significantly elevated in GD patients with moderate-to-severe GO compared to GD patients without GO. The discriminatory power of the three biomarkers, combined in a panel was confirmed by ROC plot analysis, with an AUC value of 0.93 (sensitivity of 95%; specificity of 80%). Since LYZ showed the best performance in discriminating between GD patients with (moderate-to-severe) and without GO (in combination with limited sample volume available), LYZ levels were also measured in tears from GD patients with mild GO and without GO. Significantly higher levels of LYZ were measured in GD patients with mild GO compared to those without GO (p = 0.003).. We have established a novel three-protein biomarker panel that is able to discriminate between GD patients with and without GO, which might aid in diagnostic evaluation of GO as well as an indicator for disease activity.

Topics: Adult; Aged; Biomarkers; Diagnosis, Differential; Enzyme-Linked Immunosorbent Assay; Eye Proteins; Female; Glycoproteins; Graves Disease; Graves Ophthalmopathy; Humans; Male; Middle Aged; Muramidase; ROC Curve; Seminal Plasma Proteins; Severity of Illness Index; Tears; Young Adult; Zn-Alpha-2-Glycoprotein

Disease caused by goiter is marked by changes in cellular and humoral unspecific resistance before and after operation, which at times is of decisive importance in the course of the postoperative period. Natural resistance is inhibited, to a greater measure, in patients with a long history of the disease and in those with diffuse toxic goiter. The work deals with the study of natural resistance in 98 patients with goiter before and after the operation in dynamics. The immunostimulator lysozyme was used for a more favourable course of the postoperative period. This promoted increase of the organism's natural resistance. which had a favourable effect on the course of the postoperative period.

Topics: Adjuvants, Immunologic; Adult; Female; Goiter, Nodular; Graves Disease; Humans; Immune Tolerance; Immunity, Innate; Male; Middle Aged; Muramidase; Preoperative Care

Using an enzyme linked immuno-assay (ELISA) and spectrophotometry, we determined levels of secretory IgA and lysozyme in tears of 69 patients with Graves' ophthalmopathy and 28 controls. The quantitative determination of secretory IgA and lysozyme in tears provided an impression of the functioning of the lacrimal gland in the two groups. An IgA/lysozyme ratio was calculated in both patients and controls as a parameter for the activity of the secretory IgA-producing plasma cells in the lacrimal gland. An increase in the IgA/lysozyme ratio was observed in 23 patients (33%) and one control (3%). Half of the patients who had suffered from the disease for more than 5 years showed a raised IgA/lysozyme ratio. No correlation was found between the IgA/lysozyme ratio and the NOSPECS classification. Our findings suggest that the lacrimal gland is involved in the orbital condition produced by Graves' ophthalmopathy. In most cases the involvement occurs in patients with a long history of the disease.

Topics: Adolescent; Adult; Aged; Enzyme-Linked Immunosorbent Assay; Female; Graves Disease; Humans; Immunoglobulin A, Secretory; Lacrimal Apparatus; Male; Middle Aged; Muramidase; Spectrophotometry; Tears; Thyroid Function Tests

Topics: Alanine Transaminase; Ascorbic Acid; Aspartate Aminotransferases; Cholinesterases; Graves Disease; Humans; Hyaluronoglucosaminidase; Iodine; Iron; Muramidase; Preoperative Care; Sulfhydryl Compounds; Vitamin B 12