Graves' ophthalmopathy is an autoimmune thyroid disease where orbital connective tissues become infiltrated with hyaluronan and immunocompetent cells such as lymphocytes in the setting of sometimes intense inflammation. Our studies thus far show orbital fibroblasts are phenotypically distinct from those outside the orbit, especially in their susceptibility to certain actions of inflammatory cytokines. Of particular importance is an exaggerated upregulation of hyaluronan synthesis in response to leukoregulin, a product of activated T lymphocytes. This response we believe is due to an activation of lipoxygenase (LO) pathways. Another distinction is a low basal PGE2 production despite high levels of the constitutive cyclooxygenase, PGHS-1 in orbital fibroblasts. Yet in response to leukoregulin, orbital fibroblasts synthesize extremely high levels of PGE2 as a consequence of a massive induction of the inflammatory cyclooxygenase, PGHS-2. Our findings represent substantial progress in defining the basis for both the excessive accumulation of hyaluronan and the inflammation in Graves' ophthalmopathy and set the stage for our continuing studies proposed in this application. We hypothesize that the site-selective vulnerability of the eicosanoid pathways in orbital fibroblasts is the pathogenic basis for Graves' ophthalmopathy. To identify the particular lipoxygenase pathway activated in the upregulation of hyaluronan, we propose to assess the expression and response to leukoregulin of LO proteins by Western blot and their encoding mRNAs by Northern analysis and to measure major LO metabolites by HPLC. With regard to inflammation, we will measure the expression of PGHS-1 and PGHS-2 in several strains of orbital fibroblasts from both Graves' disease and normals to determine whether responses differ as a function of the disease. To determine why basal PGE2 is low in spite of high levels of PGHS-1 protein, we will sequence the open reading frame of PGHS-1, measure microsomal cyclooxygenase activity, and analyze PGHS-1 for differences in post-translational processing. We also propose to assess whether the induction of PGHS-2 by leukoregulin is a consequence of increased gene transcription or altered mRNA turnover. We propose to identify the prostanoid receptors expressed by orbital fibroblasts and to define the signal transduction pathways activated by leukoregulin. We believe that the insights gained from these studies will be helpful in developing specific therapies.

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Research Project (R01)
Project #
5R01EY008976-07
Application #
2838307
Study Section
Visual Sciences A Study Section (VISA)
Project Start
1992-12-01
Project End
1999-11-30
Budget Start
1998-12-01
Budget End
1999-11-30
Support Year
7
Fiscal Year
1999
Total Cost
Indirect Cost
Name
Albany Medical College
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
City
Albany
State
NY
Country
United States
Zip Code
12208
Smith, Terry J (2018) New advances in understanding thyroid-associated ophthalmopathy and the potential role for insulin-like growth factor-I receptor. F1000Res 7:134
Fernando, Roshini; Grisolia, Ana Beatriz Diniz; Lu, Yan et al. (2018) Slit2 Modulates the Inflammatory Phenotype of Orbit-Infiltrating Fibrocytes in Graves' Disease. J Immunol 200:3942-3949
Smith, Terry J (2018) Challenges in Orphan Drug Development: Identification of Effective Therapy for Thyroid-Associated Ophthalmopathy. Annu Rev Pharmacol Toxicol :
Mohyi, Michelle; Smith, Terry J (2018) IGF1 receptor and thyroid-associated ophthalmopathy. J Mol Endocrinol 61:T29-T43
Lu, Yan; Atkins, Stephen J; Fernando, Roshini et al. (2018) CD34- Orbital Fibroblasts From Patients With Thyroid-Associated Ophthalmopathy Modulate TNF-? Expression in CD34+ Fibroblasts and Fibrocytes. Invest Ophthalmol Vis Sci 59:2615-2622
Smith, Terry J; Hegedüs, Laszlo (2017) Graves' Disease. N Engl J Med 376:185
Citterio, Cintia E; Veluswamy, Balaji; Morgan, Sarah J et al. (2017) De novo triiodothyronine formation from thyrocytes activated by thyroid-stimulating hormone. J Biol Chem 292:15434-15444
Smith, Terry J; Kahaly, George J; Ezra, Daniel G et al. (2017) Teprotumumab for Thyroid-Associated Ophthalmopathy. N Engl J Med 376:1748-1761
Smith, Terry (2017) TSHR as a therapeutic target in Graves' disease. Expert Opin Ther Targets 21:427-432
Fernando, Roshini; Placzek, Ekaterina; Reese, Edmund A et al. (2017) Elevated Serum Tetrac in Graves Disease: Potential Pathogenic Role in Thyroid-Associated Ophthalmopathy. J Clin Endocrinol Metab 102:776-785

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